The utilization of research evidence in Health Workforce Policies: the perspectives of Portuguese and Brazilian National Policy-Makers.

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Craveiro, Isabel; Hortale, Virginia; Oliveira, Ana Paula Cavalcante de; Dal Poz, Mario; Portela, Gustavo; Dussault, Gilles

2018-03-01

The production of knowledge on Human Resources for Health (HRH) issues has increased exponentially since 2000 but integration of the research in the policy-making process is often lagging. We looked at how research on HRH contributes or not to inform policy decisions and interventions affecting the health workforce in Portugal and Brazil. We designed a comparative case study of semi-structured interviews with present and past national decision-makers, policy advisors and researchers. Issues explored included the existence of a national HRH policy and the use, or non-use, of research evidence by policy makers and reasons to do so. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Policy-makers in Brazil recognize a greater use of evidence in the process of defining HRH policy when compared to Portugal's. But the existence of formal instruments to support policy development is not sufficient to ensure that policies are informed by evidence. In both countries the importance of the use of evidence in the formulation of policies was recognized by policy-makers. However, the influence of other factors, such as political pressures from various lobby groups and from the media and the policy short timeframe which requires rapid responses, is predominant.

Implementation research evidence uptake and use for policy-making

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Panisset Ulysses

2012-07-01

Full Text Available Abstract A major obstacle to the progress of the Millennium Development Goals has been the inability of health systems in many low- and middle-income countries to effectively implement evidence-informed interventions. This article discusses the relationships between implementation research and knowledge translation and identifies the role of implementation research in the design and execution of evidence-informed policy. After a discussion of the benefits and synergies needed to translate implementation research into action, the article discusses how implementation research can be used along the entire continuum of the use of evidence to inform policy. It provides specific examples of the use of implementation research in national level programmes by looking at the scale up of zinc for the treatment of childhood diarrhoea in Bangladesh and the scaling up of malaria treatment in Burkina Faso. A number of tested strategies to support the transfer of implementation research results into policy-making are provided to help meet the standards that are increasingly expected from evidence-informed policy-making practices.

Views of health system policymakers on the role of research in health policymaking in Israel.

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Ellen, Moriah E; Horowitz, Einav; Vaknin, Sharona; Lavis, John N

2016-01-01

The use of research evidence in health policymaking is an international challenge. Health systems, including that of Israel, are usually characterized by scarce resources and the necessity to make rapid policy decisions. Knowledge transfer and exchange (KTE) has emerged as a paradigm to start bridging the "know-do" gap. The purpose of this study was to explore the views of health system policymakers and senior executives involved in the policy development process in Israel regarding the role of health systems and policy research (HSPR) in health policymaking, the barriers and facilitators to the use of evidence in the policymaking process, and suggestions for improving the use of HSPR in the policymaking process. A survey and an interview were verbally administered in a single face-to-face meeting with health system policymakers and senior executives involved in the policy development process in Israel. The data collection period was from July to October 2014. The potential participants included members of Knesset, officials from Israel's Ministry of Health, Ministry of Finance, health services organizations, and other stakeholder organizations (i.e., National Insurance Institute). The close-ended questions were based on previous surveys that had been conducted in this field. Interviews were tape recorded and transcribed. Descriptive statistics were conducted for close ended survey-questions and thematic analysis was conducted for open-ended interview questions. There were 32 participants in this study. Participants felt that the use of HSPR helps raise awareness on policy issues, yet the actual use of HSPR was hindered for many reasons. Facilitators do exist to support the use of HSPR in the policymaking process, such as a strong foundation of relationships between researchers and policymakers. However, many barriers exist such as the lack of relevance and timeliness of much of the currently available research to support decision-making and the paucity of funding

Research, evidence and policymaking: the perspectives of policy actors on improving uptake of evidence in health policy development and implementation in Uganda

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Orem Juliet

2012-02-01

Full Text Available Abstract Background Use of evidence in health policymaking plays an important role, especially in resource-constrained settings where informed decisions on resource allocation are paramount. Several knowledge translation (KT models have been developed, but few have been applied to health policymaking in low income countries. If KT models are expected to explain evidence uptake and implementation, or lack of it, they must be contextualized and take into account the specificity of low income countries for example, the strong influence of donors. The main objective of this research is to elaborate a Middle Range Theory (MRT of KT in Uganda that can also serve as a reference for other low- and middle income countries. Methods This two-step study employed qualitative approaches to examine the principal barriers and facilitating factors to KT. Step 1 involved a literature review and identification of common themes. The results informed the development of the initial MRT, which details the facilitating factors and barriers to KT at the different stages of research and policy development. In Step 2, these were further refined through key informant interviews with policymakers and researchers in Uganda. Deductive content and thematic analysis was carried out to assess the degree of convergence with the elements of the initial MRT and to identify other emerging issues. Results Review of the literature revealed that the most common emerging facilitating factors could be grouped under institutional strengthening for KT, research characteristics, dissemination, partnerships and political context. The analysis of interviews, however, showed that policymakers and researchers ranked institutional strengthening for KT, research characteristics and partnerships as the most important. New factors emphasized by respondents were the use of mainstreamed structures within MoH to coordinate and disseminate research, the separation of roles between researchers and

Do evidence summaries increase policy-makers' use of evidence from systematic reviews: A systematic review protocol.

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Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter

2015-09-28

Systematic reviews are important for decision-makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision-makers. This systematic review will assess the effectiveness of systematic review summaries on increasing policymakers' use of systematic review evidence and to identify the components or features of these summaries that are most effective. We will include studies of policy-makers at all levels as well as health-system managers. We will include studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that present evidence in a summarized form. The primary outcomes are the following: (1) use of systematic review summaries decision-making (e.g., self-reported use of the evidence in policy-making, decision-making) and (2) policy-maker understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We will conduct a systematic review of randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series (ITS) studies. The results of this review will inform the development of future systematic review summaries to ensure that systematic review evidence is accessible to and used by policy-makers making health-related decisions.

Evidence-based policymaking: A review

Directory of Open Access Journals (Sweden)

Karen Nortje

2010-05-01

Full Text Available The process of facilitating the uptake of evidence, for example, scientific research findings, into the policymaking process is multifaceted and thus complex. It is therefore important for scientists to understand this process in order to influence it more effectively. Similarly, policymakers need to understand the complexities of the scientific process to improve their interaction with the scientific sphere. This literature review addresses those factors that influence the uptake of scientific evidence into policymaking, the barriers to using science in policymaking, as well as recommendations for improved science–policymaking interaction. A visual diagram of the gears of a car is used to convey the message of the complexities around the engagement between science and policymaking. It is concluded that the issue of evidence-based policymaking remains unresolved and questions for future research on the science–policy interface are raised.

Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy?

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Cairney, Paul; Oliver, Kathryn

2017-04-26

There is extensive health and public health literature on the 'evidence-policy gap', exploring the frustrating experiences of scientists trying to secure a response to the problems and solutions they raise and identifying the need for better evidence to reduce policymaker uncertainty. We offer a new perspective by using policy theory to propose research with greater impact, identifying the need to use persuasion to reduce ambiguity, and to adapt to multi-level policymaking systems.We identify insights from secondary data, namely systematic reviews, critical analysis and policy theories relevant to evidence-based policymaking. The studies are drawn primarily from countries such as the United States, United Kingdom, Canada, Australia and New Zealand. We combine empirical and normative elements to identify the ways in which scientists can, do and could influence policy.We identify two important dilemmas, for scientists and researchers, that arise from our initial advice. First, effective actors combine evidence with manipulative emotional appeals to influence the policy agenda - should scientists do the same, or would the reputational costs outweigh the policy benefits? Second, when adapting to multi-level policymaking, should scientists prioritise 'evidence-based' policymaking above other factors? The latter includes governance principles such the 'co-production' of policy between local public bodies, interest groups and service users. This process may be based primarily on values and involve actors with no commitment to a hierarchy of evidence.We conclude that successful engagement in 'evidence-based policymaking' requires pragmatism, combining scientific evidence with governance principles, and persuasion to translate complex evidence into simple stories. To maximise the use of scientific evidence in health and public health policy, researchers should recognise the tendency of policymakers to base judgements on their beliefs, and shortcuts based on their emotions

Examining the use of health systems and policy research in the health policymaking process in Israel: views of researchers.

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Ellen, Moriah E; Lavis, John N; Shemer, Joshua

2016-09-01

All too often, health policy and management decisions are made without making use of or consulting with the best available research evidence, which can lead to ineffective and inefficient health systems. One of the main actors that can ensure the use of evidence to inform policymaking is researchers. The objective of this study is to explore Israeli health systems and policy researchers' views and perceptions regarding the role of health systems and policy research (HSPR) in health policymaking and the barriers and facilitators to the use of evidence in the policymaking process. A survey of researchers who have conducted HSPR in Israel was developed. The survey consisted of a demographics section and closed questions, which focused on support both within the researchers' organisations and the broader environment for KTE activities, perceptions on the policymaking process, and the potential influencing factors on the process. The survey was sent to all health systems and policy researchers in Israel from academic institutions, hospital settings, government agencies, the four health insurance funds, and research institutes (n = 107). All responses were analyzed using descriptive statistics. For close-ended questions about level of agreement we combined together the two highest categories (agree or strongly agree) for analysis. Thirty-seven respondents participated in the survey. While many respondents felt that the use of HSPR may help raise awareness on policy issues, the majority of respondents felt that the actual use of HSPR was hindered for many reasons. While facilitators do exist to support the use of research evidence in policymaking, numerous barriers hinder the process such as challenges in government/provider relations, policymakers lacking the expertise for acquiring, assessing, and applying HSPR and priorities in the health system drawing attention away from HSPR. Furthermore, it is perceived by a majority of respondents that the health insurance funds

Towards a better understanding of the nomenclature used in information-packaging efforts to support evidence-informed policymaking in low- and middle-income countries.

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Adam, Taghreed; Moat, Kaelan A; Ghaffar, Abdul; Lavis, John N

2014-06-02

The growing recognition of the importance of concisely communicating research evidence and other policy-relevant information to policymakers has underpinned the development of several information-packaging efforts over the past decade. This has led to a wide variability in the types of documents produced, which is at best confusing and at worst discouraging for those they intend to reach. This paper has two main objectives: to develop a better understanding of the range of documents and document names used by the organizations preparing them; and to assess whether there are any consistencies in the characteristics of sampled documents across the names employed to label (in the title) or describe (in the document or website) them. We undertook a documentary analysis of web-published document series that are prepared by a variety of organizations with the primary intention of providing information to health systems policymakers and stakeholders, and addressing questions related to health policy and health systems with a focus on low- and middle-income countries. No time limit was set. In total, 109 individual documents from 24 series produced by 16 different organizations were included. The name 'policy brief/briefing' was the most frequently used (39%) to label or describe a document, and was used in all eight broad content areas that we identified, even though they did not have obviously common traits among them. In terms of document characteristics, most documents (90%) used skimmable formats that are easy to read, with understandable, jargon-free, language (80%). Availability of information on the methods (47%) or the quality of the presented evidence (27%) was less common. One-third (32%) chose the topic based on an explicit process to assess the demand for information from policy makers and even fewer (19%) engaged with policymakers to discuss the content of these documents such as through merit review. This study highlights the need for organizations embarking

Research priority setting for health policy and health systems strengthening in Nigeria: the policymakers and stakeholders perspective and involvement.

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Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Ndukwe, Chinwendu Daniel; Oyibo, Patrick Gold; Onwe, Friday; Aulakh, Bhupinder Kaur

2013-01-01

Nigeria is one of the low and middle income countries (LMICs) facing severe resource constraint, making it impossible for adequate resources to be allocated to the health sector. Priority setting becomes imperative because it guides investments in health care, health research and respects resource constraints. The objective of this study was to enhance the knowledge and understanding of policymakers on research priority setting and to conduct a research priority setting exercise. A one-day evidence-to-policy research priority setting meeting was held. The meeting participants included senior and middle level policymakers and key decision makers/stakeholders in the health sector in Ebonyi State southeastern Nigeria. The priorities setting meeting involved a training session on priority setting process and conduction of priority setting exercise using the essential national health research (ENHR) approach. The focus was on the health systems building blocks (health workforce; health finance; leadership/governance; medical products/technology; service delivery; and health information/evidence). Of the total of 92 policymakers invited 90(97.8%) attended the meeting. It was the consensus of the policymakers that research should focus on the challenges of optimal access to health products and technology; effective health service delivery and disease control under a national emergency situation; the shortfalls in the supply of professional personnel; and the issues of governance in the health sector management. Research priority setting exercise involving policymakers is an example of demand driven strategy in the health policymaking process capable of reversing inequities and strengthening the health systems in LMICs.

Federated health information architecture: Enabling healthcare providers and policymakers to use data for decision-making.

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Kumar, Manish; Mostafa, Javed; Ramaswamy, Rohit

2018-05-01

Health information systems (HIS) in India, as in most other developing countries, support public health management but fail to enable healthcare providers to use data for delivering quality services. Such a failure is surprising, given that the population healthcare data that the system collects are aggregated from patient records. An important reason for this failure is that the health information architecture (HIA) of the HIS is designed primarily to serve the information needs of policymakers and program managers. India has recognised the architectural gaps in its HIS and proposes to develop an integrated HIA. An enabling HIA that attempts to balance the autonomy of local systems with the requirements of a centralised monitoring agency could meet the diverse information needs of various stakeholders. Given the lack of in-country knowledge and experience in designing such an HIA, this case study was undertaken to analyse HIS in the Bihar state of India and to understand whether it would enable healthcare providers, program managers and policymakers to use data for decision-making. Based on a literature review and data collected from interviews with key informants, this article proposes a federated HIA, which has the potential to improve HIS efficiency; provide flexibility for local innovation; cater to the diverse information needs of healthcare providers, program managers and policymakers; and encourage data-based decision-making.

