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Zheng Y, Shi Y, Ji Y, Chang C. Multiple streams approach to tobacco control policymaking in the capital city of the world's largest tobacco consuming country. Health Policy Plan 2023; 38:321-329. [PMID: 36639931 PMCID: PMC10019569 DOI: 10.1093/heapol/czad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/25/2022] [Accepted: 01/13/2023] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to analyse the policymaking process of Beijing tobacco control regulations based on a multiple streams framework to provide a reference for other cities, at the national level and for the international community to promote the development of tobacco control policy. Twenty-one documents related to tobacco control in Beijing were collected, nine informants were interviewed and the interview data were analysed by a thematic framework method. It was found that indicators, feedback and a focus event in the problem stream drew the attention of policymakers and the society for tobacco control. In 2011, Ying Songnian, a representative of the Beijing Municipal People's Congress, put forward tobacco control legislation, which was just in time for the legislative reform of the Congress. The proposal was studied by the Congress, and a strategy of 'social co-governance' was founded. In the political stream, the government actively promoted tobacco control and social organizations extensively participated in it. In 2013, the General Office of the Central Committee of the Chinese Communist Party and the General Office of the State Council issued a notice on matters related to leading cadres taking the lead in banning smoking in public places, which opened a policy window for decision-makers who were hesitatant. The issue of tobacco control was successfully put on the policy agenda and contributed to the introduction of the Beijing Municipal Regulations on Smoking Control. Development of the factors in problem stream, policy stream and political stream promoted the setting up of the tobacco control policy agenda in Beijing. It is suggested that more cities should learn from the experience of Beijing, seize the opportunity of the ideological change of the ruling party, actively identify the problems, mobilize and advocate for representatives and introduce the concept of 'social co-governance' to promote tobacco control legislation.
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Affiliation(s)
- Yunting Zheng
- School of Health Management, Fujian Medical University, NO. 1 Xue Yuan Road, University Town, FuZhou, Fujian 350122, China
- School of Public Health, Peking University, NO. 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Yuhui Shi
- School of Public Health, Peking University, NO. 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Ying Ji
- School of Public Health, Peking University, NO. 38 Xue Yuan Road, Haidian District, Beijing 100191, China
| | - Chun Chang
- School of Public Health, Peking University, NO. 38 Xue Yuan Road, Haidian District, Beijing 100191, China
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Clarke B, Kwon J, Swinburn B, Sacks G. Policy processes leading to the adoption of 'Jamie's Ministry of Food' programme in Victoria, Australia. Health Promot Int 2021; 37:6292205. [PMID: 34086910 DOI: 10.1093/heapro/daab079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study investigated the policy processes related to the 2012 adoption of the Jamie's Ministry of Food programme by the Victorian Government in Australia. The aim was to provide insight into obesity prevention policy change processes to help strengthen future health promotion action. State-level government policy processes were examined through key informant interviews and a review of relevant documentation. Data were analysed using the Multiple Streams Theory and the Advocacy Coalition Framework in order to understand influences on relevant policy processes and strategies used by policy advocates to facilitate policy adoption. We found that policy adoption was facilitated by dedicated national funding for preventive health at that time, the relatively small number of stakeholders involved in the policy development process and the anticipated support for the programme by the general public due to the association with celebrity chef, Jamie Oliver. We identified that policy brokers aligned the policy with decision-maker ideologies and broader government objectives, and proactively managed potential criticisms. Evidence of intervention effectiveness was not a major driver of policy adoption. We conclude that, iven the complexity of policy processes for obesity prevention, multiple, reinforcing strategies are likely to be needed to facilitate policy change. Support for the adoption of obesity prevention policies is likely to increase when framing of policy options aligns with decision-maker values and has broad public appeal.
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Affiliation(s)
- Brydie Clarke
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
| | - Janelle Kwon
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Gary Sacks
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, 75 Pigdons Road, Waurn Ponds, Victoria 3216, Australia
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Taghizadeh S, Khodayari-Zarnaq R, Farhangi MA. Childhood obesity prevention policies in Iran: a policy analysis of agenda-setting using Kingdon's multiple streams. BMC Pediatr 2021; 21:250. [PMID: 34044800 PMCID: PMC8155654 DOI: 10.1186/s12887-021-02731-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric obesity is one of the most important health challenges of the twenty-first century. Primary prevention of childhood obesity, can lessen its consequences. This study aims to assess childhood obesity prevention policies in Iran through a policy analysis of agenda-setting using Kingdon's multiple streams. METHODS A qualitative study was conducted using in-depth interviews with 39 key informants and document review from different stages of the policymaking process of childhood and adolescent obesity prevention programs in Iran. The analysis of documents and interviews were guided based on Kingdon's multiple streams (problem, policy and political streams). RESULTS The important factors of the problem stream were the high prevalence of childhood and adolescent obesity and its risk factors in Iran. In the policy stream, a focus on preventing non-communicable diseases in the health system, increasing the workforce in health centers, promoting health school programs, and creating healthy eating buffets in schools was identified. Under the political stream, the impact of the WHO ECHO program in 2015 and the implementation of the health system transformation plan in Iran in the new government took place after 2013, caused the Iran ECHO program entered the agenda and implemented from 2016. CONCLUSIONS Now that a window of opportunity for childhood and adolescent obesity prevention policymaking has been created, the problems such as the therapeutic approach in the health system, the existence of sanctions against Iran and outbreak of coronavirus disease-19 (COVID-19), have hindered the successful implementation of this policy and the opportunity window has not been well used. However, actors need political support from the high levels of government to keep this policy on the agenda.
