Are area-level social determinants of health equity linked with implementation? An exploratory coincidence analysis of the scaled-up INFANT program
1
1 Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
2
2 NHMRC Centre of Research Excellence in the Early Promotion of Optimal Child Growth-Translate, Burwood, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
The Social Determinants of Health Equity (SDHE) are factors known to influence inequalities in health and opportunities for health, yet less is known about their impact on program implementation. Using data from the statewide scale-up of the INfant Feeding, Active play and NuTrition (INFANT) program across Victoria, Australia, this presentation explores the relationship between area-level SDHE indicators and implementation phases of INFANT. The combinations of SDHE indicators that may be linked with INFANT implementation will also be discussed.
METHODS:
Cross-tabulations (numbers and %) and descriptive statistics (mean and standard deviation, or median and interquartile range (IQR)) were used to assess differences in area-level SDHE by implementation phase for each Victorian local government area (n=79). A logistic regression analysis and coincidence analysis were used to explore the association and linkages between INFANT implementation and select SDHE indicators, for LGAs in the implementation and exploration phase (n=67).
RESULTS:
Regression analysis results indicated that the likelihood of implementing INFANT was higher in local government areas with a high level of socioeconomic advantage (OR=4.57, 95% CI 1.05 to 19.86, p=0.042). Coincidence analysis results identified four contexts linked with INFANT implementation: areas with a high level of socioeconomic advantage, areas with a low prevalence of overweight, areas with a moderate proportion of maternal child health nurses to births, and regional and rural areas with a moderate level of socioeconomic advantage and a moderate prevalence of overweight.
CONCLUSIONS:
Multiple contexts were linked with INFANT implementation, with select area-level SDHE indicators playing a role. Findings illustrate a need for a greater consideration of context to inform the tailoring of implementation efforts for areas experiencing a higher burden of the SDHE, to ensure equality in program implementation during scale-up.
The Social Determinants of Health Equity (SDHE) are factors known to influence inequalities in health and opportunities for health, yet less is known about their impact on program implementation. Using data from the statewide scale-up of the INfant Feeding, Active play and NuTrition (INFANT) program across Victoria, Australia, this presentation explores the relationship between area-level SDHE indicators and implementation phases of INFANT. The combinations of SDHE indicators that may be linked with INFANT implementation will also be discussed.
METHODS:
Cross-tabulations (numbers and %) and descriptive statistics (mean and standard deviation, or median and interquartile range (IQR)) were used to assess differences in area-level SDHE by implementation phase for each Victorian local government area (n=79). A logistic regression analysis and coincidence analysis were used to explore the association and linkages between INFANT implementation and select SDHE indicators, for LGAs in the implementation and exploration phase (n=67).
RESULTS:
Regression analysis results indicated that the likelihood of implementing INFANT was higher in local government areas with a high level of socioeconomic advantage (OR=4.57, 95% CI 1.05 to 19.86, p=0.042). Coincidence analysis results identified four contexts linked with INFANT implementation: areas with a high level of socioeconomic advantage, areas with a low prevalence of overweight, areas with a moderate proportion of maternal child health nurses to births, and regional and rural areas with a moderate level of socioeconomic advantage and a moderate prevalence of overweight.
CONCLUSIONS:
Multiple contexts were linked with INFANT implementation, with select area-level SDHE indicators playing a role. Findings illustrate a need for a greater consideration of context to inform the tailoring of implementation efforts for areas experiencing a higher burden of the SDHE, to ensure equality in program implementation during scale-up.
| eISSN: | 2654-1459 |
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