Exploring the dynamics of food-related policymaking processes and evidence use in Fiji using systems thinking.

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Waqa, Gade; Moodie, Marj; Snowdon, Wendy; Latu, Catherine; Coriakula, Jeremaia; Allender, Steven; Bell, Colin

2017-08-29

Obesity and non-communicable diseases are significant public health issues globally and particularly in the Pacific. Poor diet is a major contributor to this issue and policy change is a powerful lever to improve food security and diet quality. This study aims to apply systems thinking to identify the causes and consequences of poor evidence use in food-related policymaking in selected government ministries in Fiji and to illicit strategies to strengthen the use of evidence in policymaking. The Ministry of Health and Medical Services and the Ministry of Agriculture in Fiji were invited through their respective Permanent Secretaries to participate in the study. Three 180-minute group model building (GMB) workshops were conducted separately in each ministry over three consecutive days with selected policymakers who were instrumental in developing food-related policies designed to prevent non-communicable diseases. The GMB workshops mapped the process of food-related policymaking and the contribution of scientific and local evidence to the process, and identified actions to enhance the use of evidence in policymaking. An average of 10 policymakers participated from each ministry. The causal loop diagrams produced by each ministry illustrated the causes and consequences of insufficient evidence use in developing food policies or precursors of the specific actions. These included (1) consultation, (2) engagement with stakeholders, (3) access and use of evidence, and (4) delays in policy processes. Participants agreed to potential leverage points on the themes above, addressing pertinent policymaker challenges in precursor control, including political influence, understanding of trade policies, competing government priorities and level of awareness on the problem. Specific actions for strengthening evidence use included training in policy development and research skills, and strengthening of coordination between ministries. The GMB workshops improved participants

Unravelling networks in local public health policymaking in three European countries - a systems analysis.

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Spitters, Hilde P E M; Lau, Cathrine J; Sandu, Petru; Quanjel, Marcel; Dulf, Diana; Glümer, Charlotte; van Oers, Hans A M; van de Goor, Ien A M

2017-02-03

Facilitating and enhancing interaction between stakeholders involved in the policymaking process to stimulate collaboration and use of evidence, is important to foster the development of effective Health Enhancing Physical Activity (HEPA) policies. Performing an analysis of real-world policymaking processes will help reveal the complexity of a network of stakeholders. Therefore, the main objectives were to unravel the stakeholder network in the policy process by conducting three systems analyses, and to increase insight into the similarities and differences in the policy processes of these European country cases. A systems analysis of the local HEPA policymaking process was performed in three European countries involved in the 'REsearch into POlicy to enhance Physical Activity' (REPOPA) project, resulting in three schematic models showing the main stakeholders and their relationships. The models were used to compare the systems, focusing on implications with respect to collaboration and use of evidence in local HEPA policymaking. Policy documents and relevant webpages were examined and main stakeholders were interviewed. The systems analysis in each country identified the main stakeholders involved and their position and relations in the policymaking process. The Netherlands and Denmark were the most similar and both differed most from Romania, especially at the level of accountability of the local public authorities for local HEPA policymaking. The categories of driving forces underlying the relations between stakeholders were formal relations, informal interaction and knowledge exchange. A systems analysis providing detailed descriptions of positions and relations in the stakeholder network in local level HEPA policymaking is rather unique in this area. The analyses are useful when a need arises for increased interaction, collaboration and use of knowledge between stakeholders in the local HEPA network, as they provide an overview of the stakeholders involved and

Evidence Informed Policy Network (EVIPNet) for Better Health ...

International Development Research Centre (IDRC) Digital Library (Canada)

Research results have no value unless they are made available for due consideration by practitioners and policymakers. Scientific articles are not enough. There is need to package research results for a wider audience and to insure that the flow of information goes both ways, resulting in evidence-informed policy and ...

Using media to impact health policy-making: an integrative systematic review.

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Bou-Karroum, Lama; El-Jardali, Fadi; Hemadi, Nour; Faraj, Yasmine; Ojha, Utkarsh; Shahrour, Maher; Darzi, Andrea; Ali, Maha; Doumit, Carine; Langlois, Etienne V; Melki, Jad; AbouHaidar, Gladys Honein; Akl, Elie A

2017-04-18

Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media interventions-including social media-on the health policy-making process. Eligible study designs included randomized and non-randomized designs, economic studies, process evaluation studies, stakeholder analyses, qualitative methods, and case studies. We electronically searched Medline, EMBASE, Communication and Mass Media Complete, Cochrane Central Register of Controlled Trials, and the WHO Global Health Library. We followed standard systematic review methodology for study selection, data abstraction, and risk of bias assessment. Twenty-one studies met our eligibility criteria: 10 evaluation studies using either quantitative (n = 7) or qualitative (n = 3) designs and 11 case studies. None of the evaluation studies were on social media. The findings of the evaluation studies suggest that media interventions may have a positive impact when used as accountability tools leading to prioritizing and initiating policy discussions, as tools to increase policymakers' awareness, as tools to influence policy formulation, as awareness tools leading to policy adoption, and as awareness tools to improve compliance with laws and regulations. In one study, media-generated attention had a negative effect on policy advocacy as it mobilized opponents who defeated the passage of the bills that the media intervention advocated for. We judged the confidence in the available evidence as limited due to the risk of bias in the included studies and the indirectness of the evidence. There is currently a lack of reliable evidence to guide decisions on the use of media interventions to influence health policy-making. Additional and better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and

Exploring the use of research evidence in health-enhancing physical activity policies

DEFF Research Database (Denmark)

Hämäläinen, Riitta-Maija; Aro, Arja R.; van de Goor, Ien

2015-01-01

informed by research evidence compared to others. The aims of the present article are to explore the use of research evidence in health-enhancing physical activity (HEPA) policies, identify when research evidence was used, and find what other types of evidence were employed in HEPA policymaking. Methods......Background The gaps observed between the use of research evidence and policy have been reported to be based on the different methods of using research evidence in policymaking by researchers and actual policymakers. Some policies and policymaking processes may therefore be particularly well...... Multidisciplinary teams from six EU member states analysed the use of research evidence and other kinds of evidence in 21 HEPA policies and interviewed 86 key policymakers involved in the policies. Qualitative content analysis was conducted on both policy documents and interview data. Results Research evidence...

Evidence based policy-making: A review

CSIR Research Space (South Africa)

Strydom, FW

2010-04-01

Full Text Available The process of facilitating the uptake of evidence, for example, scientific research findings, into the policymaking process is multifaceted and thus complex. It is therefore important for scientists to understand this process in order to influence...

Evidence-based policy-making in the NHS: exploring the interface between research and the commissioning process.

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Harries, U; Elliott, H; Higgins, A

1999-03-01

The UK National Health Service (NHS) R&D strategy acknowledges the importance of developing an NHS where practice and policy is more evidence-based. This paper is based on a qualitative study which aimed to identify factors which facilitate or impede evidence-based policy-making at a local level in the NHS. The study involved a literature review and case studies of social research projects which were initiated by NHS health authority managers or general practitioner (GP) fundholders in one region of the NHS. Data were collected through in-depth interviews with lead policy-makers, GPs and researchers working on each of the case studies and analysis of project documentation. An over-arching theme from the analysis was that of the complexity of R&D in purchasing. The two worlds of research and health services management often sit uncomfortably together. For this reason it was not possible to describe a 'blueprint' for successful R&D, although several important issues emerged. These include sharing an appropriate model for research utilization, the importance of relationships in shaping R&D, the importance of influence and commitment in facilitating evidence-based change, and the resourcing of R&D in purchasing. These issues have important implications for the strategic development of R&D as well as for individual project application. Moving beyond the rhetoric of evidence-based policy-making is more likely if both policy-makers and researchers openly acknowledge this complexity and give due concern to the issues outlined.

The Use of Information by Policymakers at the Local Community Level.

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Florio, Evelyn; DeMartini, Joseph R.

1993-01-01

Discussion of decision making focuses on a study that was conducted to examine how policymakers at the local community level use social science information in making decisions. The use of social science information and other information sources in two communities examining health care issues is described. (Contains 18 references.) (LRW)

A systematic review of barriers to and facilitators of the use of evidence by policymakers.

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Oliver, Kathryn; Innvar, Simon; Lorenc, Theo; Woodman, Jenny; Thomas, James

2014-01-03

The gap between research and practice or policy is often described as a problem. To identify new barriers of and facilitators to the use of evidence by policymakers, and assess the state of research in this area, we updated a systematic review. Systematic review. We searched online databases including Medline, Embase, SocSci Abstracts, CDS, DARE, Psychlit, Cochrane Library, NHSEED, HTA, PAIS, IBSS (Search dates: July 2000 - September 2012). Studies were included if they were primary research or systematic reviews about factors affecting the use of evidence in policy. Studies were coded to extract data on methods, topic, focus, results and population. 145 new studies were identified, of which over half were published after 2010. Thirteen systematic reviews were included. Compared with the original review, a much wider range of policy topics was found. Although still primarily in the health field, studies were also drawn from criminal justice, traffic policy, drug policy, and partnership working. The most frequently reported barriers to evidence uptake were poor access to good quality relevant research, and lack of timely research output. The most frequently reported facilitators were collaboration between researchers and policymakers, and improved relationships and skills. There is an increasing amount of research into new models of knowledge transfer, and evaluations of interventions such as knowledge brokerage. Timely access to good quality and relevant research evidence, collaborations with policymakers and relationship- and skills-building with policymakers are reported to be the most important factors in influencing the use of evidence. Although investigations into the use of evidence have spread beyond the health field and into more countries, the main barriers and facilitators remained the same as in the earlier review. Few studies provide clear definitions of policy, evidence or policymaker. Nor are empirical data about policy processes or implementation of

Advancing Evidence Based Policymaking and Regulation to Ensure ...

International Development Research Centre (IDRC) Digital Library (Canada)

Advancing Evidence Based Policymaking and Regulation to Ensure Greater ... which is Communications Policy Research South (CPRsouth), a yearly conference that ... policy intellectuals through tutorials for young scholars and internships.

Enhancing the contribution of research to health care policy-making: a case study of the Dutch Health Care Performance Report.

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Hegger, Ingrid; Marks, Lisanne K; Janssen, Susan W J; Schuit, Albertine J; van Oers, Hans A M

2016-01-01

The Dutch Health Care Performance Report, issued by the National Institute of Public Health and the Environment, aims to monitor health care performance in The Netherlands. Both the National Institute and the Ministry of Health wish to increase the contribution of the Report to health care policy-making. Our aim was to identify ways to achieve that. We used contribution mapping as a theoretical framework that recognizes alignment of research as crucial to managing contributions to policy-making. To investigate which areas need alignment efforts by researchers and/or policy-makers, we interviewed National Institute researchers and policy-makers from the Ministry of Health and assessed the process for developing the 2010 Report. We identified six areas where alignment is specifically relevant for enhancing the contributions of future versions of the Dutch Health Care Performance Report: well-balanced information for different ministerial directorates; backstage work; double role actors; reports of other knowledge institutes; data collection/generation and presentation forms. The contribution of health care performance reporting to policy-making is complex and requires continuous alignment efforts between researchers and policy-makers. These efforts should form an inseparable part of health care performance reporting and although this demands considerable resources, it is worth considering since it may pay back in better contributions to policy-making. © The Author(s) 2015.

Galvanizers, guides, champions, and shields: the many ways that policymakers use public health researchers.

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Haynes, Abby S; Gillespie, James A; Derrick, Gemma E; Hall, Wayne D; Redman, Sally; Chapman, Simon; Sturk, Heidi

2011-12-01

Public health researchers make a limited but important contribution to policy development. Some engage with policy directly through committees, advisory boards, advocacy coalitions, ministerial briefings, intervention design consultation, and research partnerships with government, as well as by championing research-informed policy in the media. Nevertheless, the research utilization literature has paid little attention to these diverse roles and the ways that policymakers use them. This article describes how policymakers use researchers in policymaking and examines how these activities relate to models of research utilization. It also explores the extent to which policymakers' accounts of using researchers concur with the experiences of "policy-engaged" public health researchers. We conducted semi-structured interviews with thirty-two Australian civil servants, parliamentary ministers, and ministerial advisers identified as "research-engaged" by public health researchers. We used structured and inductive coding to generate categories that we then compared with some of the major research utilization models. Policymakers were sophisticated and multifaceted users of researchers for purposes that we describe as Galvanizing Ideas, Clarification and Advice, Persuasion, and Defense. These categories overlapped but did not wholly fit with research utilization models. Despite the negative connotation, "being used" was reported as reciprocal and uncompromising, although researchers and policymakers were likely to categorize these uses differently. Policymakers countered views expressed by some researchers. That is, they sought robust dialogue and creative thinking rather than compliance, and they valued expert opinion when research was insufficient for decision making. The technical/political character of policy development shaped the ways in which researchers were used. Elucidating the diverse roles that public health researchers play in policymaking, and the multiple ways

Trade policy governance: What health policymakers and advocates need to know.

Science.gov (United States)

Jarman, Holly

2017-11-01

Trade policies affect determinants of health as well as the options and resources available to health policymakers. There is therefore a need for health policymakers and related stakeholders in all contexts to understand and connect with the trade policymaking process. This paper uses the TAPIC (transparency, accountability, participation, integrity, capacity) governance framework to analyze how trade policy is commonly governed. I conclude that the health sector is likely to benefit when transparency in trade policymaking is increased, since trade negotiations to date have often left out health advocates and policymakers. Trade policymakers and negotiators also tend to be accountable to economic and trade ministries, which are in turn accountable to economic and business interests. Neither tend to appreciate the health consequences of trade and trade policies. Greater accountability to health ministries and interests, and greater participation by them, could improve the health effects of trade negotiations. Trade policies are complex, requiring considerable policy capacity to understand and influence. Nevertheless, investing in understanding trade can pay off in terms of managing future legal risks. Copyright © 2017. Published by Elsevier B.V.

