A comprehensive report has been prepared on the state of public health and healthcare in the Midden-Holland region of the Netherlands. This study describes the development of the report and the mechanisms behind public health knowledge utilisation by three groups of health policy actors: local authorities, public health professionals and regional care providers. The processes are studied in various qualitative ways. The mechanisms explaining the use of the report were found to be complex and different for each group of policy actors. Interaction between researchers and users is not the only factor that explains usage, but rather serves as an intermediate factor.