Rosewarne Emalie, Moore Michael, Chislett Wai-Kwan, Jones Alexandra, Trieu Kathy, Webster Jacqui
The George Institute for Global Health, The University of New South Wales, Sydney, NSW, 2006, Australia.
Health Res Policy Syst. 2021 Jul 15;19(1):100. doi: 10.1186/s12961-021-00759-1.
Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP's advocacy strategy in achieving policy change.
Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the Kotter Plus 10-step public health advocacy evaluation framework was used to guide data extraction, analysis, and synthesis.
A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction programme. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established, but communication of the vision to decision-makers was lacking, which reduced the impact of the programme as decision-makers were not provided with a clear incentive for policy change. As a result, while programme outputs were achieved, these did not translate to achieving broader strategic goals during a limited-term intervention in a political climate unconcerned with salt.
The Kotter Plus 10-step framework was a useful tool for evaluating the success of the VSRP advocacy strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within partnerships and to decision-makers, to better influence policy and improve public health impact.
公共卫生倡导策略通过将关键健康问题置于公共和政治讨论的前沿、影响决策者和公众舆论以及增加政策需求来推动政策变革。维多利亚州减盐伙伴关系（VSRP）于2014年成立，以应对澳大利亚政府在改善民众饮食方面行动不足的问题。本研究旨在评估VSRP倡导策略在实现政策变革方面的成效。
收集了VSRP活动和产出的文件，并作为全面过程评估的一部分进行了半结构化访谈。在本研究中，采用科特加10步公共卫生倡导评估框架来指导数据提取、分析和综合。
通过提供证据并概述基于州的减盐计划的潜在影响，营造了对减盐的紧迫感。这促成了一个由具备不同技能和专业知识的人组成的联盟的形成，该联盟推动了一项创新且协作的倡导行动计划的制定。确立了明确的变革愿景，但缺乏向决策者传达该愿景的工作，这降低了该计划的影响力，因为决策者没有得到政策变革的明确激励。结果，虽然实现了计划产出，但在对盐问题漠不关心的政治环境下进行的有限期干预期间，这些产出并未转化为实现更广泛战略目标的成果。
科特加10步框架是评估VSRP倡导策略成效的有用工具。该框架有助于识别关键优势，包括指导联盟的创建，以及未来类似策略中可以改进努力的领域，例如在伙伴关系内部以及与决策者进行有效沟通，以更好地影响政策并改善对公众健康的影响。
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