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The effectiveness of health impact assessment in influencing decision-making in Australia and New Zealand 2005–2009
- Source :
- BMC Public Health
- Publication Year :
- 2013
- Publisher :
- BioMed Central, 2013.
-
Abstract
- Background Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs. Methods We used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics. Results We found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement. Conclusions This study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders put on indirect impacts such as learning and relationship building suggest HIA has a role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a mechanism for developing relationships with and influencing other sectors. Accordingly when evaluating the effectiveness of HIAs we need to look beyond the direct impacts on decisions.
- Subjects :
- Program evaluation
medicine.medical_specialty
Policy making
Effectiveness
Interviews as Topic
Empirical research
Environmental health
Surveys and Questionnaires
medicine
Humans
Social determinants of health
Evaluation
Policy Making
Environmental planning
Decision Making, Organizational
business.industry
Health impact assessment
Public health
Public Health, Environmental and Occupational Health
Health services research
Australia
Health Services Research
Biostatistics
business
Research Article
New Zealand
Program Evaluation
Subjects
Details
- Language :
- English
- ISSN :
- 14712458
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- BMC Public Health
- Accession number :
- edsair.doi.dedup.....88dfda045f3dc4da6c6b83da32d80f8f