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Moving towards a new vision: implementation of a public health policy intervention

BACKGROUND: Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public’s health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced th...

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Autores principales: Valaitis, Ruta, MacDonald, Marjorie, Kothari, Anita, O’Mara, Linda, Regan, Sandra, Garcia, John, Murray, Nancy, Manson, Heather, Peroff-Johnston, Nancy, Bursey, Gayle, Boyko, Jennifer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869271/
https://www.ncbi.nlm.nih.gov/pubmed/27185039
http://dx.doi.org/10.1186/s12889-016-3056-3
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author Valaitis, Ruta
MacDonald, Marjorie
Kothari, Anita
O’Mara, Linda
Regan, Sandra
Garcia, John
Murray, Nancy
Manson, Heather
Peroff-Johnston, Nancy
Bursey, Gayle
Boyko, Jennifer
author_facet Valaitis, Ruta
MacDonald, Marjorie
Kothari, Anita
O’Mara, Linda
Regan, Sandra
Garcia, John
Murray, Nancy
Manson, Heather
Peroff-Johnston, Nancy
Bursey, Gayle
Boyko, Jennifer
author_sort Valaitis, Ruta
collection PubMed
description BACKGROUND: Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public’s health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced their implementation. This paper explores policy implementation in two exemplar public health programs -chronic disease prevention and sexually-transmitted infection prevention - in Ontario, Canada. It examines public health service providers’, managers’ and senior managements’ perspectives on the process of implementation of the Ontario Public Health Standards 2008 and factors influencing implementation. METHODS: Public health staff from six health units representing rural, remote, large and small urban settings were included. We conducted 21 focus groups and 18 interviews between 2010 (manager and staff focus groups) and 2011 (senior management interviews) involving 133 participants. Research assistants coded transcripts and researchers reviewed these; the research team discussed and resolved discrepancies. To facilitate a breadth of perspectives, several team members helped interpret the findings. An integrated knowledge translation approach was used, reflected by the inclusion of academics as well as decision-makers on the team and as co-authors. RESULTS: Front line service providers often were unaware of the new policies but managers and senior management incorporated them in operational and program planning. Some participants were involved in policy development or provided feedback prior to their launch. Implementation was influenced by many factors that aligned with Greenhalgh and colleagues’ empirically-based Diffusion of Innovations in Service Organizations Framework. Factors and related components that were most clearly linked to the OPHS policy implementation were: attributes of the innovation itself; adoption by individuals; diffusion and dissemination;the outer context – interorganizational networks and collaboration; the inner setting – implementation processes and routinization; and, linkage at the design and implementation stage. CONCLUSIONS: Multiple factors influenced public health policy implementation. Results provide empirical support for components of Greenhalgh et al’s framework and suggest two additional components – the role of external organizational collaborations and partnerships as well as planning processes in influencing implementation. These are important to consider by government and public health organizations when promoting new or revised public health policies as they evolve over time. A successful policy implementation process in Ontario has helped to move public health towards the new vision. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-016-3056-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-48692712016-05-18 Moving towards a new vision: implementation of a public health policy intervention Valaitis, Ruta MacDonald, Marjorie Kothari, Anita O’Mara, Linda Regan, Sandra Garcia, John Murray, Nancy Manson, Heather Peroff-Johnston, Nancy Bursey, Gayle Boyko, Jennifer BMC Public Health Research Article BACKGROUND: Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public’s health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced their implementation. This paper explores policy implementation in two exemplar public health programs -chronic disease prevention and sexually-transmitted infection prevention - in Ontario, Canada. It examines public health service providers’, managers’ and senior managements’ perspectives on the process of implementation of the Ontario Public Health Standards 2008 and factors influencing implementation. METHODS: Public health staff from six health units representing rural, remote, large and small urban settings were included. We conducted 21 focus groups and 18 interviews between 2010 (manager and staff focus groups) and 2011 (senior management interviews) involving 133 participants. Research assistants coded transcripts and researchers reviewed these; the research team discussed and resolved discrepancies. To facilitate a breadth of perspectives, several team members helped interpret the findings. An integrated knowledge translation approach was used, reflected by the inclusion of academics as well as decision-makers on the team and as co-authors. RESULTS: Front line service providers often were unaware of the new policies but managers and senior management incorporated them in operational and program planning. Some participants were involved in policy development or provided feedback prior to their launch. Implementation was influenced by many factors that aligned with Greenhalgh and colleagues’ empirically-based Diffusion of Innovations in Service Organizations Framework. Factors and related components that were most clearly linked to the OPHS policy implementation were: attributes of the innovation itself; adoption by individuals; diffusion and dissemination;the outer context – interorganizational networks and collaboration; the inner setting – implementation processes and routinization; and, linkage at the design and implementation stage. CONCLUSIONS: Multiple factors influenced public health policy implementation. Results provide empirical support for components of Greenhalgh et al’s framework and suggest two additional components – the role of external organizational collaborations and partnerships as well as planning processes in influencing implementation. These are important to consider by government and public health organizations when promoting new or revised public health policies as they evolve over time. A successful policy implementation process in Ontario has helped to move public health towards the new vision. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-016-3056-3) contains supplementary material, which is available to authorized users. BioMed Central 2016-05-17 /pmc/articles/PMC4869271/ /pubmed/27185039 http://dx.doi.org/10.1186/s12889-016-3056-3 Text en © Valaitis et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Valaitis, Ruta
MacDonald, Marjorie
Kothari, Anita
O’Mara, Linda
Regan, Sandra
Garcia, John
Murray, Nancy
Manson, Heather
Peroff-Johnston, Nancy
Bursey, Gayle
Boyko, Jennifer
Moving towards a new vision: implementation of a public health policy intervention
title Moving towards a new vision: implementation of a public health policy intervention
title_full Moving towards a new vision: implementation of a public health policy intervention
title_fullStr Moving towards a new vision: implementation of a public health policy intervention
title_full_unstemmed Moving towards a new vision: implementation of a public health policy intervention
title_short Moving towards a new vision: implementation of a public health policy intervention
title_sort moving towards a new vision: implementation of a public health policy intervention
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869271/
https://www.ncbi.nlm.nih.gov/pubmed/27185039
http://dx.doi.org/10.1186/s12889-016-3056-3
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