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The establishment of policy is key to the implementation of actions for health. We review the nature of policy and the definition and directions of health policy. In doing so, we explicitly cast a health political science gaze on setting parameters for researching policy change for health. A brief overview of core theories of the policy process for...
Citations
... Furthermore, Korenik and Węgrzyn (2020) highlighted the significance of public policy timing in shaping policies sustainably, drawing from economic theories like regulation theory and adaptive public policy concepts. In the realm of policy implementation, scholars like Leeuw et al. (2014) have discussed the broad scope of political science theories relevant to studying public policy changes, including hybrid approaches and coalition structuring. Moulton & Sandfort (2016) pointed out the application of complexity theory in understanding policy processes within complex systems, emphasizing the need for a strategic action field framework for policy implementation research. ...
This research aims to explore the policy model of thematic village development based on the pentahelix approach and its implementation in East Java, Indonesia. By examining the concept of pentahelix and its integration into thematic village development, the study discusses the role of each stakeholder in advancing villages towards sustainable goals. The research adopts a policy research approach, utilizing a mix-method (qualitative and quantitative) analysis. Data collection involves macro-level analysis through documents and interviews with government officials, and micro-level analysis focusing on village-level policy implementation through document studies, interviews, and observations. Data analysis follows the Miles, Huberman, and Saldana model, ensuring data validity through triangulation. The study delineates the stages of the policy model, including agenda setting, formulation, implementation, and evaluation. Agenda setting highlights the transition from addressing underdeveloped villages to empowering them. Formulation involves collaborative efforts among various stakeholders, leading to comprehensive policy plans. Implementation includes financial support allocation and technical assistance, ensuring transparency and collaboration across sectors. Evaluation assesses the policy's impact on achieving Sustainable Development Goals, demonstrating positive outcomes such as increased village autonomy and awareness of development indices. This research contributes to understanding the implementation of the pentahelix-based thematic village development model in East Java, providing insights into collaborative policy formulation and its impact on sustainable development goals. The findings offer practical implications for policymakers, emphasizing the importance of multi-stakeholder collaboration in addressing complex societal challenges.
... Cela témoigne de l'importance accordée à créer un terrain de dialogue réciproque entre politique, intervention et recherche dans notre contexte, alors que les demandes d'évaluation par les pouvoirs publics tendent à être dominées par un modèle technocratique guidé par la mesure de la performance et de l'efficacité (61). Les politiques de PS ne font pas exception à cette tendance (62). Or, l'utilisation de l'évaluation réaliste vise à comprendre une efficacité circonstanciée et non une efficacité absolue. ...
L’évaluation réaliste offre des perspectives intéressantes pour les acteurs
et actrices de terrain souhaitant adopter une approche évaluative tournée
vers la compréhension des conditions d’efficacité des interventions de
promotion de la santé. Pourtant, l’opérationnalisation de l’évaluation réaliste
par des équipes de terrain est peu documentée. C’est à cette carence que la
recherche ProSess tente d’apporter des éclairages. L’objectif poursuivi était
d’explorer l’utilisation de l’évaluation réaliste par des équipes de terrain en
charge de projets de promotion de la santé. Le dispositif de recherche devait
permettre à 4 équipes d’évaluer, avec l’approche réaliste, un ou plusieurs de
leurs projets en étant accompagnées de la chercheuse. Par l’analyse de la
mobilisation de l’évaluation réaliste, nous nous sommes interrogés sur les
conditions de mise en oeuvre de l’évaluation réaliste par des équipes de
terrain. Le présent rapport de recherche documente la manière dont chaque
étape de l’évaluation réaliste s’est déroulée avec les équipes participantes
et met en lumière 5 conditions qui semblent vertueuses pour la pratique de
l’évaluation réaliste dans le champ de la promotion de la santé, c’est-à-dire
de manière capacitante et participative.
... As it turned out, neither the top-down model nor the bottom-up model, captured "the full complexity of the implementation process" (Palfrey, 1999, p. 49, citing Elmore, 1978. Studying the factors that influence policy implementation is indeed a worthy, yet complex endeavor (de Leeuw et al., 2014;Durlak and DuPre, 2008;Franks, and Schroeder, 2013). We can rather speak of two sides of the implementation coin: challenges in the field (implementation failure), and challenges in designing the implementation (intervention failure). ...
