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Implementation Science
Published in: Implementation Science 1/2013

Open Access 01-12-2013 | Debate

Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behavior change ball

Authors: Anna-Marie Hendriks, Maria WJ Jansen, Jessica S Gubbels, Nanne K De Vries, Theo Paulussen, Stef PJ Kremers

Published in: Implementation Science | Issue 1/2013

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Abstract

Background

Childhood obesity is a ‘wicked’ public health problem that is best tackled by an integrated approach, which is enabled by integrated public health policies. The development and implementation of such policies have in practice proven to be difficult, however, and studying why this is the case requires a tool that may assist local policy-makers and those assisting them. A comprehensive framework that can help to identify options for improvement and to systematically develop solutions may be used to support local policy-makers.

Discussion

We propose the ‘Behavior Change Ball’ as a tool to study the development and implementation of integrated public health policies within local government. Based on the tenets of the ‘Behavior Change Wheel’ by Michie and colleagues (2011), the proposed conceptual framework distinguishes organizational behaviors of local policy-makers at the strategic, tactical and operational levels, as well as the determinants (motivation, capability, opportunity) required for these behaviors, and interventions and policy categories that can influence them. To illustrate the difficulty of achieving sustained integrated approaches, we use the metaphor of a ball in our framework: the mountainous landscapes surrounding the ball reflect the system’s resistance to change (by making it difficult for the ball to roll). We apply this framework to the problem of childhood obesity prevention. The added value provided by the framework lies in its comprehensiveness, theoretical basis, diagnostic and heuristic nature and face validity.

Summary

Since integrated public health policies have not been widely developed and implemented in practice, organizational behaviors relevant to the development of these policies remain to be investigated. A conceptual framework that can assist in systematically studying the policy process may facilitate this. Our Behavior Change Ball adds significant value to existing public health policy frameworks by incorporating multiple theoretical perspectives, specifying a set of organizational behaviors and linking the analysis of these behaviors to interventions and policies. We would encourage examination by others of our framework as a tool to explain and guide the development of integrated policies for the prevention of wicked public health problems.
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Metadata
Title
Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behavior change ball
Authors
Anna-Marie Hendriks
Maria WJ Jansen
Jessica S Gubbels
Nanne K De Vries
Theo Paulussen
Stef PJ Kremers
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2013
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-8-46

Other articles of this Issue 1/2013

Implementation Science 1/2013 Go to the issue

Research

Organizational factors associated with readiness to implement and translate a primary care based telemedicine behavioral program to improve blood pressure control: the HTN-IMPROVE study

Research

A qualitative analysis of a consensus process to develop quality indicators of injury care

Research

Developing program theory for purveyor programs

Study protocol

Systems intervention to promote colon cancer screening in safety net settings: protocol for a community-based participatory randomized controlled trial

Study protocol

Improving practice in community-based settings: a randomized trial of supervision – study protocol

Study protocol

Promoting state health department evidence-based cancer and chronic disease prevention: a multi-phase dissemination study with a cluster randomized trial component