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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: December 2017

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. Formal performance assessment methods for implementation monitoring are becoming more widely used. But do they tell the whole story? Can they explain why it is harder to achieve optimal implementation but not in others?

This cluster of projects is designed to identify and further develop state-of-the-art methods for collecting data about health prevention policy and program distribution; and to examine and quantify the extent to which resources and organisations’ capacity contributes to implementation and health outcomes. We aim to collate practitioner insights for ongoing improvement.

How is the project addressing the issue?

We are establishing cross-sector collaborative partnerships to identify existing widely implemented programs and policies and/or examples of monitoring systems that could help answer the following questions:

  • How are policies and programs being measured and assessed in Australia and around the world? What are the current best practices?
  • What data would be useful in accurately reflecting the causes of and variations in policy and program implementation across different geographic areas and contexts?
  • How can we use electronic, information technology methods to track health policy and programs and to better allocate resources?
  • What parts of the implementation story are we possibly missing by using electronic monitoring systems to monitor practice? How can these stories be uncovered and brought to light?

Once existing systems are identified, we will work with our partners to identify research questions and methods that will help us understand how these systems work and how they might be improved. We will use qualitative methods, such as in-depth case studies, and quantitative methods, such as social network analysis, to identify and quantify factors across regional contexts that influence variations in health policy and prevention distribution.

Through this project, we aim to explain the relationship between the intensity and quality of prevention policy and programs being delivered, and the prevention targets being achieved.

In addition to working with the health sector, we are keen 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 models for measuring policy and program distribution and dose
  • Recommendations for expanding existing data collection systems
  • Recommendations for adjusting funding formulas for prevention to accommodate differences in local regional contexts for implementation.

Updated November 2016

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
  • Ms Mandy Williams, Health Promotion Service, South Western Sydney Local Health District

The project will increase the accountability of prevention by enhancing the scope and sensitivity of methods used to track policy and program distribution.

It will increase the likelihood that prevention will be more effective and sustained by enabling funding formulas for prevention policies and programs, and capacity building, to be better tailored to account for variations between local contexts.

  • Site-specific ethics approval has been granted by most Local Health Districts
  • Field work on the Monitoring in Practice project (PHIMS) has commenced


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.