Intelligent policy making? Key actors' perspectives on the development and implementation of a national early years' initiative

Increased political enthusiasm for evidence-based policy and action has re-ignited interest in the use of evidence within political and practitioner networks. Theories of evidence-based policy making and practice are being re-considered in an attempt to better understand the processes through which knowledge translation occurs. Understanding how policy develops, and practice results, has the potential to facilitate effective evidence use. Further knowledge of the factors which shape healthcare delivery and their influence in different contexts is needed.<p></p> This paper explores the processes involved in the development of a complex intervention in Scotland's National Health Service (NHS). It uses a national oral health programme for children (Childsmile) as a case study, drawing upon key actors' perceptions of the influence of different drivers (research evidence, practitioner knowledge and values, policy, and political and local context) to programme development. Framework analysis is used to analyse stakeholder accounts from in-depth interviews. Documentary review is also undertaken.<p></p> Findings suggest that Childsmile can be described as an ‘evidence-informed’ intervention, blending available research evidence with knowledge from practitioner experience and continual learning through evaluation, to plan delivery. The importance of context was underscored, in terms of the need to align with prevailing political ideology and in the facilitative strength of networks within the relatively small public health community in Scotland. Respondents' perceptions support several existing theoretical models of translation, however no single theory offered a comprehensive framework covering all aspects of the complex processes reported. Childsmile's use of best available evidence and on-going contribution to knowledge suggest that the programme is an example of intelligent policy making with international relevance.<p></p&gt

Efficacious, effective, and embedded interventions: Implementation research in infectious disease control

Background: Research in infectious disease control is heavily skewed towards high end technology; development of new drugs, vaccines and clinical interventions. Oft ignored, is the evidence to inform the best strategies that ensure the embedding of interventions into health systems and amongst populations. In this paper we undertake an analysis of the challenge in the development of research for the sustainable implementation of disease control interventions. Results: We highlight the fundamental differences between the research paradigms associated with the development of technologies and interventions for disease control on the one hand and the research paradigms required for enhancing the sustainable uptake of those very same interventions within the communities on the other. We provide a definition for implementation research in an attempt to underscore its critical role and explore the multidisciplinary science needed to address the challenges in disease control. Conclusion: The greatest value for money in health research lies in the sustainable and effective implementation of already proven, efficacious solutions. The development of implementation research that can help provide some solutions on how this can be achieved is sorely needed

Municipal policies and plans of action aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm, Sweden: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Promoting physical activity and healthy eating habits by structural measures that reach most children in a society is presumably the most sustainable way of preventing development of overweight and obesity in childhood. The main purpose of the present study was to analyse whether policies and plans of action at the central level in municipalities increased the number of measures that aim to promote physical activity and healthy eating habits among schoolchildren aged six to 16. Another purpose was to analyse whether demographic and socio-economic characteristics were associated with the level of such measures.</p> <p>Methods</p> <p>Questionnaires were used to collect data from 25 municipalities and 18 town districts in Stockholm County, Sweden. The questions were developed to capture municipal structural work and factors facilitating physical activity and the development of healthy eating habits for children. Local policy documents and plans of action were gathered. Information regarding municipal demographic and socio-economic characteristics was collected from public statistics.</p> <p>Results</p> <p>Policy documents and plans of action in municipalities and town districts did not seem to influence the number of measures aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm County. Municipal demographic and socio-economic characteristics were, however, shown to influence the number of measures. In town districts with a high total population size, and in municipalities and town districts with a high proportion of adults with more than 12 years of education, a higher level of health-promoting measures was found. In municipalities with a high annual population growth, the number of measures was lower than in municipalities with a lower annual population growth. Another key finding was the lack of agreement between what was reported in the questionnaires regarding existence and contents of local policies and plans of action and what was actually found when these documents were scrutinized.</p> <p>Conclusion</p> <p>Policy documents and plans of action aiming to promote physical activity and healthy eating habits among schoolchildren aged six to 16 in municipalities and town districts in Stockholm County did not seem to have an impact on the local level of measures. Demographic and socio-economic characteristics of the municipalities and town districts were on the other hand associated with local health-promoting measures.</p

Kingdon’s Multiple Streams Approach: What Is the Empirical Impact of this Universal Theory?

While John Kingdon&rsquo;s Multiple Streams Approach (MSA) remains a key reference point in thepublic policy literature, few have attempted to assess MSA holistically. To assess its broaderimpact and trends in usage, we combine in-depth analysis of representative studies, withcomprehensive coverage of MSA-inspired articles, to categorize its impact. We find that Kingdon&rsquo;swork makes two separate contributions. First, it has contributed to the development of&ldquo;evolutionary&rdquo; policy theories such as punctuated equilibrium. Second, it has prompted a large,dedicated, and often empirical, literature. However, most MSA empirical applications only engagewith broader policy theory superficially. The two contributions are oddly independent of eachother. We argue that these trends in application are due largely to its intuitive appeal and low&ldquo;barrier to entry.&rdquo; Drawing on other policy approaches, we offer suggestions to improve the MSAinspired literature

Ett nytänkande entrepenörskap : En studie kring möjligheterna för innovativa företagsidéer att skapa en matproduktion med mindre miljöbelastning.

