Katherine Cullerton

Exploring power and influence in nutrition policy in Australia.

The food industry is often described as having more power and influence in nutrition policymaking than nutrition professionals, scientists and other practitioners working for the public interest; yet authors often allude to this point as an assumed truth, rather than an evidence‐based fact. This paper applies social network analysis techniques to provide a concise evidence‐based demonstration of the food industrys capacity to influence nutrition policymaking networks in Australia. Network analysis using four rounds of data collection was undertaken, and the capacity of individual actors and occupational categories to influence policy decision makers were analysed. Network graphs were developed using cluster analysis to identify the structure of clusters and the path distance of actors from decision makers. The assumed advantage for the ‘food industry’ was present both strategically in overall network position and with respect to the number of direct access points to ‘decision makers’, whereas ‘nutrition professionals’ were densely clustered together with limited links to key ‘decision makers’. The results demonstrate that the food industry holds the strategic high ground in advocating their interests to policymakers in the contexts studied. Nutrition professionals may be hampered by their reliance on strong ties with other nutrition professionals as well as limited direct links to ‘decision makers’.

Using political science to progress public health nutrition: a systematic review.

OBJECTIVE Poor dietary intake is the most important behavioural risk factor affecting health globally. Despite this, there has been little investment in public health nutrition policy actions. Policy process theories from the field of political science can aid understanding why policy decisions have occurred and identify how to influence ongoing or future initiatives. The present review aims to examine public health nutrition policy literature and identify whether a policy process theory has been used to analyse the process. DESIGN Electronic databases were searched systematically for studies examining policy making in public health nutrition in high-income, democratic countries. SETTING International, national, state and local government jurisdictions within high-income, democratic countries. SUBJECTS Individuals and organisations involved in the nutrition policy-making process. RESULTS Sixty-three studies met the eligibility criteria, most were conducted in the USA and a majority focused on obesity. The analysis demonstrates an accelerating trend in the number of nutrition policy papers published annually and an increase in the diversity of nutrition topics examined. The use of policy process theory was observed from 2003; however, it was utilised by only 14 % of the reviewed papers. CONCLUSIONS There is limited research into the nutrition policy process in high-income countries. While there has been a small increase in the use of policy process theory from 2003, an opportunity to expand its use is evident. We suggest that nutrition policy making would benefit from a pragmatic approach that ensures those trying to influence or understand the policy-making process are equipped with basic knowledge around these theories.

Joining the dots: the role of brokers in nutrition policy in Australia

BackgroundPoor diet is the leading preventable risk factor contributing to the burden of disease in Australia. A range of cost-effective, comprehensive population-focussed strategies are available to address these dietary-related diseases. However, despite evidence of their effectiveness, minimal federal resources are directed to this area. To better understand the limited public health nutrition policy action in Australia, we sought to identify the key policy brokers in the Australian nutrition policy network and consider their level of influence over nutrition policymaking.MethodsA social network analysis involving four rounds of data collection was undertaken using a modified reputational snowball method to identify the nutrition policy network of individuals in direct contact with each other. Centrality measures, in particular betweenness centrality, and a visualisation of the network were used to identify key policy brokers.ResultsThree hundred and ninety (390) individual actors with 1917 direct ties were identified within the Australian nutrition policy network. The network revealed two key brokers; a Nutrition Academic and a General Health professional from a non-government organisation (NGO), with the latter being in the greatest strategic position for influencing policymakers.ConclusionThe results of this social network analysis illustrate there are two dominant brokers within the nutrition policy network in Australia. However their structural position in the network means their brokerage roles have different purposes and different levels of influence on policymaking. The results suggest that brokerage in isolation may not adequately represent influence in nutrition policy in Australia. Other factors, such as direct access to decision–makers and the saliency of the solution, must also be considered.

Effective advocacy strategies for influencing government nutrition policy: a conceptual model

Influencing public policy change can be difficult and complex, particularly for those with limited power and resources. For any one issue there may be several groups, including the commercial sector and public health advocates advocating from different policy perspectives. However, much of the public health advocacy literature and tools available for those wanting to improve their practice is based on research from one specific perspective of an issue. This approach deprives advocates of potential insight into the most effective levers for this complex and difficult process. To provide a more comprehensive insight into effective levers for influencing public health policy change, a conceptual model for poorly-resourced advocates was developed. The model was developed through the integration and synthesis of policy process and network theories with the results from three studies conducted previously by the authors: a systematic literature review; a social network analysis of influential actors in Australian nutrition policy; plus in-depth interviews with a sample of these actors who had diverse perspectives on influencing nutrition policy. Through understanding the key steps in this model advocates will be better equipped to increase political and public will, and affect positive policy change.