Investigating the media power of a population health monitoring survey: case study of the NSW Schools Physical Activity and Nutrition Survey (SPANS)

Objective
To examine the extent and nature of news coverage of a government-funded population monitoring survey of children and the potential implications of this coverage for public health advocacy.

Methods
Case study of the NSW Schools Physical Activity and Nutrition Survey (SPANS), a population monitoring survey of school-aged children's weight and weight-related behaviours, conducted in 1997, 2004 and 2010. Printed news items from all Australian newspapers between January 1997 and December 2011 mentioning the survey findings were identified from the Factiva database and a descriptive analysis of the content conducted.

Results
Overall, 144 news items were identified. The news angles focused mainly on physical activity/sedentary behaviour; overweight/obesity and nutrition; however these angles changed between 1997 and 2011, with angles focused on physical activity/sedentary behaviour increasing, compared with overweight/obesity and nutrition angles (p=0.001). Responsibility for obesity and weight-related behaviours was most frequently assigned to parents and food marketing, and the most common solutions were policy strategies and parental/child education and support.

Conclusions
Population health surveys are newsworthy and when coupled with strategic dissemination, media can contribute to communicating health issues and interpreting findings in ways that are relevant for consumers, policy makers and stakeholders.

Implications
This case study emphasises the news value of government-funded population surveys, while providing a cautionary note about media focus on individual studies rather than a larger body of research evidence.

Policy and practice impacts of applied research: a case study analysis of the New South Wales Health Promotion Demonstration Research Grants Scheme 2000-2006

Background
Intervention research provides important information regarding feasible and effective interventions for health policy makers, but few empirical studies have explored the mechanisms by which these studies influence policy and practice. This study provides an exploratory case series analysis of the policy, practice and other related impacts of the 15 research projects funded through the New South Wales Health Promotion Demonstration Research Grants Scheme during the period 2000 to 2006, and explored the factors mediating impacts.

Methods
Data collection included semi-structured interviews with the chief investigators (n = 17) and end-users (n = 29) of each of the 15 projects to explore if, how and under what circumstances the findings had been used, as well as bibliometric analysis and verification using documentary evidence. Data analysis involved thematic coding of interview data and triangulation with other data sources to produce case summaries of impacts for each project. Case summaries were then individually assessed against four impact criteria and discussed at a verification panel meeting where final group assessments of the impact of research projects were made and key influences of research impact identified.

Results
Funded projects had variable impacts on policy and practice. Project findings were used for agenda setting (raising awareness of issues), identifying areas and target groups for interventions, informing new policies, and supporting and justifying existing policies and programs across sectors. Reported factors influencing the use of findings were: i) nature of the intervention; ii) leadership and champions; iii) research quality; iv) effective partnerships; v) dissemination strategies used; and, vi) contextual factors.

Conclusions
The case series analysis provides new insights into how and under what circumstances intervention research is used to influence real world policy and practice. The findings highlight that intervention research projects can achieve the greatest policy and practice impacts if they address proximal needs of the policy context by engaging end-users from the inception of projects and utilizing existing policy networks and structures, and using a range of strategies to disseminate findings that go beond traditional peer review publications.

The dynamic interplay of news media and bilingual education policy in Australia's Northern Territory 1988-2008

his study investigates the dynamic interplay between news media and the Northern Territory’s policy of bilingual education for indigenous children living in some remote communities. It provides evidence to support the argument that the media-related practices of a range of policy actors resulted in policy processes being shaped to a significant degree by ‘media logic’. The research is based on depth interviews and uses the spoken words of participants to gain access to the local experiences and perspectives of those invested in developing, influencing and communicating the bilingual education policy. Through the analysis of more than 20 interviews with journalists, public servants, academics, and politicians as well as indigenous and non-indigenous bilingual education advocates, I have identified a range of media-related practices that have enabled policy actors to penetrate the policy debate, define problems for policymaking and public discussion through the news media, and thereby exert particular forms of influence in the policy process. The study also provides a ‘southern theory’ analysis of the Yolngu public sphere and a Bourdesian understanding of the journalism sub-field of indigenous reporting in the Northern Territory. It shows that issues of physical and cultural remoteness and the need for journalists to develop cultural competence are the hallmarks of this reporting specialization. It also identifies marked differences in journalists’ relationships with government, academic and indigenous sources and how these differences play out in the way participants understand the production and reception of media texts. This research makes an innovative contribution to Australian Journalism Studies by demonstrating how indigenous epistemologies and knowledges offer fresh perspectives and insights about news media and indigeneity that can be brought into balance with northern theories to build what Connell (2007) has called ‘southern theory’. This dovetails with another key outcome, which is the development of an academic form of journalism that serves indigenous peoples’ self-determinist aims for scholarly research, based in indigenous perspectives and research methodologies.

