Perceptions of coherence during planning for local Public Health Work: building capacity and developing theory through collaborative action research

Background Reducing health inequalities and realizing intentions of Health-in-all-policies locally demands to combine aspects of rational and dialogue-based planning approaches to support systematic, long-term collaborations and the development of coherent perspectives locally. We apply the theory of Salutogenesis to unravel how actors developed coherent perspectives during a collaboration linked to the development and implementation of a health promoting measure. Methods Collaborative action research was applied to develop relevant and generalizable knowledge applicable for municipal practice. Data was gathered through in-depth interviews with municipal actors across 7 municipalities; and a follow-up workshop with municipal participants (n = 40) to validate and elaborate findings. During analysis, an abductive approach utilizing Salutogenesis was applied to develop practical knowledge, while also developing the theoretical framework in line with emerging insights Results Collaborators developed coherent perspectives during participation in the collaboration, suggesting that perceptions of coherence are influenced by processes and structures during collaboration that contribute to form actor’s experiences and perceptions. Perceptions of comprehensibility were linked to awareness of shared goals, disciplinary and contextual knowledge as well as clearly defined roles and responsibilities. Manageability was described as matters of perceiving challenges as resolve-able in the local context; being able to identify, activate and adapt resources, as well as supportive structures and personal competence. Meaningfulness was experienced through being able to define processes; perceptions of goal-attainment; visibility of contributions and impact, as well as experiences of learning and social cohesion. Implications of findings for practice and theory are discussed. Conclusions Applying Salutogenesis unto municipal collaboration processes yielded valid insights into how coherence can be understood and assessed beyond individual experiences. A shared vision about the common aims; the anchoring goals and procedures; the structure and content of collaboration activities (inclusive joined and mutual learning sessions) as well as the presence of feed-back loops emerge as important assets and valid entry points to facilitate for coherent experiences and processes in municipalities. The novel application of the theoretical framework can contribute to develop Salutogenesis as a sound theory for settings-based approaches within Health Promotion.