Galvanizers, Guides, Champions, and Shields: The Many Ways That Policymakers Use Public Health Researchers

Science.gov (United States)

Haynes, Abby S; Gillespie, James A; Derrick, Gemma E; Hall, Wayne D; Redman, Sally; Chapman, Simon; Sturk, Heidi

2011-01-01

Context Public health researchers make a limited but important contribution to policy development. Some engage with policy directly through committees, advisory boards, advocacy coalitions, ministerial briefings, intervention design consultation, and research partnerships with government, as well as by championing research-informed policy in the media. Nevertheless, the research utilization literature has paid little attention to these diverse roles and the ways that policymakers use them. This article describes how policymakers use researchers in policymaking and examines how these activities relate to models of research utilization. It also explores the extent to which policymakers’ accounts of using researchers concur with the experiences of “policy-engaged” public health researchers. Methods We conducted semi-structured interviews with thirty-two Australian civil servants, parliamentary ministers, and ministerial advisers identified as “research-engaged” by public health researchers. We used structured and inductive coding to generate categories that we then compared with some of the major research utilization models. Findings Policymakers were sophisticated and multifaceted users of researchers for purposes that we describe as Galvanizing Ideas, Clarification and Advice, Persuasion, and Defense. These categories overlapped but did not wholly fit with research utilization models. Despite the negative connotation, “being used” was reported as reciprocal and uncompromising, although researchers and policymakers were likely to categorize these uses differently. Policymakers countered views expressed by some researchers. That is, they sought robust dialogue and creative thinking rather than compliance, and they valued expert opinion when research was insufficient for decision making. The technical/political character of policy development shaped the ways in which researchers were used. Conclusions Elucidating the diverse roles that public health

An assessment of maternal, newborn and child health implementation studies in Nigeria: implications for evidence informed policymaking and practice

Directory of Open Access Journals (Sweden)

Chigozie Jesse Uneke

2016-08-01

Full Text Available Background: The introduction of implementation science into maternal, newborn and child health (MNCH research has facilitated better methods to improve uptake of research findings into practices. With increase in implementation research related to MNCH world-wide, stronger scientific evidence are now available and have improved MNCH policies in many countries including Nigeria. The purpose of this study was to review MNCH implementation studies undertaken in Nigeria in order to understand the extent the evidence generated informed better policy. Methods: This study was a systematic review. A MEDLINE Entrez PubMed search was performed in August 2015 and implementation studies that investigated MNCH in Nigeria from 1966 to 2015 in relation to health policy were sought. Search key words included Nigeria, health policy,maternal, newborn, and child health. Only policy relevant studies that were implementation or intervention research which generated evidence to improve MNCH in Nigeria were eligible and were selected. Results: A total of 18 relevant studies that fulfilled the study inclusion criteria were identified out of 471 studies found. These studies generated high quality policy relevance evidence relating to task shifting, breastfeeding practices, maternal nutrition, childhood immunization, kangaroo mother care (KMC, prevention of maternal to child transmission of HIV, etc. These indicated significant improvements in maternal health outcomes in localities and health facilities where the studies were undertaken. Conclusion: There is a dire need for more implementation research related to MNCH in low income settings because the priority for improved MNCH outcome is not so much the development of new technologies but solving implementation issues, such as how to scale up and evaluate interventions within complex health systems.

Using systems thinking in state health policymaking: an educational initiative.

Science.gov (United States)

Minyard, Karen J; Ferencik, Rachel; Ann Phillips, Mary; Soderquist, Chris

2014-06-01

In response to limited examples of opportunities for state policymakers to learn about and productively discuss the difficult, adaptive challenges of our health system, the Georgia Health Policy Center developed an educational initiative that applies systems thinking to health policymaking. We created the Legislative Health Policy Certificate Program - an in-depth, multi-session series for lawmakers and their staff - concentrating on building systems thinking competencies and health content knowledge by applying a range of systems thinking tools: behavior over time graphs, stock and flow maps, and a system dynamics-based learning lab (a simulatable model of childhood obesity). Legislators were taught to approach policy issues from the big picture, consider changing dynamics, and explore higher-leverage interventions to address Georgia's most intractable health challenges. Our aim was to determine how we could improve the policymaking process by providing a systems thinking-focused educational program for legislators. Over 3 years, the training program resulted in policymakers' who are able to think more broadly about difficult health issues. The program has yielded valuable insights into the design and delivery of policymaker education that could be applied to various disciplines outside the legislative process.

Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review

Directory of Open Access Journals (Sweden)

Roxanne Keynejad

2016-10-01

Full Text Available Abstract Background Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs. We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. Methods We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review. Results Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. Conclusions This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed

A Case Study of the Philadelphia Sugar-Sweetened Beverage Tax Policymaking Process: Implications for Policy Development and Advocacy.

Science.gov (United States)

Purtle, Jonathan; Langellier, Brent; Lê-Scherban, Félice

Policymakers are increasingly proposing sugar-sweetened beverage (SSB) taxes as an evidence-based strategy to reduce chronic disease risk; and local health departments (LHDs) are well-positioned to play a role in SSB policy development and advocacy. However, most SSB tax proposals fail to become law and limited empiric guidance exists to inform advocacy efforts. In June 2016, Philadelphia, Pennsylvania, passed an SSB tax. To identify features of the Philadelphia SSB tax policymaking process that contributed to the proposal's passage. Qualitative case study. Semistructured interviews were conducted with key informants closely involved with the policymaking process. Interviews were audio-recorded and transcribed. Local news media about the SSB tax proposal were analyzed to triangulate interview findings. Analysis was conducted in NVivo 10 using inductive qualitative content analysis. Philadelphia, Pennsylvania, during the SSB tax policymaking in process. Nine key informants (2 city councilpersons, 4 city agency officials, 1 community-based advocate, 1 news reporter, and 1 researcher). The Philadelphia SSB tax proposal was introduced with the explicit goal of financing universal prekindergarten and deliberately not framed as a health intervention. This framing shifted contentious debates about government involvement in individual behavior toward discussions about how to finance universal prekindergarten, a goal for which broad support existed. The LHD played an important role in communicating research evidence about potential health benefits of the SSB tax proposal at the end of the policymaking process. During local SSB tax policy development processes, LHD officials and other advocates should encourage policymakers to design SSB tax policies so that revenue is directed toward community investments for which broad public support exists. When communicating with policymakers and the public, LHDs should consider emphasizing how SSB tax revenue will be used in addition

SUPPORT Tools for Evidence-informed policymaking in health 6: Using research evidence to address how an option will be implemented

Directory of Open Access Journals (Sweden)

Lavis John N

2009-12-01

Full Text Available Abstract This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. After a policy decision has been made, the next key challenge is transforming this stated policy position into practical actions. What strategies, for instance, are available to facilitate effective implementation, and what is known about the effectiveness of such strategies? We suggest five questions that can be considered by policymakers when implementing a health policy or programme. These are: 1. What are the potential barriers to the successful implementation of a new policy? 2. What strategies should be considered in planning the implementation of a new policy in order to facilitate the necessary behavioural changes among healthcare recipients and citizens? 3. What strategies should be considered in planning the implementation of a new policy in order to facilitate the necessary behavioural changes in healthcare professionals? 4. What strategies should be considered in planning the implementation of a new policy in order to facilitate the necessary organisational changes? 5. What strategies should be considered in planning the implementation of a new policy in order to facilitate the necessary systems changes?

Unravelling networks in local public health policymaking in three European countries : A systems analysis

NARCIS (Netherlands)

Spitters, H.P.E.M.; Lau, C.J.; Sandu, P.; Quanjel, M.M.H.; Dulf, D.; Glümer, C.; Van Oers, J.A.M.; Van De Goor, L.A.M.

2017-01-01

Background Facilitating and enhancing interaction between stakeholders involved in the policymaking process to stimulate collaboration and use of evidence, is important to foster the development of effective Health Enhancing Physical Activity (HEPA) policies. Performing an analysis of real-world

Use of research evidence in policymaking in three Danish municipalities

DEFF Research Database (Denmark)

Jakobsen, Mette Winge; Lau, Cathrine Juel; Skovgaard, Thomas

2018-01-01

and statistical data as well as expert consultation were mostly used. Lack of transparency of RE use complicated the tracking of sources from introduction to actual policy impact. It can be concluded that the policymakers engaged in health issues have a wider use of RE than the policymakers working with more...... sports-oriented issues....

Designing evaluation studies to optimally inform policy: what factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?

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Wu, Shishi; Legido-Quigley, Helena; Spencer, Julia; Coker, Richard James; Khan, Mishal Sameer

2018-02-23

In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. Our qualitative study indicates that training programme evaluations that focus narrowly on direct training

The many meanings of evidence: a comparative analysis of the forms and roles of evidence within three health policy processes in Cambodia.

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Walls, Helen; Liverani, Marco; Chheng, Kannarath; Parkhurst, Justin

2017-11-10

Discussions within the health community routinely emphasise the importance of evidence in informing policy formulation and implementation. Much of the support for the evidence-based policy movement draws from concern that policy decisions are often based on inadequate engagement with high-quality evidence. In many such discussions, evidence is treated as differing only in quality, and assumed to improve decisions if it can only be used more. In contrast, political science scholars have described this as an overly simplistic view of the policy-making process, noting that research 'use' can mean a variety of things and relies on nuanced aspects of political systems. An approach more in recognition of how policy-making systems operate in practice can be to consider how institutions and ideas influence which pieces of evidence appear to be relevant for, and are used within, different policy processes. Drawing on in-depth interviews undertaken in 2015-2016 with key health sector stakeholders in Cambodia, we investigate the evidence perceived to be relevant to policy decisions for three contrasting health policy examples, namely tobacco control, HIV/AIDS and performance-based salary incentives. These cases allow us to examine the ways that policy-relevant evidence may differ given the framing of the issue and the broader institutional context in which evidence is considered. The three health issues show few similarities in how pieces of evidence were used in various aspects of policy-making, despite all being discussed within a broad policy environment in which evidence-based policy-making is rhetorically championed. Instead, we find that evidence use can be better understood by mapping how these health policy issues differ in terms of the issue characteristics, and also in terms of the stakeholders structurally established as having a dominant influence for each issue. Both of these have important implications for evidence use. Contrasting concerns of key stakeholders

Policymaking to preserve privacy in disclosure of public health data: a suggested framework.

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Mizani, Mehrdad A; Baykal, Nazife

2015-03-01

Health organisations in Turkey gather a vast amount of valuable individual data that can be used for public health purposes. The organisations use rigid methods to remove some useful details from the data while publishing the rest of the data in a highly aggregated form, mostly because of privacy concerns and lack of standardised policies. This action leads to information loss and bias affecting public health research. Hence, organisations need dynamic policies and well-defined procedures rather than a specific algorithm to protect the privacy of individual data. To address this need, we developed a framework for the systematic application of anonymity methods while reducing and objectively reporting the information loss without leaking confidentiality. This framework acts as a roadmap for policymaking by providing high-level pseudo-policies with semitechnical guidelines in addition to some sample scenarios suitable for policymakers, public health programme managers and legislators. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Facilitating the use of evidence for decision-making – a review of 64 WHO Health Evidence Network synthesis reports and its impact

DEFF Research Database (Denmark)

Nguen, Tim; Takahashi, Ryoko; Kuchenmueller, Tanja

between health policies and improvements in public health. HEN publishes synthesis reports that are timed for key policy-making events and summarizes what is known about the policy issue, the gaps in the evidence, the areas of debate and the policy options. HEN provides technical guidance to authors...... in selecting an appropriate literature search and synthesis method and writing specifically for policy-makers in mind. To facilitate the uptake of evidence in policy-making, HEN collaborates with decision-makers in identifying priority health policy areas, framing a synthesis question and disseminating...... the synthesis reports for key policy-making events. We report on the experience of over 10 years, producing 64 HEN reports and its impact on policy-making....

Model-Based Policymaking: A Framework to Promote Ethical “Good Practice” in Mathematical Modeling for Public Health Policymaking

Science.gov (United States)

Boden, Lisa A.; McKendrick, Iain J.

2017-01-01

Mathematical models are increasingly relied upon as decision support tools, which estimate risks and generate recommendations to underpin public health policies. However, there are no formal agreements about what constitutes professional competencies or duties in mathematical modeling for public health. In this article, we propose a framework to evaluate whether mathematical models that assess human and animal disease risks and control strategies meet standards consistent with ethical “good practice” and are thus “fit for purpose” as evidence in support of policy. This framework is derived from principles of biomedical ethics: independence, transparency (autonomy), beneficence/non-maleficence, and justice. We identify ethical risks associated with model development and implementation and consider the extent to which scientists are accountable for the translation and communication of model results to policymakers so that the strengths and weaknesses of the scientific evidence base and any socioeconomic and ethical impacts of biased or uncertain predictions are clearly understood. We propose principles to operationalize a framework for ethically sound model development and risk communication between scientists and policymakers. These include the creation of science–policy partnerships to mutually define policy questions and communicate results; development of harmonized international standards for model development; and data stewardship and improvement of the traceability and transparency of models via a searchable archive of policy-relevant models. Finally, we suggest that bespoke ethical advisory groups, with relevant expertise and access to these resources, would be beneficial as a bridge between science and policy, advising modelers of potential ethical risks and providing overview of the translation of modeling advice into policy. PMID:28424768

Big Data for Public Health Policy-Making: Policy Empowerment.

