Theories of the policy process in health promotion research: a review

The Ottawa Charter laid the ground work for a new research and practice agenda by urging health promoters to advocate for healthy public policies. After more than 20 years, it is now time to reflect on the state of policy research in health promotion and to examine how rigorously theories are applied. The review of the literature was
conducted on 11 peer-reviewed journals. The journals were selected for their solid track record in publishing health promotion articles and by using a set of predefined
inclusion and exclusion criteria. The articles, published between January 1986 and June 2006, were searched using Medline and CINAHL databases. The selected papers feature search terms related to ‘politics’, ‘policy’, ‘advocacy’ and ‘coalition’. We examined the theoretical grounding of each paper and whether it focuses on policy content (e.g. nature, impact, evolution of the policy), policy processes (e.g. advocacy capacity building and strategies) or theoretical/methodological issues in policy analysis. This review demonstrates that policy research in health promotion is still largely an a theoretical enterprise. Out of the 119 articles that were found eligible, 39 did apply to some degree a theoretical framework, of which 21 referred to a theoretical framework from political science. We conclude that the field has yet to acknowledge critical concepts that would help to shed light on the policy process, and that validated rigorous theoretical frameworks to inform research and practice are hardly applied. Recommendations are formulated to improve policy research in health promotion.

Multiplatform innovation and participatory citizenship : the Australian Broadcasting Corporation’s digital children’s television projects

This paper examines children’s multiplatform commissioning at the Australian Broadcasting Corporation (ABC) in the context of the digitalisation of Australian television. A pursuit of audience share and reach to legitimise its recurrent funding engenders a strategy that prioritises the entertainment values of the ABC’s children’s offerings. Nevertheless, these multiplatform texts (comprising complementary ‘on-air’ and ‘online’ textualities) evidence a continuing commitment to a youth-focussed, public service remit, and reflect the ABC’s Charter obligations to foster innovation, creativity, participation, citizenship, and the values of social inclusiveness. The analysis focuses on two recent ‘marquee’ drama projects, Dance Academy (a contemporary teen series) and My Place (a historical series for a middle childhood audience). The research draws on a series of research interviews, analysis of policy documents and textual analysis of the television and multiplatform content. The authors argue that a mixed diet of programming, together with an educative or social developmental agenda, features in the design of both program and online participation for the public broadcaster.

Healthy public in all policies

The introduction of the notion of ‘Healthy Public Policy’ in the Ottawa Charter is considered a relevant response to the emerging social-political context of the 1970s and 1980s. It also remains an important, yet volatile, argument for the consideration of policy impact on health. In our analysis, however, those that continued to argue for Healthy Public Policies and those who should develop them have remained naı¨ve about the profound political dimensions of this exercise. Applying insights from the political sciences, we argue that greater levels of connectedness and commitment across civil society, and governance integration between sectors and levels of politicking and action are required for the further success of health integrated policies. The role of communities and the key communicative drivers of the Ottawa Charter (enable, mediate and advocate) need to be strengthened in more astute strategies.

It's here! Are we ready? Five case studies of health promotion practices that address climate change from within Victorian health care settings

Issue addressed: Climate changes and environmental degradation caused by anthropogenic activities are having an irrefutable impact on human health. The critical role played by health promotion in addressing environmental challenges has a history in seminal charters − such as the Ottawa Charter for Health Promotion − that explicitly link human well-being with the natural environment. The lack of documented practice in this field prompted an investigation of health promotion practice that addresses climate change issues within health care settings.

Methods: This qualitative study involved five case studies of Victorian health care agencies that explicitly identified climate change as a priority. Individual and group interviews with ten health promotion funded practitioners as well as document analysis techniques were used to explore diverse practices across these rural, regional and urban health care agencies.

Results: Health promotion practice in these agencies was oriented toward: active and sustainable transport; healthy and sustainable food supply; mental health and community resilience; engaging vulnerable population groups such as women; and organisational development.

Conclusion: Despite differences in approach, target population and context, the core finding was that health promotion strategies, competencies and frameworks were transferable to action on climate change in these health care settings.

Health promotion and climate change : exploring the core competencies required for action

Climate change poses serious threats to human health and well-being. It exacerbates existing health inequities, impacts on the social determinants of health and disproportionately affects vulnerable populations. In the Australian region these include remote Aboriginal communities, Pacific Island countries and people with low incomes. Given health promotion’s remit to protect and promote health, it should be well placed to respond to emerging climate-related health challenges. Yet, to date, there has been little evidence to demonstrate this. This paper draws on the findings of a qualitative study conducted in Victoria, Australia to highlight that; while there is clearly a role for health promotion in climate change mitigation and adaptation at the national and international levels, there is also a need for the engagement of health promoters at the community level. This raises several key issues for health promotion practice. To be better prepared to respond to climate change, health promotion practitioners first need to re-engage with the central tenets of the Ottawa Charter, namely the interconnectedness of humans and the natural environment and, secondly, the need to adopt ideas and frameworks from the sustainability field. The findings also open up a discussion for paradigmatic shifts in health promotion thinking and acting in the context of climate change.

