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.
Relevance for practice
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.
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.
Professor Penny Hawe, Menzies Centre for Health Policy, The University of Sydney
- 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
- Dr Victoria Loblay, Menzies Centre for Health Policy, The University of Sydney
- 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
- Abeera Shahid, McMaster University, Canada (internship)
- Associate Professor Sarah Thackway, Centre for Epidemiology and Evidence, NSW Ministry of Health
- Ms Mandy Williams, Health Promotion Service, South Western Sydney Local Health District
This project was funded by the NHMRC, Australian Government Department of Health, NSW Ministry of Health, ACT Health and the HCF Research Foundation.
- Field visits to the Local Health Districts have been completed
- Qualitative coding has been completed
- 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, Groen S, Loblay V, Green A, Milat A, Persson L, Innes-Hughes C, Mitchell J, Thackway S, Williams M, Hawe P. Dynamics behind the scale up of evidence-based obesity prevention: protocol for a multi-site case study of an electronic implementation monitoring system in health promotion practice. Implement Sci. 2017; 12(146). doi: 10.1186/s13012-017-0686-5
Lobley, V. Resources and relationships: The complex role of resources in the implementation of childhood obesity interventions. Emerging Health Policy Research Conference; 27 July 2017, Sydney.
Groen, S. When can we tick the box? The story behind achieving the hardest KPI in a health promotion program. Emerging Health Policy Research Conference; 27 July 2017, Sydney.
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.
- Prevention Centre news, July 2016: Prevention Centre research shines at Menzies conference
- Prevention Centre blog, August 2017: Studying how IT monitoring affects prevention delivery in NSW
- Panel discussion on researchers and decision-makers partnering to prevent chronic disease (Dr Jo Mitchell talks about the project around 48:00 mark)