Het belang van een 'lenige geest': Agendering van integrale actie voor een Gezonde Stad

The importance of flexible mindset. Setting the agenda for integrated action on a healthy city.in this article we question how support among stakeholders for integrated action on health is built and maintained. In collaboration with health policy advisors at the province of north-brabant and an independent professional dialogue facilitator we set up a responsive evaluation among 32 municipal policy officers from different policy domains, addressing their perceptions of a healthy city and their experiences in agendasetting of integrated action in general. Perceptions consist of a ‘sustainable’ city with a ‘healthy climate for settlement of talented entrepreneurs and skilled labour force’, which facilitates ‘interactions between different social groups’, and attracts citizens to ‘engage in physical exercise and sports’. Despite the overlap in perceptions, policy officers do not maintain structural relationships with the health policy officer nor health services. Policy officers involved in integrated action on other topics have mostly learned from experience that which did not work: an activitst approach, relying solely on scientific evidence, or on the moral superiority of health over other policy topics. An important agendasetting strategy familiar to all policy officers consists of mobilising external influential actors. Furthermore, it seems crucial to develop a flexible mindset: the personal attitude and capacity –given the institutional pillarisation of policy sectors and accountability regimes– to operate in an adaptive and supportive manner. This contrasts with the top down concept of integrated health policy. The pragmatic and flexible concept of adaptive integrated action seems to be a more suitable concept for analysing and strengthening integrated health-related action. Keywords: responsive evaluation, integrated action, province north brabant, healthy city.