Science.gov (United States)

Mählmann, Laura; Reumann, Matthias; Evangelatos, Nikolaos; Brand, Angela

2018-04-04

Digitization is considered to radically transform healthcare. As such, with seemingly unlimited opportunities to collect data, it will play an important role in the public health policy-making process. In this context, health data cooperatives (HDC) are a key component and core element for public health policy-making and for exploiting the potential of all the existing and rapidly emerging data sources. Being able to leverage all the data requires overcoming the computational, algorithmic, and technological challenges that characterize today's highly heterogeneous data landscape, as well as a host of diverse regulatory, normative, governance, and policy constraints. The full potential of big data can only be realized if data are being made accessible and shared. Treating research data as a public good, creating HDC to empower citizens through citizen-owned health data, and allowing data access for research and the development of new diagnostics, therapies, and public health policies will yield the transformative impact of digital health. The HDC model for data governance is an arrangement, based on moral codes, that encourages citizens to participate in the improvement of their own health. This then enables public health institutions and policymakers to monitor policy changes and evaluate their impact and risk on a population level. © 2018 S. Karger AG, Basel.

Applying knowledge translation tools to inform policy: the case of mental health in Lebanon.

Science.gov (United States)

Yehia, Farah; El Jardali, Fadi

2015-06-06

Many reform efforts in health systems fall short because the use of research evidence to inform policy remains scarce. In Lebanon, one in four adults suffers from a mental illness, yet access to mental healthcare services in primary healthcare (PHC) settings is limited. Using an "integrated" knowledge framework to link research to action, this study examines the process of influencing the mental health agenda in Lebanon through the application of Knowledge Translation (KT) tools and the use of a KT Platform (KTP) as an intermediary between researchers and policymakers. This study employed the following KT tools: 1) development of a policy brief to address the lack of access to mental health services in PHC centres, 2) semi-structured interviews with 10 policymakers and key informants, 3) convening of a national policy dialogue, 4) evaluation of the policy brief and dialogue, and 5) a post-dialogue survey. Findings from the key informant interviews and a comprehensive synthesis of evidence were used to develop a policy brief which defined the problem and presented three elements of a policy approach to address it. This policy brief was circulated to 24 participants prior to the dialogue to inform the discussion. The policy dialogue validated the evidence synthesized in the brief, whereby integrating mental health into PHC services was the element most supported by evidence as well as participants. The post-dialogue survey showed that, in the following 6 months, several implementation steps were taken by stakeholders, including establishing national taskforce, training PHC staff, and updating the national essential drug list to include psychiatric medications. Relationships among policymakers, researchers, and stakeholders were strengthened as they conducted their own workshops and meetings after the dialogue to further discuss implementation, and their awareness about and demand for KT tools increased. This case study showed that the use of KT tools in Lebanon to

From Population Databases to Research and Informed Health Decisions and Policy.

Science.gov (United States)

Machluf, Yossy; Tal, Orna; Navon, Amir; Chaiter, Yoram

2017-01-01

In the era of big data, the medical community is inspired to maximize the utilization and processing of the rapidly expanding medical datasets for clinical-related and policy-driven research. This requires a medical database that can be aggregated, interpreted, and integrated at both the individual and population levels. Policymakers seek data as a lever for wise, evidence-based decision-making and information-driven policy. Yet, bridging the gap between data collection, research, and policymaking, is a major challenge. To bridge this gap, we propose a four-step model: (A) creating a conjoined task force of all relevant parties to declare a national program to promote collaborations; (B) promoting a national digital records project, or at least a network of synchronized and integrated databases, in an accessible transparent manner; (C) creating an interoperative national research environment to enable the analysis of the organized and integrated data and to generate evidence; and (D) utilizing the evidence to improve decision-making, to support a wisely chosen national policy. For the latter purpose, we also developed a novel multidimensional set of criteria to illuminate insights and estimate the risk for future morbidity based on current medical conditions. Used by policymakers, providers of health plans, caregivers, and health organizations, we presume this model will assist transforming evidence generation to support the design of health policy and programs, as well as improved decision-making about health and health care, at all levels: individual, communal, organizational, and national.

A multi-faceted approach to promote knowledge translation platforms in eastern Mediterranean countries: climate for evidence-informed policy.

Science.gov (United States)

El-Jardali, Fadi; Ataya, Nour; Jamal, Diana; Jaafar, Maha

2012-05-06

Limited work has been done to promote knowledge translation (KT) in the Eastern Mediterranean Region (EMR). The objectives of this study are to: 1.assess the climate for evidence use in policy; 2.explore views and practices about current processes and weaknesses of health policymaking; 3.identify priorities including short-term requirements for policy briefs; and 4.identify country-specific requirements for establishing KT platforms. Senior policymakers, stakeholders and researchers from Algeria, Bahrain, Egypt, Iran, Jordan, Lebanon, Oman, Sudan, Syria, Tunisia, and Yemen participated in this study. Questionnaires were used to assess the climate for use of evidence and identify windows of opportunity and requirements for policy briefs and for establishing KT platforms. Current processes and weaknesses of policymaking were appraised using case study scenarios. Closed-ended questions were analyzed descriptively. Qualitative data was analyzed using thematic analysis. KT activities were not frequently undertaken by policymakers and researchers in EMR countries, research evidence about high priority policy issues was rarely made available, and interaction between policymakers and researchers was limited, and policymakers rarely identified or created places for utilizing research evidence in decision-making processes. Findings emphasized the complexity of policymaking. Donors, political regimes, economic goals and outdated laws were identified as key drivers. Lack of policymakers' abilities to think strategically, constant need to make quick decisions, limited financial resources, and lack of competent and trained human resources were suggested as main weaknesses. Despite the complexity of policymaking processes in countries from this region, the absence of a structured process for decision making, and the limited engagement of policymakers and researchers in KT activities, there are windows of opportunity for moving towards more evidence informed policymaking.

Evidence-informed health policy 1 - synthesis of findings from a multi-method study of organizations that support the use of research evidence.

Science.gov (United States)

Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J

2008-12-17

Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs). We undertook a multi-method study in three phases - a survey, interviews, and case descriptions that drew on site visits - and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1) collaborate with other organizations; 2) establish strong links with policymakers and involve stakeholders in the work; 3) be independent and manage conflicts of interest among those involved in the work; 4) build capacity among those working in the organization; 5) use good methods and be transparent in the work; 6) start small, have a clear audience and scope, and address important questions; and 7) be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO) and other international organizations and networks: 1) support collaborations among organizations; 2) support local adaptation efforts; 3) mobilize support; and 4) create global public goods. This synthesis of

The Political Implications of Performance Management and Evidence-Based Policymaking

DEFF Research Database (Denmark)

Triantafillou, Peter

2015-01-01

Over the last few decades performance management (PM) has invaded the public sector in most Organisation for Economic Co-operation and Development (OECD) countries. More recently, we have seen increasing demands for evidence-based policymaking (EP). This article critically discusses the political...

The Australian government's review of positron emission tomography: evidence-based policy-making in action.

Science.gov (United States)

Ware, Robert E; Francis, Hilton W; Read, Kenneth E

2004-06-21

The Commonwealth Government constituted the Medicare Services Advisory Committee (MSAC) to implement its commitment to entrench the principles of evidence-based medicine in Australian clinical practice. With its recent review of positron emission tomography (PETReview), the Commonwealth intervened in an established MSAC process, and sanctioned the stated objective to restrict expenditure on the technology. In our opinion: The evaluation of evidence by PETReview was fundamentally compromised by a failure to meet the terms of reference, poor science, poor process and unique decision-making benchmarks. By accepting the recommendations of PETReview, the Commonwealth is propagating information which is not of the highest quality. The use of inferior-quality information for decision-making by doctors, patients and policy-makers is likely to harm rather than enhance healthcare outcomes.

An exploratory study identifying where local government public health decision makers source their evidence for policy.

Science.gov (United States)

Stoneham, Melissa; Dodds, James

2014-08-01

The Western Australian (WA) Public Health Bill will replace the antiquated Health Act 1911. One of the proposed clauses of the Bill requires all WA local governments to develop a Public Health Plan. The Bill states that Public Health Plans should be based on evidence from all levels, including national and statewide priorities, community needs, local statistical evidence, and stakeholder data. This exploratory study, which targeted 533 WA local government officers, aimed to identify the sources of evidence used to generate the list of public health risks to be included in local government Public Health Plans. The top four sources identified for informing local policy were: observation of the consequences of the risks in the local community (24.5%), statewide evidence (17.6%), local evidence (17.6%) and coverage in local media (16.2%). This study confirms that both hard and soft data are used to inform policy decisions at the local level. Therefore, the challenge that this study has highlighted is in the definition or constitution of evidence. SO WHAT? Evidence is critical to the process of sound policy development. This study highlights issues associated with what actually constitutes evidence in the policy development process at the local government level. With the exception of those who work in an extremely narrow field, it is difficult for local government officers, whose role includes policymaking, to read the vast amount of information that has been published in their area of expertise. For those who are committed to the notion of evidence-based policymaking, as advocated within the WA Public Health Bill, this presents a considerable challenge.

Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries

DEFF Research Database (Denmark)

Spitters, H P E M; van Oers, J A M; Sandu, P

2017-01-01

the design and development of the generic frame of the In2Action game focusing on enhancing collaboration in local public health policymaking networks. By keeping the game generic, it became suitable for each of the three country cases with only minor changes. The generic frame of the game is expected......BACKGROUND: One of the key elements to enhance the uptake of evidence in public health policies is stimulating cross-sector collaboration. An intervention stimulating collaboration is a policy game. The aim of this study was to describe the design and methods of the development process......: In2Action was developed as a role-play game of one day, with main focus to develop in collaboration a cross-sector implementation plan based on the approved strategic local public health policy. CONCLUSIONS: This study introduced an innovative intervention for public health policymaking. It described...

Determinants of knowledge translation from health technology assessment to policy-making in China: From the perspective of researchers

Science.gov (United States)

Liu, Wenbin; Shi, Lizheng; Pong, Raymond W.; Dong, Hengjin; Mao, Yiwei; Tang, Meng; Chen, Yingyao

2018-01-01

Background For health technology assessment (HTA) to be more policy relevant and for health technology-related decision-making to be truly evidence-based, promoting knowledge translation (KT) is of vital importance. Although some research has focused on KT of HTA, there is a dearth of literature on KT determinants and the situation in developing countries and transitional societies remains largely unknown. Objective To investigate the determinants of HTA KT from research to health policy-making from the perspective of researchers in China. Design Cross-sectional study. Methods A structured questionnaire which focused on KT was distributed to HTA researchers in China. KT activity levels in various fields of HTA research were compared, using one-way ANOVA. Principal component analysis was performed to provide a basis to combine similar variables. To investigate the determinants of KT level, multiple linear regression analysis was performed. Results Based on a survey of 382 HTA researchers, it was found that HTA KT wasn’t widespread in China. Furthermore, results showed that no significant differences existed between the various HTA research fields. Factors, such as attitudes of researchers toward HTA and evidence utilization, academic ranks and linkages between researchers and policy-makers, had significant impact on HTA KT (p-valuespolicy-makers, policy-relevance of HTA research, practicality of HTA outcomes and making HTA reports easier to understand also contributed to predicting KT level. However, academic nature of HTA research was negatively associated with KT level. Conclusion KT from HTA to policy-making was influenced by many factors. Of particular importance were collaborations between researchers and policy-makers, ensuring policy relevance of HTA and making HTA evidence easier to understand by potential users. PMID:29300753

From Population Databases to Research and Informed Health Decisions and Policy

Directory of Open Access Journals (Sweden)

Yossy Machluf

2017-09-01

Full Text Available BackgroundIn the era of big data, the medical community is inspired to maximize the utilization and processing of the rapidly expanding medical datasets for clinical-related and policy-driven research. This requires a medical database that can be aggregated, interpreted, and integrated at both the individual and population levels. Policymakers seek data as a lever for wise, evidence-based decision-making and information-driven policy. Yet, bridging the gap between data collection, research, and policymaking, is a major challenge.The modelTo bridge this gap, we propose a four-step model: (A creating a conjoined task force of all relevant parties to declare a national program to promote collaborations; (B promoting a national digital records project, or at least a network of synchronized and integrated databases, in an accessible transparent manner; (C creating an interoperative national research environment to enable the analysis of the organized and integrated data and to generate evidence; and (D utilizing the evidence to improve decision-making, to support a wisely chosen national policy. For the latter purpose, we also developed a novel multidimensional set of criteria to illuminate insights and estimate the risk for future morbidity based on current medical conditions.ConclusionUsed by policymakers, providers of health plans, caregivers, and health organizations, we presume this model will assist transforming evidence generation to support the design of health policy and programs, as well as improved decision-making about health and health care, at all levels: individual, communal, organizational, and national.

Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries.

Science.gov (United States)

Spitters, H P E M; van Oers, J A M; Sandu, P; Lau, C J; Quanjel, M; Dulf, D; Chereches, R; van de Goor, L A M

2017-12-19

One of the key elements to enhance the uptake of evidence in public health policies is stimulating cross-sector collaboration. An intervention stimulating collaboration is a policy game. The aim of this study was to describe the design and methods of the development process of the policy game ‘In2Action’ within a real-life setting of public health policymaking networks in the Netherlands, Denmark and Romania. The development of the policy game intervention consisted of three phases, pre intervention, designing the game intervention and tailoring the intervention. In2Action was developed as a role-play game of one day, with main focus to develop in collaboration a cross-sector implementation plan based on the approved strategic local public health policy. This study introduced an innovative intervention for public health policymaking. It described the design and development of the generic frame of the In2Action game focusing on enhancing collaboration in local public health policymaking networks. By keeping the game generic, it became suitable for each of the three country cases with only minor changes. The generic frame of the game is expected to be generalizable for other European countries to stimulate interaction and collaboration in the policy process.

Acceptability of financial incentives for health behaviour change to public health policymakers: a qualitative study.

