Dialogue-meetings to establish intersectoral collaboration in complex health pro-motion interventions

Abstract Background Promoting health in local communities is a complex endeavor that requires interventions that address complex social determinants of health through intersectoral collaboration. However, establishing such collaboration in practice is challenging, and understanding the processes behind intersectoral collaboration is often vaguely described. This study examines how informal, pre-intervention dialogue meetings can contribute to shaping intersectoral collaboration within the ‘Our Healthy Community’ (OHC) intervention in two Danish munici-palities. Methods The OHC framework applies a systems-based Supersetting approach to health promotion and prevention through cross-sectoral municipal collaboration. This qualitative study focuses on the intervention's pre-implementation phase, where dialogue meetings were conducted with municipal department heads. Data were collected through recordings and notes from meetings and analyzed using thematic network analysis inspired by Attride-Stirling. Results The dialogue meetings revealed substantial variation in how health and cross-sectoral rele-vance were understood across departments. While some participants readily saw the link between their sector and health promotion, others expressed skepticism. Over the course of the meetings, many departments showed a shift toward increased openness and engage-ment, facilitated by mutual dialogue, examples of prior success, and clarification of roles. Challenges included structural barriers, lack of incentives for cross-sector collaboration, and differing departmental mandates. Conclusions Pre-intervention dialogue meetings played an important role in building trust, clarifying re-sponsibilities, and reducing skepticism, thereby laying the groundwork for meaningful inter-sectoral collaboration. Such early-stage engagement processes should be recognized as es-sential for the sustainable implementation of complex health promotion interventions