... This suggests that the distinction between health policies and health systems is crucial for effective decision-making in oral health. Health policies, like S-FMR and water fluoridation, set the direction for oral health initiatives [29,30], while health systems, which include services like dental sealants, provide the organizational structure for health care delivery [30,31]. Our study's findings align with this distinction, indicating that prefectures with extensive dental sealant use may not be as engaged in promoting S-FMR ( Supplementary Fig. 5). ...
Background
Dental caries are a common non-communicable disease among children. As a public health measure at the prefectural level, school-based fluoride mouth-rinse (S-FMR) program, medical/dental expense subsidy policies, and other factors may reduce the incidence of dental caries and tooth loss. Prefectures focusing on promoting oral health policies may promote both, but the interaction effect of implementing both subsidy policies and S-FMR at the prefectural level on caries prevention has not yet been examined.
Methods
We conducted an ecological study using two-wave panel data, prefecture-level aggregated data in Japan for 2016 and 2018. Coefficient and 95% confidence intervals (CI) were calculated for the dependent variables for oral health using mixed-effects linear regression analysis adjusted for possible confounders. Two dependent variables were used; the standardized claim ratio (SCR) of deciduous tooth extraction and 12-year-olds’ decayed, missing, or filled permanent teeth (DMFT). Four independent variables were S-FMR, the SCR of dental sealants, prefectural income per person, and subsidy policy in three models: co-payment until children enter elementary school (n = 23), no co-payment until children enter elementary school (n = 7), and co-payment continuing beyond elementary school (n = 17). The effects of six interaction terms, each representing a unique pairing from the four independent variables, were individually calculated.
Results
S-FMR was negatively associated with the SCR of deciduous tooth extractions and DMFT (coefficient = -0.11, 95% CI -0.20; -0.01 and coefficient = -0.003, 95% CI -0.005; -0.001, respectively). No co-payment until children enter elementary school was positively associated with the SCR of deciduous tooth extraction compared to co-payment until children enter elementary school(coefficient = 11.42, 95% CI 3.29; 19.55). SCR of dental sealants was positively associated with the SCR of deciduous tooth extractions (coefficient = 0.12, 95% CI 0.06; 0.19) but negatively associated with DMFT (coefficient = -0.001, 95% CI -0.003; -0.0001). Per capita prefectural income was positively associated with the SCR of deciduous tooth extractions(coefficient = 0.01, 95% CI 0.001; 0.02). No interaction was found between S-FMR and the subsidy policy at both outcomes.
Conclusion
High S-FMR utilization and no co-payment until children enter elementary school were associated with fewer deciduous tooth extractions. Also, S-FMR and dental sealant were associated with decreased DMFT.
... 16,48,49,51,54 This causes inertia in policymaking institutions (institutional friction) and political decision makers (cognitive friction) toward addressing obesogenic environments 16,17,49,51 and leads to policies that target an individual's lifestyle only. 16,17,[48][49][50][51][52][54][55][56][57][58] The focus on policies that support individual-level solutions (e.g., prescribing diets, fitness regimens, and obesity medication) directly strengthens the framing of obesity as an individual problem (R1-2) and indirectly strengthens the biomedical and weight-loss industry's ownership of the problem (R3-7). 46 The dominant role of the biomedical and weight-loss sector also frustrates the development of reciprocity between health and other relevant public sectors (e.g., urban planning and taxation) by reinforcing their problem ownership (R8). ...
Despite evidence for the effectiveness of policies that target obesogenic environments, their adoption remains deficient. Using methods and concepts from complexity and political science (Stock-and-Flow analysis and Punctuated Equilibrium Theory) and a qualitative literature review, we developed system maps to identify feedback loops that hinder policymaking on mitigating obesogenic environments and feedback loops that could trigger and sustain policy change. We found numerous self-reinforcing feedback loops that buttress the assumption that obesity is an individual problem, strengthening the biomedical and commercial weight-loss sectors' claim to "ownership" over solutions. That is, improvements in therapies for individuals with obesity reinforces policymakers' reluctance to target obesogenic environments. Random events that focus attention on obesity (e.g., celebrities dismissing soda) could disrupt this cycle, when actors from outside the medical and weight-loss sector (e.g., anti-weight stigma activists) successfully reframe obesity as a societal problem, which requires robust and politically relevant engagement with affected communities prior to such events taking place. Sustained prioritization of policies targeting obesogenic environments requires shared problem ownership of affected communities and nonhealth government sectors, by emphasizing cobenefits of policies that target obesogenic environments (e.g., ultraprocessed food taxation for raising revenue) and solutions that are meaningful for affected communities.
