Planning for coherence to support systematic Public Health Work

Background: Systematic Public health Work and realizing the intentions of Health-in-all policies locally face demands to develop planning approaches that support multi-sector collaboration and enable collaborators to pursue shared aims independently over time. In this study, we explored how actors developed coherent perspectives during the development and implementation of a health promoting measure; with the aim to develop relevant knowledge to facilitate for coherent planning processes in municipalities.
Methods: Research was carried out in the context of the Program for Public Health Work in municipalities in Trondelag. Collaborative action research was applied to develop generalizable and applicable knowledge for municipal practice. In-depth interviews with municipal actors were conducted in 7 municipalities; and followed-up by 2 workshops (WS1 and 2) with municipal participants (n1=40/n2=70) to validate interview findings and explore how they can inform municipal planning practice (WS2). The theory of Salutogenesis was applied in an abductive approach to develop practice-relevant knowledge, while simultaneously developing the theoretical framework for coherent planning.
Results: Participants developed coherent perspectives during planning and implementing the public health measure, suggesting that perceptions of coherence are grounded in processes and structures during collaboration. Coherent experiences could be operationalized into the dimensions of comprehensibility, manageability and meaningfulness; and linked to distinct experiences during collaboration. A shared vision about common aims; the anchoring of goals and procedures across municipal and spatial plans; structure and content of collaboration activities, such as joined and mutual learning activities; and the presence of feed-back loops are identified as central assets to facilitate for coherent experiences and processes promoting systematic Public Health Work. Entry points for promoting coherent processes in municipal planning process are developed.
Conclusions: Utilizing municipal planning processes to facilitate for coherent processes; through a focus on activities linked to anchoring goals and procedures; planning collaboration activities that facilitate for joined and mutual learning and establishing relevant feed-back loops can make major contributions to systematic public health work locally.