Beyond fun runs and fruit bowls: an evaluation of the meso-level processes that shaped the Australian Healthy Workers Initiative
Anne C. Grunseit A D , Samantha Rowbotham A B , Melanie Pescud C , Devon Indig A and Sonia Wutzke A BA The Australian Prevention Partnership Centre, Level 6, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
B Menzies Centre for Health Policy, Level 6, Charles Perkins Centre, University of Sydney, NSW 2006, Australia.
C School of Regulation and Global Governance (RegNet), ANU College of Asia and the Pacific, Coombs Extension Building, Building 8, Fellows Road, Australian National University, Canberra, ACT 0200, Australia.
D Corresponding author. Email: anne.grunseit@sydney.edu.au
Health Promotion Journal of Australia 27(3) 251-258 https://doi.org/10.1071/HE16049
Submitted: 6 May 2016 Accepted: 26 August 2016 Published: 13 October 2016
Abstract
Issue addressed: The Australian National Partnership Agreement on Preventive Health (NPAPH) charged states and territories with the development and implementation of the Healthy Workers Initiative (HWI) to improve workplace health promotion. Most evaluation efforts focus on the setting (micro) level. In the present study the HWI at the meso-level (state program development) was examined to understand how jurisdictions navigated theoretical, practical, and political priorities to develop their programs, and the programmatic choices that support or hinder perceived success.
Methods: Interviews with HWI program coordinators and managers across seven Australian jurisdictions explored decision-making processes related to developing and implementing the HWI and the impact of defunding. Interviews were audio-recorded, transcribed and analysed using thematic analysis.
Results: Despite taking a variety of approaches to the HWI, jurisdictions had common goals, namely achieving sustainability and capacity for meaningful change. These goals transcended the performance indicators set out by the NPAPH, which were considered unachievable in the given timeframe. Four ways jurisdictions sought to achieve their goals were identified, these were: 1) taking an embedded approach to workplace health promotion; 2) ensuring relevance of the HWI to businesses; 3) engaging in collaborative partnerships with agencies responsible for implementation; and 4) cultivating evolution of the HWI.
Conclusions: This meso-level evaluation has provided valuable insights into how health promotion program coordinators translate broad, national-level initiatives into state-specific programs and how they define program success. The study findings also highlight how broader, contextual factors, such as jurisdiction size, political imperatives and funding decisions impact on the implementation and success of a national health promotion initiative.
So what?: When evaluating the translation of complex initiatives, a meso-level analysis can reveal valuable principles for informing program effectiveness and sustainability. It can also identify alignment between macro- and meso-level goals and where macro-level specifications may hinder or assist those goals.
Key words: health promotion, policy, preventive health, workplace health.
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