Journal of Professional Nursing

Diffusion of the Primary Health Care Strategy in a Small District Health Board in New Zealand

Heather Robertson, RN, PhD, Nurse Leader - Primary and Community, Tairawhiti District Health, Gisborne, NZ
Jenny Carryer, RN, PhD, FCNA(NZ), MNZM, Professor, School of Nursing, Massey University, Palmerston North, NZ
Stephen Neville, RN, PhD, FCNA(NZ), Associate Professor, Head of Department - Nursing, Auckland University of Technology, Auckland, NZ

Reference:  Robertson, H., Carryer, J., & Neville, S. (2015).  Diffusion of the primary health care strategy in a small district health board in New Zealand. Nursing Praxis in New Zealand, 31(3), 17-26. 


The Primary Health Care Strategy (2001) was launched in New Zealand by a Labour-led coalition.  This paper reports the findings of a study examining aspects of the implementation of the Strategy on primary health care nursing in a small district health board in New Zealand and contributes new understanding on the depth of issues in the diffusion of the Strategy itself.  The research approach was an instrumental case study informed by constructionism and underpinned by a qualitative interpretive design.  Data were collected from multiple sources including relevant policy documents and strategic plans as available on organisational websites at the local district health board and primary health organisation level.  Qualitative data were obtained using in-depth individual interviews with managers at middle and senior levels at the local district health board and two primary health organisations.  Focus groups were held with primary health care nurses.  Findings demonstrated that poor diffusion processes negatively influenced the deployment of primary health care nursing in this district; nurses did not understand the intent and potential of the Primary Health Care Strategy.  We suggest that policy implementation must include robust diffusion processes in the design and be purposefully inclusive of nursing where relevant.

Diffusion; innovation; primary health care (PHC); primary health care nursing

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