Electronic Thesis and Dissertation Repository


Master of Health Information Science


Health Information Science


Dr. Sandra Regan


Background: In April 2015, the Ontario government announced the expansion of beer sales in up to 450 grocery stores, thereby substantially increasing access to alcohol. This policy was introduced despite a robust body of research demonstrating a positive relationship between increased outlet density, alcohol consumption, and consequent harm. Methods: This qualitative case study explored the role of health information, and the contexts and factors which shaped its use, in the development and implementation of Ontario’s policy to expand alcohol outlet density. Kingdon’s Streams Model (2011) guided a directed content analysis of policy-related documents (n=69) and transcripts from semi-structured interviews with a range of policy actors, including government policymakers, alcohol researchers, knowledge translation actors, and media personnel (n=11). Results: The grocery outlet expansion initiative was framed as an economic and consumer convenience initiative within policy-related documents. Moreover, many interview participants perceived that the decision to implement the expansion preceded stakeholder consultations. Thus, despite efforts to highlight concern regarding increases to outlet density, knowledge translation strategies by public health actors remained reactive and unpersuasive. Accordingly, the policy appears largely incongruent with pre-existing public health frameworks, including a Health in All Policies approach more broadly. Conclusion: Health information pertaining to outlet density appears to have had a minimal role in informing the development and implementation of Ontario’s expansion policy. The Ontario government is encouraged prioritize health considerations in future policy development to prevent potential unintended consequences to population health.

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