Table 2 Statements by cluster with average importance and feasibility values
Inter-sectoral partnerships | |||
ID | Statement | Importance | Feasibility |
88 | Develop a deeper understanding of the paradigms of sectors outside of the health sector whose policies and actions influence health and people’s ability to make healthy choices, and who have sway with the community and governments | 3.7 | 3.6 |
73 | Build processes that engage sectors so they have a platform to work together | 3.6 | 3.4 |
1 | Strengthen inter-organisational networks | 3.5 | 3.6 |
15 | Better understand the role, value and impacts of cross-sectoral engagement for prevention | 3.5 | 3.7 |
75 | Invest in State facilitated multi-sector action combined with locally driven approaches, linked to a nationally led framework using the global non-communicable disease targets | 3.5 | 3.1 |
23 | Improve co-ordination of efforts across Federal and State and private health insurance players to avoid duplication of effort | 3.5 | 2.7 |
70 | Engage a more diverse group of stakeholders in public practice | 3.4 | 3.6 |
59 | Develop distributed leadership capacity | 3.1 | 2.8 |
21 | Develop procedures to effectively work through interprofessional power and turf issues, especially to reduce barriers to teamwork and equitable compensation | 2.9 | 2.6 |
Systems perspective/action | |||
ID | Statement | Importance | Feasibility |
94 | Adopt a systems approach to prevention | 3.8 | 3.1 |
83 | Incorporate a systems perspective to understand the preventive health system | 3.6 | 3.3 |
55 | Integrate the consideration of evidence-based health policy and global best practices into local and state government decision-making | 3.6 | 3.3 |
86 | Establish a secure infrastructure to support the delivery of system-wide chronic disease prevention at regional, state and national levels | 3.6 | 2.8 |
76 | Work with relevant university departments to ensure a holistic view of health is included in disciplines that contribute to upstream strategies for chronic disease prevention (e.g. built and natural planning, medical subjects, education, housing, etc.) | 3.2 | 3.5 |
Governance | |||
ID | Statement | Importance | Feasibility |
16 | Adopt a whole-of-government multi-level approach to prevention based on interconnectedness across sectors | 4.1 | 3.1 |
89 | Look beyond the ‘health portfolio’ to ensure all government health polices impact in a positive way on health | 3.9 | 3.3 |
29 | Expect all government agencies to drive changes in their sector that will improve health | 3.7 | 2.6 |
44 | Work towards a health-in-all-policies model | 3.7 | 3.0 |
33 | Incorporate governance to collaboratively address the key levers for change at local, state and national levels | 3.4 | 2.8 |
61 | Develop a governance mechanism that enables resident and community engagement in both co-designing the system and quality improvement | 3.2 | 2.9 |
40 | Organise and coordinate primary care and public health for a defined geographic population | 3.1 | 3.1 |
Roles and responsibilities | |||
ID | Statement | Importance | Feasibility |
48 | Treat prevention the same way as other parts of the healthcare continuum so that it is part of usual health service (embed entities responsible for funding and delivering prevention in Council of Australian Governments agreements) | 4.0 | 2.9 |
24 | Get clarity over whose responsibility it is to fund and deliver prevention | 3.9 | 3.1 |
45 | Promote and facilitate prevention work nationally | 3.6 | 3.6 |
63 | Ensure access to a comprehensive array of services that includes upstream prevention (addressing the socioeconomic determinants of health and behavioural risk factors), clinical prevention and care for those with chronic conditions | 3.4 | 2.7 |
87 | Allow prevention to be treated within the community rating framework in private health insurance (i.e. reinsurable) | 3.0 | 2.9 |
7 | Create competition between Primary Health Networks (PHNs) to improve the health of their population | 2.4 | 3.1 |
Evidence, feedback and learning | |||
ID | Statement | Importance | Feasibility |
17 | Ensure that government preventive health policy and programme decisions are evidence based (e.g. with accountability through scorecards, incentives and open reporting) | 4.0 | 3.2 |
39 | Fund research that is translatable, and that engages policymakers along the way to ensure traction | 3.8 | 3.8 |