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Affiliation(s)
- Shahnaz Taghizadeh
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, Tabriz University of Medical Sciences, 5166614711, Attar Nishabouri St, PO BOX: 14711, Tabriz, I. R Iran
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Cressman C, Miller FA, Guttmann A, Cairney J, Hayeems RZ. Policy Rogue or Policy Entrepreneur? The Forms and Impacts of "Joined-Up Governance" for Child Health. CHILDREN (BASEL, SWITZERLAND) 2021; 8:221. [PMID: 33805621 PMCID: PMC8001209 DOI: 10.3390/children8030221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
Abstract
Joined-up governance (JUG) approaches have gained attention as mechanisms for tackling wicked policy problems, particularly in intersectoral areas such as child health, where multiple ministries that deliver health and social services must collaborate if they are to be effective. Growing attention to the need to invest in early childhood to improve health and developmental trajectories, including through developmental screening, illustrate the challenges of JUG for child health. Using a comparative case study design comprised of the qualitative analysis of documents and key informant interviews, this work sought to explain how and why visible differences in policy choices have been made across two Canadian jurisdictions (Ontario and Manitoba). Specifically, we sought to understand two dimensions of governance (structure and process) alongside an illustrative example-the case of developmental screening, including how insiders viewed the impacts of governance arrangements in this instance. The two jurisdictions shared a commitment to evidence-based policy making and a similar vision of JUG for child health. Despite this, we found divergence in both governance arrangements and outcomes for developmental screening. In Manitoba, collaboration was prioritized, interests were aligned in a structured decision-making process, evidence and evaluation capacity were inherent to agenda setting, and implementation was considered up front. In Ontario, interests were not aligned and instead decision making operated in an opaque and siloed manner, with little consideration of implementation issues. In these contexts, Ontario pursued developmental screening, whereas Manitoba did not. While both jurisdictions aimed at JUG, only Manitoba developed a coordinated JUG system, whereas Ontario operated as a non-system. As a result, Manitoba's governance system had the capacity to stop 'rogue' action, prioritizing investments in accordance with authorized evidence. In contrast, in the absence of a formal system in Ontario, policy 'entrepreneurs' were able to seize a window of opportunity to invest in child health.
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Affiliation(s)
- Celine Cressman
- Better Outcomes Registry and Network (BORN Ontario), Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.G.); (R.Z.H.)
| | - Fiona A. Miller
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Astrid Guttmann
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.G.); (R.Z.H.)
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
- Institute for Clinical Evaluative Sciences (ICES), Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - John Cairney
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD 4072, Australia;
| | - Robin Z. Hayeems
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.G.); (R.Z.H.)
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
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Browne J, Coffey B, Cook K, Meiklejohn S, Palermo C. A guide to policy analysis as a research method. Health Promot Int 2020; 34:1032-1044. [PMID: 30101276 DOI: 10.1093/heapro/day052] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Policy analysis provides a way for understanding how and why governments enact certain policies, and their effects. Public health policy research is limited and lacks theoretical underpinnings. This article aims to describe and critique different approaches to policy analysis thus providing direction for undertaking policy analysis in the field of health promotion. Through the use of an illustrative example in nutrition it aims to illustrate the different approaches. Three broad orientations to policy analysis are outlined: (i) Traditional approaches aim to identify the 'best' solution, through undertaking objective analyses of possible solutions. (ii) Mainstream approaches focus on the interaction of policy actors in policymaking. (iii) Interpretive approaches examine the framing and representation of problems and how policies reflect the social construction of 'problems'. Policy analysis may assist understanding of how and why policies to improve nutrition are enacted (or rejected) and may inform practitioners in their advocacy. As such, policy analysis provides researchers with a powerful tool to understand the use of research evidence in policymaking and generate a heightened understanding of the values, interests and political contexts underpinning policy decisions. Such methods may enable more effective advocacy for policies that can lead to improvements in health.
