Durand Mary Alison, Petticrew Mark, Goulding Lucy, Eastmure Elizabeth, Knai Cecile, Mays Nicholas
Policy Innovation Research Unit, Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Policy Innovation Research Unit, Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Health Policy. 2015 Nov;119(11):1506-14. doi: 10.1016/j.healthpol.2015.08.013. Epub 2015 Aug 24.
The Coalition Government's Public Health Responsibility Deal (RD) was launched in England in 2011 as a public-private partnership designed to improve public health in the areas of food, alcohol, health at work and physical activity. As part of a larger evaluation, we explored informants' experiences and views about the RD's development, implementation and achievements.
We conducted 44 semi-structured interviews with 50 interviewees, purposively sampled from: RD partners (businesses, public sector and non-governmental organisations); individuals with formal roles in implementing the RD; and non-partners and former partners. Data were analysed thematically: NVivo (10) software was employed to manage the data.
Key motivations underpinning participation were corporate social responsibility and reputational enhancement. Being a partner often involved making pledges related to work already underway or planned before joining the RD, suggesting limited 'added value' from the RD, although some pledge achievements (e.g., food reformulation) were described. Benefits included access to government, while drawbacks included resource implications and the risk of an 'uneven playing field' between partners and non-partners.
To ensure that voluntary agreements like the RD produce gains to public health that would not otherwise have occurred, government needs to: increase participation and compliance through incentives and sanctions, including those affecting organisational reputation; create greater visibility of voluntary agreements; and increase scrutiny and monitoring of partners' pledge activities.
联合政府的《公共卫生责任协议》(RD)于2011年在英格兰启动,是一项公私合作计划,旨在改善食品、酒精、工作场所健康和体育活动等领域的公众健康状况。作为一项更大规模评估的一部分,我们探讨了受访者对RD的发展、实施和成就的经历及看法。
我们对50名受访者进行了44次半结构化访谈,这些受访者是从RD合作伙伴(企业、公共部门和非政府组织)、在实施RD中担任正式职务的个人以及非合作伙伴和前合作伙伴中进行有目的抽样选取的。对数据进行了主题分析:使用NVivo(10)软件来管理数据。
参与的主要动机是企业社会责任和声誉提升。成为合作伙伴通常涉及做出与加入RD之前已经在进行或计划进行的工作相关的承诺,这表明RD的“附加值”有限,尽管描述了一些承诺的成果(例如食品配方改革)。好处包括与政府接触,而缺点包括资源问题以及合作伙伴与非合作伙伴之间“竞争环境不公平”的风险。
为确保像RD这样的自愿协议能给公众健康带来原本不会产生的收益,政府需要:通过激励措施和制裁,包括那些影响组织声誉的措施,来提高参与度和合规性;提高自愿协议的透明度;加强对合作伙伴承诺活动的审查和监督。