Australia and New Zealand health policy最新文献

{"title":"The rise and fall of Australian physical activity policy 1996 - 2006: a national review framed in an international context.","authors":"Bill Bellew,&nbsp;Stephanie Schöeppe,&nbsp;Fiona C Bull,&nbsp;Adrian Bauman","doi":"10.1186/1743-8462-5-18","DOIUrl":"https://doi.org/10.1186/1743-8462-5-18","url":null,"abstract":"<p><strong>Background: </strong>This paper provides an historical review of physical activity policy development in Australia for a period spanning a decade since the release of the US Surgeon General's Report on Physical Activity and Health in 1996 and including the 2004 WHO Global Strategy on Diet, Physical Activity and Health. Using our definition of 'HARDWIRED' policy criteria, this Australian review is compared with an international perspective of countries with established national physical activity policies and strategies (New Zealand, Canada, Brazil, Scotland, Switzerland, the Netherlands and Finland). Methods comprised a literature and policy review, audit of relevant web sites, document searches and surveys of international stakeholders.</p><p><strong>Results: </strong>All these selected countries embraced multi-strategic policies and undertook monitoring of physical activity through national surveys. Few committed to policy of more than three years duration and none undertook systematic evaluation of national policy implementation. This Australian review highlights phases of innovation and leadership in physical activity-related policy, as well as periods of stagnation and decline; early efforts were amongst the best in the world but by the mid-point of this review (the year 2000), promising attempts towards development of a national intersectoral policy framework were thwarted by reforms in the Federal Sport and Recreation sector. Several well received reviews of evidence on good practices in physical activity and public health were produced in the period but leadership and resources were lacking to implement the policies and programs indicated. Latterly, widespread publicity and greatly increased public and political interest in chronic disease prevention, (especially in obesity and type 2 diabetes) have dominated the framework within which Australian policy deliberations have occurred. Finally, a national physical activity policy framework for the Health sector emerged, but not as a policy vision that was inclusive of the other essential sectors such as Education, Transport, Urban Planning as well as Sport and Recreation.</p><p><strong>Conclusion: </strong>Despite some progression of physical activity policy in the decade since 1995/6, this review found inconsistent policy development, both in Australia and elsewhere. Arguably, Australia has done no worse than other countries, but more effective responses to physical inactivity in populations can be built only on sustainable multi-sectoral public health policy partnerships that are well informed by evidence of effectiveness and good practice. In Australia and elsewhere prerequisites for success are political support, long-term investment and commitment to program implementation and evaluation. An urgent priority is media and political advocacy for physical activity focussed on these factors.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2008-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-18","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27566754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaborative review of pilot projects to inform policy: A methodological remedy for pilotitis?","authors":"Pim Kuipers, John S Humphreys, John Wakerman, Robert Wells, Judith Jones, Philip Entwistle","doi":"10.1186/1743-8462-5-17","DOIUrl":"10.1186/1743-8462-5-17","url":null,"abstract":"<p><strong>Background: </strong>In rural health and other health service development contexts, there is frustration with a reliance on pilot projects as a means of informing policy and service innovation. There is also an emerging recognition that existing research methods do not draw lessons from the failed sustainability that characterises many of these pilots and demonstration projects.</p><p><strong>Discussion: </strong>This article describes critical aspects of the methodology of a successful collaborative, multi-method, systematic synthesis of exemplary primary health care pilot projects in rural and remote Australia, which synthesised principles from a number of pilot projects to inform policy makers and planners. Hallmarks of the method were: the nature of the source materials for the research, the subsequent research engagement with the actual pilot projects, the extent of collaboration throughout the study with end-users from policy and planning arenas, and the attention to procedural quality.</p><p><strong>Summary: </strong>The methodology, while time consuming, has resulted in applied, policy-relevant findings, and evidence of consideration by policy-makers.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2008-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27544515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using deliberative techniques to engage the community in policy development.","authors":"Judy Gregory,&nbsp;Janette Hartz-Karp,&nbsp;Rebecca Watson","doi":"10.1186/1743-8462-5-16","DOIUrl":"https://doi.org/10.1186/1743-8462-5-16","url":null,"abstract":"<p><strong>Background: </strong>This paper examines work in deliberative approaches to community engagement used in Western Australia by the Department of Planning and Infrastructure and other planning and infrastructure agencies between 2001 and 2005, and considers whether the techniques could be applied to the development of health policy in Australia.</p><p><strong>Results: </strong>Deliberative processes were used in WA to address specific planning and infrastructure problems. Using deliberative techniques, community participants contributed to joint decision making and policy development. Outcomes from deliberative processes were seriously considered by the Minister and used to influence policy decisions. In many cases, the recommendations generated through deliberative processes were fully adopted by the Minister.</p><p><strong>Conclusion: </strong>The experiences in WA demonstrate that deliberative engagement processes can be successfully implemented by government and can be used to guide policy. The techniques can be adapted to suit the context and issues experienced by a portfolio, and the skills required to conduct deliberative processes can be fostered amongst the portfolio's staff. Health policy makers may be able to learn from the experiences in WA, and adopt approaches to community engagement that allow for informed deliberation and debate in the community about the future of Australia's health system.