Science.gov (United States)

Giles, Emma L; Sniehotta, Falko F; McColl, Elaine; Adams, Jean

2016-09-15

Providing financial incentives contingent on healthy behaviours is one way to encourage healthy behaviours. However, there remains substantial concerns with the acceptability of health promoting financial incentives (HPFI). Previous research has studied acceptability of HPFI to the public, recipients and practitioners. We are not aware of any previous work that has focused particularly on the views of public health policymakers. Our aim was to explore the views of public health policymakers on whether or not HPFI are acceptable; and what, if anything, could be done to maximise acceptability of HPFI. We recruited 21 local, regional and national policymakers working in England via gatekeepers and snowballing. We conducted semi-structured in-depth interviews with participants exploring experiences of, and attitudes towards, HPFI. We analysed data using the Framework approach. Public health policymakers working in England acknowledged that HPFI could be a useful behaviour change tool, but were not overwhelmingly supportive of them. In particular, they raised concerns about effectiveness and cost-effectiveness, potential 'gaming', and whether or not HPFI address the underlying causes of unhealthy behaviours. Shopping voucher rewards, of smaller value, targeted at deprived groups were particularly acceptable to policymakers. Participants were particularly concerned about the response of other stakeholders to HPFI - including the public, potential recipients, politicians and the media. Overall, the interviews reflected three tensions. Firstly, a tension between wanting to trust individuals and promote responsibility; and distrust around the potential for 'gaming the system'. Secondly, a tension between participants' own views about HPFI; and their concerns about the possible views of other stakeholders. Thirdly, a tension between participants' personal distaste of HPFI; and their professional view that they could be a valuable behaviour change tool. There are aspects of

A multi-faceted approach to promote knowledge translation platforms in eastern Mediterranean countries: climate for evidence-informed policy

Directory of Open Access Journals (Sweden)

El-Jardali Fadi

2012-05-01

Full Text Available Abstract Objectives Limited work has been done to promote knowledge translation (KT in the Eastern Mediterranean Region (EMR. The objectives of this study are to: 1.assess the climate for evidence use in policy; 2.explore views and practices about current processes and weaknesses of health policymaking; 3.identify priorities including short-term requirements for policy briefs; and 4.identify country-specific requirements for establishing KT platforms. Methods Senior policymakers, stakeholders and researchers from Algeria, Bahrain, Egypt, Iran, Jordan, Lebanon, Oman, Sudan, Syria, Tunisia, and Yemen participated in this study. Questionnaires were used to assess the climate for use of evidence and identify windows of opportunity and requirements for policy briefs and for establishing KT platforms. Current processes and weaknesses of policymaking were appraised using case study scenarios. Closed-ended questions were analyzed descriptively. Qualitative data was analyzed using thematic analysis. Results KT activities were not frequently undertaken by policymakers and researchers in EMR countries, research evidence about high priority policy issues was rarely made available, and interaction between policymakers and researchers was limited, and policymakers rarely identified or created places for utilizing research evidence in decision-making processes. Findings emphasized the complexity of policymaking. Donors, political regimes, economic goals and outdated laws were identified as key drivers. Lack of policymakers’ abilities to think strategically, constant need to make quick decisions, limited financial resources, and lack of competent and trained human resources were suggested as main weaknesses. Conclusion Despite the complexity of policymaking processes in countries from this region, the absence of a structured process for decision making, and the limited engagement of policymakers and researchers in KT activities, there are windows of

The development of ORACLe: a measure of an organisation's capacity to engage in evidence-informed health policy.

Science.gov (United States)

Makkar, Steve R; Turner, Tari; Williamson, Anna; Louviere, Jordan; Redman, Sally; Haynes, Abby; Green, Sally; Brennan, Sue

2016-01-14

Evidence-informed policymaking is more likely if organisations have cultures that promote research use and invest in resources that facilitate staff engagement with research. Measures of organisations' research use culture and capacity are needed to assess current capacity, identify opportunities for improvement, and examine the impact of capacity-building interventions. The aim of the current study was to develop a comprehensive system to measure and score organisations' capacity to engage with and use research in policymaking, which we entitled ORACLe (Organisational Research Access, Culture, and Leadership). We used a multifaceted approach to develop ORACLe. Firstly, we reviewed the available literature to identify key domains of organisational tools and systems that may facilitate research use by staff. We interviewed senior health policymakers to verify the relevance and applicability of these domains. This information was used to generate an interview schedule that focused on seven key domains of organisational capacity. The interview was pilot-tested within four Australian policy agencies. A discrete choice experiment (DCE) was then undertaken using an expert sample to establish the relative importance of these domains. This data was used to produce a scoring system for ORACLe. The ORACLe interview was developed, comprised of 23 questions addressing seven domains of organisational capacity and tools that support research use, including (1) documented processes for policymaking; (2) leadership training; (3) staff training; (4) research resources (e.g. database access); and systems to (5) generate new research, (6) undertake evaluations, and (7) strengthen relationships with researchers. From the DCE data, a conditional logit model was estimated to calculate total scores that took into account the relative importance of the seven domains. The model indicated that our expert sample placed the greatest importance on domains (2), (3) and (4). We utilised

Bridging evidence, policy, and practice to strengthen health systems for improved maternal and newborn health in Pakistan.

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Hirose, Atsumi; Hall, Sarah; Memon, Zahid; Hussein, Julia

2015-11-25

importance of implementation research, the crucial need for participation and ownership, and the recognition that policymaking can be 'informed' by rather than 'based-on' evidence. The future challenge will be to continue the momentum RAF has created and to welcome a new era of health, wealth, and growth for Pakistan.

Promoting evidence informed policy making for maternal and child health in Nigeria: lessons from a knowledge translation workshop

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Chigozie Jesse Uneke

2018-01-01

Full Text Available Background: Knowledge translation (KT is a process that ensures that research evidence gets translated into policy and practice. In Nigeria, reports indicate that research evidence rarely gets into policy making process. A major factor responsible for this is lack of KT capacity enhancement mechanisms. The objective of this study was to improve KT competence of an implementation research team (IRT, policymakers and stakeholders in maternal and child health to enhance evidence-informed policy making. Methods: This study employed a "before and after" design, modified as an intervention study. The study was conducted in Bauchi, north-eastern Nigeria. A three-day KT training workshop was organized and 15 modules were covered including integrated and end-of-grant KT; KT models,measures, tools and strategies; priority setting; managing political interference; advocacy and consensus building/negotiations; inter-sectoral collaboration; policy analysis, contextualization and legislation. A 4-point Likert scale pre-/post-workshop questionnaires were administered to evaluate the impact of the training, it was designed in terms of extent of adequacy; with "grossly inadequate" representing 1 point, and "very adequate" representing 4 points.Results: A total of 45 participants attended the workshop. There was a noteworthy improvement in the participants’ understanding of KT processes and strategies. The range of the praiseworthiness of participants knowledge of modules taught was from 2.04-2.94, the range for the post workshop mean was from 3.10–3.70 on the 4-point Likert scale. The range of percentage increase in mean for participants’ knowledge at the end of the workshop was from 13.3%–55.2%.Conclusion: The outcome of this study suggests that using a KT capacity building programme e.g., workshop, health researchers, policymakers and other stakeholders can acquire capacity and skill that will facilitate evidence-to-policy link.

Acceptability of financial incentives for health behaviour change to public health policymakers: a qualitative study

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Emma L. Giles

2016-09-01

Full Text Available Abstract Background Providing financial incentives contingent on healthy behaviours is one way to encourage healthy behaviours. However, there remains substantial concerns with the acceptability of health promoting financial incentives (HPFI. Previous research has studied acceptability of HPFI to the public, recipients and practitioners. We are not aware of any previous work that has focused particularly on the views of public health policymakers. Our aim was to explore the views of public health policymakers on whether or not HPFI are acceptable; and what, if anything, could be done to maximise acceptability of HPFI. Methods We recruited 21 local, regional and national policymakers working in England via gatekeepers and snowballing. We conducted semi-structured in-depth interviews with participants exploring experiences of, and attitudes towards, HPFI. We analysed data using the Framework approach. Results Public health policymakers working in England acknowledged that HPFI could be a useful behaviour change tool, but were not overwhelmingly supportive of them. In particular, they raised concerns about effectiveness and cost-effectiveness, potential ‘gaming’, and whether or not HPFI address the underlying causes of unhealthy behaviours. Shopping voucher rewards, of smaller value, targeted at deprived groups were particularly acceptable to policymakers. Participants were particularly concerned about the response of other stakeholders to HPFI – including the public, potential recipients, politicians and the media. Overall, the interviews reflected three tensions. Firstly, a tension between wanting to trust individuals and promote responsibility; and distrust around the potential for ‘gaming the system’. Secondly, a tension between participants’ own views about HPFI; and their concerns about the possible views of other stakeholders. Thirdly, a tension between participants’ personal distaste of HPFI; and their professional view that

Strategic information for industrial policy-making in developing countries; Information strategique pour le policy-making industriel dans les pays en developpement

Energy Technology Data Exchange (ETDEWEB)

Gonod, P F

1990-05-01

The practice shows that many crucial decisions for industrialization in developing countries have been taken based on incomplete information. For strategic decisions an incomplete information may have catastrophic consequences. The function of policy-making is defined as the process by which the information generated/or used in a particular context is reevaluated in a different context in order to formulate/or execute a policy of alternative decisions. It follows that the industrial information must be presented in such a manner to allow a reevaluation and alternative decisions. 30 notes.

Evidence-informed health policy 1 – Synthesis of findings from a multi-method study of organizations that support the use of research evidence

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Moynihan Ray

2008-12-01

Full Text Available Abstract Background Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs. Methods We undertook a multi-method study in three phases – a survey, interviews, and case descriptions that drew on site visits – and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Results Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1 collaborate with other organizations; 2 establish strong links with policymakers and involve stakeholders in the work; 3 be independent and manage conflicts of interest among those involved in the work; 4 build capacity among those working in the organization; 5 use good methods and be transparent in the work; 6 start small, have a clear audience and scope, and address important questions; and 7 be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO and other international organizations and networks: 1 support collaborations among organizations; 2 support local adaptation efforts; 3 mobilize support; and 4 create

Evidence-informed health policy 4 – Case descriptions of organizations that support the use of research evidence

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Oxman Andrew D

2008-12-01

Full Text Available Abstract Background Previous efforts to produce case descriptions have typically not focused on the organizations that produce research evidence and support its use. External evaluations of such organizations have typically not been analyzed as a group to identify the lessons that have emerged across multiple evaluations. Case descriptions offer the potential for capturing the views and experiences of many individuals who are familiar with an organization, including staff, advocates, and critics. Methods We purposively sampled a subgroup of organizations from among those that participated in the second (interview phase of the study and (once from among other organizations with which we were familiar. We developed and pilot-tested a case description data collection protocol, and conducted site visits that included both interviews and documentary analyses. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. We produced both a brief (one to two pages written description and a video documentary for each case. Results We conducted 51 interviews as part of the eight site visits. Two organizational strengths were repeatedly cited by individuals participating in the site visits: use of an evidence-based approach (which was identified as being very time-consuming and existence of a strong relationship between researchers and policymakers (which can be challenged by conflicts of interest. Two organizational weaknesses – a lack of resources and the presence of conflicts of interest – were repeatedly cited by individuals participating in the site visits. Participants offered two main suggestions for the World Health Organization (and other international organizations and networks: 1 mobilize one or more of government support, financial resources, and the participation of both policymakers and researchers; and 2 create knowledge-related global public goods. Conclusion The findings from

Information for mental health systems: an instrument for policy-making and system service quality.

Science.gov (United States)

Lora, A; Lesage, A; Pathare, S; Levav, I

2017-08-01

Information is crucial in mental healthcare, yet it remains undervalued by stakeholders. Its absence undermines rationality in planning, makes it difficult to monitor service quality improvement, impedes accountability and human rights monitoring. For international organizations (e.g., WHO, OECD), information is indispensable for achieving better outcomes in mental health policies, services and programs. This article reviews the importance of developing system level information with reference to inputs, processes and outputs, analyzes available tools for collecting and summarizing information, highlights the various goals of information gathering, discusses implementation issues and charts the way forward. Relevant publications and research were consulted, including WHO studies that purport to promote the use of information systems to upgrade mental health care in high- and low-middle income countries. Studies have shown that once information has been collected by relevant systems and analyzed through indicator schemes, it can be put to many uses. Monitoring mental health services, represents a first step in using information. In addition, studies have noted that information is a prime resource in many other areas such as evaluation of quality of care against evidence based standards of care. Services data may support health services research where it is possible to link mental health data with other health and non-health databases. Information systems are required to carefully monitor involuntary admissions, restrain and seclusion, to reduce human rights violations in care facilities. Information has been also found useful for policy makers, to monitor the implementation of policies, to evaluate their impact, to rationally allocate funding and to create new financing models. Despite its manifold applications, Information systems currently face many problems such as incomplete recording, poor data quality, lack of timely reporting and feedback, and limited

Evidence-based information needs of public health workers: a systematized review.

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Barr-Walker, Jill

2017-01-01

This study assessed public health workers' evidence-based information needs, based on a review of the literature using a systematic search strategy. This study is based on a thesis project conducted as part of the author's master's in public health coursework and is considered a systematized review. Four databases were searched for English-language articles published between 2005 and 2015: PubMed, Web of Science, Library Literature & Information Science Index, and Library, Information Science & Technology Abstracts (LISTA). Studies were excluded if there was no primary data collection, the population in the study was not identified as public health workers, "information" was not defined according to specific criteria, or evidence-based information and public health workers were not the major focus. Studies included in the final analysis underwent data extraction, critical appraisal using CASP and STROBE checklists, and thematic analysis. Thirty-three research studies were identified in the search, including twenty-one using quantitative methods and twelve using qualitative methods. Critical appraisal revealed many potential biases, particularly in the validity of research. Thematic analysis revealed five common themes: (1) definition of information needs, (2) current information-seeking behavior and use, (3) definition of evidence-based information, (4) barriers to information needs, and (5) public health-specific issues. Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers' information needs.

