@article{511e04a150914ac1a0fcf84e337e60d7,
title = "Evaluation of Health in All Policies: Concept, theory and application",
abstract = "This article describes some of the crucial theoretical, methodological and practical issues that need to be considered when evaluating Health in All Policies (HiAP) initiatives. The approaches that have been applied to evaluate HiAP in South Australia are drawn upon as case studies, and early findings from this evaluative research are provided. The South Australian evaluation of HiAP is based on a close partnership between researchers and public servants. The article describes the South Australian HiAP research partnership and considers its benefits and drawbacks in terms of the impact on the scope of the research, the types of evidence that can be collected and the implications for knowledge transfer. This partnership evolved from the conduct of process evaluations and is continuing to develop through joint collaboration on an Australian National Health & Medical Research Council grant. The South Australian research is not seeking to establish causality through statistical tests of correlations, but instead by creating a 'burden of evidence' which supports logically coherent chains of relations. These chains emerge through contrasting and comparing findings from many relevant and extant forms of evidence. As such, program logic is being used to attribute policy change to eventual health outcomes. The article presents the preliminary program logic model and describes the early work of applying the program logic approach to HiAP. The article concludes with an assessment of factors that have accounted for HiAP being sustained in South Australia from 2008 to 2013.",
keywords = "Health in All Policies, evaluation, policy, social determinants of health",
author = "Fran Baum and Angela Lawless and Toni Delany and Colin Macdougall and Carmel Williams and Danny Broderick and Deborah Wildgoose and Elizabeth Harris and Dennis McDermott and Ilona Kickbusch and Jennie Popay and Michael Marmot",
note = "Funding Information: Box 2. Key factors and actions that have contributed to HiAP remaining on the policy agenda since 2008 Problems: HiAP is promoted as a strategy to address complex (wicked) problems Initial residency and subsequent return visits of a high profile health theorist (Ilona Kickbusch) who promoted HiAP as a strategy to manage SA{\textquoteright}s rising rates of chronic disease, ageing population and resulting budgetary pressure, thereby, also giving this an international context. The current size of the health care budget and the projections for its growth were perceived as unsustainable and HiAP was positioned as an innovative means of reducing demand for health care. Policy: HiAP is positioned as an integral and integrated part of the SA policy context Executive Committee of Cabinet mandated the application of HiAP approaches across strategic projects linked to South Australia{\textquoteright}s Strategic Plan at the end of 2008. HiAP has been able to adapt to key policy drivers, such as whole of government policies, SASP and the Seven Cabinet Priorities (SASP is the acronym for the South Australian Strategic Plan. SASP is a key policy driver in SA, which includes measurable targets that reflect goals and priorities for SA. The Seven Cabinet Priorities focus Government work on key areas of importance and progress work to achieve SASP targets in these areas. Further information available at: http://saplan.org.au/, last accessed 28 April 2014) and, within the health sector, the SA Primary Prevention Plan and the Eat Well, Be Active Strategy. Links between HiAP, SA policy documents, broader state priorities and the international policy context are emphasized and regularly promoted by HiAP staff. HiAP requires only a small investment with the potential for a significant policy and health impact. The South Australian Public Health Act (June 2011) (For details see http://www.sahealth.sa.gov.au/publichealthact, last accessed 28 April 2014) containing provisions for the systematic integration of HiAP approaches and other mechanisms for embedding health considerations in State Government decision-making processes. The implementation of the South Australian Public Health Act mandates public health planning by local municipalities and the adoption of HiAP and other related mechanisms (e.g. HIA) within that sphere of government. Politics: HiAP is supported across Government HiAP is governed and supported by the Department of the Premier and Cabinet. HiAP initially received strong political support from the SA Premier partly because the recommendation came from the Thinkers in Residence program and it was directly related to the SASP. HiAP is more acceptable because it works within the existing structures of government rather than creating new structures. Focus of the HiAP work shifts with changing political circumstances in order to maintain relevance and currency. HiAP progresses and achievements are regularly promoted to high-level decision makers during events and briefings. Intended to maintain awareness of, and confidence in, the potential of a HiAP approach. Publisher Copyright: {\textcopyright} 2014 The Author.",
year = "2014",
month = jun,
day = "1",
doi = "10.1093/heapro/dau032",
language = "English",
volume = "29",
pages = "i130--i142",
journal = "Health Promotion International",
issn = "0957-4824",
publisher = "Oxford University Press",
}