Policy making lessons for public health nurses: Strategic banana peels, amateur lobbyists and outflanking maneuvers

Background: In response to striking childhood obesity rates in Oregon, public health policy advocates led by a public health nurse lobbyist proposed legislation to regulate competitive or junk foods in school vending machines during the 2005 Oregon Legislative Session. Several theories propose to explain, predict or provide guidance in the policymaking process. The policy process surrounding The Oregon Healthy School Foods bill (Senate Bill 560), however, cannot be fully characterized by these theories. Senate Bill 560 (SB 560) followed a twisted course through rule-making and legislative and political processes but suffered from events not well articulated in theories of policy. The purpose of this study is to explicate the public policy process more fully so that public health nurses and policy advocates may achieve more successful public policy.

Methods: Qualitative semi-structured interviews were employed with proponents, opponents and observers to the SB 560 policy process in the 2005 Oregon Legislative Session. An analysis of Grounded Theory was performed using open coding of interview data and comparison of emerging themes.

Results: Three overlapping themes were identified in qualitative interviews with SB 560 proponents, opponents and observers. Strategically placed legislative banana peels, proponents' amateurish performance, and legislative outflanking by opponents more fully characterize the policy process than extant policy theory and may account for the failure of SB 560 in 2005. A brief update and political analysis of the 2007 Oregon Legislative Session in which the Healthy School Foods bill passed will be presented.

Conclusions: Basic common sense political actions and maneuvering more fully explain the fate of healthy school foods legislation in Oregon and suggest that public health nurse policymakers and lobbyists must be more than sincere advocates if they are to carry the legislature and improve public health policy. The composition of the legislature is key to the successful passage of public health legislation suggesting that political opportunity is more important than incremental policy actions.