title: Using Win-Win Strategies to Implement Health in All Policies: A Cross-Case Analysis.
abstract: 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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Our findings enrich theoretical understanding in an under-unexplored area of intersectoral action. They also provide policy makers with examples of HiAP across wealthy welfare regimes, and improve understanding of successful HiAP implementation practices, including the win-win approach.
authors: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.
authors: Agnes
authors: A
authors: Molnar
authors: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.
authors: Emilie
authors: E
authors: Renahy
authors: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors: Patricia
authors: P
authors: O'Campo
authors: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.|Bloomberg School of Nursing, University of Toronto, Toronto, Canada.
authors: Carles
authors: C
authors: Muntaner
authors: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.
authors: Alix
authors: A
authors: Freiler
authors: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.|Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada.
authors: Ketan
authors: K
authors: Shankardass
mesh_terms: D003469:Culture; D062489:Health Impact Assessment; D006284:Health Plan Implementation; D006291:Health Policy; D006295:Health Resources; D006801:Humans; D010342:Patient Acceptance of Health Care; D011634:Public Health; D062486:Public Health Surveillance; D011792:Quebec; D013021:South Australia; D013548:Sweden