An Operational Approach to Policy Analysis: The Craft: Prescriptions for Better Analysis

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In the last two decades, PI has become increasingly recognized as an important public health issue. This section addresses five key characteristics that are integral to contextualizing PI as a public health issue. It then discusses how these characteristics affect perceptions and approaches to reducing PI and promoting physical activity.

Despite increasing efforts to promote physical activity, the prevalence of PI has remained rather stable in most developed nations [ 20 , 21 ]. It is even on the rise in developing nations because patterns of behavior similar to those in developed countries are being adopted such as urbanization, car ownership [ 22 ]. These dynamics have thrust the importance of engaging in physical activity onto the global stage and have resulted in newly formed partnerships and approaches to reduce PI [ 6 ].

The scope of fields in which PI might be reduced was expanded beyond sport and exercise to include a number of broader domains such as leisure-time, transportation, occupational work and household. These domains involve additional stakeholders and multiple sectors and levels of activities [ 25 ]. PI is attributed to a number of determinants. Among them are age, educational attainment demographic and biological factors , attitudes, enjoyment psychological factors , social support from family and peers social and cultural factors , and the availability of infrastructures and facilities physical environment factors [ 26 ].

Ecological models have been developed to cover the variety of, and interrelationships between, causal factors [ 27 ]. There exists a variety of evidence-based interventions to tackle the public health issue of PI [ 28 - 31 ]. They include individual and group-based interventions e. Reviews of these interventions do indicate that a number of different strategies might need to be combined in order to effectively promote physical activity [ 32 ].

There exists a substantial body of literature on the role of policy problems within the policy-making process.

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A major topic in this literature is agenda setting, in other words when and how do public issues become problems that are believed to require public action [ 33 , 34 ]. Another important discourse that has a strong social constructivist component pertains to policy problem definition, i. Several authors provide criteria for how to distinguish and characterize policy problem definitions [ 35 , 38 ]. However, this literature remains focused on the different perspectives various actors have on problems.

Such a perspective is interesting because it directs attention to potentially successful problem solutions. Characterizing policy problems is a two-stage process. Given the well-known relationship between implementing appropriate policy instruments and subsequent policy outcomes [ 15 ], further investigation of the second stage of policy problem definition seems to be crucial for both developing adequate theories about policies to counteract PI and for designing successful strategies for practical policy implementation.

To date, however, such an investigation is neither a major topic of interest amongst policy analysts nor is it featured in the public health literature. By applying these variables, we can begin to identify some general features that distinguish PI from other policy problems. As discussed below, contextual factors may contribute to the way that PI is defined as a policy problem in different regions or nations. However, we argue that some basic features that characterize PI as a policy problem are applicable in all political contexts, as they flow from the nature of the social phenomenon of PI rather than from contextual particularities.

Peters defines it as the degree to which policy problems can actually be solved.

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PI can be regarded as a chronic rather than an acute policy problem. In general, both national and supranational policies to counteract PI seem to have resulted in only modest increases in physical activity levels. For example, data gathered by the U. National Center for Health Statistics [ 21 ] indicate that sedentary lifestyles have remained virtually unchanged in the last 10 years. In addition, frequent calls for new policies in the area of PI underline the chronic nature of the policy problem [ 39 ]. As a result, much existing literature seems to support policy options that work to reduce PI rather than to eliminate it entirely.

According to Peters, chronic policy problems often result in two noteworthy consequences that affect successful policy implementation [ 15 ]. The first consequence pertains to sustainability, and refers to the need to develop policy procedures and monitoring that are able to deal with the policy problem on a long-term basis. Although national policies to counteract PI were developed in a number of countries in the last two decades, real-world time frames for policy implementation often remain rather short, and political efforts strongly vary over time.

For example, in a historic comparison of physical activity policies in Australia and seven other countries, Bellew et al. The second consequence pertains to the fact that such problems may require more than one type of solution.