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Affiliation(s)
- Jennifer Browne
- Department of Public Health, School of Psychology and Public Health, Latrobe University, Bundoora, Victoria, Australia
| | - Brian Coffey
- Department of Global, Urban and Social Studies, RMIT University, 124 La Trobe Street, Melbourne, Victoria, Australia
| | - Kay Cook
- Department of Social Sciences, Faculty of Health, Arts and Design, Swinburne University, 24 Wakefield Street, Hawthorn, Victoria, Australia
| | - Sarah Meiklejohn
- Department of Nutrition Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, Australia
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Townsend B, Strazdins L, Harris P, Baum F, Friel S. Bringing in critical frameworks to investigate agenda-setting for the social determinants of health: Lessons from a multiple framework analysis. Soc Sci Med 2020; 250:112886. [PMID: 32151781 DOI: 10.1016/j.socscimed.2020.112886] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/06/2020] [Accepted: 02/23/2020] [Indexed: 11/25/2022]
Abstract
Public health scholars have increasingly called for greater attention to the political and policy processes that enable or constrain successful prioritisation of health on government agendas. Much research investigating policy agenda-setting in public health has focused on the use of single frameworks, in particular Kingdon's Multiple Streams Framework. More recently, scholars have argued that blending complementary policy frameworks can enable greater attention to a wider range of drivers that influence government agendas away from or towards progressive social and health policies. In this paper, we draw on multiple policy process frameworks in a study of agenda-setting for Australia's first national paid parental leave scheme. Introduced in 2011 after decades of advocacy, this scheme provides federal government-funded parental leave for eighteen weeks' pay at the minimum wage for primary caregivers, with evaluations showing improved health and equity outcomes. Drawing on empirical data collected from documentary sources and interviews with 25 key policy informants, we find that a combination of policy frameworks; in this case, Kingdon's Multiple Streams; Advocacy Coalition Framework; Punctuated Equilibrium; Narrative Policy Framework; and Policy Feedback helped explain how this landmark social policy came about. However, none of these frameworks were adequate without situating them within a critical feminist lens which enabled an explicit focus on the gendered nature of power. We argue that, alongside making use of policy process frameworks, social determinants of health policy research needs to engage with critical frameworks which share an explicit agenda for improving people's daily living conditions and the re-distribution of power, money, and resources in ways that promote health equity.
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Affiliation(s)
- Belinda Townsend
- Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia.
| | - Lyndall Strazdins
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Patrick Harris
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
| | - Fran Baum
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, Australia
| | - Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance, Australian National University, Canberra, Australia
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7
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Embryonic Stem Cell Research: A Policy Analysis. Plast Surg Nurs 2020; 40:54-58. [PMID: 32102082 DOI: 10.1097/psn.0000000000000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Many health care issues generate minimal passion, promoting benign commentary and support from the various stakeholders involved. Stem cell research does not fall into this category, and on the contrary, embryonic stem cell (ESC) research has continued to foster controversy and emotion. Since 1998, which marked the first successful laboratory isolation of ESCs, this research continues to ignite moral, ethical, and legal debate over its efficacy. The focus of this policy analysis is to introduce the issues, examine and address the various perspectives that surround ESC research, and present policy options and/or solutions that may be used to successfully create a policy consensus regarding this much debated topic.
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Clarke B, Swinburn B, Sacks G. Understanding the LiveLighter® obesity prevention policy processes: An investigation using political science and systems thinking. Soc Sci Med 2019; 246:112757. [PMID: 31927475 DOI: 10.1016/j.socscimed.2019.112757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/05/2019] [Accepted: 12/18/2019] [Indexed: 11/19/2022]
Abstract
The health and economic burden associated with overweight and obesity warrants comprehensive policy action; however, to date, there has been limited policy progress globally. This study sought to advance obesity prevention policy research and practice by applying theories of the policy process to study decision-making processes involved in the adoption of the contentious LiveLighter® social marketing campaign by the Victorian government in Australia. Through analysis of documents and interviews with policy makers, this qualitative study aimed to gain a better understanding of the dynamic influences on policy decision-making. Multiple theories of the policy process were used to elucidate policy drivers and Causal Loop Diagramming methods were used to illustrate the LiveLighter® policy decision-making systems. Findings highlighted a number of key influences including: various external events, evidence of the problem and intervention effectiveness, resistance from various stakeholders and the political capabilities of central policy makers. The policy systems map provided insight into the difficulties experienced by policy actors in achieving policy change, as well as to develop a conceptual framework for identifying potential leverage points to influence future obesity prevention policy decisions. Together the findings can inform future advocacy efforts for improving the implementation of obesity prevention policy action.
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Affiliation(s)
- Brydie Clarke
- Deakin University, Global Obesity Centre, Institute for Health Transformation, 221 Burwood Highway, Burwood, Victoria, 3125, Australia; Population Health and Prevention Strategy Branch, Department of Health and Human Services, 50 Lonsdale Street, Victoria, 3000, Australia.
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Victoria Street West, Auckland, 1142, New Zealand.
| | - Gary Sacks
- Deakin University, Global Obesity Centre, Institute for Health Transformation, 221 Burwood Highway, Burwood, Victoria, 3125, Australia.
