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Wolfenden L, Hawe P, Rychetnik L, Sutherland R, Barnes C, Yoong S, Giles-Corti B, Mitchell J, Bauman A, Milat AJ, Chai LK, Mayfield S, Mastersson N, Freebairn L, Sacks G, Wilson A, Wright A, Wiggers J. A call to action: More collaborative implementation research is needed to prevent chronic disease. Aust N Z J Public Health 2022; 46:549-553. [PMID: 35735905 DOI: 10.1111/1753-6405.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales.,The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales
| | - Penelope Hawe
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales
| | - Lucie Rychetnik
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales
| | - Rachel Sutherland
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales
| | - Courtney Barnes
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales
| | - Serene Yoong
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales.,Faculty Health, Arts and Design, Swinburne University of Technology, Victoria
| | - Billie Giles-Corti
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Centre for Urban Research, RMIT University, Melbourne, Victoria
| | - Jo Mitchell
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Centre for Population Health, New South Wales Ministry of Health, Sydney, New South Wales
| | - Adrian Bauman
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales
| | - Andrew J Milat
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, New South Wales
| | - Li Kheng Chai
- School of Exercise and Nutrition Science, Queensland University of Technology at the Centre for Children's Health Research (CCHR), South Brisbane, Queensland.,Health and Wellbeing Queensland, Queensland Government, Milton, Queensland
| | - Sara Mayfield
- Health and Wellbeing Queensland, Queensland Government, Milton, Queensland
| | - Nadia Mastersson
- The Commission on Excellence and Innovation in Health, Government of South Australia, Adelaide, South Australia
| | - Louise Freebairn
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Brain and Mind Centre, University of Sydney, Sydney, New South Wales
| | - Gary Sacks
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Deakin University, Global Obesity Centre, Institute for Health Transformation, Geelong, Victoria
| | - Andrew Wilson
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, New South Wales.,Sydney School of Public Health, University of Sydney, Sydney, New South Wales
| | - Annemarie Wright
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria.,Victorian Health Promotion Foundation, Melbourne, Victoria
| | - John Wiggers
- School of Medicine and Public Health, The University of Newcastle, New South Wales.,Hunter Medical Research Institute, New Lambton, New South Wales
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Lee K, van Nassau F, Grunseit A, Conte K, Milat A, Wolfenden L, Bauman A. Scaling up population health interventions from decision to sustainability - a window of opportunity? A qualitative view from policy-makers. Health Res Policy Syst 2020; 18:118. [PMID: 33036633 PMCID: PMC7547476 DOI: 10.1186/s12961-020-00636-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/22/2020] [Indexed: 12/28/2022] Open
Abstract
Background While known efficacious preventive health interventions exist, the current capacity to scale up these interventions is limited. In recent years, much attention has focussed on developing frameworks and methods for scale-up yet, in practice, the pathway for scale-up is seldom linear and may be highly dependent on contextual circumstances. Few studies have examined the process of scaling up from decision to implementation nor examined the sustainability of scaled-up interventions. This study explores decision-makers’ perceptions from real-world scaled-up case studies to examine how scale-up decisions were made and describe enablers of successful scale-up and sustainability. Methods This qualitative study included 29 interviews conducted with purposively sampled key Australian policy-makers, practitioners and researchers experienced in scale-up. Semi-structured interview questions obtained information regarding case studies of scaled-up interventions. The Framework Analysis method was used as the primary method of analysis of the interview data to inductively generate common and divergent themes within qualitative data across cases. Results A total of 31 case studies of public health interventions were described by interview respondents based on their experiences. According to the interviewees’ perceptions, decisions to scale up commonly occurred either opportunistically, when funding became available, or when a deliberate decision was made and funding allocated. The latter scenario was more common when the intervention aligned with specific political or strategic goals. Decisions to scale up were driven by a variety of key actors such as politicians, senior policy-makers and practitioners in the health system. Drivers of a successful scale-up process included good governance, clear leadership, and adequate resourcing and expertise. Establishing accountability structures and appropriate engagement mechanisms to encourage the uptake of interventions were also key enablers. Sustainability was influenced by evidence of impact as well as good acceptability among the general or target population. Conclusions Much like Kingdon’s Multiple Streams Theory of ‘policy windows’, there is a conceptually similar ‘window for scale-up’, driven by a complex interplay of factors such as political need, strategic context, funding and key actors. Researchers and policy-makers need to consider scalability from the outset and prepare for when the window for scale-up opens. Decision-makers need to provide longer term funding for scale-up to facilitate longer term sustainability and build on the resources already invested for the scale-up process.
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Affiliation(s)
- Karen Lee
- School of Public Health, University of Sydney, Camperdown, NSW, 2050, Australia. .,The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia.
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anne Grunseit
- School of Public Health, University of Sydney, Camperdown, NSW, 2050, Australia.,The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia
| | - Kathleen Conte
- The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia.,Menzies Centre for Health Policy, School of Public Health and the University Centre for Rural Health, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Andrew Milat
- Centre for Epidemiology and Evidence, New South Wales Ministry of Health, 100 Christie Street, St Leonards, NSW, 2065, Australia
| | - Luke Wolfenden
- The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia.,University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Adrian Bauman
- School of Public Health, University of Sydney, Camperdown, NSW, 2050, Australia.,The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia
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