Background
Methods
Study design
Search strategy
Identification of theories of the policy process
Application of theories of the policy process to obesity prevention
Inclusion of relevant studies
Quality assessment
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Credibility (truth value), which can be enhanced through the use of verbatim quotes, auditor or participant validation, or through the use of persistent observation.
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Dependability, which is enhanced through reporting details of data-sampling, -collection and -analysis that is logical and appropriate given the selected methodology. Furthermore, dependability is enhanced when the research is traceable by employed strategies such as peer review, debriefing, audit trails or triangulation.
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Confirmability, according to whether there was documentation of the researchers’ reflexivity to allow an assessment of the potential influence of their theoretical perspectives on the resulting presented findings; and
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Transferability, evaluating whether research findings are transferable to other specific settings through the provision of a ‘thick description’ of the research context.
Data extraction
Data synthesis
Results
Identification of theories of the policy process
Name of theory of the policy process | Alternative names identified in search |
---|---|
Advocacy Coalition Framework (ACF) | Advocacy Coalition Theory Sabatier |
Multiple Streams Theory (MST) | Multiple Streams Framework Multiple Streams Analysis Three Streams Model Three Streams Framework Kingdon’s Theory |
Punctuated Equilibrium Theory (PET) | Baumgartner and Jones' |
Institutional Analysis and Development (IAD) | Ostrum |
Institutional theory | Institutionalism Theory |
Garbage Can Model | |
Bacchi’s theory | What’s the problem represented to be? Bacchi’s approach |
Agenda setting theory | |
Incrementalism | |
Rational Choice Theory (RCT) | Rational Choice |
Actor Network Theory (ANT) | |
Policy Network Theory (PNT) | |
Theory of Collaborative Policy Networks | |
Marxism | |
Neo-liberalism | |
Diffusion of Innovations (DOI) | |
Narrative policy framework (NPF) | |
Policy Feedback Theory (PFT) | |
Social Construction Framework (SCF) | Social Construction Theory |
Application of theories of the policy process to obesity prevention
Author, year | Study setting | Policy level | Policy focus area | ‘Stages’ of policy processes investigated
(agenda setting, policy formulation, implementation; evaluation; or any combinations of the above)
| Design and methods | Study participant information | Critical appraisal ratinga | Other strengths/ limitations (e.g., sampling strategy; ethics approval) | |||
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Credibility
Do the findings represent the views of participant?
| Transferability
Were there contextual details provided?
| Dependability
Was the process logical, traceable?
|
Confirmability
Are findings qualitatively confirmable through an analysis of audit trail?
| ||||||||
Craig et al. 2010 [68] | Arkansas, United States of America (USA) | State level | Healthy eating environment policy Legislation to support healthy eating. The Act 1220 including the following components: • Child Health Advisory Committee (Education and Health representation). • Local regional schools PA and nutrition committee • State wide screening of BMI reporting back to parents • Vending machine legislation (restrictions) • Community health professionals within school setting | Stages of focus not specified however appears to focus on policy process stages leading to policy adoption (i.e., agenda setting and policy formulation) | Qualitative using secondary document data collected as part of a comprehend-sive evaluation of Arkansas Act 1220. Key informant interviews were also conducted with persons knowledge-eable of or involved in the passage of Act 1220. | No details were provided regarding study participants demo-graphics. | M | M | M-H | L | Secondary data source means that the theory did not inform the type of questions that were asked, potentially limiting what was able to be deduced. No details regarding ethics approval. |
Dodson et al. 2009 [69] | Multiple states across USA | State level policy making (across several states) | General childhood obesity prevention legislation. Not a specific policy or set of policies. | Stages of focus not specified however appears to focus on policy process stages leading to policy adoption (i.e., agenda setting and policy formulation) | Qualitative study using interviews | There were 16 participants from 11 states, from various political parties, their professional background and length of tenure within their organisation, and geographical area represented also varied. | H | M-H | M | L | This was not a study of a specific policy process but rather of obesity prevention policy processes generally. |