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Mah CL, Hasdell R, Minaker LM, Soo SD, Cook B, Demaio AR. Entrepreneurialism and health-promoting retail food environments in Canadian city-regions. Health Promot Int 2019; 33:1055-1065. [PMID: 28973674 DOI: 10.1093/heapro/dax049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The retail sector is a dynamic and challenging component of contemporary food systems with an important influence on population health and nutrition. Global consensus is clear that policy and environmental changes in retail food environments are essential to promote healthier diets and reduce the burden of obesity and non-communicable diseases. In this article, we explore entrepreneurialism as a form of social change-making within retail food environments, focusing on small food businesses. Small businesses face structural barriers within food systems. However, conceptual work in multiple disciplines and evidence from promising health interventions tested in small stores suggest that these retail places may have a dual role in health promotion: settings to strengthen regional economies and social networks, and consumer environments to support healthier diets. We will discuss empirical examples of health-promoting entrepreneurialism based on two sets of in-depth interviews we conducted with public health intervention actors in Toronto, Canada, and food entrepreneurs and city-region policy actors in St. John's, Canada. We will explore the practices of entrepreneurialism in the retail food environment and examine the implications for population health interventions. We contend that entrepreneurialism is important to understand on its own and also as a dimension of population health intervention context. A growing social scientific literature offers a multifaceted lens through which we might consider entrepreneurialism not only as a set of personal characteristics but also as a practice in networked and intersectoral cooperation for public and population health.
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Affiliation(s)
- Catherine L Mah
- Faculty of Health, Dalhousie University, Halifax, NS, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rebecca Hasdell
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Leia M Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, ON, Canada
| | - Stephanie D Soo
- Policy and Innovation Branch, Ontario Ministry of Health and Long-Term Care, Toronto, ON, Canada
| | - Brian Cook
- Toronto Food Strategy, Toronto Public Health, Toronto, ON, Canada
| | - Alessandro R Demaio
- Copenhagen School of Global Health, University of Copenhagen, Copenhagen, Denmark
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Clarke B, Swinburn B, Sacks G. Understanding Health Promotion Policy Processes: A Study of the Government Adoption of the Achievement Program in Victoria, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112393. [PMID: 30380619 PMCID: PMC6265848 DOI: 10.3390/ijerph15112393] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 12/25/2022]
Abstract
Despite the growing health and economic burden associated with overweight and obesity, preventive policy progress has been deficient globally. This study investigated the policy process involved in the adoption of the Achievement Program, a settings-based health promotion intervention that was a key pillar of the Healthy Together Victoria obesity prevention initiative. The qualitative study utilised multiple theories of the policy process, as well as Causal Loop Diagramming (CLD) methods, to understand the policy systems underlying the decision to adopt the Achievement Program. Factors that impacted this obesity prevention policy adoption included problem prioritisation at Federal and state government levels; political risks regarding policy action and inaction, and framing used by policy advocates to reduce risks and highlight the opportunities related to the Achievement Program policy implementation. The use of CLD methods was advantageous to further conceptualise potential leverage points and effective ways to influence obesity prevention policy in future. As such, the findings contribute to the obesity prevention policy evidence base and toward developing a number of recommended actions for policy actors seeking to increase future policy action.
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Affiliation(s)
- Brydie Clarke
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Burwood 3220, Australia.
- Prevention and Population Health Branch, Department of Health and Human Services, Melbourne 3000, Australia.
| | - Boyd Swinburn
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Burwood 3220, Australia.
- School of Population Health, University of Auckland, Auckland 1010, New Zealand.
| | - Gary Sacks
- Global Obesity Centre, Centre for Population Health Research, Deakin University, Burwood 3220, Australia.
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Zupanets IA, Dobrova VY, Ratushna KL, Silchenko SO. Introduction of open visiting policy in intensive care units in Ukraine: policy analysis and the ethical perspective. Asian Bioeth Rev 2018; 10:105-121. [PMID: 33717281 PMCID: PMC7747421 DOI: 10.1007/s41649-018-0057-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 07/03/2018] [Indexed: 10/26/2022] Open
Abstract
Open visiting policy (OVP) in intensive care units (ICU) is considered a favorable visiting regime that may benefit patients and their family members as well as medical staff. The article examines the conditions and causes of OVP-making process in Ukraine and presents the ethical analysis of its implications with respect to the key stakeholders: ICU patients, family members, and medical staff. The OVP, established by the Ministry of Health in June, 2016, changes current approaches to the recognition of the role of families in critically ill patients' care dramatically; it does, however, have serious shortcomings. The analysis of risks and benefits showed that OVP does not adequately cater to the needs of all the key players-family members, patients, and medical staff. Moreover, there is no clear mechanism to control OVP implementation via feedback from all the key players (particularly patients and their families). These issues give rise to a concern that the implementation of OVP will die on the vine. In order to prevent this, a range of measures is required: the optimization of the ICU facilities and internal procedures, supervision of OVP implementation by policy-makers, training of medical staff, and providing family members with educational programs. Considering current shortcomings, it is crucially important to develop clear and consistent internal guidelines in hospitals that will guarantee the introduction of open ICU visiting and quality of critical care provisions.
