Using win-win strategies to implement health in all policies: A cross-case analysis

Agnes Molnar, Emilie Renahy, Patricia O'Campo, Carles Muntaner, Alix Freiler, Ketan Shankardass

Research output: Contribution to journalArticlepeer-review

54 Citations (Scopus)


Background: In spite of increasing research into intersections of public policy and health, little evidence shows how policy processes impact the implementation of Health in All Policies (HiAP) initiatives. Our research sought to understand how and why strategies for engaging partners from diverse policy sectors in the implementation of HiAP succeed or fail in order to uncover the underlying social mechanisms contributing to sustainable implementation of HiAP. Methods: In this explanatory multiple case study, we analyzed grey and peer-review literature and key informant interviews to identify mechanisms leading to implementation successes and failures in relation to different strategies for engagement across three case studies (Sweden, Quebec and South Australia), after accounting for the role of different contextual conditions. Findings: Our results yielded no support for the use of awareness-raising or directive strategies as standalone approaches for engaging partners to implement HiAP. However, we found strong evidence that mechanisms related to "win-win" strategies facilitated implementation by increasing perceived acceptability (or buy-in) and feasibility of HiAP implementation across sectors. Win-win strategies were facilitated by mechanisms related to several activities, including: the development of a shared language to facilitate communication between actors from different sectors; integrating health into other policy agendas (eg., sustainability) and use of dual outcomes to appeal to the interests of diverse policy sectors; use of scientific evidence to demonstrate the effectiveness of HiAP; and using health impact assessment to make policy coordination for public health outcomes more feasible and to give credibility to policies being developed by diverse policy sectors.

Original languageEnglish
Article numbere0147003
JournalPloS one
Issue number2
Publication statusPublished - 2016 Feb 1

Bibliographical note

Funding Information:
Agnes Molnar and Emilie Renahy contributed to the work as postdoctoral fellows in the ACHIEVE Research Partnership: Action for Health Equity Interventions at the Centre for Research on Inner City Health at St. Michael's Hospital. The authors gratefully acknowledge the support of Peterborough KM Hunter Charitable Foundation, The Canadian Institutes for Health Research Grant ( ) grant numbers 111608 (PO) and 96566 (KS), Wilfrid Laurier University (KS) and the Ontario Ministry of Health and Long-Term Care ( ). The views expressed in this publication are the views of the authors and do not necessarily reflect the views of the Ontario Ministry of Health and Long-Term Care.

Publisher Copyright:
© 2016 Molnar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology
  • General Agricultural and Biological Sciences
  • General


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