Table 1 General description of constructs and indicators of the DISC-model

1) Policy and regulations

2) Attitudes of financing bodies

The collaborative process is influenced by a number of factors that are beyond the control or influence of the alliance itself:

1) Clear, preferably inter-sectoral policies, laws and regulations providing challenging and sound goals for health promotion may enhance the collaborative process. Limiting factors may be diffuse borders between policy domains, contradicting policies of different public sectors and policies focusing on the transformation of public organizations into private enterprises.

2) An encouraging and accommodating attitude of financing bodies and commitment to provide the necessary funding over a longer period to prevent a brain drain from starting during the initial developmental phase, supports the collaborative process.

3) Existing alliances

4) Characteristics of organizations

5) Research power

6) Direct relevant governmental policies

The collaborative process evolves in a context which can be influenced by the partners themselves

When parties have more positive experiences with each other in previous collaborative processes, need less energy for internal changes, have more research power and feel more supported by policies which they can influence as well, they are more open to sustainable collaborative process supporting inter-sectoral health promotion.

7) Vision

8) Innovation perspective

9) Change strategies

10) Network development

The aspired change requires management by one or a small group of leaders.

In order to establish a successful collaboration individual and collective leadership skills are necessary to guide the developmental process. Change management strategies should fit the chosen innovation perspective and be supportive of the health promotion subject. The most relevant actors are included, and where missing, this will be accomplished by extending the network of the leaders of the collaborative process.

11) actors, task & structure (who, what and how)

During the development and initial implementation phase the collaborative process is dealt with as a project in a project management structure.

This includes deciding who are the actors in the project, what do they need to do and how do they operate (planning, procedures, evaluation, communication, etcetera). This project management structure fades out when the subject of the collaborative process is (close to) being integrated in regular work and the alliance becomes self-supportive.

Perceptions:

12) Goals

13) Importance/Win-win

14) Consensus

15) Involvement

The collaborative support can be assessed on the levels of perceptions, intentions and actions of the parties involved.

Intersectoral collaboration evolves more smoothly when participating organizations share goals and interests, perceive positive outcomes supportive of their own goals, are able to reach consensus on the goal of the collaborative process and are of the opinion that the most relevant parties are involved in the collaborative process.

Intentions to:

16) Mutual trust

18) Commitment

19) Change

Parties involved should start with the intention to trust each other (if not present, this needs to be worked on first), the intention to commit themselves to the collaborative process and its subject and the intention to make changes within ones own organization, if needed, in favor of the collaborative process.

Actions:

20) Innovative actions

a) Adaptations

b) Reallocation of resources

21) Formalizations

The collaborative process may induce a wide variety of actions, varying from the implementation to major innovations within ones own organizations to the inclusion of relatively minor adaptations of regular procedures. The actions may involve a reallocation of resources as well. Whatever actions result from a collaborative process, it is important that these are formalized in order to enhance sustainability. The level of formalization needed depends mainly on the type of action itself.

22) From idea and project management to formalized regular work

The collaborative process influences the development of the coordinated (school) health promotion and supports the move towards sustainability (goal):

Under continuous influence of the collaborative process, an idea is elaborated and develops into regular working routine being formalize. During this process the subject of the collaborative process evolves: it 'changes color' under influence of the collaborative process itself.