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Policies, Politics, and Paradigms: Healthy Planning in Australian Local Government. SUSTAINABILITY 2018. [DOI: 10.3390/su10041008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Local government in Australia is critically positioned to provide built environment initiatives that respond to the increasing prevalence of non-communicable diseases (NCD), climate change, and various other human and ecological health considerations. However, action on the ground has not been as widespread as might be expected, particularly in improving community health. This research explores the barriers to and enablers of the implementation of healthy planning and active living initiatives through in-depth interviews with healthy planning and active living advocates. Advocates are seen to promote healthy planning in relatively weak policy settings, where politicised, largely reactive decisions by individual politicians or practitioners are the main determinants of project success. The most important factor affecting project uptake and implementation is how the ‘problem’ of healthy planning, or what might be considered a healthy planning paradigm, is presented. Such a paradigm includes a strong reliance on the co-benefits of projects; it is also subject to the way that healthy planning is communicated and framed. Potential problems around such a setting are subsequently examined, identifying the potential reasons for the slow delivery of healthy planning.
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Baker P, Hawkes C, Wingrove K, Demaio AR, Parkhurst J, Thow AM, Walls H. What drives political commitment for nutrition? A review and framework synthesis to inform the United Nations Decade of Action on Nutrition. BMJ Glob Health 2018; 3:e000485. [PMID: 29527338 PMCID: PMC5841521 DOI: 10.1136/bmjgh-2017-000485] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 01/10/2018] [Accepted: 01/10/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Generating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016-2025). In this review of the empirical nutrition policy literature, we ask: what factors generate, sustain and constrain political commitment for nutrition, how and under what circumstances? Our aim is to inform strategic 'commitment-building' actions. METHOD We adopted a framework synthesis method and realist review protocol. An initial framework was derived from relevant theory and then populated with empirical evidence to test and modify it. Five steps were undertaken: initial theoretical framework development; search for relevant empirical literature; study selection and quality appraisal; data extraction, analysis and synthesis and framework modification. RESULTS 75 studies were included. We identified 18 factors that drive commitment, organised into five categories: actors; institutions; political and societal contexts; knowledge, evidence and framing; and, capacities and resources. Irrespective of country-context, effective nutrition actor networks, strong leadership, civil society mobilisation, supportive political administrations, societal change and focusing events, cohesive and resonant framing, and robust data systems and available evidence were commitment drivers. Low-income and middle-income country studies also frequently reported international actors, empowered institutions, vertical coordination and capacities and resources. In upper-middle-income and high-income country studies, private sector interference frequently undermined commitment. CONCLUSION Political commitment is not something that simply exists or emerges accidentally; it can be created and strengthened over time through strategic action. Successfully generating commitment will likely require a core set of actions with some context-dependent adaptations. Ultimately, it will necessitate strategic actions by cohesive, resourced and strongly led nutrition actor networks that are responsive to the multifactorial, multilevel and dynamic political systems in which they operate and attempt to influence. Accelerating the formation and effectiveness of such networks over the Nutrition Decade should be a core task for all actors involved.
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Affiliation(s)
- Phillip Baker
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Corinna Hawkes
- Centre for Food Policy, City University London, London, UK
| | - Kate Wingrove
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Alessandro Rhyl Demaio
- Department of Nutrition for Health and Development, World Health Organisation, Geneva, Switzerland
| | - Justin Parkhurst
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Anne Marie Thow
- Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia
| | - Helen Walls
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Leverhulme Centre for Integrated Research on Agriculture and Health, London, UK
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Unwin N, Samuels TA, Hassell T, Brownson RC, Guell C. The Development of Public Policies to Address Non-communicable Diseases in the Caribbean Country of Barbados: The Importance of Problem Framing and Policy Entrepreneurs. Int J Health Policy Manag 2017; 6:71-82. [PMID: 28812782 PMCID: PMC5287932 DOI: 10.15171/ijhpm.2016.74] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 06/05/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Government policy measures have a key role to play in the prevention and control of non-communicable diseases (NCDs). The Caribbean, a middle-income region, has the highest per capita burden of NCDs in the Americas. Our aim was to examine policy development and implementation between the years 2000 and 2013 on NCD prevention and control in Barbados, and to investigate factors promoting, and hindering, success. METHODS A qualitative case study design was used involving a structured policy document review and semi-structured interviews with key informants, identified through stakeholder analysis and 'cascading.' Documents were abstracted into a standard form. Interviews were recorded, transcribed verbatim and underwent framework analysis, guided by the multiple streams framework (MSF). There were 25 key informants, from the Ministry of Health (MoH), other government Ministries, civil society organisations, and the private sector. RESULTS A significant policy window opened between 2005 and 2007 in which new posts to address NCDs were created in the MoH, and a government supported multi-sectoral national NCD commission was established. Factors contributing to this government commitment and funding included a high level of awareness, throughout society, of the NCD burden, including media coverage of local research findings; the availability of policy recommendations by international bodies that could be adopted locally, notably the framework convention on tobacco control (FCTC); and the activities of local highly respected policy entrepreneurs with access to senior politicians, who were able to bring together political concern for the problem with potential policy solutions. However, factors were also identified that hindered multi-sectoral policy development in several areas, including around nutrition, physical activity, and alcohol. These included a lack of consensus (valence) on the nature of the problem, often framed as being predominantly one of individuals needing to take responsibility for their health rather than requiring government-led environmental changes; lack of appropriate detailed policy guidance for local adaptation; conflicts with other political priorities, such as production and export of alcohol, and political reluctance to use legislative and fiscal measures. CONCLUSION The study's findings indicate mechanisms to promote and support NCD policy development in the Caribbean and similar settings.