9 | Build electronic data systems that are interoperable, allow data sharing, and are useful as feedback loops, and platforms for shared learning and continuous quality improvement, including performance accountability | 3.8 | 3.2 |
27 | Develop robust return on investment data for the main non-communicable disease prevention strategies | 3.7 | 3.5 |
57 | Establish a national health prevention surveillance system linked to national chronic disease and risk factor targets that monitors key non-communicable disease targets (smoking, weight status, physical activity levels, alcohol-related measures) | 3.7 | 3.3 |
2 | Rigorously evaluate prevention initiatives using robust research study designs (e.g. consort criteria) | 3.6 | 3.5 |
67 | Develop an evaluation framework that is consonant with the realities of complex systems and system improvement | 3.6 | 3.5 |
20 | Learn from both global best-practice and domestic successes and failures | 3.5 | 4.1 |
81 | Establish and model the level of investment in strategies that is required to reduce prevalence of major chronic disease risks | 3.5 | 3.5 |
72 | Invest in the health intelligence and knowledge infrastructure to inform our thinking, planning and monitoring | 3.5 | 3.3 |
80 | Develop, communicate and utilise better indicators for health and wellbeing, including return on investment (incorporating health-in-all-policies, triple bottom line policy and economic approaches) | 3.5 | 3.4 |
42 | Review restrictive privacy legislation that prevents data linkages across domains (e.g. Medicare, Pharmaceutical Benefit Scheme and Private Health Insurance) and reduces the ability to engage with the public who have chronic disease | 3.5 | 3.2 |
6 | Build learning systems that allow examination of implementation/adaptation as well as outcomes | 3.3 | 3.4 |
49 | Conduct studies to better define the dose (intensity, duration, reach) required to achieve the Global Targets for non-communicable disease prevention in the Australian context | 3.1 | 3.1 |
19 | Develop a tool box that researchers and policymakers alike can use to measure the impact and potential impact of public health law | 3.0 | 3.6 |
46 | Use a chronic disease prevention score-card report that ranks each PHN area across the country to raise public awareness | 2.8 | 3.3 |
79 | Work with PHNs to create a chronic disease prevention score-card report that ranks each PHN area across the country | 2.8 | 3.4 |
5 | Adopt and promote a national health risk assessment system (like ‘micromorts’) that attributes the health value/cost to specific activities or habits and use this as a way to communicate health risk and change behaviour | 2.6 | 2.7 |
Funding and Incentives | |||
ID | Statement | Importance | Feasibility |
92 | Establish long-term funding mechanisms to support sustainable and on-going work on prevention | 4.4 | 3.0 |
74 | Align financial incentives and supports with strategic objectives and measurable outcomes | 3.7 | 3.1 |
71 | Fund prevention action and research through a national body (e.g. like the recently closed Australian National Preventive Health Agency) | 3.6 | 3.1 |
13 | Incentivise team based, outreach care for patients with complex chronic disease | 2.8 | 3.2 |
4 | Provide capitated funding to GPs based on an enrolled population achieving measured health prevention targets | 2.8 | 2.8 |
Creating demand | |||
ID | Statement | Importance | Feasibility |
30 | Raise the profile of public health with politicians and other decision-makers | 4.1 | 3.6 |
54 | Raise the profile of the benefits of a preventative (rather than curative) focus for the health system | 3.9 | 3.9 |
8 | Improve communication about prevention nationally | 3.7 | 4.2 |
58 | create a sense of urgency in the community about chronic disease | 3.6 | 3.3 |
66 | focus on positive messages about living a fulfilling life | 2.7 | 3.7 |
Primary Prevention | |||
ID | Statement | Importance | Feasibility |
26 | Increase focus on primary prevention | 4.1 | 3.3 |
3 | Put more emphasis on and resources into getting the upstream determinants of health right | 4.0 | 3.0 |
68 | Invest heavily in primary prevention – work with kids and their families | 3.6 | 3.3 |
11 | Take an inclusive vs. normative approach to overweight and obesity (focus on health not weight/specific body mass index) to reduce associated stigma | 2.6 | 3.4 |