Form versus function : a study into interactive learning process affecting the implementation of sustainability in commercial buildings

Owners and tenants of sustainable buildings are now realising the sustainable building that they own or occupy and also how they use the building have a significant impact on their work practices. These stakeholders are demanding sustainability outcomes such as improved occupant health and performance, lower energy and material consumption use as well as encouraging healthy ecosystem in their sustainable building. Clearly the level of user knowledge about a sustainable building and its technologies makes a difference about the actual behaviour towards sustainable buildings (Knott 2007, Stenberg 2007) There remains two major challenge faced by sustainable building occupants: (i) addressing the gap between an occupant's expectations of sustainable building outcomes and what the building actually provides and (ii) overcoming the lack of user knowledge about sustainability design and operation for a particular with regards to performance (Jailani et. al, 2011). This is an innovative study designed to address these challenges. It uses a focus group approach to investigate the gap between (a) user expectations and (b) sustainable building performance, with reference to the relationship between interactive learning process and the level of implementation of sustainability in commercial buildings. The outcome from the study will provide a post-occupancy evaluation of the perception of occupants in sustainable buildings. Most importantly, this information can then assist architects and designers in private and government organisations to successfully develop future sustainable design and policy which can fully capitalise on the original intention when delivering sustainable buildings, as well as providing an innovative feedback mechanism between occupiers and architects.

Social capital and public policy – the current challenge facing the Victorian Government

Social capital, since Putnam’s 1993 work, has captured the imagination of policy-makers the world over, and Australia is no exception. In 2005 the Department of Victorian Communities launched its Actions for Community Strengthening policy statement, which draws heavily on social capital theory. This article explores the theoretical underpinnings of the government’s policy and critiques its failure to deal adequately with the causal relationship between social capital and its supposed community benefits. The article then seeks to isolate the missing factors through a look at recent research on volunteerism and argues that the institution of collaborative/interactive governance needs to be underpinned by sound socio-economic reform.

Community views on responding to a local asbestos disease epidemic : implications for policy and practice

The Latrobe Valley region of Victoria, Australia, has the highest rate of asbestos disease in the state due to extensive past use of asbestos in the power industry. Current responses to asbestos disease epidemics in Australia and internationally are dominated by medical, scientific, legal and government perspectives. The voices and perspectives of those most directly affected – exposed and diseased workers, their families and communities – are relatively rarely heard.A qualitative interview study was conducted to determine what people in the Latrobe Valley community think could or should be done following their own asbestos disease epidemic. Analysis identified several themes. Notably, these represent a sophisticated community understanding of issues that is largely consistent with state-of-the-art occupational health and public health knowledge.Some themes are well known already, eg the need for fair and timely compensation, adequate healthcare facilities and services, and more education. Others point to neglected possibilities, such as the need for reconciliation and social healing to complement the dominant individual medico-legal focus. Employer suppression of hazard information and denial of asbestos-related disease in past decades continues to have a profound effect on people's views in the present. Reconciliation in some form, eg acknowledgement of or apology for past wrongs, was identified as a necessary first step in developing new and better policy and practice responses; action in this regard has important implications for the implementation and effectiveness of other policy and practice interventions. Further, a need for substantive community participation in the development of policy and practice responses – currently lacking – was identified. Findings suggest that community is an under-recognised and under-utilised resource in responding to a local asbestos disease epidemic.The Latrobe Valley situation is a microcosm of the broader Australian and international story. It offers insights on the perspectives of those most affected by asbestos issues, how such people and their views can be used to strengthen current policy and practice responses, and how their participation is essential to building comprehensive public and social health responses to this global problem.