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Affiliation(s)
- Nigel Unwin
- Chronic Disease Research Centre, University of the West Indies, Bridgetown, Barbados
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
| | - T. Alafia Samuels
- Chronic Disease Research Centre, University of the West Indies, Bridgetown, Barbados
| | | | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO, USA
- Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Cornelia Guell
- MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK
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Clarke B, Swinburn B, Sacks G. The application of theories of the policy process to obesity prevention: a systematic review and meta-synthesis. BMC Public Health 2016; 16:1084. [PMID: 27737707 PMCID: PMC5064928 DOI: 10.1186/s12889-016-3639-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 09/04/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Theories of the policy process are recommended as tools to help explain both policy stasis and change. METHODS A systematic review of the application of such theoretical frameworks within the field of obesity prevention policy was conducted. A meta-synthesis was also undertaken to identify the key influences on policy decision-making. RESULTS The review identified 17 studies of obesity prevention policy underpinned by political science theories. The majority of included studies were conducted in the United States (US), with significant heterogeneity in terms of policy level (e.g., national, state) studied, areas of focus, and methodologies used. Many of the included studies were methodologically limited, in regard to rigour and trustworthiness. Prominent themes identified included the role of groups and networks, political institutions, and political system characteristics, issue framing, the use of evidence, personal values and beliefs, prevailing political ideology, and timing. CONCLUSIONS The limited application of political science theories indicates a need for future theoretically based research into the complexity of policy-making and multiple influences on obesity prevention policy processes.
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Affiliation(s)
- Brydie Clarke
- Global Obesity Centre, Centre for Population Health Research, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia. .,Population Health & Prevention Strategy Unit, Prevention, Population, Primary and Community Health Branch, Department of Health and Human Services, 50 Lonsdale Street, Melbourne, Victoria, 3000, Australia.
| | - Boyd Swinburn
- Global Obesity Centre, Centre for Population Health Research, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.,Population Nutrition and Global Health, University of Auckland, Victoria Street West, Auckland, 1142, New Zealand
| | - Gary Sacks
- Global Obesity Centre, Centre for Population Health Research, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
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Playing the policy game: a review of the barriers to and enablers of nutrition policy change. Public Health Nutr 2016; 19:2643-53. [PMID: 27034196 DOI: 10.1017/s1368980016000677] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To progress nutrition policy change and develop more effective advocates, it is useful to consider real-world factors and practical experiences of past advocacy efforts to determine the key barriers to and enablers of nutrition policy change. The present review aimed to identify and synthesize the enablers of and barriers to public policy change within the field of nutrition. DESIGN Electronic databases were searched systematically for studies examining policy making in public health nutrition. An interpretive synthesis was undertaken. SETTING International, national, state and local government jurisdictions within high-income, democratic countries. RESULTS Sixty-three studies were selected for inclusion. Numerous themes were identified explaining the barriers to and enablers of policy change, all of which fell under the overarching category of 'political will', underpinned by a second major category, 'public will'. Sub-themes, including pressure from industry, neoliberal ideology, use of emotions and values, and being visible, were prevalent in describing links between public will, political will and policy change. CONCLUSIONS The frustration around lack of public policy change in nutrition frequently stems from a belief that policy making is a rational process in which evidence is used to assess the relative costs and benefits of options. The findings from the present review confirm that evidence is only one component of influencing policy change. For policy change to occur there needs to be the political will, and often the public will, for the proposed policy problem and solution. The review presents a suite of enablers which can assist health professionals to influence political and public will in future advocacy efforts.
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Abstract
Many health care issues generate minimal passion, promoting benign commentary and support from the various stakeholders involved. Stem cell research does not fall into this category, and on the contrary, embryonic stem cell (ESC) research has continued to foster controversy and emotion. Since 1998, which marked the first successful laboratory isolation of ESCs, this research continues to ignite moral, ethical, and legal debate over its efficacy. The focus of this policy analysis is to introduce the issues, examine and address the various perspectives that surround ESC research, and present policy options and/or solutions that may be used to successfully create a policy consensus regarding this much debated topic.
