Abstract
A core function of the public health nutrition workforce is advocacy. Little is known of the nutritionists' role in policymaking from a policy process theory perspective. The current study analyses the nutritionists' role in advocating for a six-year governmental plan on obesity prevention in Quebec, Canada. We conducted qualitative research using Quebec's obesity policy as a case study to understand the role of nutritionists in advocating for obesity prevention policies. A conceptual framework combining the Advocacy Coalition Framework with a political analysis model based on the Theory of the Strategic Actor was developed to analyse the beliefs, interests and strategies of policy actors including nutritionists. Data sources comprised semi-structured open-ended interviews with key policy actors (n 25), including eight nutritionists (32 %) and policy-related documents (n 267). Data analysis involved thematic coding and analysis using NVivo 11 Pro. Quebec, Canada. Key policy actors including nutritionists. Nutritionists formed the core of the dominant public health coalition. They advocated for an inter-sectoral governmental plan to prevent obesity through enabling environments. Their advocacy, developed through an iterative process, comprised creating a think tank and reinforcing partnerships with key policy actors, conducting research and developing evidence, communicating policy positions and advocacy materials, participating in deliberative forums and negotiating an agreement with other coalitions in the policy subsystem. Nutritionists' advocacy influenced agenda setting and policy formulation. This research may contribute to empowering the public health nutrition workforce and strengthening its advocacy practices. It informs practitioners and researchers concerned with obesity policy and workforce development.
Highlights
Using a conceptual framework drawn from political science, the current study aims to explain the role of nutritionists in the GAP agenda setting and formulation through an analysis of their belief system characteristics, networks and advocacy strategies
Advocacy coalitions’ policy beliefs We identified four advocacy coalitions[27,28] interacting in the policy subsystem and named them based on a concise descriptor of their policy beliefs: an Enabling Environments Advocacy Coalition (EEAC), a Healthy Lifestyles Promoting Advocacy Coalition (HLPAC), an Agri-Food Advocacy Coalition (AFAC) and a Community Development Advocacy Coalition (CDAC)
Nutritionists constituted the core of the EEAC, the dominant advocacy coalition
Summary
The case is the agenda setting and formulation of the GAP by the Province of Quebec. We used the Advocacy Coalition Framework (ACF)(25) to identify advocacy coalitions and explain the GAP’s processes for agenda setting and formulation (Fig. 1). The ACF outlines a three-tiered belief system comprising deep core, policy core and secondary beliefs and groups actors who. ▪ Deep core ▪ Policy core ▪ Secondary aspects NVivo 11 Pro share the same policy core beliefs and coordinate substantially in a coalition[26,27,28]. Coalitions within a policy subsystem marshal resources and advance strategies to translate their beliefs into policies. Many would disagree with this assumption and would believe that self-interests, or power maximisation, are Advocacy Coalition Framework Flow Diagram - ACFa. Relatively stable factors 1. Basic attributes of the problem area and distribution of natural resources
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