A constant learning curve in working towards integrated health policy: twelve years of practical experience at a...

By establishing and implementing an integrated four-year health policy, Dutch municipalities contribute significantly to the protection and promotion of public health. Scientific literature has many insights into integrated health policy, determinants of health and interventions. How is this knowledge used when determining and shaping an integrated health policy? The authors share their experiences concerning the role of knowledge in: 1) determining policy; 2) integrated collaboration; 3) working towards a healthy living environment; and 4) creating a citywide health movement.

Based on working on an integrated health policy and the setbacks we have encountered, we have experienced that scientific knowledge and models provide a framework for policy implementation, but other types of knowledge about context, processes and practice are just as important. Furthermore, we learned that other factors are often more decisive in policy and implementation, including the interests of individual parties, correct timing, continuity of persons, and courageous administrators. Working on integrated health policy is a continuous process of staying on course and adapting at the same time, in which searching for the suitable knowledge to work in an evidence-informed way must be part of it.

The greatest challenge when using knowledge in practice lies in expanding the collaboration between researchers, policymakers, professionals and inhabitants, for example by using boundary spanners. The collaboration should aim to organise a long-lasting adaptive collaboration aimed at mutual learning. This should focus on shared discussion of relevant knowledge, with less emphasis on pure acquisition and use of scientific knowledge.