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Affiliation(s)
- Hermine Warren
- Hermine Warren, DNP, APRN, CANS, CNM, is a doctor of nursing practice who has been in nursing since 1974, with an advanced practice degree since 1980. She is also a certified aesthetic nurse specialist in Southern California, an educational/clinical trainer for two top pharmaceutical companies, and has maintained a clinical practice in the nonsurgical cosmetic subspecialty field since 2004
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18
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Using political science to progress public health nutrition: a systematic review. Public Health Nutr 2015; 19:2070-8. [DOI: 10.1017/s1368980015002712] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectivePoor dietary intake is the most important behavioural risk factor affecting health globally. Despite this, there has been little investment in public health nutrition policy actions. Policy process theories from the field of political science can aid understanding why policy decisions have occurred and identify how to influence ongoing or future initiatives. The present review aims to examine public health nutrition policy literature and identify whether a policy process theory has been used to analyse the process.DesignElectronic databases were searched systematically for studies examining policy making in public health nutrition in high-income, democratic countries.SettingInternational, national, state and local government jurisdictions within high-income, democratic countries.SubjectsIndividuals and organisations involved in the nutrition policy-making process.ResultsSixty-three studies met the eligibility criteria, most were conducted in the USA and a majority focused on obesity. The analysis demonstrates an accelerating trend in the number of nutrition policy papers published annually and an increase in the diversity of nutrition topics examined. The use of policy process theory was observed from 2003; however, it was utilised by only 14 % of the reviewed papers.ConclusionsThere is limited research into the nutrition policy process in high-income countries. While there has been a small increase in the use of policy process theory from 2003, an opportunity to expand its use is evident. We suggest that nutrition policy making would benefit from a pragmatic approach that ensures those trying to influence or understand the policy-making process are equipped with basic knowledge around these theories.
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Smith N, Mitton C, Dowling L, Hiltz MA, Campbell M, Gujar SA. Introducing New Priority Setting and Resource Allocation Processes in a Canadian Healthcare Organization: A Case Study Analysis Informed by Multiple Streams Theory. Int J Health Policy Manag 2015; 5:23-31. [PMID: 26673646 DOI: 10.15171/ijhpm.2015.169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 09/14/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In this article, we analyze one case instance of how proposals for change to the priority setting and resource allocation (PSRA) processes at a Canadian healthcare institution reached the decision agenda of the organization's senior leadership. We adopt key concepts from an established policy studies framework - Kingdon's multiple streams theory - to inform our analysis. METHODS Twenty-six individual interviews were conducted at the IWK Health Centre in Halifax, NS, Canada. Participants were asked to reflect upon the reasons leading up to the implementation of a formal priority setting process - Program Budgeting and Marginal Analysis (PBMA) - in the 2012/2013 fiscal year. Responses were analyzed qualitatively using Kingdon's model as a template. RESULTS The introduction of PBMA can be understood as the opening of a policy window. A problem stream - defined as lack of broad engagement and information sharing across service lines in past practice - converged with a known policy solution, PBMA, which addressed the identified problems and was perceived as easy to use and with an evidence-base from past applications across Canada and elsewhere. Conditions in the political realm allowed for this intervention to proceed, but also constrained its potential outcomes. CONCLUSION Understanding in a theoretically-informed way how change occurs in healthcare management practices can provide useful lessons to researchers and decision-makers whose aim is to help health systems achieve the most effective use of available financial resources.
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Affiliation(s)
- Neale Smith
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Craig Mitton
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - Mary-Ann Hiltz
- Strategy and Organizational Performance, IWK Health Centre, Halifax, NS, Canada
| | - Matthew Campbell
- Strategy and Organizational Performance, IWK Health Centre, Halifax, NS, Canada
| | - Shashi Ashok Gujar
- Strategy and Organizational Performance, IWK Health Centre, Halifax, NS, Canada.,Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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Perspectives of Fijian Policymakers on the Obesity Prevention Policy Landscape. BIOMED RESEARCH INTERNATIONAL 2015; 2015:926159. [PMID: 26380307 PMCID: PMC4561938 DOI: 10.1155/2015/926159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/10/2015] [Indexed: 01/07/2023]
Abstract
In Fiji and other Pacific Island countries, obesity has rapidly increased in the past decade. Therefore, several obesity prevention policies have been developed. Studies show that their development has been hampered by factors within Fiji's policy landscape such as pressure from industry. Since policymakers in the Fijian national government are primarily responsible for the development of obesity policies, it is important to understand their perspectives; we therefore interviewed 15 policymakers from nine Fijian ministries. By applying the "attractor landscape" metaphor from dynamic systems theory, we captured perceived barriers and facilitators in the policy landscape. A poor economic situation, low food self-sufficiency, power inequalities, inappropriate framing of obesity, limited policy evidence, and limited resource sharing hamper obesity policy developments in Fiji. Facilitators include policy entrepreneurs and policy brokers who were active when a window of opportunity opened and who strengthened intersectoral collaboration. Fiji's policy landscape can become more conducive to obesity policies if power inequalities are reduced. In Fiji and other Pacific Island countries, this may be achievable through increased food self-sufficiency, strengthened intersectoral collaboration, and the establishment of an explicit functional focal unit within government to monitor and forecast the health impact of policy changes in non-health sectors.
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21
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Anderson GD. Child sexual abuse prevention policy: an analysis of Erin's law. SOCIAL WORK IN PUBLIC HEALTH 2014; 29:196-206. [PMID: 24802215 DOI: 10.1080/19371918.2013.776321] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Child sexual abuse affects thousands of children in the United States and is vastly underreported. Tertiary prevention policies, primarily in the form of sex offender registries and community notification programs, have received the most attention and funding. Few policies have focused on school-based prevention. One recently passed law in Illinois mandates all K-5 public schools to implement sexual abuse prevention programs. The law was championed by a young social worker, Erin Merryn. Through the multiple streams framework, this article examines the unique set of political circumstances, united with Merryn's advocacy, which created the opportunity for the law to pass.
