Factors affecting policy implementation for childhood obesity prevention in New South Wales, Australia: policy mapping and interviews with senior officials

Abstract

Aim: To explore the implementation of a whole-of-government strategy as a policy tool for the early prevention of childhood obesity in New South Wales (NSW), Australia. Subject and methods: This paper presents a case study of childhood obesity prevention in the context of implementing the NSW Healthy Eating and Active Living (HEAL) Strategy. We undertook reflexive thematic analysis of interviews with senior officials (n = 25) and content analysis of policy mapping across the NSW Government. Results: HEAL was dominated by approaches focused on health services and settings and few environmental actions were undertaken. Four themes were identified: (1) making good citizens, (2) narrowing the scope of prevention, (3) competing government interests and (4) limited collaborative mechanisms. We additionally identified a cross-cutting theme around the expressed need for more evidence. Conclusion: Ultimately the HEAL Strategy provided a comprehensive framework with the potential to prevent obesity in early childhood, but it lacked commitment from leadership and willingness across agencies to ensure collaboration on its most contentious areas, notably food environments.