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Cited by 68Public Health Policies and EducationHealth Policy Implementation ScienceGlobal Public Health Policies and Epidemiology

Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behavior change ball

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Hendriks, Anna-Marie, Jansen, Maria WJ, Gubbels, Jessica S, De Vries, Nanne K, Paulussen, Theo, Kremers, Stef PJ·2013·Implementation Science
DOI 10.1186/1748-5908-8-46PMC PMC3637591
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Abstract

BACKGROUND: Childhood obesity is a 'wicked' public health problem that is best tackled by an integrated approach, which is enabled by integrated public health policies. The development and implementation of such policies have in practice proven to be difficult, however, and studying why this is the case requires a tool that may assist local policy-makers and those assisting them. A comprehensive framework that can help to identify options for improvement and to systematically develop solutions may be used to support local policy-makers. DISCUSSION: We propose the 'Behavior Change Ball' as a tool to study the development and implementation of integrated public health policies within local government. Based on the tenets of the 'Behavior Change Wheel' by Michie and colleagues (2011), the proposed conceptual framework distinguishes organizational behaviors of local policy-makers at the strategic, tactical and operational levels, as well as the determinants (motivation, capability, opportunity) required for these behaviors, and interventions and policy categories that can influence them. To illustrate the difficulty of achieving sustained integrated approaches, we use the metaphor of a ball in our framework: the mountainous landscapes surrounding the ball reflect the system's resistance to change (by making it difficult for the ball to roll). We apply this framework to the problem of childhood obesity prevention. The added value provided by the framework lies in its comprehensiveness, theoretical basis, diagnostic and heuristic nature and face validity. SUMMARY: Since integrated public health policies have not been widely developed and implemented in practice, organizational behaviors relevant to the development of these policies remain to be investigated. A conceptual framework that can assist in systematically studying the policy process may facilitate this. Our Behavior Change Ball adds significant value to existing public health policy frameworks by incorporating multiple theoretical perspectives, specifying a set of organizational behaviors and linking the analysis of these behaviors to interventions and policies. We would encourage examination by others of our framework as a tool to explain and guide the development of integrated policies for the prevention of wicked public health problems.

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Authors
Hendriks, A.-M., Jansen, M. W., Gubbels, J. S., De Vries, N. K., Paulussen, T., & Kremers, S. P.
Affiliations
  • GGD Zuid Limburg (NL)
  • Maastricht University (NL)
  • Netherlands Organisation for Applied Scientific Research (NL)
Corresponding author
Hendriks, Anna-Marie
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2013-04-18
Volume
8
Issue
1
Pages
46-46
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/1748-5908-8-46
PMC
PMC3637591
OpenAlex
W2138010874
Cited by
68
References
78
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2023: 5 · 2022: 5 · 2021: 7 · 2020: 1 · 2019: 3 · 2018: 6 · 2017: 7 · 2016: 6 · 2015: 10 · 2014: 11 · 2013: 3
FWCI
18.11
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by)
  • TNO Repository (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
ZonMw (200100001)
Topics
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
Keywords
childhood obesity, local government, Behaviour Change Wheel, wicked problems, policy process, organizational behavior, policy implementation, obesity prevention, conceptual framework
MeSH terms
Decision Making, Organizational, Diffusion of Innovation, Health Policy, Health Promotion, Humans, Interprofessional Relations, Local Government, Obesity, Organizational Innovation, Professional Practice, Delivery of Health Care, Integrated

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