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Implementing health policy: lessons from the Scottish Well Mens policy initiative.

Douglas, Flora; van Teijlingen, Edwin; Smith, Cairns; Moffat, Mandy

Authors

Edwin van Teijlingen

Cairns Smith

Mandy Moffat



Abstract

Background: Little is known about how health professionals translate national government health policy directives into action. This paper examines that process using the so-called Well Men's Services (WMS) policy initiative as a ‘real world’ case study. The WMS were launched by the Scottish Government to address men's health inequalities. Our analysis aimed to develop a deeper understanding of policy implementation as it naturally occurred, used an analytical framework that was developed to reflect the ‘rational planning' principles health professionals are commonly encouraged to use for implementation purposes. Methods and materials: A mixed-methods qualitative enquiry using a data archive generated during the WMS policy evaluation was used to critically analyze (post hoc) the perspectives of national policy makers, and local health and social care professionals about the: (a) ‘policy problem’, (b) interventions intended to address the problem, and (c) anticipated policy outcomes. Results and conclusions: This analysis revealed four key themes: (1) ambiguity regarding the policy problem and means of intervention; (2) behavioral framing of the policy problem and intervention; (3) uncertainty about the policy evidence base and outcomes, and; (4) a focus on intervention as outcome. This study found that mechanistic planning heuristics (as a means of supporting implementation) fails to grapple with the indeterminate nature of population health problems. A new approach to planning and implementing public health interventions is required that recognises the complex and political nature of health problems; the inevitability of imperfect and contested evidence regarding intervention, and, future associated uncertainties.

Citation

DOUGLAS, F., VAN TEIJLINGEN, E., SMITH, C. and MOFFAT, M. 2015. Implementing health policy: lessons from the Scottish Well Mens policy initiative. AIMS public health [online], 2(4): addressing chronic disease prevention and tobacco control in the retail environment, pages 887-905. Available from: https://doi.org/10.3934/publichealth.2015.4.887

Journal Article Type Article
Acceptance Date Dec 11, 2015
Online Publication Date Dec 21, 2015
Publication Date Dec 31, 2015
Deposit Date Mar 12, 2021
Publicly Available Date Mar 12, 2021
Journal AIMS Public Health
Publisher AIMS Press
Peer Reviewed Peer Reviewed
Volume 2
Issue 4
Pages 887-905
DOI https://doi.org/10.3934/publichealth.2015.4.887
Keywords Policy implementation; Health inequalities; Men's health; Planning frameworks; Scotland
Public URL https://rgu-repository.worktribe.com/output/1255683

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