Freundenberg et al. 2015 [62] | Comparison of London and New York | Municipal level | Food policies, which included strategies to reduce obesity | Focused on election cycles providing opportunities for policies to be developed, and hence to stage of policy adoption only. | Document analysis | NA- document analysis | M | L-M | L | L | Secondary data source means that the theory did not inform the type of questions that were asked, potentially limiting what was able to be deduced. |
Gladwin et al. 2008 [70] | Alberta, Canada | Provincial and local (local school board networks) and individual school level. | Daily physical activity mandatory requirements in schools as well as policy processes relating to decisions to not adopt the walking to school bus program. | Stages of focus not specified however appears to focus on policy process stages leading to policy adoption (i.e., agenda setting and policy formulation) | Qualitative comparative study of case study of two policies. Collected interviews (primary data) and documents related to the policy (secondary data). | None provided. | M | L-M | M | L | Only four of the interviewees were from the provincial level. The remainder were with parents, health professionals or school board members. |
Gomez, 2015 [51] | Comparative study of USA and Brazil | National policy level | General obesity prevention policy. | Stages not specified however long term perspective allowed consideration of all aspects of the policy process (including feedback feeding into subsequent decision making) | Qualitative comparative case study drawing on secondary data sources of various documents (peer reviewed journal articles, government documents, and reports) | NA- document analysis | L | M | M | L | Secondary data source means that the theory did not inform the type of questions that were asked, potentially limiting what was able to be deduced. |
Houlihan et al. 2006 [52] | England, and Wales, United Kingdom (UK) | National policy level | Policy focused on incorporation of physical activity/sport into school curriculum | Not specified however the use of two ‘synthesis’ theories could potentially include all ‘stages’ | Qualitative study drawing on key informant interviews. | Nine participants in total, Including senior civil servants or senior members of interest/ professional organizations or senior academics. | M | M-H | L | L | No information regarding ethics approval. |
Khayesi et al. 2011 [71] | Curitiba, Brazil | State level policy | Transport sector policy to increase active transport (through car dependence reduction policies) | No stages specified | Historical case study utilising documents. Two key informants assisted to inform the selection process of documents but did not provide any primary data. | NA- Document analysis | L-M. | M | L-M | L | Secondary data source means that the theory did not inform the type of questions that were asked, potentially limiting what was able to be deduced. |
McBeth et al.2013 [72] | USA | Federal level policy | Obesity prevention policy generally | Agenda setting and the potential subsequent influence on policy formulation | Cross-sectional study documents (newspaper articles) using content analysis | NA- document analysis | H | H | H | L | Secondary data source means that the theory did not inform the type of questions that were asked, potentially limiting what was able to be deduced. |
Milton et al. 2015 [75] | England, UK | National level policy | Walking promotion policy | Stages of focus not specified however appears to focus on policy process stages leading to policy adoption (i.e., agenda setting and policy formulation) | Qualitative case study drawing on document analysis and interview | Participants included representatives from relevant government departments and not for profit organisations, as well as, several independent consultants and other known advocates. | H | H | H | L | Details of ethics approval provided. |
Mosier et al. 2013 [64] | USA, states of Colorado and Kansas | State level | Sales and excise tax policy on Sugar Sweetened Beverages (SSB) | Stages of focus not specified however appears to focus on policy process stages leading to policy adoption (i.e., agenda setting and policy formulation) | Qualitative comparative study, utilising observations, interviews and document analysis. | Nine individuals, involved in the policy processes were interviewed. No further details were reported. | M-H | M | M-H | L | No information regarding ethics approval. |
Olstad, et al. 2015 [73] | Canada | State and provincial level | School based physical activity policy (legislation, rules, requirements) | All stages of policy process (including implementation) | Historical multiple case study. Systematic document review was used (no interviews or observation) | NA- no interviews | H | H | H | L | Secondary data source means that the theory did not inform the type of questions that were asked, potentially limiting what was able to be deduced. |