Unravelling networks in local public health policymaking in three European countries

DEFF Research Database (Denmark)

Spitters, Hilde P.E.M.; Lau, Cathrine J; Sandu, Petru

2017-01-01

the main stakeholders involved and their position and relations in the policymaking process. The Netherlands and Denmark were the most similar and both differed most from Romania, especially at the level of accountability of the local public authorities for local HEPA policymaking. The categories...... of these European country cases. Methods: A systems analysis of the local HEPA policymaking process was performed in three European countries involved in the 'REsearch into POlicy to enhance Physical Activity' (REPOPA) project, resulting in three schematic models showing the main stakeholders...... of driving forces underlying the relations between stakeholders were formal relations, informal interaction and knowledge exchange. Conclusions: A systems analysis providing detailed descriptions of positions and relations in the stakeholder network in local level HEPA policymaking is rather unique...

Agenda Setting and Evidence in Maternal Health: Connecting Research and Policy in Timor-Leste.

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Wild, Kayli; Kelly, Paul; Barclay, Lesley; Martins, Nelson

2015-01-01

The evidence-based policy (EBP) movement has received significant attention in the scientific literature; however, there is still very little empirical research to provide insight into how policy decisions are made and how evidence is used. The lack of research on this topic in low- and middle-income countries is of particular note. We examine the maternity waiting home policy in Timor-Leste to understand the role of context, policy characteristics, individual actors, and how evidence is used to influence the policy agenda. The research tracked the maternity waiting home policy from 2005 to 2009 and is based on in-depth interviews with 31 senior policy-makers, department managers, non-government organization representatives, and United Nations advisors. It is also informed by direct observation, attendance at meetings and workshops, and analysis of policy documents. The findings from this ethnographic case study demonstrate that although the post-conflict context opened up space for new policy ideas senior Ministry of Health officials rather than donors had the most power in setting the policy agenda. Maternity waiting homes were appealing because they were a visible, non-controversial, and logical solution to the problem of accessing maternal health services. Evidence was used in a variety of ways, from supporting pre-determined agendas to informing new policy directions. In the pursuit of EBP, we conclude that the power of research to inform policy lies in its timeliness and relevance, and is facilitated by the connection between researchers and policy-makers.

The use of evidence in maternal health: Connecting research and policy in Timor-Leste

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Kayli Janine Wild

2015-09-01

Full Text Available The evidence-based policy (EBP movement has received significant attention in the scientific literature, however, there is still very little empirical research to provide insight into how policy decisions are made and how evidence is used. The lack of research on this topic in low and middle-income countries is of particular note. We examine the maternity waiting home policy in Timor-Leste to understand the role of context, policy characteristics, individual actors and how evidence is used to influence the policy agenda. The research tracked the maternity waiting home policy from 2005 to 2009 and is based on in-depth interviews with 31 senior policy-makers, department managers, non-government organisation (NGO representatives and United Nations (UN advisors. It is also informed by direct observation, attendance at meetings and workshops and analysis of policy documents. The findings from this case study demonstrate the importance of political context, policy characteristics and the power of senior Ministry of Health officials rather than donors in setting the policy agenda. Maternity waiting homes were appealing because they were a visible, non-controversial and logical solution to the problem of accessing maternal health services. Evidence was used in a variety of ways, from supporting pre-determined agendas to informing new policy directions. In the pursuit of EBP, we conclude that the power of research to inform policy lies in its timeliness and relevance, and is facilitated by the connection between researchers and policy-makers.

Strategic information for industrial policy-making in developing countries

International Nuclear Information System (INIS)

Gonod, P.F.

1990-05-01

The practice shows that many crucial decisions for industrialization in developing countries have been taken based on incomplete information. For strategic decisions an incomplete information may have catastrophic consequences. The function of policy-making is defined as the process by which the information generated/or used in a particular context is reevaluated in a different context in order to formulate/or execute a policy of alternative decisions. It follows that the industrial information must be presented in such a manner to allow a reevaluation and alternative decisions. 30 notes

Exploring governance learning: How policymakers draw on evidence, experience and intuition in designing participatory flood risk planning.

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Newig, Jens; Kochskämper, Elisa; Challies, Edward; Jager, Nicolas W

2016-01-01

The importance of designing suitable participatory governance processes is generally acknowledged. However, less emphasis has been put on how decision-makers design such processes, and how they learn about doing so. While the policy learning literature has tended to focus on the substance of policy, little research is available on learning about the design of governance. Here, we explore different approaches to learning among German policymakers engaged in implementing the European Floods Directive. We draw on official planning documents and expert interviews with state-level policymakers to focus on learning about the procedural aspects of designing and conducting participatory flood risk management planning. Drawing on the policy learning and evidence-based governance literatures, we conceptualise six types of instrumental 'governance learning' according to sources of learning (endogenous and exogenous) and modes of learning (serial and parallel). We empirically apply this typology in the context of diverse participatory flood risk management planning processes currently unfolding across the German federal states. We find that during the first Floods Directive planning cycle, policymakers have tended to rely on prior experience in their own federal states with planning under the Water Framework Directive to inform the design and carrying out of participatory processes. In contrast, policymakers only sporadically look to experiences from other jurisdictions as a deliberate learning strategy. We argue that there is scope for more coordinated and systematic learning on designing effective governance, and that the latter might benefit from more openness to experimentation and learning on the part of policymakers.

Cross-sector cooperation in health-enhancing physical activity policymaking

DEFF Research Database (Denmark)

Hämäläinen, Riitta-Maija; Aro, Arja R.; Juel Lau, Cathrine

2016-01-01

in health-enhancing physical activity (HEPA) policies in six European Union (EU) member states. METHODS: Qualitative content analysis of HEPA policies and semi-structured interviews with key policymakers in six European countries. RESULTS: Cross-sector cooperation varied between EU member states within HEPA...

Managing Health Information System | Campbell | Nigerian ...

African Journals Online (AJOL)

The effective planning, management monitoring and evaluation of health services, health resources and indeed the health system requires a wealth of health information, with its simultaneous effective and efficient management. It is an instrument used to help policy-making, decision making and day to day actions in the ...

Increasing Use of Research Findings in Improving Evidence-Based Health Policy at the National Level

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Meiwita Budiharsana

2017-11-01

Full Text Available In February 2016, the Minister of Health decided to increase the use of research findings in improving the quality of the national health policy and planning. The Ministry of Health has instructed the National Institute of Health Research and Development or NIHRD to play a stronger role of monitoring and evaluating all health programs, because “their opinion and research findings should be the basis for changes in national health policies and planning”. Compared to the past, the Ministry of Health has increased the research budget for evidence-based research tremendously. However, there is a gap between the information needs of program and policy-makers and the information offered by researchers. A close dialogue is needed between the users (program managers, policy makers and planners and the suppliers (researchers and evaluators to ensure that the evidence-based supplied by research is useful for programs, planning and health policy.

Electronic tools for health information exchange: an evidence-based analysis.

Science.gov (United States)

2013-01-01

As patients experience transitions in care, there is a need to share information between care providers in an accurate and timely manner. With the push towards electronic medical records and other electronic tools (eTools) (and away from paper-based health records) for health information exchange, there remains uncertainty around the impact of eTools as a form of communication. To examine the impact of eTools for health information exchange in the context of care coordination for individuals with chronic disease in the community. A literature search was performed on April 26, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published until April 26, 2012 (no start date limit was applied). A systematic literature search was conducted, and meta-analysis conducted where appropriate. Outcomes of interest fell into 4 categories: health services utilization, disease-specific clinical outcomes, process-of-care indicators, and measures of efficiency. The quality of the evidence was assessed individually for each outcome. Expert panels were assembled for stakeholder engagement and contextualization. Eleven articles were identified (4 randomized controlled trials and 7 observational studies). There was moderate quality evidence of a reduction in hospitalizations, hospital length of stay, and emergency department visits following the implementation of an electronically generated laboratory report with recommendations based on clinical guidelines. The evidence showed no difference in disease-specific outcomes; there was no evidence of a positive impact on process-of-care indicators or measures of efficiency. A limited body of research specifically examined eTools for health information exchange in the population and setting of interest. This evidence included a

The evidence-policy divide: a 'critical computational linguistics' approach to the language of 18 health agency CEOs from 9 countries.

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Bell, Erica; Seidel, Bastian M

2012-10-30

There is an emerging body of literature suggesting that the evidence-practice divide in health policy is complex and multi-factorial but less is known about the processes by which health policy-makers use evidence and their views about the specific features of useful evidence. This study aimed to contribute to understandings of how the most influential health policy-makers view useful evidence, in ways that help explore and question how the evidence-policy divide is understood and what research might be supported to help overcome this divide. A purposeful sample of 18 national and state health agency CEOs from 9 countries was obtained. Participants were interviewed using open-ended questions that asked them to define specific features of useful evidence. The analysis involved two main approaches 1)quantitative mapping of interview transcripts using Bayesian-based computational linguistics software 2)qualitative critical discourse analysis to explore the nuances of language extracts so identified. The decision-making, conclusions-oriented world of policy-making is constructed separately, but not exclusively, by policy-makers from the world of research. Research is not so much devalued by them as described as too technical- yet at the same time not methodologically complex enough to engage with localised policy-making contexts. It is not that policy-makers are negative about academics or universities, it is that they struggle to find complexity-oriented methodologies for understanding their stakeholder communities and improving systems. They did not describe themselves as having a more positive role in solving this challenge than academics. These interviews do not support simplistic definitions of policy-makers and researchers as coming from two irreconcilable worlds. They suggest that qualitative and quantitative research is valued by policy-makers but that to be policy-relevant health research may need to focus on building complexity-oriented research methods for

Challenges to generating evidence-informed policy and the role of systematic reviews and (perceived) conflicts of interest.

Science.gov (United States)

Apollonio, Dorie E; Bero, Lisa A

2016-01-01

Multiple efforts to generate evidence-informed policy have attempted to teach policymakers how to understand and apply scientific research findings in their decision-making. These efforts have had limited success, because policymakers generally do not understand scientific methods. We piloted efforts to teach policy intermediaries - specifically consumer advocacy groups - how to understand and apply health research, anticipating that they might offer such evidence to policymakers in more accessible forms. Four workshops focusing on research design and methods were conducted with consumer advocacy groups in 2010. We coded and analyzed participant responses regarding their confidence in interpreting research findings and assessments of research credibility, and the extent to which their knowledge about research findings changed after completing the workshops. Our findings suggest that although participants expressed strong interest in understanding scientific research, their ability to develop confidence about scientific research methods was limited. However, like policymakers, consumer advocacy group members intuited that financial conflicts of interest could compromise scientific findings, although they initially underestimated their effects on research results. After training, consumer advocates also saw the value of using systematic reviews rather than individual studies. Our findings suggest that although advocates may not feel confident in their understanding of scientific research, they found it easier to understand the value of systematic reviews and the risks of conflicts of interest than other statistical concepts and terminology. Focusing on making these types of information available may offer a useful way for policymakers and consumer advocates to interpret the validity of policy-relevant scientific research.

How well are health information websites displayed on mobile phones? Implications for the readability of health information.

Science.gov (United States)

Cheng, Christina; Dunn, Matthew

2017-03-01

Issue addressed More than 87% of Australians own a mobile phone with Internet access and 82% of phone owners use their smartphones to search for health information, indicating that mobile phones may be a powerful tool for building health literacy. Yet, online health information has been found to be above the reading ability of the general population. As reading on a smaller screen may further complicate the readability of information, this study aimed to examine how health information is displayed on mobile phones and its implications for readability. Methods Using a cross-sectional design with convenience sampling, a sample of 270 mobile webpages with information on 12 common health conditions was generated for analysis, they were categorised based on design and position of information display. Results The results showed that 71.48% of webpages were mobile-friendly but only 15.93% were mobile-friendly webpages designed in a way to optimise readability, with a paging format and queried information displayed for immediate viewing. Conclusion With inadequate evidence and lack of consensus on how webpage design can best promote reading and comprehension, it is difficult to draw a conclusion on the effect of current mobile health information presentation on readability. So what? Building mobile-responsive websites should be a priority for health information providers and policy-makers. Research efforts are urgently required to identify how best to enhance readability of mobile health information and fully capture the capabilities of mobile phones as a useful device to increase health literacy.

Elusive implementation: an ethnographic study of intersectoral policymaking for health.

Science.gov (United States)

Holt, Ditte Heering; Rod, Morten Hulvej; Waldorff, Susanne Boch; Tjørnhøj-Thomsen, Tine

2018-01-30

For more than 30 years policy action across sectors has been celebrated as a necessary and viable way to affect the social factors impacting on health. In particular intersectoral action on the social determinants of health is considered necessary to address social inequalities in health. However, despite growing support for intersectoral policymaking, implementation remains a challenge. Critics argue that public health has remained naïve about the policy process and a better understanding is needed. Based on ethnographic data, this paper conducts an in-depth analysis of a local process of intersectoral policymaking in order to gain a better understanding of the challenges posed by implementation. To help conceptualize the process, we apply the theoretical perspective of organizational neo-institutionalism, in particular the concepts of rationalized myth and decoupling. On the basis of an explorative study among ten Danish municipalities, we conducted an ethnographic study of the development of a municipal-wide implementation strategy for the intersectoral health policy of a medium-sized municipality. The main data sources consist of ethnographic field notes from participant observation and interview transcripts. By providing detailed contextual description, we show how an apparent failure to move from policy to action is played out by the ongoing production of abstract rhetoric and vague plans. We find that idealization of universal intersectoralism, inconsistent demands, and doubts about economic outcomes challenge the notion of implementation as moving from rhetoric to action. We argue that the 'myth' of intersectoralism may be instrumental in avoiding the specification of action to implement the policy, and that the policy instead serves as a way to display and support good intentions and hereby continue the process. On this basis we expand the discussion on implementation challenges regarding intersectoral policymaking for health.