I denna uppsats kommer jag att utforska matproduktionens roll i arbetet mot hållbarhet utifrån FN’s Agenda 2030. Om en del i arbetet mot förändring kan vara att se på de entrepenörer i dagens samhälle vars affärsidéer uppfyller alla de krav vi kan tänkas ställa på en hållbar matproduktion. För att genomföra detta har jag har intervjuat fyra sådana entrepenörer inom primärproduktionen vars affärsidéer som sticker ut ifrån mängden. Med hjälp av koncept inom innovationsteori ifrån Alexander Styhres ”A social theory of innovation” så som lekfullhet, slösaktigt och ömsesidighet, har jag sedan analyserat deras metoder och tillvägagångssätt. På så vis har jag identifierat och skapat en bild av hur innovation och entreprenörsskap tillsammans kan arbeta sida vid sida mot en hållbar framtid. Likt ett frö som planteras i jord har dessa affärsidéer grott i huvudet hos mina respondenter som ett resultat av en medvetenhet kring brister i vårt samhälle. För att sedan uppenbara sig som fullskaliga affärsidéer och koncept med potential för vinst såväl i monetära termer som i mänskligt välmående, och kan därmed visa på hur innovation kan bidra till en mer hållbar matproduktion

Ett nytänkande entrepenörskap : En studie kring möjligheterna för innovativa företagsidéer att skapa en matproduktion med mindre miljöbelastning.

I denna uppsats kommer jag att utforska matproduktionens roll i arbetet mot hållbarhet utifrån FN’s Agenda 2030. Om en del i arbetet mot förändring kan vara att se på de entrepenörer i dagens samhälle vars affärsidéer uppfyller alla de krav vi kan tänkas ställa på en hållbar matproduktion. För att genomföra detta har jag har intervjuat fyra sådana entrepenörer inom primärproduktionen vars affärsidéer som sticker ut ifrån mängden. Med hjälp av koncept inom innovationsteori ifrån Alexander Styhres ”A social theory of innovation” så som lekfullhet, slösaktigt och ömsesidighet, har jag sedan analyserat deras metoder och tillvägagångssätt. På så vis har jag identifierat och skapat en bild av hur innovation och entreprenörsskap tillsammans kan arbeta sida vid sida mot en hållbar framtid. Likt ett frö som planteras i jord har dessa affärsidéer grott i huvudet hos mina respondenter som ett resultat av en medvetenhet kring brister i vårt samhälle. För att sedan uppenbara sig som fullskaliga affärsidéer och koncept med potential för vinst såväl i monetära termer som i mänskligt välmående, och kan därmed visa på hur innovation kan bidra till en mer hållbar matproduktion

Child health promotion : Analyses of activities and policy processes in 25 Swedish municipalities

The Swedish municipalities are important actors that offer appropriate environments for healthpromoting activities directed at children and adolescents. Enhanced understanding on how such activities develop is needed to improve local public health action. The overall objective of this thesis was to describe potential explanatory factors in municipal health-promoting measures directed at children and adolescents, in order to facilitate for national actors to support healthpromoting action in the municipalities. In the first three papers of this thesis the intentions of 25 Swedish municipalities to promote children and adolescents' health are described. Safety promotion (Study I), health promotion in preschools (Study II) and health promotion in schools (Study III) were of primary interest. In the next step policy processes and factors that might explain municipal public health action were analysed (Study IV). Finally, data from Study 1 were used to test correlations between municipal safety-promoting activities and health outcome (Study V). Although intentions to promote children's health were in general quite well developed, there were some exceptions and variations among the municipalities. Significant correlations between municipal healthpromoting activities and outcome variables were revealed on injuries (Study V) but not on youth behaviour (Study III). Municipal socio-economic status, measured as proportion adults with more than 12 years of education, did not predict the level of healthpromoting measures, whereas municipal growth seemed to have a hampering effect. These results were consistently observed in Studies I-III. Faster growing municipalities reported fewer safety-promoting measures, a lower fraction of preschool staff with a university degree and a lower fraction of full-time employed teachers with a university degree than slower growing municipalities. Five potential explanatory factors for policy process development were identified in Study IV: financial problems, perceived local needs, external funding, national and international policy documents and presence of a local public health sector. Politicians, public officials and nongovernmental organisations were important actors in different phases of the policy process, with strong commitment, professional skills and powerful position in the organisation as main characteristics. The health sector in general, epidemiological statistics and evidence-based methods were seldom mentioned in Study IV. Potential policy implications based on the results presented in this thesis are that disseminating public health-related knowledge through international and national policy documents and supporting institutionalisation of a local public health sector might be useful methods to stimulate and support municipal public health action. Further, means to introduce and distribute epidemiological statistics and evidence-based methods to the municipalities ought to be considered. Increased and improved cooperation between public health sciences and political sciences (e.g., by integrated courses and shared research projects) could be helpful in developing public health research within the municipal arena

”Att förbereda sig för framtiden liksom” : Gymnasieelevers kunskap, erfarenheter och framtidstankar om arbetsmiljöfrågor

2021-01-14</p