Bridging policy and implementation science: operationalising political and structural determinants for health policy implementation evaluation.
7 affiliations
- 1Leibniz Institute for Prevention Research and Epidemiology- BIPS, Achterstrasse 30, 28359, Bremen, Germany. [email protected].
- 2Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Domus Medica, Sognsvannsveien 9, Oslo, 0372, Norway.
- 3Leibniz Institute for Prevention Research and Epidemiology- BIPS, Achterstrasse 30, 28359, Bremen, Germany.
- 4El-Erian Professor of Behavioural Economics and Policy, University of Cambridge, Cambridge, CB3 9ET, UK.
- 5Institute of Psychology, SWPS University, Ostrowskiego Street 30b, Wroclaw, PL53238, Poland.
- 6Lyda Hill Institute of Human Resilience, University of Colorado at Colorado Springs, 4863 North Nevada Avenue, Colorado Springs, CO, 80918, USA.
- 7Health Sciences Bremen, University of Bremen, Bibliothekstr. 1, 28359, Bremen, Germany.
Abstract
Background
Despite their critical role in shaping public health policy implementation, key political and structural determinants within implementation frameworks are often poorly defined, underreported, or treated as background rather than as core implementation variables. Existing implementation science frameworks acknowledge these determinants, they lack systematic, operationalised guidance for reporting them, resulting in limited explanatory power, poor comparability, and an overemphasis on individual-level factors.Objective
This paper aims to improve reporting standards in public health policy implementation evaluation by defining key political and structural determinants and proposing their operationalisation within established implementation frameworks.Methods
The synthesis drew on seven systematic and scoping reviews and three in-depth case studies from the PEN, ASTRA, and STOP projects, covering nutrition, physical activity, and tobacco control. We consolidated predefined, theory-informed extraction categories from the underlying reviews, together with recurring reporting gaps, into overarching reporting dimensions. We then contextualised and refined these dimensions using evidence from the three case studies across diverse governance levels and socio-political settings.Results
We consolidated and operationalised eight core reporting dimensions: (1) policy objectives and scope, (2) actors, power, and competence, (3) legal status and jurisdiction, (4) policy instruments (regulatory, economic, communicative, behavioural), (5) implementation strategies (centralised vs. decentralised, coordination mechanisms), (6) resources (financial, human, material, and implementation costs), (7) equity impact and (8) policy lifecycle. The dimensions specify political and structural information relevant to policy implementation evaluation and provide a structured basis for more systematic and transparent reporting across diverse policy contexts. The operationalisation is designed to complement and to be integrated into established implementation frameworks.Conclusion
Systematic and transparent reporting of political and structural determinants is essential for understanding the success or failure of policy implementation. The proposed operationalisation offers researchers and evaluators a practical approach to strengthen public health policy implementation evaluations. Designed for integration into frameworks such as CFIR and CICI, it may help identify leverage points, support adaptive policy design, and contribute to more effective, equitable, and sustainable public health interventions.
Related
- Operationalising the Operational Guidance on Infant and Young Child Feeding in Emergencies: A Narrative Review of Implementation Strategies, Barriers, Facilitators, and Health System Integration in Humanitarian Settings
- Operationalising a Comprehensive Lactation Management Centre in a Tertiary NICU in North India: A Retrospective Implementation Study With Before-After Comparison of Breastfeeding and Counselling Coverage
- When labour protections fail the healers: Structural violence, health system fragility and the political economy of Nigeria's medical brain drain
- Implementation strategies, outcomes and determinants of integrated care for cardiometabolic conditions and mental, neurological and substance use disorders: protocol for a mixed-methods systematic review
- Multi-method Analysis of Implementation Determinants and Strategies to Support the Implementation of Contingency Management for Methamphetamine Use in an HIV Care Setting
BibTeX
@article{forberger2026bridging,
title = {{Bridging policy and implementation science: operationalising political and structural determinants for health policy implementation evaluation.}},
author = {Sarah Forberger and Biljana Meshkovska and Lucia A Reisch and Aleksandra Luszczynska and Hajo Zeeb},
journal = {Implementation science communications},
year = {2026},
month = oct,
doi = {10.1186/s43058-026-01137-0},
url = {https://europepmc.org/article/MED/42894255},
note = {CC BY},
}
RIS
TY - JOUR
TI - Bridging policy and implementation science: operationalising political and structural determinants for health policy implementation evaluation.
AU - Sarah Forberger
AU - Biljana Meshkovska
AU - Lucia A Reisch
AU - Aleksandra Luszczynska
AU - Hajo Zeeb
PY - 2026
DA - 2026/10/11
JO - Implementation science communications
DO - 10.1186/s43058-026-01137-0
UR - https://europepmc.org/article/MED/42894255
AB - Background Despite their critical role in shaping public health policy implementation, key political and structural determinants within implementation frameworks are often poorly defined, underreported, or treated as background rather than as core implementation variables. Existing implementation science frameworks acknowledge these determinants, they lack systematic, operationalised guidance for reporting them, resulting in limited explanatory power, poor comparability, and an overemphasis on individual-level factors.Objective This paper aims to improve reporting standards in public health policy implementation evaluation by defining key political and structural determinants and proposing their operationalisation within established implementation frameworks.Methods The synthesis drew on seven systematic and scoping reviews and three in-depth case studies from the PEN, ASTRA, and STOP projects, covering nutrition, physical activity, and tobacco control. We consolidated predefined, theory-informed extraction categories from the underlying reviews, together with recurring reporting gaps, into overarching reporting dimensions. We then contextualised and refined these dimensions using evidence from the three case studies across diverse governance levels and socio-political settings.Results We consolidated and operationalised eight core reporting dimensions: (1) policy objectives and scope, (2) actors, power, and competence, (3) legal status and jurisdiction, (4) policy instruments (regulatory, economic, communicative, behavioural), (5) implementation strategies (centralised vs. decentralised, coordination mechanisms), (6) resources (financial, human, material, and implementation costs), (7) equity impact and (8) policy lifecycle. The dimensions specify political and structural information relevant to policy implementation evaluation and provide a structured basis for more systematic and transparent reporting across diverse policy contexts. The operationalisation is designed to complement and to be integrated into established implementation frameworks.Conclusion Systematic and transparent reporting of political and structural determinants is essential for understanding the success or failure of policy implementation. The proposed operationalisation offers researchers and evaluators a practical approach to strengthen public health policy implementation evaluations. Designed for integration into frameworks such as CFIR and CICI, it may help identify leverage points, support adaptive policy design, and contribute to more effective, equitable, and sustainable public health interventions.
SN - 2662-2211
ER -