Communicating program outcomes to encourage policymaker support for evidence-based state tobacco control.

Science.gov (United States)

Schmidt, Allison M; Ranney, Leah M; Goldstein, Adam O

2014-12-04

Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003-2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans) and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1) high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2) the primacy of economic concerns in making policy decisions, (3) ideological differences in views of the state's role in tobacco control, (4) the impact of lobbyist and constituent in-person appeals, and (5) the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

A retrospective health policy analysis of the development and implementation of the voluntary health insurance system in Lebanon: learning from failure.

Science.gov (United States)

El-Jardali, Fadi; Bou-Karroum, Lama; Ataya, Nour; El-Ghali, Hana Addam; Hammoud, Rawan

2014-12-01

Public policymaking is complex and suffers from limited uptake of research evidence, particularly in the Eastern Mediterranean Region (EMR). In-depth case studies examining health policymaking in the EMR are lacking. This retrospective policy analysis aims at generating insights about how policies are being made, identifying factors influencing policymaking and assessing to what extent evidence is used in this process by using the Lebanese Voluntary Health Insurance policy as a case study. The study examined the policymaking process through a policy tracing technique that covered a period of 12 years. The study employed a qualitative research design using a case study approach and was conducted in two phases over the course of two years. Data was collected using multiple sources including: 1) a comprehensive and chronological media review; 2) twenty-two key informant interviews with policymakers, stakeholders, and journalists; and 3) a document review of legislations, minutes of meetings, actuarial studies, and official documents. Data was analyzed and validated using thematic analysis. Findings showed that the voluntary health insurance policy was a political decision taken by the government to tackle an urgent political problem. Evidence was not used to guide policy development and implementation and policy implementers and other stakeholders were not involved in policy development. Factors influencing policymaking were political interests, sectarianism, urgency, and values of policymakers. Barriers to the use of evidence were lack of policy-relevant research evidence, political context, personal interests, and resource constraints. Findings suggest that policymakers should be made more aware of the important role of evidence in informing public policymaking and the need for building capacity to develop, implement and evaluate policies. Study findings are likely to matter in light of the changes that are unfolding in some Arab countries and the looming

Evidence-informed capacity building for setting health priorities in low- and middle-income countries: A framework and recommendations for further research.

Science.gov (United States)

Li, Ryan; Ruiz, Francis; Culyer, Anthony J; Chalkidou, Kalipso; Hofman, Karen J

2017-01-01

Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders - not only the technical capacity to "do" research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE) framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values); academics need to understand and respond to decision-makers' needs to produce relevant research. The health system at all levels will need institutional capacity building to incentivise routine generation and use of evidence. Knowledge brokers, including priority-setting agencies (such as England's National Institute for Health and Care Excellence, and Health Interventions and Technology Assessment Program, Thailand) and the media can play an important role in facilitating engagement and knowledge transfer between the various actors. Especially at the outset but at every step, it is critical that patients and the public understand that trade-offs are inherent in priority-setting, and careful efforts should be made to engage them, and to hear their views throughout the process. There is thus no single approach to capacity building; rather a spectrum of activities that recognises the roles and skills of all stakeholders. A range of methods, including formal and informal training, networking and engagement, and support through collaboration on projects, should be flexibly employed (and tailored to specific needs of each country) to support institutionalisation of evidence-informed priority-setting. Finally, capacity building should be a two-way process; those who build capacity should also attend to their own capacity

Research evidence and policy: qualitative study in selected provinces in South Africa and Cameroon.

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Naude, Celeste E; Zani, Babalwa; Ongolo-Zogo, Pierre; Wiysonge, Charles S; Dudley, Lillian; Kredo, Tamara; Garner, Paul; Young, Taryn

2015-09-03

The translation of research into policy and practice is enhanced by policymakers who can recognise and articulate their information needs and researchers that understand the policymakers' environment. As researchers, we sought to understand the policymaking process and how research evidence may contribute in South Africa and Cameroon. We conducted qualitative in-depth interviews in South Africa and focus group discussions in Cameroon with purposively sampled subnational (provincial and regional) government health programme managers. Audio recorded interviews were transcribed, thematically coded and analysed. Participants in both countries described the complex, often lengthy nature of policymaking processes, which often include back-and-forth consultations with many diverse stakeholder groups. These processes may be influenced by political structures, relationships between national and subnational levels, funding and international stakeholder agendas. Research is not a main driver of policy, but rather current contextual realities, costs, logistics and people (clinicians, NGOs, funders) influence the policy, and research plays a part. Research evidence is frequently perceived as unavailable, inaccessible, ill-timed or not applicable. The reliability of research on the internet was questioned. Evidence-informed health decision-making (EIDM) is regarded as necessary in South Africa but is less well understood in Cameroon. Insufficient time and capacity were hindrances to EIDM in both countries. Good relationships between researchers and policymakers may facilitate EIDM. Researchers should have a good understanding of the policymaking environment if they want to influence it. Greater interaction between policymakers and researchers is perceived as beneficial when formulating research and policy questions as it raises researchers' awareness of implementation challenges and enables the design of tailored and focused strategies to respond to policymakers' needs

Communicating Program Outcomes to Encourage Policymaker Support for Evidence-Based State Tobacco Control

Directory of Open Access Journals (Sweden)

Allison M. Schmidt

2014-12-01

Full Text Available Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003–2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1 high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2 the primacy of economic concerns in making policy decisions, (3 ideological differences in views of the state’s role in tobacco control, (4 the impact of lobbyist and constituent in-person appeals, and (5 the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol

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Hill Sophie

2012-03-01

Full Text Available Abstract Background Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. Methods This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1, we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2, before being uploaded to the Internet and evaluated (Stages 3 and 4. Discussion This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader

Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol.

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Hill, Sophie; Filippini, Graziella; Synnot, Anneliese; Summers, Michael; Beecher, Deirdre; Colombo, Cinzia; Mosconi, Paola; Battaglia, Mario A; Shapland, Sue; Osborne, Richard H; Hawkins, Melanie

2012-03-16

Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS) integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1), we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2), before being uploaded to the Internet and evaluated (Stages 3 and 4). This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader efforts to provide evidence-based health information for

Evidence-informed health policy 3 - interviews with the directors of organizations that support the use of research evidence.

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Lavis, John N; Oxman, Andrew D; Moynihan, Ray; Paulsen, Elizabeth J

2008-12-17

Only a small number of previous efforts to describe the experiences of organizations that produce clinical practice guidelines (CPGs), undertake health technology assessments (HTAs), or directly support the use of research evidence in developing health policy (i.e., government support units, or GSUs) have relied on interviews and then only with HTA agencies. Interviews offer the potential for capturing experiences in great depth, particularly the experiences of organizations that may be under-represented in surveys. We purposively sampled organizations from among those who completed a questionnaire in the first phase of our three-phase study, developed and piloted a semi-structured interview guide, and conducted the interviews by telephone, audio-taped them, and took notes simultaneously. Binary or categorical responses to more structured questions were counted when possible. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. Illustrative quotations were identified to supplement the narrative description of the themes. We interviewed the director (or his or her nominee) in 25 organizations, of which 12 were GSUs. Using rigorous methods that are systematic and transparent (sometimes shortened to 'being evidence-based') was the most commonly cited strength among all organizations. GSUs more consistently described their close links with policymakers as a strength, whereas organizations producing CPGs, HTAs, or both had conflicting viewpoints about such close links. With few exceptions, all types of organizations tended to focus largely on weaknesses in implementation, rather than strengths. The advice offered to those trying to establish similar organizations include: 1) collaborate with other organizations; 2) establish strong links with policymakers and stakeholders; 3) be independent and manage conflicts of interest; 4) build capacity; 5) use good methods and be transparent; 6) start small and

Development of Evidence-Based Health Policy Documents in Developing Countries: A Case of Iran

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Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-01-01

Background: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. Methods: In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. Results: 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Conclusion: Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers

Development of evidence-based health policy documents in developing countries: a case of Iran.

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Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-02-07

Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policy-making. 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.

Evidence-based information needs of public health workers: a systematized review

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Jill Barr-Walker, MPH, MS

2017-01-01

Conclusions: Recommendations are given for how librarians can increase the use of evidence-based information in public health research, practice, and policy making. Further research using rigorous methodologies and transparent reporting practices in a wider variety of settings is needed to further evaluate public health workers’ information needs.

Supporting Better Evidence Generation and Use within Social Innovation in Health in Low- and Middle-Income Countries: A Qualitative Study.

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Ballard, Madeleine; Tran, Jenny; Hersch, Fred; Lockwood, Amy; Hartigan, Pamela; Montgomery, Paul

2017-01-01

While several papers have highlighted a lack of evidence to scale social innovations in health, fewer have explored decision-maker understandings of the relative merit of different types of evidence, how such data are interpreted and applied, and what practical support is required to improve evidence generation. The objectives of this paper are to understand (1) beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (2) approaches to evidence generation and evaluation used in systems and policy change, and (3) how better evidence-generation can be undertaken and supported within social innovation in health. Thirty-two one-on-one interviews were conducted between July and November 2015 with purposively selected practitioners, policymakers, and funders from low- and middle- income countries (LMICs). Data were analysed using a Framework Analysis Approach. While practitioners, funders, and policymakers said they held outcome evidence in high regard, their practices only bear out this assertion to varying degrees. Few have given systematic consideration to potential unintended consequences, in particular harm, of the programs they implement, fund, or adopt. Stakeholders suggest that better evidence-generation can be undertaken and supported within social innovation in health by supporting the research efforts of emerging community organizations; creating links between practitioners and academia; altering the funding landscape for evidence-generation; providing responsive technical education; and creating accountability for funders, practitioners, and policymakers. How better evidence-generation can be undertaken and supported within social innovation in health is a previously under-operationalised aspect of the policy-making process that remains essential in order to refrain from causing harm, enable the optimization of existing interventions, and ultimately, to scale and fund what works.

Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.

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Armstrong, Rebecca; Waters, Elizabeth; Moore, Laurence; Dobbins, Maureen; Pettman, Tahna; Burns, Cate; Swinburn, Boyd; Anderson, Laurie; Petticrew, Mark

2014-12-14

The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions. The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health. In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision

Evidence & Gap Maps: A tool for promoting evidence informed policy and strategic research agendas.

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Snilstveit, Birte; Vojtkova, Martina; Bhavsar, Ami; Stevenson, Jennifer; Gaarder, Marie

2016-11-01

A range of organizations are engaged in the production of evidence on the effects of health, social, and economic development programs on human welfare outcomes. However, evidence is often scattered around different databases, web sites, and the gray literature and is often presented in inaccessible formats. Lack of overview of the evidence in a specific field can be a barrier to the use of existing research and prevent efficient use of limited resources for new research. Evidence & Gap Maps (EGMs) aim to address these issues and complement existing synthesis and mapping approaches. EGMs are a new addition to the tools available to support evidence-informed policymaking. To provide an accessible resource for researchers, commissioners, and decision makers, EGMs provide thematic collections of evidence structured around a framework which schematically represents the types of interventions and outcomes of relevance to a particular sector. By mapping the existing evidence using this framework, EGMs provide a visual overview of what we know and do not know about the effects of different programs. They make existing evidence available, and by providing links to user-friendly summaries of relevant studies, EGMs can facilitate the use of existing evidence for decision making. They identify key "gaps" where little or no evidence from impact evaluations and systematic reviews is available and can be a valuable resource to inform a strategic approach to building the evidence base in a particular sector. The article will introduce readers to the concept and methods of EGMs and present a demonstration of the EGM tool using existing examples. Copyright © 2016 Elsevier Inc. All rights reserved.

Processes of local alcohol policy-making in England: Does the theory of policy transfer provide useful insights into public health decision-making?

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Gavens, Lucy; Holmes, John; Buykx, Penny; de Vocht, Frank; Egan, Matt; Grace, Daniel; Lock, Karen; Mooney, John D; Brennan, Alan

2017-06-13

Recent years have seen a rise in new and innovative policies to reduce alcohol consumption and related harm in England, which can be implemented by local, as opposed to national, policy-makers. The aim of this paper is to explore the processes that underpin the adoption of these alcohol policies within local authorities. In particular, it aims to assess whether the concept of policy transfer (i.e. a process through which knowledge about policies in one place is used in the development of policies in another time or place) provides a useful model for understanding local alcohol policy-making. Qualitative data generated through in-depth interviews and focus groups from five case study sites across England were used to explore stakeholder experiences of alcohol policy transfer between local authorities. The purposive sample of policy actors included representatives from the police, trading standards, public health, licensing, and commissioning. Thematic analysis was used inductively to identify key features in the data. Themes from the policy transfer literature identified in the data were: policy copying, emulating, hybridization, and inspiration. Participants described a multitude of ways in which learning was shared between places, ranging from formal academic evaluation to opportunistic conversations in informal settings. Participants also described facilitators and constraints to policy transfer, such as the historical policy context and the local cultural, economic, and bureaucratic context, which influenced whether or not a policy that was perceived to work in one place might be transferred successfully to another context. Theories of policy transfer provide a promising framework for characterising processes of local alcohol policy-making in England, extending beyond debates regarding evidence-informed policy to account for a much wider range of considerations. Applying a policy transfer lens enables us to move beyond simple (but still important) questions of

Information demands of occupational health physicians and their attitude towards evidence-based medicine.