53 | Enhance transitional/interstitial care for individuals with chronic disease | 2.6 | 3.1 |
35 | Provide funding for not-for-profit organisations to include healthy activities for children | 2.6 | 3.5 |
Social determinants and equity | |||
ID | Statement | Importance | Feasibility |
34 | Have strategies and plans that address the social determinants of health rather than just refer to them | 3.9 | 3.0 |
90 | Invest in policy innovation that will benefit neglected or marginalised Australian populations who suffer disproportionately – not simply the mainstream | 3.9 | 3.3 |
28 | Ensure a minimum package of basic services for Indigenous Australians | 3.8 | 3.2 |
93 | Emphasise the reduction of inequity | 3.8 | 3.2 |
82 | Better target prevention activities to high risk or vulnerable groups | 3.5 | 3.5 |
69 | Institute a re-distributive health policy that takes account of the unequal distribution of power and resources and contributes to unfair and avoidable health inequities | 3.4 | 2.3 |
10 | Target preconception health to break the cycle of inter-generational risk | 3.1 | 3.3 |
22 | Ensure culturally acceptable, community-led alcohol strategies | 3.1 | 3.2 |
Healthy environments | |||
ID | Statement | Importance | Feasibility |
91 | Encourage incidental physical activity by improving public transport and reducing car density | 3.5 | 3.2 |
60 | Promote physical activity by improving, increasing and joining up walking infrastructure | 3.4 | 3.4 |
95 | Increase opportunity for physical activity through building codes and requirement on property developers | 3.4 | 3.3 |
78 | Actively encourage workplaces through legislation that promotes healthy living | 3.3 | 3.2 |
18 | Provide better access to safe green space | 3.3 | 3.3 |
77 | Improve air quality | 2.8 | 2.5 |
Food and nutrition | |||
ID | Statement | Importance | Feasibility |
32 | Regulate advertising of junk food to children | 3.9 | 3.3 |
84 | Regulate the food environment to limit the fat, sugar and salt content of processed food | 3.8 | 2.9 |
65 | Develop strategies to facilitate/regulate food product reformulation | 3.6 | 3.0 |
62 | Limit access to ‘fast food’ by using zoning laws to reduce the density of fast food outlets | 3.3 | 2.8 |
12 | Reduce fast food serving sizes | 3.1 | 2.7 |
37 | Encourage eating more plant food and trends towards a more vegetarian diet (e.g. through subsidising fruit and vegetables) | 3.1 | 2.7 |
36 | Legislate the labelling of foods containing trans fats | 3.0 | 3.4 |
50 | Limit access to baby formula (e.g. by reducing inappropriate marketing or limiting to prescription only where clinically indicated) | 2.2 | 2.4 |
Regulation and policy | |||
ID | Statement | Importance | Feasibility |
41 | Develop a long-term prevention strategy and funding commitment | 4.3 | 3.3 |
43 | Create and implement urban, regional and rural planning policies that support health-promoting built environments | 4.0 | 3.4 |
64 | Have the Australian Government provide leadership in taking on the food industry through a range of strategies (pricing, marketing, placement, sponsorship) that have been effective in tackling tobacco | 3.9 | 2.8 |
31 | Mandate clear planning mechanisms so our built environment supports physical activity and access to healthy food | 3.9 | 3.2 |
47 | Significantly shift the balance of transport investment towards active travel modes (cycling, walking, public transport) | 3.9 | 2.8 |
51 | Make greater use of regulation and taxation in prevention (e.g. of junk food and sugar-sweetened drinks, introduce an alcohol floor price) | 3.8 | 3.1 |
38 | Make inclusion of active community facilities mandatory for all new town planning and developments | 3.7 | 3.3 |
56 | Use fiscal measures (e.g. taxation) to discourage unhealthy behaviours and encourage healthy ones | 3.7 | 3.0 |
25 | Mandate (legislate) a system of health impact assessments at all levels of government that require legislation and fiscal initiatives to be assessed for their impact on chronic disease, in the same vein as environmental assessments | 3.5 | 2.6 |
52 | Develop a national nutrition policy | 3.2 | 3.8 |
85 | Include health impact analysis and strategies to minimise negative health impact of liquor licensing applications and fast food registrations | 3.2 | 3.2 |
14 | Work with suppliers to impact change, rather than taxing soft drinks | 2.3 | 2.7 |