Understanding similarities in the local implementation of a healthy environment programme: Insights from policy studies

► The paper studies intersectoral health action in the implementation of a healthy environment programme in Quebec (Canada). ► As the programme is procedural and relies on local actors for implementation, significant local variations were expected. ► But results showed similarity in programme implementation, which we explained with characteristics of the programme itself. ► Some of these mechanisms limited local actors' opportunities for intersectoral action and de facto influenced implementation. ► This is consistent with policy studies research on policy instruments showing that these may produce unintended effects.