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Shedding light on how health policies are implemented

Project title: Policy and program implementation and the role of context in explaining prevention effectiveness

Start date: January 2016

Expected end date: June 2018

What is the issue?

Policies and programs that can help prevent chronic disease sometimes fall short of success because they are not fully implemented or don’t reach the right people. Electronic methods for implementation monitoring and performance assessment are becoming more widely used. But do they tell the whole story? Can they explain why it is harder to achieve optimal implementation in some places but not in others?

This project is exploring some state-of-the-art electronic methods for collecting data about health prevention policy and program distribution; and to examine and quantify the extent to which resources and organisational capacity contribute to implementing policies and achieving targets. We aim to collate practitioner insights for ongoing practice and e-monitoring improvement.

How is the project addressing the issue?

The project team has established a collaborative partnership with NSW Health to identify examples of monitoring systems that can help answer the following questions:

  • How are policies and programs reflected in the e-monitoring of health promotion?
  • What are the current best practices?
  • What variation in policy and program implementation is captured across different geographic areas and contexts?
  • How is policy and program “dose” or intensity defined and measured?
  • What parts of the implementation and health promotion practice story are we possibly missing in current electronic monitoring systems? How can these stories be uncovered and brought to light?

The team is using qualitative methods (ethnography and interviews) and quantitative methods (social network analysis) to identify and quantify factors across different regional contexts that explain experience and variation in the implementation of programs of policies.

Our case study centres around the Population Health Information and Management System (PHIMS). This IT system enables NSW Health to set up, manage and report against the aims of the Healthy Children Initiative, which targets early childcare and primary schools in NSW to promote healthy eating and physical activity.

In addition to working with the health sector, the team wants to identify examples from other sectors – such as education, justice and community services – that could help inform best practices for health policy and practice monitoring and implementation.

What are the expected outcomes?

  • Identification of best practice e-monitoring  methods for measuring policy and program distribution and dose
  • Recommendations for improving and expanding existing data collection systems
  • Recommendations for adjusting resources and support for practice to accommodate differences in local regional contexts for implementation.

Updated April 2017

Project lead:

Professor Penny Hawe, Menzies Centre for Health Policy, The University of Sydney

Project team:

  • Dr Katie Conte, Menzies Centre for Health Policy, The University of Sydney
  • Dr Sisse Gron, Menzies Centre for Health Policy, The University of Sydney
  • Ms Christine Innes-Hughes, NSW Office of Preventive Health
  • Ms Amanda Lockeridge, NSW Office of Preventive Health
  • Dr Andrew Milat, Centre for Epidemiology and Evidence, NSW Ministry of Health
  • Dr Jo Mitchell, Centre for Population Health, NSW Ministry of Health
  • Ms Lina Persson, Centre for Epidemiology and Evidence, NSW Ministry of Health
  • Dr Samantha Rowbotham, Menzies Centre for Health Policy, The University of Sydney
  • Associate Professor Sarah Thackway, Centre for Epidemiology and Evidence, NSW Ministry of Health
  • Dr Victoria Loblay, Menzies Centre for Health Policy, The University of Sydney
  • Ms Mandy Williams, Health Promotion Service, South Western Sydney Local Health District

The project will provide insights to enhance the scope and sensitivity of methods used to track policy and program distribution, thereby making the tracking systems (for accountability) more accurate and useful.

It will increase the likelihood that prevention will be more effective and sustained by making practice more visible and supported.

  • Field visits to the Local Health Districts have been completed
  • Qualitative coding and analysis is ongoing
  • The partnership team has identified priority areas on which to focus analysis
  • We are currently designing workshops to report back to Local Health Districts


Conte, KP, Gwynn, J, Turner, N, Koller, C, Gilham, K. Engaging local Aboriginal lay leaders to deliver health promotion programs to remote and rural communities. Poche Centre for Indigenous Health Research Showcase; 28 July 2016, Sydney.

Conte, KP, Hawe, P. What’s measured and what’s not: dynamics of program implementation monitoring. Emerging Health Policy Research Conference; 13 July 2016, Sydney.

Rowbotham, S. Conte, KP, Hawe, P. Operationalising ‘dose’ in public health interventions: A scoping review. Emerging Health Policy Research Conference; 13 July 2016, Sydney.