Table 1.
Barriers regarding intersectoral collaboration | Reference |
| |
Content-related barriers | |
Lack of awareness of the childhood obesity problem in nonhealth sectors. | Aarts et al. [23] |
Limited involvement from other sectors in developing cross-sectoral policies. | Thow et al. [24] |
Lack of political support for creating activity-friendly neighborhoods. | Aarts et al. [23] |
Neoliberal political climate and individualistic societal climate. | Schwartz and Brownell [25] |
Ambiguous political climate, governments do not seem eager to implement restrictive or legislative policy measures since this would mean they have to confront powerful lobbies by private companies. | Nestle [26] Peeler et al. [27] Verduin et al. [28] |
Relevance to government's fiscal priorities was important in gaining support for soft drink taxes. | Thow et al. [29] |
Lack of agenda-setting: lack of relevance and competing priorities. | Allender et al. [30] |
Promoting healthy eating environments is not considered a greater priority for local government than food safety. | Allender et al. [31] Caraher and Coveney [32] |
Other legislated planning guidance may take priority for planning and transport professionals. | Bovill [33] |
Focusing only on health concerns: not taking into account policy issues of other sectors. | Thow et al. [24] |
“Wicked” nature of obesity making it very unattractive to invest in its prevention. | Head [34] |
Complexity of the legislative framework. | Allender et al. [35] |
Low probability of decreasing the incidence of childhood obesity within the short timeframe that most politicians work in (which is determined by election frequencies). | Aarts et al. [23] Head [34] |
Difficulty of developing consensus about ways to tackle the problem due to the lack of hard scientific evidence about effective solutions. | Aarts et al. [23] Head [34] Nishant et al. [36] |
Framing of obesity as an individual health problem. | Dorfman and Wallack [37] Klein and Dietz [38] Phillips et al. [39] Merry [40] |
| |
Process-related barriers | |
Local government officials lacking the knowledge and skills to collaborate with actors outside their own department. | Steenbakkers et al. [16] |
Insufficient resources (time, budget). | Steenbakkers et al. [16] Woulfe et al. [18] Aarts et al. [23] |
Lack of a clear enforcement mechanism. | Thow et al. [24] |
Perceived or real lack of power to achieve change. | Thow et al. [29] |
Government priorities change. | Nestle [26] |
Lack of membership diversity in the collaborative partnerships. | Woulfe et al. [18] |
Lack of clarity about the notion of intersectoral collaboration. | Harting et al. [19] |
Top-down bureaucracy and hierarchy, disciplinarity and territoriality, sectoral budgets, and different priorities and procedures in each sector. | Bovill [33] |
Insufficient organizational structures. | Steenbakkers et al. [16] Woulfe et al. [18] Alter and Hage [41] Hunter [42] Warner and Gould [43] |
Poor quality of interpersonal or interorganizational relationships. | Woulfe et al. [18] Isett and Provan [44] |
Lack of involvement by managers in collaborative efforts. | Steenbakkers et al. [45] |
Lack of communication and insufficient joint planning. | R. Axelsson and S. B. Axelsson [46] |
Lack of common vision and leadership. | Woulfe et al. [18] Hunter [42] |
| |
Facilitators regarding intersectoral collaboration | |
| |
Content-related facilitators | |
Broad justification for the policy initiative. | Thow et al. [24] |
Tailoring of information to the political context: information relevant to the government's agenda. |
Schwartz and Brownell [25] Bowen and Zwi [47] |
Political risk assessment and saleability. | Schwartz and Brownell [25] |
Selection of policy tools that align with the government priorities (e.g., trade commitments)—ideally tools that are already used by trade policy makers in other contexts—and a broad justification for the policy initiative. | Thow et al. [24] |
| |
Process-related facilitators | |
Policy change supported by external funding. | Thow et al. [29] |
Cost-benefit analysis for any potential regulatory intervention. | Thow et al. [29] |
Systematic evidence base to provide clear feedback on the size and scope of the obesity epidemic at a local level. | Thow et al. [29] |
Sensitivity to community and market forces. | Thow et al. [29] |
Suitable funding allowing local government to play a part in the promotion of healthy food environments. | Thow et al. [29] |
Changing regulations to allow local government to play a part in the promotion of healthy food environments. | Thow et al. [29] |
Strategically planning for agenda-setting. | Nestle [26] |
Development and implementation of intersectoral health-promoting policies by engaging stakeholders in finance at an early stage to identify priorities and synergies. | Nestle [26] |
Developing cross-sectoral advocacy coalitions. | Nestle [26] |
Basing proposals on existing legislative mechanisms where possible. | Nestle [26] |
Active involvement of health policy makers in initiating the policies. | Nestle [26] |
Advocacy making policy uptake and implementation easier. | Thow et al. [24] |
Use of existing taxation mechanisms enabling successful policy implementation. | Nestle [26] |