Neoliberalism, economic restructuring and policy change : precarious housing and precarious employment in Australia

Housing, employment and economic conditions in many nations have changed greatly over the past decades. This paper explores the ways in which changing housing markets, economic conditions and government policies have affected vulnerable individuals and households, using Australia as a case study. The paper finds a substantial number and proportion of low income Australians have been affected by housing and employment that is insecure with profound implications for vulnerability. Importantly, the paper suggests that in Australia the economic gains achieved as a consequence of mining-related growth in the early 2000s were translated as greater employment security for some on low incomes, but not all. Enhanced access to employment in this period was differentiated by gender, with women largely missing out on the growth in jobs. For the population as a whole, employment gains were offset by increased housing insecurity as accommodation costs rose. The paper finds low income lone parents were especially vulnerable because they were unable to benefit from a buoyant labour market over the decade 2000–2010. They were also adversely affected by national policy changes intended to encourage engagement with paid work. The outcomes identified for Australia are likely to have been mirrored in other nations, especially those that have embraced, or been forced to adopt, more restrictive welfare and income support regimes.

A Q methodology study of stakeholders' views about accountability for promoting healthy food environments in England through the responsibility deal food network

In March 2011, the United Kingdom's (UK's) Government launched five Public Health Responsibility Deal Networks to address public health priorities. The Networks used voluntary partnerships to influence peoples' choice architecture to move them toward healthier behaviors. The purpose of this research was to conduct an exploratory study of diverse stakeholders' perspectives about perceived responsibility and accountability expectations to improve food environments in England through the Food Network partnerships. A purposive sample of policy elites (n=31) from government, academia, food industry and non-government organizations sorted 48 statements related to improving food environments in England. Statements were grounded in three theoretical perspectives (i.e., legitimacy, nudge and public health law). PQMethod 2.33 statistical software program used factor analysis to identify viewpoints based on intra-individual differences for how participants sorted statements. The results revealed three distinct viewpoints, which explained 64% of the variance for 31 participants, and emphasized different expectations about responsibility. The food environment protectors (n=17) underscored government responsibility to address unhealthy food environments if voluntary partnerships are ineffective; the partnership pioneers (n=12) recognized government-industry partnerships as legitimate and necessary to address unhealthy food environments; and the commercial market defenders (n=1) emphasized individual responsibility for food choices and rejected government intervention to improve food environments. Consensus issues included: protecting children's right to health; food industry practices that can and should be changed; government working with industry on product reformulation; and building consumer support for economically viable healthy products. Contentious issues were: inadequacy of accountability structures and government inaction to regulate food marketing practices targeting children. We conclude that understanding different viewpoints is a step toward building mutual trust to strengthen accountability structures that may help stakeholders navigate ideologically contentious issues to promote healthy food environments in England.

Northern Lights: the positive policy example of Sweden, Finland, Denmark and Norway

The nations of Scandinavia and Finland, or Nordic Europe, continue to provide living proof that economic prosperity can be combined with social equality and environmental responsibility. This book, written from an Australian perspective, explores previous outside policy interest in the Nordic nations and outlines some lessons which the English-speaking world, in particular, can learn now from the achievements of the four main Nordic European nations. In terms of income distribution these countries are still much more equal than Australia, Britain, New Zealand and Canada – and nearly twice as equal as the United States. Workforce participation rates are high in the Nordic nations but working hours remain within reasonable limits, enabling genuine work–life balance. Sweden has played a leading role in improving wellbeing, and lowering poverty, among children. Finland has achieved stunning success in schools since the 1990s. Denmark invests in comprehensive skills training as part of providing security, as well as flexibility, in people’s employment lives. Norway’s taxation approach and other measures ensure that its natural resources are used sustainably for the entire nation’s long-term wealth. All of these achievements are relevant to the policy choices for the future which Australia, and other English-speaking countries, can now make.

An empirical study on accountability for promoting healthy food environments in England through the public health responsibility deal food network

Objective: In 2011, the United Kingdom launched five Public Health Responsibility Deal Networks inspired by ‘nudge theory’ to facilitate healthy-lifestyle behaviors. This study used Q methodology to examine stakeholders’ views about responsibility and accountability for healthy food environments to reduce obesity and diet-related chronic diseases. Design: A purposive sample of policy elites (n=31) from government, academia, food industry and civil society sorted 48 statements grounded in three theoretical perspectives (i.e., legitimacy, nudge and public health law). Factor analysis identified intra-individual statement sorting differences. Results: A three-factor solution explained 64 percent of the variance across three distinct viewpoints: food environment protectors (n=17) underscored government responsibility to address unhealthy food environments; partnership pioneers (n=12) recognized government-industry partnerships as legitimate; and the commercial market defenders (n=1) emphasized individual responsibility for food choices and rejected any government intervention. Conclusions: Building trust and strengthening accountability structures may help stakeholders navigate differences to engage in constructive actions. This research may inform efforts in other countries where voluntary industry partnerships are pursued to address unhealthy food environments.

Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting

 Background: The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions.
Methods: The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health.
Results: In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making.
Conclusions: This study makes an important contribution to understanding how evidence is used within the public health LG context.

Opportunities and challenges in developing a whole-of-government national food and nutrition policy: lessons from Australia's National Food Plan

OBJECTIVE: The present article tracks the development of the Australian National Food Plan as a 'whole of government' food policy that aimed to integrate elements of nutrition and sustainability alongside economic objectives. DESIGN: The article uses policy analysis to explore the processes of consultation and stakeholder involvement in the development of the National Food Plan, focusing on actors from the sectors of industry, civil society and government. Existing documentation and submissions to the Plan were used as data sources. Models of health policy analysis and policy streams were employed to analyse policy development processes. SETTING: Australia. SUBJECTS: Australian food policy stakeholders. RESULTS: The development of the Plan was influenced by powerful industry groups and stakeholder engagement by the lead ministry favoured the involvement of actors representing the food and agriculture industries. Public health nutrition and civil society relied on traditional methods of policy influence, and the public health nutrition movement failed to develop a unified cross-sector alliance, while the private sector engaged in different ways and presented a united front. The National Food Plan failed to deliver an integrated food policy for Australia. Nutrition and sustainability were effectively sidelined due to the focus on global food production and positioning Australia as a food 'superpower' that could take advantage of the anticipated 'dining boom' as incomes rose in the Asia-Pacific region. CONCLUSIONS: New forms of industry influence are emerging in the food policy arena and public health nutrition will need to adopt new approaches to influencing public policy.

Place-based initiatives to tackle mature-age workers’ long-term unemployment in Australia, drawing on successful Nordic precedents

In order to tackle unemployment for the at-risk group of mature-age workers displaced by industry sector restructuring, exemplary place-based initiatives are needed focusing on a selected area of high disadvantage identified by Professor Tony Vinson’s 2015 Jesuit Social Services report Dropping off the Edge, with an Australian state government committed to supporting the initiative, as that report recommends. In order to make such a place-based initiative exemplary in its outcomes, so that it leads to uptake in other areas of high disadvantage, it needs to be thoroughly informed by successful Nordic precedents. In particular, the new Australian place-based initiative needs to be informed by Danish regionally-focused large-scale job skills programs involving transition into a proximate sector of employment growth; and by Norwegian measures for more even population distribution outside capital cities or in particular hard-hit regions within capital cities. An advantage of the proposed initiative is that it will also produce measurable results for children in families in which neither parent works, whose needs are normally tackled (if at all) by separate policy actions in separate tiers or departments of government. Australian children are disproportionately disadvantaged by the internationally extreme concentration of joblessness. Denmark’s Løntilskud and Virksomhedspraktik job training programs subsidised by municipalities and the national government, and supported by Danish trade unions, will be discussed in this paper for the positive effects they have for participants, including establishing or re-establishing unemployed people’s structured work habits and routines, improving their networks along with their social skills, and boosting their confidence. This paper will outline in detail the types of features the proposed new Australian place-based initiative will require, drawing on and drilling down further into data and analysis presented in the author’s recent book: Northern Lights: The Positive Policy Example of Sweden, Finland, Denmark and Norway.

Neoliberalism, economic restructuring and policy change: precarious housing and precarious employment in Australia

 Housing, employment and economic conditions in many nations have changed greatly over the past decades. This paper explores the ways in which changing housing markets, economic conditions and government policies have affected vulnerable individuals and households, using Australia as a case study. The paper finds a substantial number and proportion of low income Australians have been affected by housing and employment that is insecure with profound implications for vulnerability. Importantly, the paper suggests that in Australia the economic gains achieved as a consequence of mining-related growth in the early 2000s were translated as greater employment security for some on low incomes, but not all. Enhanced access to employment in this period was differentiated by gender, with women largely missing out on the growth in jobs. For the population as a whole, employment gains were offset by increased housing insecurity as accommodation costs rose. The paper finds low income lone parents were especially vulnerable because they were unable to benefit from a buoyant labour market over the decade 2000–2010. They were also adversely affected by national policy changes intended to encourage engagement with paid work. The outcomes identified for Australia are likely to have been mirrored in other nations, especially those that have embraced, or been forced to adopt, more restrictive welfare and income support regimes.