... Following this, the third and fourth sections offer a critical account of the literature on the populism-health nexus in general, and during the COVID-19 pandemic in particular, respectively. The final section sets out the conditions for a new political science of, and for, health -a call that has been increasingly made within the discipline of public health (De Leeuw et al. 2014;Bekker et al. 2018) and identifies potential avenues for further research. ...
... 5 Policymaking and nurses are closely related to each other which can benefit the health system in terms of patient care. 6 Nurses' performance is related to their involvement in policy-making and implementation processes at the higher level which makes them competent enough to participate in issues related to patients by addressing the concerned agendas. [7][8] However, nurses are mostly ignored in policy-making and implementation processes by the leadership and administration. ...
... Data was analyzed through seven steps of Moustakas (1994) modified van Kaam analysis model. 17 (1) horizonalization; considering relevant information (2) reduction and elimination of irrelevant information (3) thematize the invariant constituents clustering thematizing the information according to emerging themes (4) thematize the invariant constituents clustering thematizing the information according to emerging themes (5) create an individual textural description or individual theme development; keeping codes and themes with direct quotes from each participant relevant to the phenomena under study (6) Create composite textural descriptions development of core themes from the participant's individual themes (7) create composite structural descriptions texturalstructural description of meanings; descriptive transcript or dominant constituents, clusters and sub-themes supporting the themes. 18 All three researchers took part in the data coding for triangulation, as a result, codes, categories, and themes were developed from the data which are presented in Table 2. ...
Introduction: The anticipated mortality from coronary artery diseases (CAD) will be 25 million by 2025 throughout the Globe. Coronary Artery Bypass Grafting (CABG) is the most performed procedure in this regard worldwide. The process of preparing a plan and intention to achieve the goals through concerned individuals is called policy making. Policymaking and nurses are closely related to each other which can benefit the health system in terms of patient care. Nurses' performance is related to their involvement in policymaking and implementation processes at the higher level which makes them competent enough to participate in issues related to patients by addressing the concerned agendas. However, nurses are mostly ignored in policymaking and implementation processes by the leadership and administration. Certain factors such as poor infrastructure, lack of proper goal setting, complex system, the inability of the organization to monitor and evaluate nurses' abilities for participation in policy-making, negative image of nurses, misunderstanding in the society about nurses, lack of acceptance and empowerment in policy-making, autocratic administration and resistance to move forward are the challenges in this regard. Material & Methods: The study was conducted at tertiary care government and private hospitals in Peshawar, Pakistan, from November 2020 to May 2021. A phenomenological research design was used, and data was collected through semi-structured interviews with the help of an interview guide and probing questions to understand nurses' experiences and involvement in policy making and implementation process among Coronary Artery Bypass Grafting (CABG) patients. Dominant constituents, clusters, subthemes, and themes were framed through Moustakas modified van Kaam analysis model. Results: A total of 16 nurses; 07 male and 09 female participated in the study. Three main themes were generated: no involvement in policy-making, promoting policymaking among nurses, and passion for caring. Most of the participants viewed that nurses are not involved in policymaking about post-CABG patents. Furthermore, nurses have the highest contribution to patient care but still are not accepted by patients, administrators, health workers, and society. Conclusion: Nurses who provide care to post-CABG
patients and are always available at their bedside are ignored in policy policy-making and implementation processes. These nurses having higher education and vast experience in cardiac surgery need to be involved in the mentioned process by the concerned authorities and can be trusted for better results.
... The policies and strategies that local authorities publish represent their, publicly available, documentation of the planned activities to change residents' financial behaviour. Policies are highlighted as a means of generating and guiding the implementation of behaviour change interventions [10,11]. Therefore, the content and specification of policies are suggested to be extremely important in the later implementation of interventions and the associated outcomes [12,13]. ...
... Policy documents are often the initial, and sometimes only, record of behaviour change interventions and can be used to guide their later implementation [10]. Therefore, it could be argued that the design and reporting within policy documents should be approached using the same systematic methods. ...
