Appraising the Implementation of Complexity Approaches Within the Public Health Sector in Scotland. An Assessment Framework for Pre-Implementation Policy Evaluation
Complexity approaches have gained international attention as potentially effective strategies to address population health challenges. In light of this, the Scottish government (Scot. Gov.) set the implementation of these approaches as the recommended practice for its public health sector organizati...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2021.653588/full |
| _version_ | 1818736919409852416 |
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| author | Claudia Zucca Emily Long Jeremy Hilton Mark McCann |
| author_facet | Claudia Zucca Emily Long Jeremy Hilton Mark McCann |
| author_sort | Claudia Zucca |
| collection | DOAJ |
| description | Complexity approaches have gained international attention as potentially effective strategies to address population health challenges. In light of this, the Scottish government (Scot. Gov.) set the implementation of these approaches as the recommended practice for its public health sector organizations. This study evaluates the opportunity and feasibility of implementing complexity approaches in public health Scotland employees' everyday routine by employing a qualitative study that involves 20 stakeholders, representative of different organizations and roles. We made use of an assessment framework based on Soft Systems Methodology (SSm) and Normalization Process Theory (NPT) comprised of five phases: Phase One defines the boundaries, aims, and goals of the issue under study; Phase Two consists of data collection, drawing on the e-Health Implementation Toolkit (e-HIT); Phase Three involves short presentations and breakout group activities to provide information on the new policy; Phase Four employs system thinking tasks to structure debate and builds shared understanding among participants; Phase Five applies NPT to appraise the organizational position around complexity based on information from the preceding steps. We found two main obstacles to implementing complexity approaches: (1) a lack of a shared understanding of the key concepts in complexity and their practical implications; (2) stakeholders' fear of significant disruption to work routines and power relationships. We recommend addressing these issues with appropriate training and customization of goals and tools that may enable complexity approaches to succeed within the Scottish public health context. Our assessment framework allows the recognition of key mechanisms to support how Scotland's Public Health body can enhance the implementation of complexity approaches. The appraisal framework could be used to study early-stage policy implementation in other contexts. |
| first_indexed | 2024-12-18T00:44:48Z |
| format | Article |
| id | doaj.art-ec1fc4f4e80b4c56977beb1307618a12 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-18T00:44:48Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-ec1fc4f4e80b4c56977beb1307618a122022-12-21T21:26:47ZengFrontiers Media S.A.Frontiers in Public Health2296-25652021-09-01910.3389/fpubh.2021.653588653588Appraising the Implementation of Complexity Approaches Within the Public Health Sector in Scotland. An Assessment Framework for Pre-Implementation Policy EvaluationClaudia Zucca0Emily Long1Jeremy Hilton2Mark McCann3Jheronimus Academy of Data Science, Tilburg University, Tilburg, NetherlandsMRC/CSO Social and Public Health Sciences Unit (MRC), University of Glasgow, Glasgow, United KingdomSchool of Defence and Security, Cranfield University at the Defence Academy of the UK, Cranfield, United KingdomMRC/CSO Social and Public Health Sciences Unit (MRC), University of Glasgow, Glasgow, United KingdomComplexity approaches have gained international attention as potentially effective strategies to address population health challenges. In light of this, the Scottish government (Scot. Gov.) set the implementation of these approaches as the recommended practice for its public health sector organizations. This study evaluates the opportunity and feasibility of implementing complexity approaches in public health Scotland employees' everyday routine by employing a qualitative study that involves 20 stakeholders, representative of different organizations and roles. We made use of an assessment framework based on Soft Systems Methodology (SSm) and Normalization Process Theory (NPT) comprised of five phases: Phase One defines the boundaries, aims, and goals of the issue under study; Phase Two consists of data collection, drawing on the e-Health Implementation Toolkit (e-HIT); Phase Three involves short presentations and breakout group activities to provide information on the new policy; Phase Four employs system thinking tasks to structure debate and builds shared understanding among participants; Phase Five applies NPT to appraise the organizational position around complexity based on information from the preceding steps. We found two main obstacles to implementing complexity approaches: (1) a lack of a shared understanding of the key concepts in complexity and their practical implications; (2) stakeholders' fear of significant disruption to work routines and power relationships. We recommend addressing these issues with appropriate training and customization of goals and tools that may enable complexity approaches to succeed within the Scottish public health context. Our assessment framework allows the recognition of key mechanisms to support how Scotland's Public Health body can enhance the implementation of complexity approaches. The appraisal framework could be used to study early-stage policy implementation in other contexts.https://www.frontiersin.org/articles/10.3389/fpubh.2021.653588/fullhealth policypopulation health managementcomplexitysystems theorypolicy makingorganizational behavior |
| spellingShingle | Claudia Zucca Emily Long Jeremy Hilton Mark McCann Appraising the Implementation of Complexity Approaches Within the Public Health Sector in Scotland. An Assessment Framework for Pre-Implementation Policy Evaluation Frontiers in Public Health health policy population health management complexity systems theory policy making organizational behavior |
| title | Appraising the Implementation of Complexity Approaches Within the Public Health Sector in Scotland. An Assessment Framework for Pre-Implementation Policy Evaluation |
| title_full | Appraising the Implementation of Complexity Approaches Within the Public Health Sector in Scotland. An Assessment Framework for Pre-Implementation Policy Evaluation |
| title_fullStr | Appraising the Implementation of Complexity Approaches Within the Public Health Sector in Scotland. An Assessment Framework for Pre-Implementation Policy Evaluation |
| title_full_unstemmed | Appraising the Implementation of Complexity Approaches Within the Public Health Sector in Scotland. An Assessment Framework for Pre-Implementation Policy Evaluation |
| title_short | Appraising the Implementation of Complexity Approaches Within the Public Health Sector in Scotland. An Assessment Framework for Pre-Implementation Policy Evaluation |
| title_sort | appraising the implementation of complexity approaches within the public health sector in scotland an assessment framework for pre implementation policy evaluation |
| topic | health policy population health management complexity systems theory policy making organizational behavior |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2021.653588/full |
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