Understanding Health Promotion Policy Processes: A Study of the Government Adoption of the Achievement Program in Victoria, Australia

Abstract

Despite the growing health and economic burden associated with overweight and obesity, preventive policy progress has been deficient globally. This study investigated the policy process involved in the adoption of the Achievement Program, a settings-based health promotion intervention that was a key pillar of the Healthy Together Victoria obesity prevention initiative. The qualitative study utilised multiple theories of the policy process, as well as Causal Loop Diagramming (CLD) methods, to understand the policy systems underlying the decision to adopt the Achievement Program. Factors that impacted this obesity prevention policy adoption included problem prioritisation at Federal and state government levels; political risks regarding policy action and inaction, and framing used by policy advocates to reduce risks and highlight the opportunities related to the Achievement Program policy implementation. The use of CLD methods was advantageous to further conceptualise potential leverage points and effective ways to influence obesity prevention policy in future. As such, the findings contribute to the obesity prevention policy evidence base and toward developing a number of recommended actions for policy actors seeking to increase future policy action.

Understanding the dynamics of obesity prevention policy decision-making using a systems perspective: A case study of Healthy Together Victoria

“…The analysis of the processes leading to the adoption of each policy intervention revealed numerous interconnected influences on obesity prevention policy processes [ 48 , 49 , 51 ]. Synthesis of the findings from each policy intervention revealed multiple recurrent associations and feedback mechanisms between components of the policy systems.…”

“…The case study revealed that government staff involved in crafting policy proposals sought involvement from a diverse range of stakeholders as part of policy development processes. Interview participants noted that decision-makers recognised the advantages of stakeholder consultation in policy development, particularly for the LiveLighter ®, Menu Kilojoule Labelling Legislation , and the Achievement Program policy processes, whereby numerous stakeholder groups who would be impacted by the policy were reportedly made to feel that they had an opportunity to contribute to the policy development process [ 48 , 49 , 51 ]. In addition, stakeholder groups were given the opportunity to learn, at an early stage of the process, about how the proposed policy was likely to impact them [ 58 , 59 ].…”

“…In addition, evidence of implementation feasibility (R6), often independent of evidence of policy effectiveness, was noted by participants as critical in regards to several policy interventions, including the Achievement Program , Jamie’s Ministry of Food , Live Lighter ®, and Menu Kilojoule Labelling Legislation [ 48 , 49 , 51 ]. An example of the use of evidence of implementation feasibility was in relation to Menu Kilojoule Labelling Legislation , where government policy makers introducing the policy emphasised the established nature of similar policies in other Australian jurisdictions.…”

“…Hence, central influences that occurred for one particular HTV policy process, but not in others, were not captured in the meta-CLD. However, findings specific to the processes for individual policy interventions are available elsewhere [ 48 , 49 , 51 ]. Future applications of the CLD methodology to various obesity prevention policy processes may help build evidence regarding the characteristics that are universal, or at least common, to various policy systems, as compared to those that are context or policy instrument specific (e.g., regulation compared to taxation).…”

The added value of using the HEPA PAT for physical activity policy monitoring: a four-country comparison

“…It assumes that the stages tend to repeat over and over again as policy is further developed and adapted to real-world circumstances. The approach has been applied to the field of health and health promotion by various authors [16][17][18]. In this audit of PA policies, the main benefit of applying the policy cycle model is the division of policy-making into different phases, which prompts policy-makers and stakeholders to think about the process in a systematic way when identifying actors, approaches and outputs for each step and also helps to structure the subsequent analysis.…”