Elsevier

Health Policy

Volume 101, Issue 1, June 2011, Pages 11-19
Health Policy

Multi-sector policy action to create activity-friendly environments for children: A multiple-case study

https://doi.org/10.1016/j.healthpol.2010.09.011Get rights and content

Abstract

Objectives

The aim of this study is (1) to gain insight into current multi-sector policy initiatives that contribute to activity-friendly environments for children in four Dutch municipalities, (2) to investigate the role of multi-sector collaboration in multi-sector policy action and (3) to gain insight into critical facilitators and possible challenges for multi-sector policy action aimed at creating activity-friendly environments for children.

Methods

A policy analysis was conducted in four Dutch municipalities by means of semi-structured interviews with 25 policy officers from different policy sectors. Interviews were transcribed ad verbatim and analyzed using qualitative data coding software.

Results

Each policy sector carried out policy measures related to (the environmental determinants of) physical activity among children, but most respondents were not aware of the potential effectiveness of their policy measures regarding this topic. In two municipalities structural collaboration between policy sectors was present, but the number of sectors involved was limited. Awareness and support among all policy sectors, a stimulating political environment, and knowing each other and being informed about other sectors’ policies were mentioned as facilitators for multi-sector policy action. The main challenge for multi-sector policy action was lack of time and resources.

Conclusions

This study shows that multi-sector policy action aimed at activity-friendly environments could be stimulated by raising awareness and defining problem ownership, enhancing multi-sector collaboration and paying attention to facilitators and challenges.

Section snippets

Background

Lack of physical activity among children is a serious problem in many affluent countries and has several unfavorable health consequences such as an increased risk of development of overweight and obesity, cardiovascular disease, hypertension, diabetes, psychosocial problems and a poor development of motor skills [1], [2], [3]. Nowadays, there is growing attention for the role of environmental characteristics in determining children's physical activity level. Next to individual characteristics,

Methods

Complex organizational phenomena, such as multi-sector policy action, are best studied with qualitative research methods, especially when the research field is still in its infancy and no clear cut hypotheses are available in advance [17]. Case study research is particularly suitable, because it pays attention to the contemporary and contextual conditions in relation to the topic under research [18].

Policy initiatives related to activity-friendly environments

Based on the number of quotations in the transcripts (pooled for the four municipalities), Fig. 1 gives an indication of the current policy initiatives of the different policy sectors addressing (the environmental determinants of) physical activity in children. The policy initiatives mentioned by the respondents included written policy plans such as a plan for play facilities (municipality A), a bicycle memorandum and air quality plan (municipality B), and a sports memorandum and public health

Discussion

This study provides insight into the current multi-sector policy actions aimed at creating activity-friendly environments for children, the role of multi-sector policy collaboration herein, and explores facilitators and challenges for such a multi-sector policy approach in four Dutch municipalities. Based on the results of this and other studies, opportunities for further enhancing multi-sector health policies are discussed below.

Conclusions

This study shows that multi-sector policy action aimed at creating activity-friendly environments for children is still in its infancy and that such an approach can be stimulated by raising awareness and defining problem ownership, further enhancing multi-sector collaboration and paying appropriate attention to facilitators and challenges.

Acknowledgements

This research is financially supported by a grant from ZonMw, The Netherlands Organization for Health Research and Development (grant ID nr 71600003). The authors thank Joyce de Goede, Ilse Storm and Kees Span for their constructive criticism on the interview protocol and Yvonne Kloots, Wendy Wagenaar and Maartje van Ommen for the transcription of the interviews.

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