Conservation of urban historic districts in China : present models of integration and utilization of historic resources and challenges for authenticity

Chinese urban historic districts retain abundant urban traditional features, local characteristics and historic architecture. They not only gather and display urban cultural heritage but extend and develop urban historic culture and social traditions. In 1964 the “Venice Charter” expanded the concept and scope of historical and cultural heritage conservation from individual building heritage, historical sites comprising heritage buildings and historical environments to whole historic districts. At the same time, authenticity was adopted as a principle of heritage conservation. In 1994 the Nara Document on Authenticity confirmed that authenticity is of great importance to the conservation of cultural heritage. In 2003, “The Hoi An Declaration on Conservation of Historic Districts of Asia” reinforced the significance, integrity and authenticity of historic district conservation. In China, with the accelerated urbanization process and improved living conditions of urban residents, the unique values and historic and cultural heritage of historic districts is being destroyed. Considerable historic and cultural heritage has been reconstructed, leading to the loss of authenticity of these historic districts. This paper provides an overview of the Chinese situation. It highlights the problems and demonstrates a clear need to protect the authenticity of these historic districts. Authenticty is evaluated against various Chinese conservation of historic districts having regard to international experience and methods. As a result, it will be demonstrated that conservation modes of authenticity of urban historic districts in China and historic resources should be employed to ensure: 1) the restoration and conservation of historic architecture; 2) the preservation and renovation of old spaces and structures; 3) the integration and coordination of historic and new buildings; and the 4) the continuation and succession of historic culture and local tradition.

Have we really thought through health reform?

With all the discussion around about health care reform in Australia we are missing a fundamental issue about health and illness. They are not the same! There is a disconnect between the rhetoric of reform, the apparent political support for prevention and health promotion, and the realities of decisions being taken and understanding of the underlying assumptions of health determinants.Preventing ill health and promoting health have been seen as the point of departure for good health care, at least rhetorically, ever since the Alma Ata Declaration (1978) and the Ottawa Charter (1986). Australia along with other member states of the WHO is signatories to both and they have underpinned official health policy with a rhetorical flourish in many a document since.

Intellectual property rights in indigenous cultural heritage : basic concepts and continuing controversies

The developments at international level in the debate on what intellectual property (IP) lawyers refer to as traditional cultural expressions (TCEs) have to be seen in the context of the decolonisation movements after the Second World War. Post-war developments saw the formation of the United Nations (UN) and the emphasis on human rights in the UN Charter. With this emphasis came development programmes for indigenous peoples and the recognition of indigenous rights in the ILO Convention No. 107 of the 1957 Concerning the Protection and Intergration of Indigenous and Other Tribal and Semi-Tribal Populations in the Independant Countries. The decolonisation movements also initiated or renewed a parallel debate about the repatriation of items of cultural heritage. There was a remarkable shift in this discussion from 'cultural heritage of mankind' to cultural particularism and an emphasis on 'cultural property' ....

Recalling yesterday, predicting tomorrow : revisit South Australia conservation practice for heritage mining places, a practical guide for Malaysia

Mining started in South Australia in the early 1840s with the discovery of silver-lead ore at Glen Osmond in 1841 and later copper in Kapunda in 1842 and Burra in 1845; all these discoveries greatly contributed to South Australia's economic development. South Australia entered the mining era at the time when the Cornish engine was at the peak of its development, and the horizontal engine was beginning its rise in popularity. These South Australian historic mining sites contain extensive extant evidence of technology, innovation and human endeavours that previously went into the mining activity. This paper seeks to critically review items for inclusion on the South Australian State Heritage Register, the character of mining heritage places, enforcement by legislation, interpretation of the heritage assessment and how these practices could guide Malaysia in recognizing industrial heritage as a significant part of its cultural heritage that needs to be conserved, restored and managed as a legacy for present and future generations.

Factors associated with attributes of internal audit departments : a canonical analysis

This study explores internal audit (IA) practices in selected Ethiopian organizations to identify factors associated with attributes of IA departments. Analytical questionnaire survey responses of 188 IA directors and staff from Ethiopian government ministries, state-owned enterprises and private companies were used. Canonical analysis results show that IA proficiency, scope of IA work and quality of IA planning and execution are higher in organizations where organizational policy authorizing IA is clearly defined, organizational risk exposure is high and internal audit's linkage with external audit is strong. The findings suggest that in organizations that are exposed to high risk, management tends to appreciate IA's assistance in managing risk and thus strengthens IA. Results also suggest the importance of internal and external audit linkages and IA charter (or similar organizational policy) to strengthen IA. The study provides further evidence of differences in IA attributes between public and private sector entities.

