Storm Ilse, Harting Janneke, Stronks Karien, Schuit Albertine J
National Institute for Public Health and the Environment, Public Health and Health Services Division, Centre for Public Health Forecasting, PO Box 1, 3720 BA Bilthoven, The Netherlands.
Academic Medical Centre University of Amsterdam, Department of Public Health and Epidemiology, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
Health Policy. 2014 Feb;114(2-3):183-91. doi: 10.1016/j.healthpol.2013.05.006. Epub 2013 Jun 12.
Many local governments are trying to establish health in all polices (HiAP), but no sensitive tool is available to measure HiAP growth processes. This study explores the applicability of a general maturity model to classify stages of HiAP and to characterize its manifestations and conditions.
Based on other maturity models we have developed a maturity model for HiAP (MM-HiAP), which consists of six maturity levels and 14 corresponding key characteristics. This model was applied to assess HiAP growth processes within 16 municipalities in the Netherlands. We used municipal policies on health inequalities as a case. Empirical data was gathered based on document analysis, a questionnaire and interviews.
Using this model we were able to classify HiAP growth processes by several characteristics, such as the recognition of the importance of HiAP (Stage I; four municipalities), HiAP described in policy documents and collaboration with sectors present (Stage II; seven municipalities), concrete collaboration agreements and structural consultations forms (Stage III; four municipalities), and a broad, shared vision on HiAP (Stage IV; two municipalities). Examples of necessary conditions were sufficient support and resources.
This study shows that it is possible to apply a maturity model to classify stages of HiAP in municipalities. Use of the MM-HiAP as a formal measuring instrument depends on further operationalization and validation.
许多地方政府都在尝试制定“健康融入所有政策”（HiAP），但尚无灵敏的工具可用于衡量HiAP的发展进程。本研究探讨一种通用成熟度模型在对HiAP阶段进行分类以及描述其表现形式和条件方面的适用性。
基于其他成熟度模型，我们开发了一种HiAP成熟度模型（MM-HiAP），该模型由六个成熟度级别和14个相应的关键特征组成。此模型被用于评估荷兰16个城市的HiAP发展进程。我们以城市关于健康不平等问题的政策为例。基于文献分析、问卷调查和访谈收集实证数据。
使用该模型，我们能够依据若干特征对HiAP发展进程进行分类，例如对HiAP重要性的认知（第一阶段；4个城市）、政策文件中对HiAP的描述以及与相关部门的合作（第二阶段；7个城市）、具体的合作协议和结构化协商形式（第三阶段；4个城市），以及对HiAP的广泛、共同愿景（第四阶段；2个城市）。必要条件的例子包括足够的支持和资源。
本研究表明，应用成熟度模型对城市中的HiAP阶段进行分类是可行的。将MM-HiAP用作正式测量工具取决于进一步的操作化和验证。