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In order to address this, Peters suggests using policy instruments that are flexible and adaptable [ 15 ]. In addition, built-in evaluation and quality management tools may contribute to the flexibility of policy instruments. Daugbjerg et al. PI can be characterized as a policy problem with a high degree of political complexity because it involves a variety of sectors, actors and interests. For example, the benefits of maintaining an active lifestyle e.

These models are designed to address a large number of variables e. Thus, political and programmatic complexities of a policy problem might also interact. Arguments about the superiority of different multiple causation models might result in political struggles about which interventions should be used to promote physical activity. For example, some political actors might call for mass media campaigns to address psychological factors associated with physical activity behaviour.

Since the development of mass media campaigns might also reduce levels of inter-sectoral dependencies they are more easily developed by a single policy sector , such campaigns might be seen as appropriate.

Other political actors, however, might dispute the effectiveness of mass media campaigns and call instead for other kinds of programs. An important example is the CDC in the United States, which found evidence on the effectiveness of stand-alone mass media campaigns to promote physical activity to be insufficient [ 29 ] and recommended integrated community-based interventions with a focus on physical activity-friendly environments instead [ 28 ].

The consequences resulting from dealing with policies that maintain high levels of complexity coincide with consequences associated with other variables. High political complexity may also lead researchers to similar conclusions as those reached when analyzing causation. In this context, it may be adequate to apply multiple policy instruments to deal with the variety of variables that may be relevant for changing sedentary behaviour [ 15 ]. The question of scale refers to the degree to which a policy problem can be disaggregated into smaller components that are easier to deal with than the problem as a whole.

For example, the development of a physical activity-friendly environment does not require large spending at a single point in time but may be dealt with by various actors from different sectors and at different levels through multiple smaller budget allocations over an extended period of time.

For example, if a policy problem requires a collective solution i. With respect to PI, many interventions are targeted toward specific sub-populations. Another potential divisibility issue is that certain public initiatives to promote physical activity might yield benefits mostly for those who are already active e. The issue of divisibility of PI as a policy problem may also apply to potential collaboration and conflicts between different sectors, for example the sport and the health sector. Willingness of agencies to cooperate inter-sectorally may depend on the division of costs and benefits of potential actions between sectors.

Bercovitz describes how the launch of the Active Living policy by the Canadian government in the early s caused organizations from the fitness and amateur sport sector to become more involved in the health arena due to expected organizational benefits [ 43 ]. Conversely, Bellew et al. Many factors are known to impact physical activity behaviour, including value orientation. Value orientations are unlikely to be changed by allocating financial resources alone. Instead, they may require application of a mix of educational and other strategies. This dynamic renders the policy problem of PI more difficult to deal with.

Experience from community-based interventions illustrates the limited monetarization of PI. For example, public funding was an important aspect in BIG project, which targeted women in difficult life situations in a German city [ 41 ]. Financial support enabled women to take part in a cooperative process to plan physical activity programs, and low fees were an important prerequisite for many women to participate in physical activity classes. At the same time, however, there were important barriers to physical activity that could not be removed by simply spending money.

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For example, the mixed-gender policy at municipal swimming pools prevented many migrant women from swimming. This problem was eventually solved by altering pool access policies and creating women-only pool hours. If the number of actors involved is comparably small and if the behaviours to be influenced are not too complex, direct regulatory governmental interventions designed to solve the problem might be more successful than if the situation involved a larger number of actors individuals, organizations and sectors and behaviours.

As a consequence, the solution of policy problems with a broad scope of activity might call for policy instruments that are more sophisticated than ones like command-and-control regulations passed down by the government. In particular, multiple and flexible policy instruments like the ones already indicated above are likely to be appropriate in this context.

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The scope of activity involved in counteracting PI is considerable. As such, it may require the use and development of interventions that attempt to change behaviour in large segments of the population as well as in organizations from public, volunteer and private sectors. Indeed, governments tend to initiate a number of different actions to deal with the broad scope of activities involved in promoting physical activity.