'Ecological embeddedness' and its public health implications: findings from an exploratory study

Western culture over the last two centuries has become significantly ecologically 'dis-embedded', with nature increasingly reduced to resources for human use. The consequence is global environmental degradation, including accelerating climate change. Much recent research supports associations between nature contact and human health and well-being, and between feelings of nature-connectedness and pro-environmental attitudes and behaviours. The oft-cited Ottawa Charter for Health Promotion (WHO, Ottawa Charter for Health Promotion, 1986) emphasises human-environment inextricability; however public health discourse and response has not fully engaged with this recognition. This qualitative study explored the attitudes, motivations, and experiences-including formative influences-of six individuals whose behaviour was congruent with recognition of human-nature interconnectedness; such individuals may be understood as ecologically embedded. Key aspects of participants' experience, identified through grounded theory thematic analysis, were (i) connecting with nature (especially in childhood); (ii) seeing the threat and taking it personally; (iii) the nature of reality; (iv) dedicated beyond the ego-oriented self; and (v) sustaining the eco-centric self. The findings highlight the necessity for cross-sectoral advocacy at all levels of government policy development focused on recognition of human-environment connectedness, especially bridging health, planning and education policies affecting children. Only thus will both population health and ecological health on which population health depends be possible.

Are there news gaps in rural/regional Australia? Researching media plurality beyond Finkelstein

Rural/regional news is emerging as a vital area of media policy and research throughout the world as industry bodies, governments and academics grapple with debates concerning the future of news in a complex digital world. However, there has been little examination of media plurality at the rural/regional level, or research into the sustainability of the sector in Australia. Such concerns go to questions of what roles industry and government might play in ensuring its future. The Finkelstein report in 2012 noted that many rural/regional newspapers in Australia had limited resources and consequently low capacity for in-depth coverage of local issues. In the meantime, the funding model of the Australian Broadcasting Corporation (which services rural/regional areas as part of its charter) has come under intense scrutiny by the federal Liberal-National Party coalition government. Signs from abroad – especially from the United Kingdom – are troubling. Several independent inquiries have called for policy initiatives to address what British scholars describe as the growing “democratic deficit” created by the closure of hundreds of local UK newspapers since 2004. This paper canvasses current and emerging media policy settings in the UK, the United States and Australia before posing some broader questions on the future of rural/regional news in Australia.

Business strateBusiness strategies under conditions of uncertainty: The rise of mutual life insurers in colonial Australiagies under conditions of uncertainty

The early development of Australian life insurance was marked by the failure of stock companies to successfully establish a market presence. Mutual insurers emerged in the mid-nineteenth century in response to this gap in supply. The underlying rationale behind their establishment differed but the business model adopted proved remarkably successful. Mutual life insurers dominated the market for life insurance for nearly a century. This chapter investigates mutualism as a business strategy that addressed particular problems associated with doing business in a small and underdeveloped economy. Business and social networks were important facilitators of new business. In addition, most mutual life insurers had a social/philanthropic charter and they were able to utilize this to build business. An outcome of this mix was the emergence of a particular type of entrepreneurship that fostered innovative product development and cemented the role of mutual insurers as market leaders.. The Variety, Choice, Governance, and Regulation of Organizational Forms 2.

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Parcerias público-privadas em educação: novos arranjos na agenda internacional da educação

A intensificação das dinâmicas da globalização nas últimas décadas tem impulsionado a influência de organizações e redes globais de múltiplos atores que atuam no campo das políticas educacionais. O movimento de desterritorialização do fazer político abre espaço para iniciativas de natureza diversa, tanto do ponto de vista da sua esfera de atuação quanto dos atores envolvidos. No contexto dessas novas articulações, iniciativas marcadas pelo envolvimento do setor privado na educação pública têm se desenvolvido em um arranjo complexo referido como parcerias público-privadas em educação. A presente pesquisa analisa essas parcerias em educação, que surgem em um cenário de transformações no próprio funcionamento e organização dos Estados e nas relações que se estabelecem para além das suas fronteiras. Tendo em vista a complexidade do tema e a fim de investigar como ele se traduz e se desenvolve localmente, três experiências são analisadas com maior profundidade: o Chile, com seu sistema de escolas subvencionadas, os Estados Unidos, com as charter schools e a Holanda, que tem seu sistema educacional historicamente estruturado a partir do conceito de school choice. A partir da análise conceitual sobre as parcerias público-privadas em educação e do aprofundamento da pesquisa nesses casos representativos, esta dissertação busca problematizar esse arranjo nas politicas públicas de educação e evidenciar como o seu desenvolvimento está articulado com instituições e processos que transcendem o enquadramento dos Estados-Nação.