JMIR Publications

ABSTRACT

Background:

The INHERIT project has evaluated Intersectoral Cooperation (IC) in 12 European case studies that attempt to promote health, environmental sustainability and equity through behaviour and lifestyle change. These factors are the concern of multiple sectors of government and society. This requires cooperation of the health and environmental sector with other sectors to allow for effective action. IC is thus essential to promote a triple-win of health, environmental sustainability and equity.

Objective:

This protocol paper describes the design of a qualitative study to gain insights into successful organization of IC, facilitators and barriers and how future steps can be taken to improve IC in the evaluated case studies.

Methods:

Each case study was studied qualitatively by means of one focus group. A total of 12 focus groups in 10 different European countries with stakeholders, implementers, policymakers and/or citizens were held between October 2018 and March 2019. In each focus group, five to eight participants attended. The focus group method was based on Appreciative Inquiry, an asset-based approach that focuses on what works well, why it is working well and how to strengthen assets in the future. A stepped approach was used, with central coordination and analysis, and local implementation and reporting. Local teams were trained to apply a common protocol using a webinar and handbook on organizing, conducting and reporting focus groups. Data was gathered in each country in the local language. Translated data was analyzed centrally using deductive thematic analysis, with consideration of further emerging themes. Analyses were informed by the COM-b behavior system to categorize facilitators and barriers into capability-, motivation-, or opportunity-related themes, as these factors influence behavior of both individuals and groups. Online review sessions with representatives from all local research teams were held to check data analysis results and evaluate the stepped approach.

Results:

Data collection is now completed, a total of 76 individuals participated in 12 focus groups. In December 2019, data analysis was nearly complete, with final results to be published in spring 2020.

Conclusions:

This study proposes a stepped approach that allows cross-country focus group research using a strict protocol whilst dealing with language and cultural differences. The study generates insights into IC processes and facilitators in different countries and case studies, to filter out which facilitators are essential to include. Simultaneously, the approach can strengthen cooperation among stakeholders by looking at future cooperation possibilities. By providing knowledge on how to plan for, improve and sustain IC successfully in order to deal with today’s multisectoral challenges, this study can contribute to better intersectoral action to realize a triple-win of better health, sustainability and equity. This protocol can serve as a tool for others who plan to conduct cross-country qualitative research.