Building a Prevention System: Infrastructure to Strengthen Health Promotion Outcomes

Area of Science:

• Public Health
• Health Systems Research
• Prevention Science

Background:

• Prevention systems enhance health promotion interventions.
• Large-scale prevention initiatives require robust macro-infrastructure.
• The Healthy Together Victoria (HTV) initiative aimed to build such infrastructure.

Purpose of the Study:

• To describe the establishment of the HTV macro-infrastructure.
• To explore participants' understanding of systems thinking within HTV.
• To identify strengths and weaknesses of the HTV prevention system.

Main Methods:

• Conducted 31 semi-structured interviews.
• Applied a chronic disease prevention framework for coding.
• Utilized causal loop diagrams and feedback loops to illustrate findings.

Main Results:

• HTV successfully created a connected system with workforce, funding, and leadership.
• Gaps identified in operating guidelines, professional development, and real-time evaluation.
• Inexperienced users defaulted to program implementation over systems engagement.

Conclusions:

• HTV was innovative in establishing infrastructure and shared language.
• The model was insufficient for population-level chronic disease reduction due to missing oversight and intervention focus.
• The HTV system requires clarity on systems practice and recognition as complex and adaptive.