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

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

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
• Electronic ISSN: 2327-8994
• 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