BACKGROUND Much of the research about Health in All Policies (HiAP) implementation is descriptive, and there have been calls for more evaluative evidence to explain how and why successes and failures have occurred. In this cross-case study of six state- and national-level governments (California, Ecuador, Finland, Norway, Scotland and Thailand), we tested hypotheses about win-win strategies for engaging policy-makers in HiAP implementation drawing on components identified in our previous systems framework. METHODS We used two sources of data - key informant interviews and peer-reviewed and grey literature. Using a protocol, we created context-mechanism-outcome pattern configurations to articulate mechanisms that explain how win-win strategies work and fail in different contexts. We then applied our evidence for all cases to the systems framework. We assessed the quality of evidence within and across cases in terms of triangulation of sources and strength of evidence. We also strengthened hypothesis testing using replication logic. RESULTS We found robust evidence for two mechanisms about how and why win-win strategies build partnerships for HiAP implementation - the use of shared language and the value of multiple outcomes. Within our cases, the triangulation was strong, both hypotheses were supported by literal and contrast replications, and there was no support against them. For the third mechanism studied, using the public-health arguments win-win strategy, we only found evidence from Finland. Based on our systems framework, we expected that the most important system components to using win-win strategies are sectoral objectives, and we found empirical support for this prediction. CONCLUSIONS We conclude that two mechanisms about how and why win-win strategies build partnerships for HiAP implementation - the use of shared language and the value of multiple outcomes - were found as relevant to the six settings. Both of these mechanisms trigger a process of developing synergies and releasing potentialities among different government sectors and these interactions between sectors often work through sectoral objectives. These mechanisms should be considered when designing future HiAP initiatives and their implementation to enhance the emergence of non-health sector policy-makers' engagement.

中文翻译：

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双赢战略如何以及为何能促使决策者实施“所有政策中的健康”？对六个州和国家级政府的多案例研究。

背景技术关于“所有政策中的健康”（HiAP）实施的许多研究都是描述性的，并且已经呼吁提供更多评估性证据来解释成功和失败的发生方式和原因。在对六个州和国家级政府（加利福尼亚州，厄瓜多尔，芬兰，挪威，苏格兰和泰国）的跨案例研究中，我们检验了有关使政策制定者参与HiAP实施的双赢战略的假设，这些假设是根据联合国环境规划署确定的内容进行的。我们以前的系统框架。方法我们使用了两种数据来源-关键知情人访谈和经过同行评审的灰色文献。使用协议，我们创建了上下文机制结果模式配置，以阐明解释双赢策略如何在不同上下文中工作和失败的机制。然后，我们将所有案例的证据应用于系统框架。我们根据三角剖分的来源和证据强度评估了案件内部和案件之间的证据质量。我们还使用复制逻辑加强了假设检验。结果我们找到了关于两种机制如何以及为什么双赢战略为HiAP实施建立伙伴关系的有力证据，即共享语言的使用和多种结果的价值。在我们的案例中，三角剖分很强，两个假设都得到了文字和对比复制的支持，而没有反对者支持它们。对于研究的第三个机制，使用公共卫生论点双赢策略，我们仅从芬兰找到了证据。基于我们的系统框架，我们期望使用双赢策略最重要的系统组件是部门目标，并且我们发现了这一预测的经验支持。结论我们得出的结论是，发现了关于双赢战略如何以及为何建立HiAP实施伙伴关系的两种机制-共享语言的使用和多种成果的价值-与这六个环境相关。这两种机制都触发了在不同政府部门之间发展协同增效和释放潜力的过程，而且部门之间的这些相互作用通常通过部门目标来实现。在设计未来的HiAP计划及其实施以增强非卫生部门决策者参与的出现时，应考虑这些机制。这两种机制都触发了在不同政府部门之间发展协同增效和释放潜力的过程，而部门之间的这些相互作用通常通过部门目标来实现。在设计未来的HiAP计划及其实施以增强非卫生部门决策者参与的出现时，应考虑这些机制。这两种机制都触发了在不同政府部门之间发展协同增效和释放潜力的过程，而且部门之间的这些相互作用通常通过部门目标来实现。在设计未来的HiAP计划及其实施以增强非卫生部门决策者参与的出现时，应考虑这些机制。