How does the Organisational and Policy Setting Facilitate and Inhibit Implementation of the Healthy Start Workforce Project?

Abstract

The Healthy Start Workforce Project aims to build the knowledge and capacity of the maternal and child health workforce in order to support women and young families to adopt healthier dietary and physical activity behaviours. This thesis was part of a process evaluation, to identify and understand how policy and organisational settings facilitate or inhibit the implementation of the Healthy Start Workforce Project. The literature review assessed other maternal and child health diet and physical activity workforce development interventions using the ANGELO framework, to identify the contextual factors evaluated. To assess the macro-level contextual drivers, the policy analysis identified key priority areas of the legislative, national and local policies. The relevant policies were then analysed against a nutrition and physical activity maternal and child health framework developed from the World Health Organisation Global Action Plan for the Prevention and Control of Noncommunicable diseases 2013–2020. The organisational analysis used a case study design to identify and understand the factors within the organisational environment. This included leadership support that facilitates or hinders the implementation of the Healthy Start Workforce Project. A review of the literature found that physical and sociocultural domains were assessed more than political and economic domains. Client-centred practice and the implementation of participatory community based approaches to achieve behaviour change in the areas of nutrition and physical activity are high priorities at both national and local levels. The policy analysis identified a ‘policy gap’ that exists for strategies to improve behaviour change skills training. The organisational analysis demonstrated that the Healthy Start Workforce Project philosophy aligns well with the mission of the organisations involved in maternal and child health care, and most were committed to and supportive of the project. However, translation of the new skills learnt during the training into policy and practice may be limited by organisational priorities and staff workload.