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Background: The decentralization of school health care policy in The Netherlands was followed by an increase in diversity, which was most often not evidence-based. This study aims to clarify the use of scientific knowledge in school health care policy-making processes: multi-actor processes in networks, trying to solve certain problems. Methods: Case-study design in four Municipal Health Service regions, using documents and half-structured interviews as data sources. Results: Scientific knowledge is used by only 42% of the actors in 58% of decision-making rounds in policy-making processes. ‘Recent’ regional data on health indicators are used more often than ‘established’ (inter)national knowledge of theoretical models. Mainly school health professionals use knowledge as a resource to influence the policy process. Other actors (e.g. managers and municipalities) use formal power, money or ‘initiative’ as their main resources. Powerful actors put forward less scientific knowledge than actors in dependent positions. Individual actors with a combined scientific and political frame of reference put forward knowledge most frequently, especially in complex networks with many actors, more than one powerful actor, more than one arena, more than one dominant resource and more than one dominant frame of reference. Conclusion: The use of scientific knowledge in school health care policy-making processes can and must be improved. Liaison officers can bridge the gap between doctors and policymakers, especially in complex policy networks. They combine a scientific and a political frame of reference and act upon scientific knowledge as a resource in their efforts to influence the policy-making process.

Au debut des annees 90, le gouvernement neerlandais et des representants des organisations patronales ont exhorte le secteur de l’enseignement superieur professionnel (HBO) a restructurer son offre de formations. Les differentes filieres du HBO ont ete sommees de reduire le nombre de leurs programmes afin d’en ameliorer les performances. Une theorie fondee sur la dependance financiere et l’analyse de reseau est avancee pour expliquer pourquoi certains sous-secteurs ont reagi differemment aux pressions exercees. L’analyse experimentale de quatre sous-secteurs est effectuee : agriculture, economie, ingenierie, et culture-societe. L’hypothese de depart n’a pu etre qu’en partie confirmee, mais un effet combine d’une dependance a l’egard du gouvernement, d’une dependance a l’egard du marche du travail, et de l’heterogeneite sous-sectorielle est demontrable. Vu le nombre limite de cas etudies, des recherches complementaires sont recommandees. Parallelement, il est entendu que la macro-demarche quantitative retenue doive etre completee par des microanalyses (etudes de cas) de l’apparition et de la disparition des programmes de formation.

The decentralization of school health care policy in The Netherlands was followed by an increase in diversity, which was most often not evidence-based. This study aims to clarify the use of scientific knowledge in school health care policy-making processes: multi-actor processes in networks, trying to solve certain problems.Case-study design in four Municipal Health Service regions, using documents and half-structured interviews as data sources.Scientific knowledge is used by only 42% of the actors in 58% of decision-making rounds in policy-making processes. 'Recent' regional data on health indicators are used more often than 'established' (inter)national knowledge of theoretical models. Mainly school health professionals use knowledge as a resource to influence the policy process. Other actors (e.g. managers and municipalities) use formal power, money or 'initiative' as their main resources. Powerful actors put forward less scientific knowledge than actors in dependent positions. Individual actors with a combined scientific and political frame of reference put forward knowledge most frequently, especially in complex networks with many actors, more than one powerful actor, more than one arena, more than one dominant resource and more than one dominant frame of reference.The use of scientific knowledge in school health care policy-making processes can and must be improved. Liaison officers can bridge the gap between doctors and policymakers, especially in complex policy networks. They combine a scientific and a political frame of reference and act upon scientific knowledge as a resource in their efforts to influence the policy-making process.

This article deals with cultural theory in the version of Thompson, Ellis and Wildavsky. Cultural theory is important for research in the area of political and policy science because this theory has the pretension of pinning down endogenous preference formation. Using Durkheim's dimensions, 'social integration' and 'regulation of the actions of individuals', cultural theory distinguishes five ways of life or cultures, namely individualism, hierarchy, egalitarianism, fatalism and autonomy. The statement that there are only five ways of life is, however, the result of a selective interpretation of the dimension, 'regulation of the actions of individuals'. A broad perspective on this dimension - including the 'horizontal' aspects of human relations - will lead to the conclusion that there is a sixth culture existent that has been neglected by current cultural theory. This sixth culture is essentially 'mutualism-driven'. In this mutualist way of life, people hold highly specified positions and are closely associated. The production of goods and services within this culture is based on cooperation and mutual adjustment. Power is widely spread, but not because equal rights and duties are considered a good thing. Knowledge and skills are primary in mutualist settings, and power follows knowledge and skills.Keywords: cultural theory; dimensions of sociality; preference formation; ways of life; social organization

Introduction: multi-level and multi-actor governance O. van Heffen, et al. Part I: Effects of Government Institutions. The comitology game: European policymaking with parliamentary involvement B. Steunenberg, D. Schmidtchen. Institutional change in the emerging European polity K. van Kersbergen, et al. The secret and cost of success: institutional change and policy change M.S. de Vries. The swamp of Dutch politics: how the impact of modernization on political behavior is modified by institutional context K. Aarts, et al. Interactive decision making and representative democracy: institutional collisions and solutions E.-H. Klijn, J.F.M. Koppenjan. Is mediation a suitable alternative to court trials? An assessment of institutional effects on the processing of disputes M. Oude Vrielink. Institutionalism: state models and policy processes O. van Heffen, P.-J. Klok. Part II: Change of government institutions. Restructuring a corporatist welfare state: managed liberalization and the role of the state, the social partners and the market in Dutch social security and labor market policy R. van der Veen. Administrative conditions to institutional politics: federalism in an unitary state T.A.J. Toonen. Public governance in Europe: a historical-institutional tour d'horizon W.J.M. Kickert, J.L.M. Hakvoort. Information and communication technology and the redefinition of the functional and normative boundaries of government V.J.J.M. Bekkers. Part III: Formation of government institutions. The mobilization of bias revisited: institutional design, cultural bias and policy-oriented learning F. Hendriks. Interactive policy making as a serious alternative: Balancing between an open and closed approach M. Esselbrugge.Process Management H. de Bruijn, E. ten Heuvelhof. Managing public-private partnerships: influencing processes and institutional context of public-private partnerships E.-H. Klijn, G.R. Teisman. Legal institutions as systems of legal norms D.W.P. Ruiter. Contributors. Index.

This paper discusses the implications of the recent adoption of interactive forms of governance in Dutch urban policy. Advocates of this new approach claim that interactive governance will have positive effects for (1) the quality of urban democracy and urban governability and (2) for the solution of the information problems inherent in coping with (wicked) urban problems. On the basis of an extensive evaluation of the implementation of the new policies in four of the 25 Dutch municipalities involved, these claims are critically assessed.