Policymakers' perspectives on designing school-based health initiatives for Victorian adolescents

Initiatives based on the Health Promoting Schools (HPS) framework have previously been successful in improving health and well-being yet there is little evidence of how these findings translate into policy. This study therefore aimed to analyse the political considerations that underpinned policymakers' decisions for the design and implementation of a programme based on HPS in middle and high schools in Victoria, Australia. Interpretive policy analysis was undertaken using interviews with a purposive sample of government and non-government policy actors. Interviews explored factors influencing programme design and implementation and were analysed using thematic analysis. Ten in-depth interviews, including 11 participants, were conducted. The analysis revealed four themes. The Achievement Program was designed through (i) the establishment of strategic collaborations and good governance, involving people that made valuable and diverse contributions to the design process while acknowledging their (ii) positions of power, (iii) ensuring careful attention was paid to evidence-informed programme design and (iv) incorporation of real-time feedback from other settings. Policymakers believe this approach has the potential to improve policy adoption. There is a need to explore if this approach to policy development influences adherence and improves health outcomes.