Prevention Tracker: Learning locally to act nationally

What is the issue?

Governments at all levels as well as many non-government and private organisations fund and implement programs to promote the health and wellbeing of communities. This is in response to growing evidence of the effectiveness of programs that promote the safe use of alcohol, better nutrition, increased physical activity and stopping smoking, and the subsequent positive impacts of these changes in lifestyle behaviours on preventing many chronic diseases.

Increasingly, the literature reports attempts to ‘map’ and quantify these prevention policies and programs and measure their effects on community health and wellbeing. Our view, however, is that prevention policies and programs alone are not sufficient to achieve significant and sustainable results. Chronic disease is a complex problem, resulting from multiple, interconnected causes. As such, prevention policies and programs should be recognised as just one part of a more comprehensive ‘system’ or series of interconnected elements, which combine to influence chronic disease prevention.

This way of thinking about systems for health and wellbeing is akin to the notion of health system building blocks put forward by the World Health Organization. In addition to policies and programs, the World Health Organization’s Health Systems Framework recognises the important role that system elements or building blocks such as governance, financing and human resources have in health system performance.

We believe local communities provide a way to explore the building blocks, or elements, that influence chronic disease prevention.

To improve our understanding of what does and doesn’t work to prevent lifestyle-related chronic disease in local communities, we need to better understand:

• What local prevention systems look like
• The role of policies and programs, as well as other system elements or building blocks, in influencing local prevention systems
• What can be done to activate these local prevention systems to achieve maximum population health impact.

We can take this local knowledge from many communities and build a comprehensive picture of an effective prevention system. In short, we hope we can learn locally to act nationally.

How is the project addressing the issue?

The pilot tested the feasibility of forming a national program called Prevention Tracker. The proof-of-concept pilot study in Glenorchy, Tasmania:

1. Identified and ‘mapped’ in a structured way the system elements or building blocks in Glenorchy that support the prevention of lifestyle-related chronic disease
2. Classified these elements according to the function they play in the local prevention system
3. Measured the scope and reach of the elements
4. Examined local community members’ and leaders’ awareness of, and engagement with these elements, and perceptions of their value
5. Established whether the information produced through this initiative is useful and is used locally to track and improve the health of the community in Glenorchy
6. Estimated how much it would cost and how long it would take to replicate the pilot methods in a number of additional communities across Australia.

Relevance for practice

This initiative developed methods for identifying and measuring local prevention systems. The data will allow us to make comparisons over time, both within communities as well as across different communities.

Our vision is that using and comparing local community information will help to guide action at both local and national levels – actions such as better allocation of resources and stronger partnerships – to reduce the impact of chronic disease. Ultimately, we will pool and use what we learn from local communities to inform what is needed at a state and national level for an effective, efficient and equitable system for the prevention of lifestyle-related chronic disease in Australia.

What were the outcomes?

With the proof of concept found to be both feasible and useful, the Prevention Tracker project was expanded to a number of communities across different areas and populations of the country. Information about the expanded project is here. The hope is that Prevention Tracker will become a national initiative for monitoring the quantity, nature and variation in efforts to improve the health and wellbeing of local communities.

Acknowledgement

In partnership with staff of the Tasmanian Department of Health and Human Services and community leaders in Glenorchy, Prevention Centre Deputy Director Associate Professor Sonia Wutzke and Research Officer Maria Gomez designed and implemented the proof-of-concept pilot study.

A small Advisory Group advised on the design and implementation of the project. These members include:

• Professor Adrian Bauman, University of Sydney
• Dr Anne Grunseit, University of Sydney
• Professor Penny Hawe, Menzies Centre for Health Policy, University of Sydney
• Marge Overs, Prevention Centre
• Professor Andrew Wilson, Prevention Centre and University of Sydney