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2008-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-16","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27540177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of draft Australian rehabilitation service standards: comparison with international standards.","authors":"Susan K Graham, Ian D Cameron, Hugh G Dickson","doi":"10.1186/1743-8462-5-15","DOIUrl":"10.1186/1743-8462-5-15","url":null,"abstract":"<p><strong>Background: </strong>Following her review of health systems and structures Dwyer 1 suggested that there is a need to evaluate models of care for individuals with chronic diseases. Rehabilitation services aim to optimise the activity and participation of individuals with restrictions due to both acute and chronic conditions. Assessing and optimising the standard of these services is one method of assuring the quality of service delivered to these individuals. Knowledge of baseline standards allows evaluation of the impact of health care reforms in this area of need. The aim of this article is to compare the currently available rehabilitation service standards in Australia with those used in the USA and the UK.</p><p><strong>Results: </strong>The mixed method qualitative analysis performed on the three sets of standards demonstrated repeatability and convergence via the use of triangulation. Australian Faculty of Rehabilitation Medicine (AFRM) standards were found to be consistent and concise, to provide definitions, and to cover the majority of clinically relevant issues to an extent similar to the other rehabilitation service standards. Inclusion of standards for business practices, the rehabilitation process for the person served, and outpatient and community-based rehabilitation services should be considered by the AFRM.</p><p><strong>Conclusion: </strong>The AFRM standards are an appropriate way of assessing rehabilitation services in Australia. As suggested by other workers 23 there should be ongoing review and field testing of the standards to maximise the relevance and utilisation of the standards.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":" ","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2008-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2474639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40434069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legal themes concerning obesity regulation in the United States: Theory and practice.","authors":"James G Hodge,&nbsp;Andrea M Garcia,&nbsp;Supriya Shah","doi":"10.1186/1743-8462-5-14","DOIUrl":"10.1186/1743-8462-5-14","url":null,"abstract":"<p><p> Despite national health objectives to reduce the incidence of obesity to 15% of the population by 2010, public health data suggest that the incidence of obesity in the United States is actually increasing. The U.S. recognizes that it (like other industrialized countries) faces an epidemic of obesity and related health conditions. How can U.S. jurisdictions (federal, state, and local) and the private sector respond to this epidemic through laws and policies that are directly or indirectly designed to address obesity? This article analyzes the theoretical and practical roles of law as a tool to curb obesity in the U.S. It proffers ten major legal themes to address obesity among the U.S. population, including: (1) use of incentives to encourage healthier behaviors; (2) use of financial disincentives to discourage unhealthy behaviors; (3) requirements to improve food quality, diversity, or availability; (4) compensation for injured persons seeking recourse; (5) restriction of access to unhealthy foods; (6) regulations aimed at influencing consumer choices; (7) control of marketing and advertising; (8) creation of communities that support healthy lifestyles; (9) physical education/fitness requirements; and (10) insurance coverage mandates.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":" ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2008-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40514051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity prevention: the role of policies, laws and regulations.","authors":"Boyd A Swinburn","doi":"10.1186/1743-8462-5-12","DOIUrl":"https://doi.org/10.1186/1743-8462-5-12","url":null,"abstract":"<p><p> The commercial drivers of the obesity epidemic are so influential that obesity can be considered a robust sign of commercial success - consumers are buying more food, more cars and more energy-saving machines. It is unlikely that these powerful economic forces will change sufficiently in response to consumer desires to eat less and move more or corporate desires to be more socially responsible. When the free market creates substantial population detriments and health inequalities, government policies are needed to change the ground rules in favour of population benefits.Concerted action is needed from governments in four broad areas: provide leadership to set the agenda and show the way; advocate for a multi-sector response and establish the mechanisms for all sectors to engage and enhance action; develop and implement policies (including laws and regulations) to create healthier food and activity environments, and; secure increased and continued funding to reduce obesogenic environments and promote healthy eating and physical activity.Policies, laws and regulations are often needed to drive the environmental and social changes that, eventually, will have a sustainable impact on reducing obesity. An 'obesity impact assessment' on legislation such as public liability, urban planning, transport, food safety, agriculture, and trade may identify 'rules' which contribute to obesogenic environments. In other areas, such as marketing to children, school food, and taxes/levies, there may be opportunities for regulations to actively support obesity prevention. Legislation in other areas such as to reduce climate change may also contribute to obesity prevention ('stealth interventions'). A political willingness to use policy instruments to drive change will probably be an early hallmark of successful obesity prevention.