Phillpots, 2012 [53] | England, United Kingdom | National policy | Sport and physical activity integration into school curriculum | All stages of policy process (including decision to cease the implemented policy) | Qualitative study design, drawing upon interviews, and document analysis. | Twenty-three interviewees from a range of government sport and education agencies who had been involved in the policy area for at least 5 years. | H | M | L-M | L | No information regarding ethics approval. |
Quinn et al. 2015 [65] | King County, Washington, USA | Local level | Non-regulatory nutritional guidelines for food and beverages sold in vending machines. | Stages of focus not specified however appears to focus on policy process stages leading to policy adoption (i.e., agenda setting and policy formulation) | Qualitative case study design, using focus group, interview, and document review methods. | Focus groups: local health department staff interviews: Local Board of Health members, local elected, municipal staff, department directors officials, health expert from across 5 local jurisdictions | M | L | M-H | L | Ethics was obtained and details of the duration and timing of the interviews were given. |
Reid and Thornburn 2011 [54] | Scotland, United Kingdom | National level | Physical education and activity policy | No stages specified, although clear focus on agenda setting | Field research involved key informant interviews | Participants from: various government departments (education, sport), local government sports development staff, relevant peak bodies, not for profit organizations, and politicians. | H | M-H | M-H | M-H | No information regarding ethics approval. |
Thow et al. 2014 [63] | Ghana | National Level | A food standards policy to limit the amount of fat in meat and meat cuts | All stages from agenda setting, formulation, adoption and evaluation | Mixed methods case study | Participants were policy makers, implement-ers, producers, processors and retailers and respresented numerous government departments and stakeholder groups/ organisations | M | H | M | L | Ethics was obtained. |
Ulmer et al. 2012 [74] | New Orleans, USA | State level | A Fresh Food Retailer policy Initiative | Stages of focus not specified however appears to focus on policy process stages leading to policy adoption (i.e., agenda setting and policy formulation) | Qualitative study using interviews | Participants were from various organizations and included city agency staff, city council members, grocers, representatives from trade associations and fınancial institutions, public health professionals, and food advocates. | L-M | L-M | L | L | No information regarding ethics approval. |
Yeatman, 2003 [76] | Australia | Local level policies (four case studies) | Food policy | Stages of focus not specified however appears to focus on policy process stages leading to policy adoption (i.e., agenda setting and policy formulation) | Case studies using interviews and document analysis | Participants included local food policy councils, local elected members and local government middle managers. | L-M | M | L | L | No information regarding ethics approval. |
Study characteristics
Policy location and government level
Policy area of focus
Quality of studies
Meta-themes from included studies
Author, year | Theory used | Influences on policy processes | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Coalition/ industry group lobbying | Political Institutions and political systems | Leadership of key individuals | Narrative and framing | Prevailing political ideology | Personal values & beliefs | Use of evidence | Timing | External socio-political (exogenous) factors | ||
Craig et al. 2010 [68] | Multiple Streams theory (MST) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
Dodson et al. 2009 [69] | MST | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
Freunen-berg et al. 2015 | MST and Advocacy Coalition Framework (ACF) | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
Gladwin et al. 2008 [70] | MST | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
Gomez 2015 [51] | Institutional theory | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
Houlihan et al. 2006 [52] | MST and ACF | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
Khayesi et al. 2011 [71] | MST | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
McBeth et al. 2013 [72] | Narrative Policy Framework | ✓ | ||||||||
Milton and Grix 2015 [75] | MST | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
Mosier et al. 2013 [64] | MST | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Olstad et al. 2015 [73] | Diffusion of innovations theory | ✓ | ✓ | ✓ | ✓ | |||||
Phillpots 2013 [53] | ACF | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
Quinn et al. 2015 [65] | MST | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
Reid and Thornburn 2011 [54] | MST | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
Thow et al. 2014 [63] | Health Policy Analysis Triangle | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |||
Ulmer et al. 2012 [74] | ACF | ✓ | ✓ | ✓ | ✓ | ✓ | ||||
Yeatman 2003 [76] | Agenda setting theory and MST | ✓ | ✓ | ✓ | ✓ |