Understanding prevention and early intervention in public policy

They say “prevention is better than cure”. By intervening early in people’s lives, policymakers can more effectively address policy problems. However, policymakers need to understand the complexities of using these approaches.

At a glance

A paper in Policy Design and Practice - Beyond “prevention is better than cure”: understanding prevention and early intervention as an approach to public policy - identifies the following factors supporting prevention and early intervention as an approach to public policy:

• legitimacy for government intervention
• policy environment
• open policy process
• evidence in policymaking.

The paper identifies opportunities for policymakers to improve the design and implementation of such policies. This involves:

• greater understanding of the perspectives and roles of stakeholders
• the use of public resources.

Legitimacy for government intervention

Policymakers designing and implementing prevention and early intervention policies need to:

• set out a clear rationale for intervening prior to allocating public resources.
• be aware of how people’s concerns about an intervention may challenge a policy’s legitimacy.

Reasons for prevention and early intervention include:

• intervening at an early stage reduces future demand and cost of public services.
• recognising how a person’s socio-economic background or early life experiences can impact on their life (e.g, reducing school absenteeism and early school leaving).
• intervening confers greater individual and social benefits than not intervening (e.g. investment in early childhood learning).

Legitimacy can be challenged by the view that an interventionist modern state is overly protective. It is also argued that early intervention fails to address the root cause of the policy problem such as social inequality.

Policy environment

For a prevention and early intervention policy to progress it needs to acquire:

• space on the policy agenda
• resources to support effective implementation.

Policy makers operate with limited time, capacity and resources. Efforts to win greater attention and resources for prevention and early intervention may be stymied by inertia in the policy making process.

It can be difficult to convince decision makers to shift resources from dealing with an immediate problem to investing in interventions that may not deliver intended outcomes for some time.

Open policy process

Policy challenges can encompass multiple policy areas and often require multi-agency cooperation. Policymakers developing prevention and early intervention policies need to:

• adopt a holistic approach to identifying stakeholders; and
• support engagement with a broad range of stakeholders in order to learn from their experience and expertise.

Prevention and early intervention challenges the traditional top-down model. Policy expertise is not confined to government departments. There may be significant levels of expertise within local communities. Policy interventions encourage and support people in designing, shaping and delivering policy solutions to address the needs of their own lives.

An open and inclusive approach to prevention and early intervention policy highlights the need for strong policy governance. The absence of engagement ignores the lessons of experience. Engagement is also needed to manage the relationships essential to effective implementation.

Evidence in policymaking

For prevention and early intervention to deliver on its promise, policymakers need to ensure:

• evidence from scientific research is translated into policy-relevant knowledge.
• there is a leadership culture that values skilled experts, develops the capacity of staff to undertake such work and demands the use of evidence in policymaking.
• they address expectations that evidence of effectiveness will be used to scale-up an intervention’s delivery so that more can benefit.

The views of policy experts and practitioners

Workshops were convened with participants from the public service and non-government organisations. These sessions engaged 79 people from 62 organisations in the areas of health, children, young people and families.

Participants saw prevention and early intervention as a potentially powerful approach to public policy. There is a range of available actions including:

• a prudential approach that educates people and develops their responsibility for their own well-being.
• stopping harm from happening.
• anticipating problems and working with people to strengthen protective factors and reduce risk factors.

A key issue is influencing the policy agenda. It is a challenge to convince decision-makers to shift resources from dealing with an obvious problem to investing in interventions that may not deliver the intended outcomes for some time. This challenge is accentuated by the short-term political cycle.

The strong appeal of prevention and early intervention policies is in knowing what to do. When interventions are designed around the end user, there is a focus on the individual outcomes being achieved. Theories of change and program logic models can strengthen this as they concentrate on the beneficiaries, the causes of the problem and the process involved in achieving the intervention’s goal.

The bottom line

There are opportunities for policy makers to improve the development of prevention and early intervention policies. These include:

• promoting a common understanding of prevention and early intervention as an approach to addressing policy challenges
• developing a better understanding of the policy intervention’s goals and limitations.
• engaging with stakeholders across all stages of the policy cycle.
• facilitating learning through open, reflective and critical engagement between stakeholders.

Want to read more?

Beyond “prevention is better than cure”: understanding prevention and early intervention as an approach to public policy – Fiachra Kennedy, Policy Design and Practice, March 2020.

This Research Brief is written by Maria Katsonis as part of ANZSOG’s new research translation series, The Bridge. This project is designed to bridge the gap between the research work of academics and the policy work of public managers by providing access to visible and accessible high-quality research. The Bridge is emailed fortnightly to thousands of engaged readers and centers around a Research Brief which distills academic research into an easy-to-read format.

Sign up to the Bridge