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2008-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27482675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic policy approach to changing the food system and physical activity environments to prevent obesity.","authors":"Gary Sacks,&nbsp;Boyd A Swinburn,&nbsp;Mark A Lawrence","doi":"10.1186/1743-8462-5-13","DOIUrl":"https://doi.org/10.1186/1743-8462-5-13","url":null,"abstract":"<p><p> As obesity prevention becomes an increasing health priority in many countries, including Australia and New Zealand, the challenge that governments are now facing is how to adopt a systematic policy approach to increase healthy eating and regular physical activity. This article sets out a structure for systematically identifying areas for obesity prevention policy action across the food system and full range of physical activity environments. Areas amenable to policy intervention can be systematically identified by considering policy opportunities for each level of governance (local, state, national, international and organisational) in each sector of the food system (primary production, food processing, distribution, marketing, retail, catering and food service) and each sector that influences physical activity environments (infrastructure and planning, education, employment, transport, sport and recreation). Analysis grids are used to illustrate, in a structured fashion, the broad array of areas amenable to legal and regulatory intervention across all levels of governance and all relevant sectors. In the Australian context, potential regulatory policy intervention areas are widespread throughout the food system, e.g., land-use zoning (primary production within local government), food safety (food processing within state government), food labelling (retail within national government). Policy areas for influencing physical activity are predominantly local and state government responsibilities including, for example, walking and cycling environments (infrastructure and planning sector) and physical activity education in schools (education sector). The analysis structure presented in this article provides a tool to systematically identify policy gaps, barriers and opportunities for obesity prevention, as part of the process of developing and implementing a comprehensive obesity prevention strategy. It also serves to highlight the need for a coordinated approach to policy development and implementation across all levels of government in order to ensure complementary policy action.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2008-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-13","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27482676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's law got to do with it part 1: A framework for obesity prevention.","authors":"Roger S Magnusson","doi":"10.1186/1743-8462-5-10","DOIUrl":"https://doi.org/10.1186/1743-8462-5-10","url":null,"abstract":"<p><p> This article provides a conceptual framework for thinking about the role of law in responding to population weight gain in Australia. Part 1 focuses on two core questions. Firstly, in pursuing the aim of weight reduction at the population level, what should law be trying to influence? The challenge here is to identify a model of the determinants of obesity that is adequate for legal purposes and that illustrates the entry points where law could best be used as an instrument of public health policy. Secondly, what kinds of strategies and tools can law offer to obesity prevention? The challenge here is to identify a model of law that captures the variety of contributions law is capable of making, at different levels of government, and across different legal systems.In Part 1 of the article, I argue that although law can intervene at a number of levels, the most important opportunities lie in seeking to influence the social, economic and environmental influences that shape patterns of eating and nutrition across the population as a whole. Only policies that impact broadly across the population can be expected to influence the weight distribution curve that has shifted relentlessly to the right in recent decades. Part 2 of the article builds on this analysis by offering a critical review of selected legal strategies for healthier nutrition and obesity prevention.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2008-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27482673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's law got to do with it Part 2: Legal strategies for healthier nutrition and obesity prevention.","authors":"Roger S Magnusson","doi":"10.1186/1743-8462-5-11","DOIUrl":"https://doi.org/10.1186/1743-8462-5-11","url":null,"abstract":"<p><p> This article is the second in a two-part review of law's possible role in a regulatory approach to healthier nutrition and obesity prevention in Australia. As discussed in Part 1, law can intervene in support of obesity prevention at a variety of levels: by engaging with the health care system, by targeting individual behaviours, and by seeking to influence the broader, socio-economic and environmental factors that influence patterns of behaviour across the population. Part 1 argued that the most important opportunities for law lie in seeking to enhance the effectiveness of a population health approach.Part 2 of this article aims to provide a systematic review of the legal strategies that are most likely to emerge, or are worth considering, as part of a suite of policies designed to prevent population weight gain and, more generally, healthier nutrition. While the impact of any one intervention may be modest, their cumulative impact could be significant and could also create the conditions for more effective public education campaigns. This article addresses the key contenders, with particular reference to Australia and the United States.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2008-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27482674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity: should there be a law against it? Introduction to a symposium.","authors":"Roger S Magnusson","doi":"10.1186/1743-8462-5-9","DOIUrl":"https://doi.org/10.1186/1743-8462-5-9","url":null,"abstract":"<p><p> The rapid rise in rates of overweight and obesity among adults and children in Australia and New Zealand has intensified debate about the most effective policies for obesity prevention. Law has much to contribute to this policy discussion, although its role is often misunderstood. The articles in this symposium follow on from a conference hosted in September 2006 by the Centre for Health Governance, Law & Ethics in the Faculty of Law, University of Sydney, titled: Obesity: should there be a law against it? In different ways, these articles provide a variety of perspectives on regulatory responses to obesity, including theoretical justifications for a legal approach, conceptual models that assist in making sense of law's role, as well as specific legal strategies for obesity prevention in various settings.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2008-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27482204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}