INTRODUCTION:
A multicenter participatory study designed to improve methodologies for the formulation and implementation of state Health Promotion (HP) policies in Brazil¹. The relevance of this study lies in the institutional gap: 20 years after the National Health Promotion Policy (PNPS) was enacted, only six Brazilian states have established their own guidelines, which exacerbates territorial inequities².

OBJECTIVE:
To develop and validate methodologies for the formulation and implementation of public Health Promotion policies in five Brazilian states, strengthening governance and democratic management.

METHODS:
Participatory qualitative research conducted between September 2023 and March 2026. The methodological framework integrated a scoping review (20000 articles identified), document analysis (95 documents), interviews, and Reflective Circles based on Paulo Freire’s Research Itinerary. The sample included 150 participants, including managers, key stakeholders, health councilors, and community leaders. Data analysis was supported by Atlas.ti software. State workshops and the resulting methodology underwent a validation process with Ministry of Health specialists and a panel of external expert judges.

RESULTS:
The analysis focused on the operational axes of the PNPS³, such as intersectorality and territorialization. Potentialities: local partnerships, staff motivation, and managerial cooperation. Challenges: fragmented funding, management turnover, insufficient human resources, and the dichotomy between health promotion and disease prevention. Pathways: centrality of social participation, focus on territorial vulnerabilities, and alignment with the equity policies of the Unified Health System (SUS).

CONCLUSIONS:
Dialogue between managers and civil society is the foundation for qualifying public policies. Collective knowledge construction, sensitive to local contexts, proved capable of institutionalizing Health Promotion at the state level, fostering federative autonomy and the reduction of inequities.