1. Health in All Policies: An academic-policy partnership to determine the extent to which HiAP promotes health and equity Professor Fran Baum (Flinders University) Carmel Williams (SA Health) SA HiAP Research Team Research Translation Faculty Symposium, Sydney, October 2015

2. Fran Baum Academic/Policy Research Partnership Ilona Kickbusch Colin MacDougall Liz Harris Dennis McDermott Angela Lawless Danny Broderick Kevin Buckett Michael Marmot Sandy Pitcher Jennie Popay Andrew Stanley Carmel Williams Deb Wildgoose Toni Delany (Project manager) Anna Lane (Research assistant)

3. Retrospective analysis of the development of the SA HiAP initiative Prospective, theory driven action research on implementation NHMRC Funded Research 2012-2016 Research questions address the following: (1)Is HiAP effective? (2) What are its strengths and weakness in bringing about action across sectors of government? (3) Does a combination of program logic and action research work as an evaluation framework?

4. E N G A G E M E N T Regular discussions with policy staff to present findings and seek feedback on directions of the research, regular presentations at research forums to distribute findings Theorising about HiAP & the research approach Interviews: Over 100 interviews with senior policy staff, political and other non- bureaucratic actors and other key informants Program Logic 2 workshops Online survey 2 surveys undertaken 2 years apart 7 case study assessments of HiAP initiatives Document analysis Participant interviews Observations Context mapping Documenting changes Multiple methods

5. HiAP has encouraged other Government sectors to be aware of the health impact of their core activity and change aspects of their policies as a result. The program logic models have been used to link these changes to eventual health and well-being outcomes. Key research findings [to date]

6. Working collaboratively not easy because of different institutional drivers University World Policy & government world How do you mix the two? © 2012 Presentation Process | CO Pack 2

7. Partnership has deep roots Existing research-policy links through several branches of SA Health & Social DPC /SACHRU @ Flinders Supportive & innovative policy environment e.g. State Plan, Thinker in residence, New Public Health Act

8. Building the partnership 1.Governance established to address risks 2.Potential risks to the partnership anticipated at outset including externally facilitated workshop – anticipated issues well

9. Potential issues faced by researchers and actuality Pressure to publish results may conflict with intellectual property issues and government reluctance to see unfavourable findings published. To some extent true – public servants also have to second guess what is “unfavourable” Concern that government is slow to make decisions and not able to admit mistakes. Things have moved fast and government has changed direction Over the five years of the grant governments will change, there are likely to be new governance structures and new policy actors that will complicate the research and frustrate researchers. Lots of changes in structures some change in policy actors (lost but not gained) Will policy actors be keen to continue participation over the term of the research? Perhaps not sometimes, but commitment has lasted Will policy actors permit research to be conducted in a way that leads to a strong and defensible methodology? Some truth to this – requires trust building and flexibility from researchers

10. Potential issues faced by policy actors and actuality Concern that the research might transgress sensitive areas, and academics will want to push ahead despite potentially politically damaging findings. Some truth as academics interested in outcomes, fit with theory and less with political sensitivities Concern that academic publishing takes a long time and this will conflict with the need for information more quickly to inform government. Yes real issue – research analysis takes time and journal publishing takes time too Concern that the research might increase workload. Yes does increase workload but there are benefits for effort Will research with partners in other sectors impact negatively on relationships with a burden of time and energy? Other sectors seemed to appreciate evidence-based approach Keen to use evaluation findings to improve intersectoral working and the quality of policy and so bring better outcomes for SA. Could see South Australia HiAP recognised as significant, backed by rigorous research evidence. YES in the main

11. Benefits of research for policy actors Gives HiAP credibility –Important within political context focussed on acute care –Strengthen claim to an evidence based approach HiAP partners and staff gain from participating in research, provides opportunity for reflexivity Regular feedback of findings allows for continual improvement of HiAP Existing research gives rise to ideas for future research

12. Other Possible pitfalls from research Research happens at one point in time – policy making is dynamic – hard to capture the dynamic nature and so research only gives a point-of-time picture which may be misleading Policy drivers can change quickly and so evidence becomes less useful Policy actors have limited ability to respond to less than positive findings: ‘caught in the sandwich’ between evidence and political imperatives

13. Partnership has required sustained commitment on both sides – building understanding and trust There are conflicts between drivers for researchers and those for policy making – both sides need to consider implications more carefully Policy change happens quickly and so “old” evidence less useful Researchers take critical edge and policy makers increasing have to defend actions and can’t take critical stance. What role do values play in mediating work of researchers and policy actors? To what extent are powerful actors in the policy system really interested in evidence based policy in a politically driven context? Lessons for Research Translation

14. Thank you! fran.baum@flinders.edu.au carmel.williams@sa.gov.au HiAP Research Project Manager: Toni Delany toni.delany@flinders.edu.au