title: Health policy in South Australia 2003-10: primary health care workforce perceptions of the impact of policy change on health promotion.
abstract: OBJECTIVE
  This paper examines recent Australian health reform policies and considers how the primary health care (PHC) workforce experiences subsequent change and perceives its impact on health promotion practice.
  
  
  METHODS
  Health policy documents were analysed to determine their intended impact on health promotion. Interviews were conducted with 39 respondents from four State-funded PHC services to gain their perceptions of the impact of policy change on health promotion.
  
  
  RESULTS
  There have been a plethora of policy and strategy documents over the last decade relevant to PHC, and these suggest an intention to strengthen health promotion. However, respondents report that changes to the role and focus of PHC services have led to fewer opportunities for health promotion. Services are struggling to engage in health promotion activity, while funding and policy directions are prioritised to targeted, individual behaviour change.
  
  
  CONCLUSIONS
  The experience of PHC workforce respondents in South Australia suggests that, despite policy intentions, health promotion practice is much reduced. Our research suggests that rigorous evaluation of health sector reforms should be undertaken to assess both intended and unintended outcomes in terms of service quality and delivery. SO WHAT? Health promoters are experiencing a contradictory policy and practice environment, and this research should assist health promoters in advocating for more government accountability in the implementation of policies in order to advance comprehensive PHC.
authors.affiliation: Southgate Institute for Health, Society, and Equity, Faculty of Health Sciences, Flinders University, Adelaide, SA 5042, Australia.
authors.forename: Gwyn
authors.initials: G
authors.lastname: Jolley
authors.affiliation: Southgate Institute for Health, Society, and Equity, Faculty of Health Sciences, Flinders University, Adelaide, SA 5042, Australia.
authors.forename: Toby
authors.initials: T
authors.lastname: Freeman
authors.affiliation: Southgate Institute for Health, Society, and Equity, Faculty of Health Sciences, Flinders University, Adelaide, SA 5042, Australia.
authors.forename: Fran
authors.initials: F
authors.lastname: Baum
authors.affiliation: Southgate Institute for Health, Society, and Equity, Faculty of Health Sciences, Flinders University, Adelaide, SA 5042, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Hurley
authors.affiliation: Southgate Institute for Health, Society, and Equity, Faculty of Health Sciences, Flinders University, Adelaide, SA 5042, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Lawless
authors.affiliation: Southgate Institute for Health, Society, and Equity, Faculty of Health Sciences, Flinders University, Adelaide, SA 5042, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Bentley
authors.affiliation: Faculty of Medicine, Institute of Population Health, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.
authors.forename: Ronald
authors.initials: R
authors.lastname: Labonté
authors.affiliation: School of Public Health, University of the Western Cape, Cape Town, Bellville 7535, South Africa.
authors.forename: David
authors.initials: D
authors.lastname: Sanders
mesh_terms: D001291:Attitude of Health Personnel; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D010465:Perception; D011320:Primary Health Care / Q000458:organization & administration*; D024382:Professional Role; D015397:Program Evaluation; D013021:South Australia