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Key elements of a successful integrated community-based approach aimed at reducing socioeconomic health inequalities in the Netherlands: A qualitative study

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  • Lisa Wilderink
  • Ingrid Bakker
  • Albertine J Schuit
  • Jacob C Seidell
  • Carry M Renders

Abstract

Background: Since 2010, the Zwolle Healthy City approach, an integrated community-based approach, has been implemented in the Dutch municipality of Zwolle. This approach is proven successful in reducing health inequalities. However, the key elements of this approach are not clear. The current study aimed to identify key elements of this successful local community-based approach, according to the perspectives of various stakeholders. Methods: Semi-structured interviews were carried out with 29 professionals who were involved in the approach in the period 2010–2018 and have occupations at the strategic (n = 4), tactical (n = 17) and operational level (n = 8). Data was analyzed using the thematic analysis approach. Results: We identified nine perceived key elements that contributed to the success of the approach aimed at reducing socioeconomic health inequalities. The respondents indicated the following key elements: (1) collaboration between a variety of local organizations that want to have impact on the health of citizens; (2) support for the approach on the strategic, tactical and operational level of involved organizations; (3) proper communication and coordination, both for the network and within the organizations; (4) embeddedness in organizations’ policies and processes and (5) collaboration with private organizations is of added value, although there is no “one size fits all”. Other key elements are (6) collaboration with citizens, (7) profiling the approach like a brand and (8) moving along with and taking advantage of opportunities. Finally, (9) continuous monitoring and evaluating goals and processes, and learning from the results, is important. Conclusion: Nine key elements were identified that, according to various stakeholders, contributed to the success of the Zwolle Healthy City approach. These insights are important to further strengthen the Zwolle Healthy City approach but may also help and inspire other local integrated community-based approaches aimed at reducing socioeconomic health inequalities, to improve and adapt the approach within their specific local and dynamic context.

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  • Lisa Wilderink & Ingrid Bakker & Albertine J Schuit & Jacob C Seidell & Carry M Renders, 2020. "Key elements of a successful integrated community-based approach aimed at reducing socioeconomic health inequalities in the Netherlands: A qualitative study," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-17, October.
    • Handle: RePEc:plo:pone00:0240757
    DOI: 10.1371/journal.pone.0240757
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    1. Lindström, Martin & Hanson, Bertil S. & Östergren, Per-Olof, 2001. "Socioeconomic differences in leisure-time physical activity: the role of social participation and social capital in shaping health related behaviour," Social Science & Medicine, Elsevier, vol. 52(3), pages 441-451, February.
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    1. Lisa Wilderink & Ingrid Bakker & Albertine J. Schuit & Jacob C. Seidell & Carry M. Renders, 2021. "Involving Children in Creating a Healthy Environment in Low Socioeconomic Position (SEP) Neighborhoods in The Netherlands: A Participatory Action Research (PAR) Project," IJERPH, MDPI, vol. 18(22), pages 1-16, November.

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