Promoting Intersectoral Collaboration Through the Evaluations of Public Health Interventions: Insights From Key Informants in 6 European Countries

Abstract Background: Intersectoral collaboration is critical to the successful implementation of many public health interventions (PHIs). Little attention has been paid to whether and how processes at the stage of evaluation can promote intersectoral collaboration. The objective of this study was to examine European experiences and views on whether and how the evaluation of PHIs promote intersectoral collaboration. Methods: A qualitative study design was used. We conducted semi-structured interviews with 15 individuals centrally involved in the evaluation of PHIs in 6 European countries (Austria, Denmark, England, Germany, Norway, and Switzerland). Questions pertained to current processes for evaluating PHIs in the country and current and potential strategies for promoting intersectoral collaboration. Transcripts were analyzed using thematic analysis to identify key themes responding to our primary objective. Results: Experiences with promoting intersectoral collaboration through the evaluation of PHIs could be summarized in 4 themes: (1) Early involvement of non-health sectors in the evaluative process and inclusion of non-health benefits can promote intersectoral collaboration, but should be combined with greater influence of these sectors in shaping PHIs; (2) Harmonization of methodological approaches may enable comparison of results and facilitate intersectoral collaboration, but should not be an overriding goal; (3) Involvement in health impact assessments (HIAs) can promote intersectoral collaboration, but needs to be incentivized and be conducted without putting overwhelming demands on non-health sectors; (4) A designated body for evaluating PHIs may promote intersectoral collaboration, but its design needs to take account of realities of policy-making. Conclusion: The full potential for promoting intersectoral collaboration through the evaluation of PHIs appears currently unrealized in the settings we studied. To further promote intersectoral collaboration, evaluators and decisionmakers may consider the full range of strategies characterized in this study. This may be most effective if the strategies are deployed so that they reinforce each other, value outcomes beyond health, and are tailored to maximize political priority for PHIs across sectors. Keywords: Strategies for Evaluation, Promoting Intersectoral Collaboration, Public Health Interventions Copyright: © 2021 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License ( by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Kriegner S, Ottersen T, Røttingen JA, Gopinathan U. Promoting intersectoral collaboration through the evaluations of public health interventions: insights from key informants in 6 European countries. Int J Health Policy Manag. 2021;10(2):67–76. doi:10.34172/ijhpm.2020.19 *Correspondence to: Sabrina Kriegner Email: Article History: Received: 8 February 2019 Accepted: 1 February 2020 ePublished: 26 February 2020 Original Article Full list of authors’ affiliations is available at the end of the article. Int J Health Policy Manag 2021, 10(2), 67–76 doi 10.34172/ijhpm.2020.19 Background Public health interventions (PHIs), for the purpose of this study defined as population-based, preventive interventions, experience particular challenges with respect to receiving political priority and support for implementation compared to curative clinical services. Frequently cited reasons for lack of priority and support are that the benefits tend to be accrued over the long-term, are not easily visible, and are not immediately felt by individual beneficiaries.1-5 Moreover, a factor making implementation of PHIs particularly challenging is that these interventions in many instances require collaboration between sectors and action outside the health sector.6,7 This is partly because many of the factors targeted by PHIs are significantly shaped by decisions within the purview of sectors beyond the health sector.8-11 Accordingly, successfully increasing the priority for and implementing PHIs require ways of facilitating intersectoral collaboration. Discussions on intersectoral collaboration in the context of PHIs have typically focused on how to facilitate intersectoral collaboration once it has been decided to implement a given PHI or in the context of influencing other sector’s policies and programs as part of implementing the Health in All Policies (HiAP) approach.12,13 Policy goals that imply shared responsibilities between sectors might also motivate intersectoral public health collaboration. Among the most prominent examples are the Sustainable Development Goals (SDGs).8,9,14 However, it might be desirable to facilitate intersectoral involvement at a much earlier s