What works when working together?: Cross-sector collaboration barriers & facilitators of a built environment Health Impact Assessment in Southern Nevada

Abstract

Purpose Cross-sector collaboration can improve community health because decisions made across sectors influence health. Health Impact Assessments (HIAs) and other health-focused, cross-sector collaborations encounter challenges. This case study uses a completed HIA to explore factors impeding and supporting health-related cross-sectoral collaboration. Methods Semi-structured key informant interviews with 10 of 12 HIA working group participants were conducted and analysed using a content analysis approach. Results Analysis generated 48 codes across seven themes in three primary groups: HIA as a collaborative tool; logistical and systemic barriers; and benefits and logistical, interpersonal, and sectoral facilitators. Recognizing the importance of knowledge, analysis, and principles outside of one’s field (n = 62) was the most common facilitator. Limited time was the most common barrier (n = 21). Participants discussed more facilitators (n = 303) than barriers (n = 144); perceived multiple benefits (n = 92), including networking and connecting land use and health; and described facilitators like communication, continuity, engagement, project management, compensation, varying perspectives, and diverse skills. They identified coordination challenges, needs to engage more with stakeholders and the community, limited time, and changes among partners as primary barriers. Conclusions Findings can help prepare cross-sector partners about what to expect, aid in mitigating challenges, and further knowledge about what supports and hinders Health in All Policies collaborations.

Keywords

• health in all policies
• health impact assessment
• cross-sector collaboration
• social determinants of health
• partnerships