Playing the policy game: a review of the barriers to and enablers of nutrition policy change
Playing the policy game: a review of the barriers to and enablers of nutrition policy change
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DOI：
10.1017/s1368980016000677
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发表时间：
2016-10-01
影响因子：
3.2
通讯作者：
Gallegos, Danielle
中科院分区：
文献类型：
--
作者：
Cullerton, Katherine;Donnet, Timothy;Gallegos, Danielle
目的：为了推进营养政策改革并培养更有效的倡导者，考虑现实世界的因素和过去倡导工作的实际经验，以确定营养政策改革的主要障碍和推动因素，是有益的。本审查的目的是确定和综合的使能因素和障碍，公共政策的变化在领域内的nutrition.Design：电子数据库进行了系统的研究，研究公共卫生营养的政策制定。A interpretive synthesis was carried out.Setting：国际，国家，州和地方政府的管辖范围内的高收入，democratic countries.Results：63项研究被选中纳入。确定了许多主题，解释了政策变革的障碍和推动因素，所有这些主题都属于“政治意愿”这一最重要的类别，第二个主要类别是“公共意愿”。分主题，包括来自行业的压力，新自由主义的意识形态，使用的情感和价值观，并被可见，普遍在描述之间的联系，公共意愿，政治意愿和政策changes.Conclusions：缺乏公共政策改变营养的挫折感往往源于一种信念，即政策制定是一个理性的过程中，证据是用来评估的相对成本和效益的选择。本次审查的结果证实，证据只是影响政策变化的一个组成部分。要改变政策，就必须有政治意愿，而且往往是公众意愿，以解决拟议的政策问题和解决办法。审查提出了一套使能手段，可协助卫生专业人员在今后的宣传工作中影响政治和公众意愿。
Objective: To progress nutrition policy change and develop more effective advocates, it is useful to consider real-world factors and practical experiences of past advocacy efforts to determine the key barriers to and enablers of nutrition policy change. The present review aimed to identify and synthesize the enablers of and barriers to public policy change within the field of nutrition.Design: Electronic databases were searched systematically for studies examining policy making in public health nutrition. An interpretive synthesis was undertaken.Setting: International, national, state and local government jurisdictions within high-income, democratic countries.Results: Sixty-three studies were selected for inclusion. Numerous themes were identified explaining the barriers to and enablers of policy change, all of which fell under the overarching category of 'political will', underpinned by a second major category, 'public will'. Sub-themes, including pressure from industry, neoliberal ideology, use of emotions and values, and being visible, were prevalent in describing links between public will, political will and policy change.Conclusions: The frustration around lack of public policy change in nutrition frequently stems from a belief that policy making is a rational process in which evidence is used to assess the relative costs and benefits of options. The findings from the present review confirm that evidence is only one component of influencing policy change. For policy change to occur there needs to be the political will, and often the public will, for the proposed policy problem and solution. The review presents a suite of enablers which can assist health professionals to influence political and public will in future advocacy efforts.