Coalition theory as a framework for understanding and implementing intersectoral health-related interventions

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Abstract
Although it is regarded as a central concept in the practice of health promotion, intersectoral health-related action (IHA) has, to date, failed more often than it has succeeded. In this paper we review relevant social scientific literature, offer a working definition of intersectoral action and explore the usefulness of coalition theory as a theoretical framework through which to understand IHA theoretically and practically. Coalition theory has been previously used to study political alliances but it encompasses a series of parameters pertinent to the analysis of IHA. These parameters are: the rewards people expect to gain from participation in a coalition; the political assets they have to bring to the coalition; the non-utilitarian preferences they develop; the coalition's rules for decision-making; and the organisational context in which the coalition operates. We used these five parameters to study three intersectoral endeavours in Quebec, one at the local level and two at the provincial level, including activities associated with the Healthy Cities movement. Coalition theory proved useful in unravelling the mechanisms of these endeavours and appears promising as a tool for studying and/or implementing intersectoral health-related interventions.

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