Systems thinking in local government: intervention design and adaptation in a community-based study.

BACKGROUND: Systems thinking approaches are increasingly being used by communities to address complex chronic disease. This paper reports on the VicHealth Local Government Partnership (VLGP) which sought to co-create improvements in the health and well-being of children and young people by working with local government in Victoria, Australia. METHODS: The VLGP included a series of health promotion modules, aimed at creating policy, programme and practice changes across local government. One of these modules, Connecting the Dots - creating solutions for lasting change, aimed to build capacity for systems thinking in municipal public health and well-being planning across 13 councils. The approach was adapted and data were collected on the stimuli for, and results of, adaptation. RESULTS: The council adapted the systems thinking approach to meet geographic characteristics, priority health issue/s and participant target group needs. Adaptions applied to workshop materials, training delivery, existing and new resources, and to align with other community-based approaches. Stimuli for adaptation included the COVID-19 pandemic, needs of children and young people, capacity of council to deliver the workshop series, and time available within the project or for the participant group. CONCLUSIONS: Systems thinking was used and adapted by councils to improve the health and well-being of children and young people and increase the voices of children and young people in decision-making. Flexible delivery is critical to ensure communities can adapt the approach to meet local needs.

School-Based Education: An Opportunity to Promote Equitable Access to Sexual and Reproductive Health Knowledge.

All young people are entitled to knowledge and support that protects their sexual and reproductive health. School-based education is the most opportune setting for young people to have equitable access to sexual and reproductive health education. However, there is room for significant improvements in the provision of sexual and reproductive health education globally, and a range of barriers to be addressed. The Global Standards for Health Promoting Schools is a framework for governments, policy-makers, and schools to ensure that all students receive sexual and reproductive health education and support that promotes their sexual and reproductive health and overall health and well-being. The Global Standards for Health Promoting Schools acknowledges that school environments, partnerships, governance, policies, and resources are ultimately influenced by government resources and policy, and that advocacy and meaningful action across each standard is required.

Setting Preconception Care Priorities in Australia Using a Delphi Technique.

Preconception health affects fertility, pregnancy, and future health outcomes but public awareness of this is low. Our aims were to rank priorities for preconception care (PCC), develop strategies to address these priorities, and establish values to guide future work in preconception healthcare in Australia. A Delphi technique involved two rounds of online voting and mid-round workshops. Inputs were a scoping review of PCC guidelines, a priority setting framework and existing networks that focus on health. During July and August, 2021, 23 multidisciplinary experts in PCC or social care, including a consumer advocate, completed the Delphi technique. Ten priority areas were identified, with health behaviors, medical history, weight, and reproductive health ranked most highly. Six strategies were identified. Underpinning values encompassed engagement with stakeholders, a life course view of preconception health, an integrated multi-sectorial approach and a need for large scale collaboration to implement interventions that deliver impact across health care, social care, policy and population health. Priority populations were considered within the social determinants of health. Health behaviors, medical history, weight, and reproductive health were ranked highly as PCC priorities. Key strategies to address priorities should be implemented with consideration of values that improve the preconception health of all Australians.

Facilitators to healthy canteen policy implementation: A qualitative approach.

ISSUE ADDRESSED: Governments across the world use guidelines and policy to support improving the quality and nutrition in school canteens, yet little is known about what makes for success in supporting school canteens. This study aimed to investigate the factors influencing the implementation of a healthy school canteen policy. METHODS: A qualitative descriptive approach using interviews with a purposive sample of Victorian schools that had successfully implemented a healthy school canteen was conducted. Twelve interviews were conducted with principals (n = 4), assistant principal (n = 1), canteen managers (n = 5), food services manager (n = 1) and canteen staff members (n = 3) across six Victorian schools. Data were analysed using a content analysis approach. RESULTS: Three key themes explained the adoption of policy: Values - emphasising service over profit; Knowledge - understanding of nutrition and the policy; and Support - from within and external to the school. CONCLUSIONS: Implementation of school canteen policy is more likely to be achieved when a school can focus on the service and educative component of the policy and where there is a shared priority for healthy eating across the entire school community. SO WHAT?: Creating a culture of service and community engagement with a healthy school canteen may increase policy implementation and should be the focus of future health promotion efforts.