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Table 1 Key lessons from the Victorian Salt Reduction Partnership

From: An evaluation of the Victorian Salt Reduction Partnership’s advocacy strategy for policy change

 

Lessons

Supporting quotes

Step 1. Establishing a sense of urgency

Develop the evidence needed to establish a sense of urgency, such as the economic/business case (e.g. potential for lives saved), and use this to build your coalition, develop your change vision, and generate public and political will

[Organization] did a scoping study way back in the beginning to identify the evidence and information about successful salt reduction strategies and then provided that to VicHealth about how they could establish a state-wide strategy (Research 2)

I think that’s a key part of building a business case to government, to show what is feasible (SGSA 13)

Step 2. Creating the guiding coalition

Invite individuals from different sectors, with different skills and expertise, to create a diverse coalition focused on common goals and capable of developing innovation approaches

Beware that this diversity can result in communication challenges and tension regarding public health priorities

I think those core groups brought a really good mix of skills and expertise, which I think we all learnt from. In my early days on the partnership when we were establishing the agenda, it was really useful and great because we all learned from one another and you know we had some pretty fiery kind of debates and discussions, which were great (NGO 7)

It’s been really effective to have these different organizations with different skill sets working so closely together (NGO 21)

Step 3. Develop and maintain influential relationships

Focus on developing and maintaining relationships with policy makers, but also utilize coalition members’ pre-existing relationships

Raise the profile of the coalition through media advocacy to facilitate connections with influential people

Build relationships with the “opposition” to enable the development of a unified solution to the public health issue

The partnership has had a positive influence on keeping something happening and helping get it up—certainly useful for [name] as a member of the Healthy Food Partnership to use its work to achieve salt very firmly on the agenda (NGO 8)

[Name] recommended through the Healthy Food Partnership, as a way of monitoring progress, that those independent surveys be done in exactly the same way (NGO 8)

Step 4. Develop a change vision

Use a programme logic model to facilitate the development of a comprehensive change vision, including activities, outputs, and outcomes that can be used to monitor programme fidelity and measure success

Looking at the evidence, engaging with the key stakeholders around it, appraising options for action, feasibility, political acceptability a whole host of different domains to then draw-up a shared plan, on what the consensus for action that everyone could co-commit to (SGSA 13)

Steps 5 and 6. Communicate the vision for buy-in and empower broad-based action

Identify stakeholders to communicate the change vision to and use active, targeted dissemination strategies to reach them

Create and disseminate documents and resources to support communication of the change vision and solutions to the public health issue, including policy position statements and how-to guides

Use the media to further communicate your vision

We developed the call to action document. I think it was a great output and a deliverable… it’s probably the first time organizations have got together to actually get some form of consensus, a blueprint on what we need going forward (NGO 7)

What’s been really effective has been the product category reports. We used those for strategic advocacy to get media attention (Research 2)

Step 7. Be opportunistic

Identify potential opportunities to accelerate policy progress and pursue opportunities that are aligned with your change vision to optimize intervention effectiveness

A reformulation programme was being discussed, being designed, being consulted on, we could then put Partnership responses in (SGSA 11)

Step 8. Generate short-term wins

Establish approaches to measure or monitor advocacy progress and short-term wins through project outputs that can be linked to outcomes in the programme logic model

Some good work in terms of lessons from the Victorian Salt Partnership to the Healthy Food Partnership, to offer to share resources, that’s got a good response (Research 2)

Step 9. Never let up

Be patient and persist while waiting for the right leadership, the right resources, the right time, and the right opportunities

Like in tobacco control or any other public health area often it can take twenty or thirty years for the advocacy to reach a critical mass and then find a sympathetic minister or a sympathetic government or a sympathetic community and the timing is right and suddenly you get an opportunity (SGSA 13)

Step 10. Incorporate changes into the culture

Increase public and political awareness through implementing the above steps to change culture and accomplish policy change

Whilst we might not have seen policy change, we’ve definitely continued the conversation and put support behind it (NGO 21)

There’s been some good work but as a whole it probably hasn’t quite had the impact at the state and federal level as we would have wanted. That’s not necessarily because of the fault of any of the partners, it’s partly because of the political conversations and agendas out where salt is and you can’t make an issue popular with politicians if they don’t want it to be and there’s not a public push (SGSA 10)