The uptake of public health policies: The case of Eat Well Be Active

Anthony Chee Siong Leow (2011). The uptake of public health policies: The case of Eat Well Be Active PhD Thesis, School of Human Movement Studies, The University of Queensland.

       
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Author Anthony Chee Siong Leow
Thesis Title The uptake of public health policies: The case of Eat Well Be Active
School, Centre or Institute School of Human Movement Studies
Institution The University of Queensland
Publication date 2011-03
Thesis type PhD Thesis
Supervisor Professor Doune Macdonald
Dr. Louise McCuaig
Dr. Peter Hay
Total pages 469
Total colour pages 36
Total black and white pages 433
Subjects 11 Medical and Health Sciences
Abstract/Summary The enlistment of schools for health promotion purposes is not new and dates back to the mid 19th century. In recent times, the significance of schools as key locales for public health strategies aimed at producing healthy bodies has increased, given the close attention of policy makers. However, there is a paucity of research in Australia and worldwide studying the administration of public health policies in schools, in particular (i) the uptake of these policies within the health/education interface and (ii) how they impact the work of the educational staff in schools. Prompted by this dearth of research in policy implementation between the health/education interface, I undertook this research project to bridge the gap. While these school-based health policies are often planned by policymakers outside the schools’ locus of control, schools and their teachers are expected to be familiar with and able to implement these policies. However, insufficient attention has been paid by policymakers to the complexity of the policy enactment environments and the challenges schools face in responding to multiple policy (and other) demands and expectations simultaneously (S. Ball, 1997). A pertinent example of this policy dilemma faced by Queensland (Australia) schools is the demands made on them by both health and education policies i.e. the Eat Well Be Active (EWBA) policies and. the National Assessment Program for Literacy and Numeracy (NAPLAN). Thus, using the case study of the Queensland Government’s EWBA campaign targeting the achievement of healthy body weight among Queensland children and young people, I examined the uptake of public health policies by schools through the responses of the school administrators and teachers amidst their other academic concerns. In so doing, this study draws attention to the challenges of policy implementation situated within the health/education interface. In particular, it highlights the significant tensions between policymakers and policy implementers through the identification of shortcomings within the policy conception and power relations inherent within the implementation process of the EWBA Action Plan and its derivatives. The theoretical framework was an amalgam of poststructuralist (Foucault) and structuralist (Bernstein) theories. While Foucault’s work provides the tools to highlight the discursive positioning of subjects i.e. schools and teachers within the policy process in the neoliberal context, Bernstein enables connections to be made both within and outside of schools and more importantly between policy makers and policy implementers. Although originating from different research trajectories, taken together, the two theorists complement and enrich each other, offering persuasive theoretical perspectives in policy analysis as was in this case. Data were collected and analysed drawing on elements of critical, structuralist and post-structuralist research paradigms through critical discourse and discourse analyses of the EWBA policies and semi-structured interviews with school personnel (n=54) from 16 participating schools (8 state schools, 7 state high schools and 1 private school) with regard to the implementation of health-related policies in schools. In addition, five officials in leadership capacities within the Queensland Government hierarchy were interviewed to provide data from a policy-making perspective. The findings suggested that there was variability in the policies’ uptake, with some schools having more extensive implementation than others. This uptake was facilitated by strong leadership, staff support and access to external funding and resources. Barriers which deterred teachers from implementing the policies included the lack of time, insufficient funding, inadequate expertise and their focus on literacy and numeracy. Where there was policy fidelity in some case schools, policy subversions occurred in others. It was also revealed that when there were competing interests, teachers often gave primacy to numeracy and literacy over other policy demands e.g. mandated physical activity time for students. Both interviewees from schools and government departments underscored the difficulties in working with external partners in realising the objectives of the EWBA strategy. In theorising these findings using Bernstein’s theoretical constructs, the data illustrated why there was little policy fidelity despite the prescriptive tone and deterministic language within the text of the Smart policies (derivatives of the EWBA Action Plan). At the same time, the challenges in partnership work extolled by neo-liberal policies were explored through the appropriation of Bernstein’s concepts of vertical and horizontal discourses. While schools have demonstrated the potential to promote healthy living among students in the case of EWBA, policy makers need to contextualise their planning efforts and take account of the complex policy environments of schools. This finding has practical implications for policymakers in promoting healthy body weight in the school environment as it denotes that the best of intentions can be derailed by happenings outside the government’s locus of control. Theoretically, the framework employed in this study enhances the understanding of policy studies and may be transferable to the studying of public health policy implementation across a range of sites.
Keyword Bernstein
Foucault
Governmentality
Health and Physical Education
Health Promotion
Obesity Prevention
Nutrition
Pedagogic Device
Physical Activity
Policy Implementation
Additional Notes Pages to be printed in colour: 19, 33, 35, 37, 128, 213, 364, 424, 425, 427, 429-454 (Page numbers according to pdf file) Page to be printed in landscape: 178 (Page number according to pdf file)

 
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Created: Tue, 30 Aug 2011, 04:22:26 EST by Mr Anthony Chee Siong Leow on behalf of Library - Information Access Service