Use of a knowledge broker to establish healthy public policies in a city district: a developmental evaluation.

Kirsten Langeveld,Janneke Harting,Karien Stronks

doi:10.1186/s12889-016-2832-4

Kirsten Langeveld, Janneke Harting + Show 1 more

Open Access

https://doi.org/10.1186/s12889-016-2832-4

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Abstract

BackgroundPublic health is to a large extent determined by non-health-sector policies. One approach to address this apparent paradox is to establish healthy public policies. This requires policy makers in non-health sectors to become more aware of the health impacts of their policies, and more willing to adopt evidence-informed policy measures to improve health. We employed a knowledge broker to set the agenda for health and to specify health-promoting policy alternatives. This study aimed at gaining in-depth understanding of how this knowledge broker approach works.MethodsIn the context of a long-term partnership between the two universities in Amsterdam and the municipal public health service, we employed a knowledge broker who worked part-time at a university and part-time for an Amsterdam city district. When setting an agenda and specifying evidence-informed policy alternatives, we considered three individual policy portfolios as well as the policy organization of the city district. We evaluated and developed the knowledge broker approach through action research using participant observation.ResultsOur knowledge brokering strategy led to the adoption of several policy alternatives in individual policy portfolios, and was especially successful in agenda-setting for health. More specifically, health became an issue on the formal policy agenda as evidenced by its uptake in the city district’s mid-term review and the appointment of a policy analyst for health. Our study corroborated the importance of process factors such as building trust, clearly distinguishing the knowledge broker role, and adequate management support. We also saw the benefits of multilevel agenda-setting and specifying policy alternatives at appropriate policy levels. Sector-specific responsibilities hampered the adoption of cross-sectoral policy alternatives, while thematically designed policy documents offered opportunities for including them. Further interpretation revealed three additional themes in knowledge brokering: boundary spanning, a ripple effect, and participant observation.ConclusionsThe employment of a knowledge broker who works simultaneously on both agenda-setting for health as well as the specification of health-promoting policy alternatives seems to be a promising first step in establishing local healthy public policies. Future studies are needed to explore the usefulness of our approach in further policy development and policy implementation.

Highlights

Public health is to a large extent determined by nonhealth-sector policies, as many environmental, economic and political factors influencing health are beyond the authority of the health sector itself [1]
Building healthy public policy has been referred to as putting “...health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health” [3]
Context The pilot was developed by the academic collaborative center (ACC) for public health in Amsterdam

Summary

Introduction

One approach to address this apparent paradox is to establish healthy public policies This requires policy makers in non-health sectors to become more aware of the health impacts of their policies, and more willing to adopt evidence-informed policy measures to improve health. One barrier to the establishment of such policies is insufficient awareness among the actors involved of the potential health impacts of non-health-sector policies—whether negative or positive [5, 6]. Another barrier is that evidence in support of health-promotion measures is not accepted and integrated into the policies of other sectors [7]. A knowledge broker could be beneficial in this respect [8,9,10], evidence on how knowledge is effectively disseminated and translated across boundaries between research and policy remains anecdotal and inconclusive [9, 11, 12]

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