Table 2.

Barriers and Facilitators to the STEP-HIA Process and Lessons Learned

Barriers	Lessons Learned
Time	HAs may take longer than anticipated, especially when integrated with other assessments.
Competing priorities	While the HI A may be a priority for those working on it, other partners may have compet- ing priorities that take precedence. Find opportunities to work with partners to move the project forward.
Securing easements	Building long distance trails can necessitate easement acquisition to access private lands. The legal process can take time and cause delays in the overall planning process.
Staff turnover	Turnover at partner agencies and organizations can set efforts back. It may be important to engage with multiple persons at multiple levels of an organization to maintain project continuity over time.
Historical use of land	Identify how land has been used in the past and include those who have historically used the land when possible.
Opposition	It may be important to identify and prepare for opposition to HIA findings. Traditional land or trail users may not support new, broader uses with greater health impact.
Facilitators	Lessons Learned
Relationship building	Building and fostering strong relationships with decision-makers takes time but may be crucial to HIA success.
Local champion	Identifying and working with a local champion who is respected in the community can enhance credibility and garner support.
Community involvement	Having the active involvement of community members in the HIA process may promote health equity and be essential to success.
Mapping	Geographic Information System mapping can provide essential information for the identi- fication of the populations affected by the policy, program or plan under HIA assessment.
Leveraging resources	Leveraging resources from other programs can provide essential data, personnel or other resources that can move the HIA forward.