Hardy Lisa Jane, Wertheim Peter, Bohan Kyle, Quezada Julio Cesar, Henley Eric
Department of Anthropology, Interdisciplinary Health Policy Institute, Northern Arizona University, Flagstaff, AZ 86011, USA.
Health Promot Pract. 2013 Jul;14(4):514-23. doi: 10.1177/1524839912461253. Epub 2012 Nov 6.
Scholars and clinicians are increasingly recognizing the complexity of social contexts of health and the need for multifunctioning approaches to health care problems including community- and policy-level strategies. Barriers to change in health care policy can sometimes be attributed to the actions of advocacy coalitions who operate from a limited view of "policy change." Advocates have a tendency to pressure stakeholders to mandate laws as a final resolution of a movement, often leading to failure or, worse, stigmatizing of issues. A more inclusive focus on health policy change as an ongoing process increases the efficacy of advocacy and outcomes measurement. This article presents a tool for policy action that coalition members developed through the implementation of a 3-year grant to improve the safety net for preventing childhood obesity. Scholars and policy makers developed the Policy Coalition Evaluation Tool with the intent to create a model to guide and measure efforts and outcomes of a local community-based policy coalition. The authors suggest using community-based participatory research approaches for developing a coalition-specific Policy Coalition Evaluation Tool to increase the effectiveness of advocacy groups and the documentation of coalition activities over time.
学者和临床医生越来越认识到健康社会环境的复杂性,以及针对包括社区和政策层面策略在内的医疗保健问题采取多功能方法的必要性。医疗保健政策变革的障碍有时可归因于倡导联盟的行动,这些联盟从有限的“政策变革”视角开展运作。倡导者往往向利益相关者施压,要求将法律作为运动的最终解决方案,这往往导致失败,或者更糟糕的是,使问题受到污名化。将健康政策变革更全面地视为一个持续过程,会提高倡导的效力和成果衡量。本文介绍了一种政策行动工具,该工具是联盟成员通过实施一项为期三年的拨款开发的,旨在改善预防儿童肥胖的安全网。学者和政策制定者开发了政策联盟评估工具,目的是创建一个模型,以指导和衡量基于当地社区的政策联盟的努力和成果。作者建议采用基于社区的参与性研究方法,来开发针对特定联盟的政策联盟评估工具,以提高倡导团体的有效性,并随着时间推移记录联盟活动。