Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behavior change ball

Implementation Science

Stef PJ Kremers¹  Theo Paulussen²  Nanne K De Vries¹  Jessica S Gubbels¹  Maria WJ Jansen⁴  Anna-Marie Hendriks³ 

[1]Department of Health Promotion, NUTRIM, School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands

[2]TNO (Netherlands Organisation of Applied Scientific Research) Healthy Living, Leiden, The Netherlands

[3]Academic Collaborative Centre for Public Health Limburg, Regional Public Health Service, Geleen, The Netherlands

[4]Department of Health Services Research, Caphri, School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands

关键词: Local government;    Organizational change;    Behavior change;    Prevention;    Childhood obesity;    Health policy;    Integrated approach;    Intersectoral collaboration;    Conceptual framework;   

Others  :  813691
DOI  :  10.1186/1748-5908-8-46

 received in 2012-10-05, accepted in 2013-04-08,  发布年份 2013

【 摘 要 】

Background

Childhood obesity is a ‘wicked’ public health problem that is best tackled by an integrated approach, which is enabled by integrated public health policies. The development and implementation of such policies have in practice proven to be difficult, however, and studying why this is the case requires a tool that may assist local policy-makers and those assisting them. A comprehensive framework that can help to identify options for improvement and to systematically develop solutions may be used to support local policy-makers.

Discussion

We propose the ‘Behavior Change Ball’ as a tool to study the development and implementation of integrated public health policies within local government. Based on the tenets of the ‘Behavior Change Wheel’ by Michie and colleagues (2011), the proposed conceptual framework distinguishes organizational behaviors of local policy-makers at the strategic, tactical and operational levels, as well as the determinants (motivation, capability, opportunity) required for these behaviors, and interventions and policy categories that can influence them. To illustrate the difficulty of achieving sustained integrated approaches, we use the metaphor of a ball in our framework: the mountainous landscapes surrounding the ball reflect the system’s resistance to change (by making it difficult for the ball to roll). We apply this framework to the problem of childhood obesity prevention. The added value provided by the framework lies in its comprehensiveness, theoretical basis, diagnostic and heuristic nature and face validity.

Summary

Since integrated public health policies have not been widely developed and implemented in practice, organizational behaviors relevant to the development of these policies remain to be investigated. A conceptual framework that can assist in systematically studying the policy process may facilitate this. Our Behavior Change Ball adds significant value to existing public health policy frameworks by incorporating multiple theoretical perspectives, specifying a set of organizational behaviors and linking the analysis of these behaviors to interventions and policies. We would encourage examination by others of our framework as a tool to explain and guide the development of integrated policies for the prevention of wicked public health problems.

【 授权许可】

   
2013 Hendriks et al.; licensee BioMed Central Ltd.

【 图 表 】

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