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Related Experiment Video

Updated: Dec 27, 2025

The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time

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Key Performance Indicators for program scale-up and divergent practice styles: a study from NSW, Australia.

Sisse Grøn^1,2, Victoria Loblay³, Kathleen P Conte⁴

¹DTU - Technical University of Denmark, Engineering Systems Design, Akademivej, Building 358, 2800 Kgs. Lyngby, Denmark.

Health Promotion International

|February 28, 2020

Summary

Government health teams in Australia use different strategies to implement large-scale childhood obesity prevention programs in schools and child care centers. Findings reveal distinct approaches to meeting targets, balancing equity, and achieving program goals.

Keywords:

KPI ethnography health promotion intervention

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Area of Science:

Public Health
Health Promotion
Obesity Prevention

Background:

Childhood obesity is a significant public health issue requiring large-scale government interventions.
School and child care settings are key environments for implementing obesity prevention programs.
Australia's largest scale-up of these programs involves health promotion teams supporting educational services.

Purpose of the Study:

To examine the decision-making and strategizing processes of health promotion teams during a large-scale obesity prevention program implementation.
To identify variations in how teams adapt to program targets and resource allocation.
To understand the challenges faced in balancing implementation targets with equity considerations.

Main Methods:

Ethnographic fieldwork and interviews were conducted over 12 months across all participating districts.
The study analyzed variations in decision-making and strategizing among health promotion teams.
A 'tight-loose-tight' model was used, with funding and accountability for Key Performance Indicators (KPIs), but local discretion in strategy.

Main Results:

Three distinct styles of practice were identified: KPI-driven, relationship-driven, and equity-driven.
Health promotion teams made trade-offs when adapting to KPIs.
Some teams experienced difficulties balancing the need to address equity with the requirement to meet implementation targets.

Conclusions:

Program scale-up models need to acknowledge the complexity of implementation strategies.
Recognizing diverse team practices, such as KPI-driven, relationship-driven, and equity-driven approaches, is crucial.
Future program tracking and scale-up models could benefit from incorporating these complexities to better support health promotion teams.