Intelligent policy making? Key actors' perspectives on the development and implementation of an early years' initiative in Scotland’s public health arena

Deas, Leigh and Mattu, Leanne and Gnich, Wendy (2013) Intelligent policy making? Key actors' perspectives on the development and implementation of an early years' initiative in Scotland’s public health arena. Social Science and Medicine, 96. pp. 1-8. ISSN 0277-9536 (https://doi.org/10.1016/j.socscimed.2013.07.001)

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Abstract

Increased political enthusiasm for evidence-based policy and action has re-ignited interest in the use of evidence within political and practitioner networks. Theories of evidence-based policymaking and evidence-based practice are being re-considered in an attempt to better understand the processes through which knowledge translation occurs. Understanding the mechanisms through which policy is developed, and how practice results, is essential to ensuring effective evidence use. Nonetheless, a paucity of studies exploring the factors which shape healthcare delivery and their relative influence in different contexts remains. This paper explores the processes involved in the conceptualisation and delivery of a complex intervention in Scotland's National Health Service (NHS) setting. It uses a national oral health programme for children (Childsmile) as an illustrative case, drawing upon key actors' perceptions of the absolute and relative influence of different drivers (evidence, policy and practitioner experience) to the development of the initiative. Framework analysis is used to thematically analyse documentary evidence and stakeholder accounts gathered through bespoke, in-depth interviews. Findings suggest that Childsmile can be viewed as an example of an 'evidence-informed' intervention, blending available research evidence with knowledge from practitioner experience and continual learning through evaluation, to plan delivery. The importance of context was underscored, both in terms of the need to align with prevailing political ideology and in the facilitative strength of networks within the relatively small public health community in Scotland. Key actors' perceptions were found to support several existing theoretical models of translation. There are sufficient grounds to conclude that Childsmile is an example of 'intelligent policy making' (Sanderson, 2009), giving reason to be optimistic about the current model of policymaking and healthcare delivery in Scotland.

ORCID iDs

Deas, Leigh, Mattu, Leanne ORCID logoORCID: https://orcid.org/0000-0002-1969-2241 and Gnich, Wendy;
CORE (COnnecting REpositories)