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Affiliation(s)
- Gwendolyn D Anderson
- a School of Social Work, University of Minnesota , Twin Cities, St. Paul , Minnesota , USA
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Batchelder A, Matusitz J. "Let's Move" campaign: applying the extended parallel process model. SOCIAL WORK IN PUBLIC HEALTH 2014; 29:462-472. [PMID: 25068611 DOI: 10.1080/19371918.2013.865110] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article examines Michelle Obama's health campaign, "Let's Move," through the lens of the extended parallel process model (EPPM). "Let's Move" aims to reduce the childhood obesity epidemic in the United States. Developed by Kim Witte, EPPM rests on the premise that people's attitudes can be changed when fear is exploited as a factor of persuasion. Fear appeals work best (a) when a person feels a concern about the issue or situation, and (b) when he or she believes to have the capability of dealing with that issue or situation. Overall, the analysis found that "Let's Move" is based on past health campaigns that have been successful. An important element of the campaign is the use of fear appeals (as it is postulated by EPPM). For example, part of the campaign's strategies is to explain the severity of the diseases associated with obesity. By looking at the steps of EPPM, readers can also understand the strengths and weaknesses of "Let's Move."
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Affiliation(s)
- Alicia Batchelder
- a Nicholson School of Communication, University of Central Florida , Orlando , Florida , USA
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Lyn R, Aytur S, Davis TA, Eyler AA, Evenson KR, Chriqui JF, Cradock AL, Goins KV, Litt J, Brownson RC. Policy, systems, and environmental approaches for obesity prevention: a framework to inform local and state action. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2013; 19:S23-33. [PMID: 23529052 PMCID: PMC4943076 DOI: 10.1097/phh.0b013e3182841709] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The public health literature has not fully explored the complexities of the policy process as they relate to public health practice and obesity prevention. We conducted a review of the literature across the policy science and public health fields, distilled key theories of policy making, and developed a framework to inform policy, systems, and environmental change efforts on obesity prevention. Beginning with a conceptual description, we focus on understanding three domains of the policy process: the problem domain, the policy domain, and the political domain. We identify key activities in the policy process including the following: (a) assessing the social and political environment; (b) engaging, educating and collaborating with key individuals and groups; (c) identifying and framing the problem; (d) utilizing available evidence; (e) identifying policy solutions; and (f) building public support and political will. The article provides policy change resources and case studies to guide and support local and state efforts around obesity prevention.
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Affiliation(s)
- Rodney Lyn
- Division of Health Management and Policy, Institute of Public Health, Georgia State University, Atlanta, Georgia 30302, USA.
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Jones E, Eyler AA, Nguyen L, Kong J, Brownson RC, Bailey JH. It's all in the lens: differences in views on obesity prevention between advocates and policy makers. Child Obes 2012; 8:243-50. [PMID: 22799551 PMCID: PMC4772790 DOI: 10.1089/chi.2011.0038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Intervention strategies to reduce obesity include policy and environmental changes that are designed to provide opportunities, support, and cues to help people develop healthier behaviors. Policy changes at the state level are one way to influence access, social norms, and opportunities for better nutrition and increased physical activity among the population. METHODS Ten states were selected for a broad variance in obesity rates and number of enacted obesity prevention policies during the years of 2006-2009. Within the selected states, a purely qualitative study of attitudes of childhood obesity policy using semistructured telephone interviews was conducted. Interviews were conducted with state policy makers who serve on public health committees. A set of six states that had more than eight childhood obesity policies enacted were selected for subsequent qualitative interviews with a convenience sample of well-established advocates. RESULTS Policy makers in states where there was more childhood obesity policy action believed in the evidence behind obesity policy proposals. Policy makers also varied in the perception of obesity as a constituent priority. The major differences between advocates and policy makers included a disconnect in information dissemination, opposition, and effectiveness of these policies. CONCLUSIONS The findings from this study show differences in perceptions among policy makers in states with a greater number of obesity prevention bills enacted. There are differences among policy makers and advocates regarding the role and effectiveness of state policy on obesity prevention. This presents an opportunity for researchers and practitioners to improve communication and translation of evidence to policy makers, particularly in states with low legislation.
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Affiliation(s)
- Ellen Jones
- School of Health Related Professions, University of Mississippi Medical Center, Jackson, MS; and National Association of Chronic Disease Directors
| | - Amy A. Eyler
- Prevention Research Center in St. Louis, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO
| | - Leah Nguyen
- Prevention Research Center in St. Louis, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO
| | - Jooyoung Kong
- Prevention Research Center in St. Louis, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO.,Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Jessica H. Bailey
- School of Health Related Professions, University of Mississippi Medical Center, Jackson, MS
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