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Bridging the Gap in Policy Implementation through a Health Equity Lens: Insights from a 2-Year Study on Measurement

Gabriella M McLoughlin1,2, Chelsea R Singleton3, Callie Walsh-Bailey4

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This study developed tools to measure equitable policy implementation, focusing on Universal School Meals (USM). Findings will help researchers assess how policies address health inequities effectively.

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Area of Science:

  • Implementation Science
  • Health Equity
  • Policy Evaluation

Background:

  • Policy implementation measurement often lacks an equity focus, hindering understanding of health equity interventions.
  • Universal School Meals (USM) policies aim to address health inequities but require equitable implementation for success.

Purpose of the Study:

  • To identify key constructs for equitable school health policy implementation.
  • To establish face and content validity of measures for implementation determinants, processes, and outcomes.

Main Methods:

  • A survey of school health policy experts identified key constructs (Aim 1).
  • Survey instruments were developed and cognitively tested with user groups (Aim 2).
  • Iterative data analysis categorized feedback for instrument refinement.

Main Results:

  • 122 school health policy experts responded to the Aim 1 survey.
  • Cognitive testing for Aim 2 showed predominantly "easy" revisions (69%).
  • Key feedback themes included wording, perceived control, and equity descriptions.

Conclusions:

  • Developed tools can be adapted for equitable assessment of policy implementation.
  • These measures can aid implementation researchers and practitioners in diverse settings.
  • Focusing on equity in measurement is crucial for achieving intended policy outcomes.