Local authorities in the UK often try to improve their residents’ financial well-being by promoting changes in behaviour. The extent to which these behaviour change activities are based on relevant theory or evidence is unknown. This research aims to retrospectively analyse the content of local authorities’ policies to identify opportunities for improvement. The Action, Actor, Context, Target, Time (AACTT) framework was used to assess the specification of target behaviours. The Behaviour Change Wheel (BCW) process was used to assess intervention content. Within the policy documents, target behaviours were not consistently specified in terms of the AACTT criteria. Descriptions of interventions lacked detail with 28% unable to be categorised and there was a reliance on Education (46%) to change financial behaviour. The designing and reporting of interventions to change residents’ financial behaviour were not always aligned with behavioural science evidence and utilising systematic frameworks could help local authorities achieve policy objectives.
... Four levels of interventions to deal with inequalities were described by Whitehead, including activities to strengthen individuals, communities (including the health of the disadvantaged communities), improving conditions of living and work environments across the whole population, and promoting healthy macro-policy. Policies can address issues at all these levels, by allocating resources to evidence-based interventions and policy instruments (Whitehead, 2007;de Leeuw, Clavier and Breton, 2014;Hillier-Brown et al., 2014). The most important components of a cancer prevention strategy are national policies and programmes to reduce exposure to cancer risk factors, raise awareness by providing people with information and support their need to adopt healthy lifestyles, and implement governance and decision-making processes in cancer screening as fundamental pillars of an effective cancer prevention strategy (World Health Organization, 2023a). ...
... Whilst a universally accepted definition of the nature and character of policy is lacking (de Leeuw, Clavier and Breton, 2014), it may be broadly agreed that policies which pertain to health aim "to improve the conditions under which people live: secure, safe, adequate, and sustainable livelihoods, lifestyles, and environments including housing, education, nutrition, information exchange, child care, transportation and necessary community and personal social and health services" (Milio, 2001). Policies provide a course of action which can guide and influence decisions, as policies are derived from standards of practice, law and regulations (O'Donnell and Vogenberg, 2012). ...
Cancer is a global public health problem, but its exact prevalence in people with intellectual disabilities is still uncertain. This population, with limited health skills and complex health needs, faces many challenges in cancer prevention, screening, timely diagnosis and treatment. Furthermore, they are often underrepresented in general cancer prevention and screening policies across Europe, leading to widened disparities in health outcomes and premature mortality. Thus, unified national and local policies are needed to reduce inequalities and promoting a pan-European inclusion of people with intellectual disabilities. Our goal is to raise public awareness of this issue, including the involvement of people with intellectual disabilities, and promote engagement from relevant stakeholders. The COST Action ‘Cancer- Understanding Prevention in Intellectual Disabilities’ (CUPID) project will address health inequalities faced by people with intellectual disabilities in relation to cancer, and support the development of policy recommendations specifically tailored to their unique cognitive and healthcare needs, having a positive long-term impact on quality of life.
... Policies can be understood as solutions to problems that needs resolve within a certain amount of time (de Leeuw et al. 2014;Milio 2001). In this understanding of what policymaking is, lies an inherent need to define the problem at hand to find the best possible solutions and to decide which problems to prioritize over others. ...
Terrorist attacks threaten the security of states and individuals, and often spur widespread state responses once they have occurred. Recent research has focused on health contingency in relation to terrorism and unveiled divergence in terms of how European countries approach this task. To understand more about this divergence, it is relevant to investigate how states define the issue of terrorism in contingency policies. The current study utilized theories of framing as part of policymaking and document analysis with a thematic analysis approach, to scrutinize to what extent terrorism was framed as a security issue in health contingency in relation to terrorist attacks in Norway and France, and how this affected policy outcomes. The analysis unveiled that a securitized frame was not prominent in the Norwegian approach to health contingency. In the French material, however, terrorism was described as a threat to national security. Second, terrorism response within the healthcare field was described as a form of “nonmilitary defense,” clearly positioning the healthcare system in the response to this national security threat. The framing of terrorism in policy documents was linked to diverging policy responses in the two countries. The most distinct difference is that victims of terrorism hold particular rights in France, but not in Norway. This entails that in France, the definition of terrorism, and whether specific events are defined as terrorism or not, in part become decisive for the help received.