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Schaafsma, Frederieke; Hulshof, Carel; van Dijk, Frank; Verbeek, Jos

2004-08-01

This study assessed the extent and nature of information demands among occupational health physicians and their attitude towards the application of evidence-based medicine in occupational health. A questionnaire survey was carried out among a random sample of 159 physicians practicing occupational medicine in The Netherlands. The questionnaire investigated the type and number of questions encountered in daily practice, the actions taken in response, the physicians' experience in using scientific databases on the Internet, and their attitude towards evidence-based medicine. The occupational health physicians' questions concerned medical, legal, and rehabilitation topics in particular. In pursuing answers to their questions, they generally chose to contact colleagues. Scientific databases were not consulted very often, although, in general, the attitude towards evidence-based medicine was positive. In addition to known barriers for practicing evidence-based medicine, occupational health physicians perceive a lack of scientific evidence in their field. The extensiveness of the field of knowledge in occupational health care was not regarded as an obstacle to their application of evidence-based medicine. Occupational health physicians have a demand for information on a broad range of topics, and, in most cases, their attitude towards evidence-based medicine is fairly positive. Besides education and training in evidence-based medicine, access to the Internet and the presence of a good knowledge infrastructure would help occupational health physicians use evidence-based medicine.

Evidence-based medicine - an appropriate tool for evidence-based health policy? A case study from Norway.

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Malterud, Kirsti; Bjelland, Anne Karen; Elvbakken, Kari Tove

2016-03-05

Evidence-based policy (EBP), a concept modelled on the principles of evidence-based medicine (EBM), is widely used in different areas of policymaking. Systematic reviews (SRs) with meta-analyses gradually became the methods of choice for synthesizing research evidence about interventions and judgements about quality of evidence and strength of recommendations. Critics have argued that the relation between research evidence and service policies is weak, and that the notion of EBP rests on a misunderstanding of policy processes. Having explored EBM standards and knowledge requirements for health policy decision-making, we present an empirical point of departure for discussing the relationship between EBM and EBP. In a case study exploring the Norwegian Knowledge Centre for the Health Services (NOKC), an independent government unit, we first searched for information about the background and development of the NOKC to establish a research context. We then identified, selected and organized official NOKC publications as an empirical sample of typical top-of-the-line knowledge delivery adhering to EBM standards. Finally, we explored conclusions in this type of publication, specifically addressing their potential as policy decision tools. From a total sample of 151 SRs published by the NOKC in the period 2004-2013, a purposive subsample from 2012 (14 publications) advised major caution about their conclusions because of the quality or relevance of the underlying documentation. Although the case study did not include a systematic investigation of uptake and policy consequences, SRs were found to be inappropriate as universal tools for health policy decision-making. The case study demonstrates that EBM is not necessarily suited to knowledge provision for every kind of policy decision-making. Our analysis raises the question of whether the evidence-based movement, represented here by an independent government organization, undertakes too broad a range of commissions using

Obesity prevention programs and policies: practitioner and policy-maker perceptions of feasibility and effectiveness.

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Cleland, Verity; McNeilly, Briohny; Crawford, David; Ball, Kylie

2013-09-01

The aims of this study were to map obesity prevention activity being implemented by government, non-government, and community-based organizations; to determine practitioner and policy-maker perceptions of the feasibility and effectiveness of a range of evidence-based obesity prevention strategies; and to determine practitioner and policy-maker perceptions of preferred settings for obesity prevention strategies. This study involved a cross-sectional survey of 304 public health practitioners and policy-makers from government, non-government, and community organizations across Victoria, Australia. Participants reported their organizations' current obesity prevention programs and policies, their own perceptions of the feasibility and effectiveness of strategies to prevent obesity and their preferred settings for obesity prevention. Thirty-nine percent had an obesity prevention policy, and 92% were implementing obesity prevention programs. The most common programs focused on education, skill-building, and increasing access to healthy eating/physical activity opportunities. School curriculum-based initiatives, social support for physical activity, and family-based programs were considered the most effective strategies, whereas curriculum-based initiatives, active after-school programs, and providing access to and information about physical activity facilities were deemed the most feasible strategies. Schools were generally perceived as the most preferred setting for obesity prevention. Many organizations had obesity prevention programs, but far fewer had obesity prevention policies. Current strategies and those considered feasible and effective are often mismatched with the empirical literature. Systems to ensure better alignment between researchers, practitioners, and policy-makers, and identifying effective methods of translating empirical evidence into practice and policy are required. Copyright © 2012 The Obesity Society.

Supporting Better Evidence Generation and Use within Social Innovation in Health in Low- and Middle-Income Countries: A Qualitative Study.

Directory of Open Access Journals (Sweden)

Madeleine Ballard

Full Text Available While several papers have highlighted a lack of evidence to scale social innovations in health, fewer have explored decision-maker understandings of the relative merit of different types of evidence, how such data are interpreted and applied, and what practical support is required to improve evidence generation. The objectives of this paper are to understand (1 beliefs and attitudes towards the value of and types of evidence in scaling social innovations for health, (2 approaches to evidence generation and evaluation used in systems and policy change, and (3 how better evidence-generation can be undertaken and supported within social innovation in health.Thirty-two one-on-one interviews were conducted between July and November 2015 with purposively selected practitioners, policymakers, and funders from low- and middle- income countries (LMICs. Data were analysed using a Framework Analysis Approach.While practitioners, funders, and policymakers said they held outcome evidence in high regard, their practices only bear out this assertion to varying degrees. Few have given systematic consideration to potential unintended consequences, in particular harm, of the programs they implement, fund, or adopt. Stakeholders suggest that better evidence-generation can be undertaken and supported within social innovation in health by supporting the research efforts of emerging community organizations; creating links between practitioners and academia; altering the funding landscape for evidence-generation; providing responsive technical education; and creating accountability for funders, practitioners, and policymakers.How better evidence-generation can be undertaken and supported within social innovation in health is a previously under-operationalised aspect of the policy-making process that remains essential in order to refrain from causing harm, enable the optimization of existing interventions, and ultimately, to scale and fund what works.

The Impact of the Information Revolution on Policymakers’ Use of Intelligence Analysis

Science.gov (United States)

2005-01-01

Revolution on the Market for Information The major effect of this explosion in technology is the proliferation of information consumers and providers. Their... technology . The State Department gives its policymakers the least connectivity to any real time or electronic information as its officials lack Internet ...connectivity than others to the intelligence community, as well as to the Internet and other sources of information age open sources. This will have a profound

Assessment of policy makers' individual and organizational capacity to acquire, assess, adapt and apply research evidence for maternal and child health policy making in Nigeria: a cross-sectional quantitative survey.

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Uneke, Chigozie Jesse; Sombie, Issiaka; Keita, Namoudou; Lokossou, Virgil; Johnson, Ermel; Ongolo-Zogo, Pierre; Uro-Chukwu, Henry Chukwuemeka

2017-09-01

Throughout the world, there is increasing awareness and acknowledgement of the value of research evidence in the development of effective health policy and in quality health care practice and administration. Among the major challenges associated with the lack of uptake of research evidence into policy and practice in Nigeria is the capacity constraints of policymakers to use research evidence in policy making. To assess the capacity of maternal and child health policy makers to acquire, access, adapt and apply available research evidence. This cross-sectional quantitative survey was conducted at a national maternal, newborn and child health (MNCH) stakeholders' engagement event. An evidence to policy self-assessment questionnaire was used to assess the capacity of forty MNCH policy makers to acquire, assess, adapt and apply research evidence for policy making. Low mean ratings were observed ranging from 2.68-3.53 on a scale of 5 for knowledge about initiating/conducting research and capacity to assess authenticity, validity, reliability, relevance and applicability of research evidence and for organizational capacity for promoting and using of research for policy making. There is need to institute policy makers' capacity development programmes to improve evidence-informed policymaking.

Pharmaceutical companies' role in state vaccination policymaking: the case of human papillomavirus vaccination.

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Mello, Michelle M; Abiola, Sara; Colgrove, James

2012-05-01

We sought to investigate roles that Merck & Co Inc played in state human papillomavirus (HPV) immunization policymaking, to elicit key stakeholders' perceptions of the appropriateness of these activities, and to explore implications for relationships between health policymakers and industry. We used a series of state case studies combining data from key informant interviews with analysis of media reports and archival materials. We interviewed 73 key informants in 6 states that were actively engaged in HPV vaccine policy deliberations. Merck promoted school-entry mandate legislation by serving as an information resource, lobbying legislators, drafting legislation, mobilizing female legislators and physician organizations, conducting consumer marketing campaigns, and filling gaps in access to the vaccine. Legislators relied heavily on Merck for scientific information. Most stakeholders found lobbying by vaccine manufacturers acceptable in principle, but perceived that Merck had acted too aggressively and nontransparently in this case. Although policymakers acknowledge the utility of manufacturers' involvement in vaccination policymaking, industry lobbying that is overly aggressive, not fully transparent, or not divorced from financial contributions to lawmakers risks undermining the prospects for legislation to foster uptake of new vaccines.

Patterns of trust in sources of health information.

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Lawson, Rob; Forbes, Sarah; Williams, John

2011-01-21

To understand the different patterns of trust that exist regarding different sources of information about health issues. Data from a large national health lifestyles survey of New Zealanders was examined using a factor analysis of trust toward 24 health information sources (HIS). Differences in trust are compared across a range of demographic variables. Factor analysis identified six different groupings of health information. Variations in trust in sources for health information are identified by age, employment status, level of education, income, sex and ethnic group. Systematic variations exist in the trust that people report with respect to different sources of health information. Understanding these variations may assist policymakers and other agencies which are responsible for planning the dissemination of health information.

National health policy-makers' views on the clarity and utility of Countdown to 2015 country profiles and reports: findings from two exploratory qualitative studies.

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Hunter, Benjamin M; Requejo, Jennifer H; Pope, Ian; Daelmans, Bernadette; Murray, Susan F

2014-08-15

The use of sets of indicators to assess progress has become commonplace in the global health arena. Exploratory research has suggested that indicators used for global monitoring purposes can play a role in national policy-making, however, the mechanisms through which this occurs are poorly understood. This article reports findings from two qualitative studies that aimed to explore national policy-makers' interpretation and use of indicators from country profiles and reports developed by Countdown to 2015. An initial study aimed at exploring comprehension of Countdown data was conducted at the 2010 joint Women Deliver/Countdown conference. A second study was conducted at the 64th World Health Assembly in 2011, specifically targeting national policy-makers. Semi-structured interviews were carried out with 29 and 22 participants, respectively, at each event. Participants were asked about their understanding of specific graphs and indicators used or proposed for use in Countdown country profiles, and their perception of how such data can inform national policy-making. Responses were categorised using a framework analysis. Respondents in both studies acknowledged the importance of the profiles for tracking progress on key health indicators in and across countries, noting that they could be used to highlight changes in coverage, possible directions for future policy, for lobbying finance ministers to increase resources for health, and to stimulate competition between neighbouring or socioeconomically similar countries. However, some respondents raised questions about discrepancies between global estimates and data produced by national governments, and some struggled to understand the profile graphs shown in the absence of explanatory text. Some respondents reported that use of Countdown data in national policy-making was constrained by limited awareness of the initiative, insufficient detail in the country profiles to inform policy, and the absence of indicators felt to

A Research Agenda for the Common Core State Standards: What Information Do Policymakers Need?

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Rentner, Diane Stark; Ferguson, Maria

2014-01-01

This report looks specifically at the information and data needs of policymakers related to the Common Core State Standards (CCSS) and the types of research that could provide this information. The ideas in this report were informed by a series of meetings and discussions about a possible research agenda for the Common Core, sponsored by the…

[Public policy-making on breast cancer in Latin America].

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González-Robledo, M C; González-Robledo, L M; Nigenda, G

2013-03-01

To understand the public policy-making process as it relates to breast cancer care in five Latin American countries. An exploratory-evaluative study was conducted in Argentina, Brazil, Colombia, Mexico, and Venezuela in 2010, with the selection of countries based on convenience sampling. Sixty-five semi-structured interviews were conducted with government officials, academics, and representatives of trade associations and civil society organizations. A content analysis of secondary sources was performed. Information sources, data, and informants were mixed using the triangulation method for purposes of analysis. The countries that have made the most progress in public policy-making related to breast cancer are Brazil and Mexico. Although Argentina, Colombia, and Venezuela do not have policies, they do have breast cancer care programs and activities. Two perspectives on the development of public policies became evident: the first includes the broad participation of both governmental and nongovernmental sectors, whereas the second, more narrow approach involves government authorities alone. The results point to significant differences in public policy-making related to breast cancer in the Region. They also show that greater progress has been made in countries where policies have been developed through inclusive participation processes.

Web-based geo-visualisation of spatial information to support evidence-based health policy: a case study of the development process of HealthTracks.

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Jardine, Andrew; Mullan, Narelle; Gudes, Ori; Cosford, James; Moncrieff, Simon; West, Geoff; Xiao, Jianguo; Yun, Grace; Someford, Peter

Place is of critical importance to health as it can reveal patterns of disease spread and clustering, associations with risk factors, and areas with greatest need for, or least access to healthcare services and promotion activities. Furthermore, in order to get a good understanding of the health status and needs of a particular area a broad range of data are required which can often be difficult and time consuming to obtain and collate. This process has been expedited by bringing together multiple data sources and making them available in an online geo-visualisation, HealthTracks, which consists of a mapping and reporting component. The overall aim of the HealthTracks project is to make spatial health information more accessible to policymakers, analysts, planners and program managers to inform decision-making across the Department of Health Western Australia. Preliminary mapping and reporting applications that have been utilised to inform service planning, increased awareness of the utility of spatial information and improved efficiency in data access were developed. The future for HealthTracks involves expanding the range of data available and developing new analytical capabilities in order to work towards providing external agencies, researchers and eventually the general public access to rich local area spatial data.

Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda.

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Nabyonga-Orem, Juliet; Mijumbi, Rhona

2015-03-08

Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors' views regarding what evidence they deemed appropriate to guide health policy development. Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. © 2015 by Kerman University of Medical Sciences.

Evidence for Informing Health Policy Development in Low- Income Countries (LICS: Perspectives of Policy Actors in Uganda

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Juliet Nabyonga-Orem

2015-05-01

Full Text Available Background Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs, the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods Using exploratory qualitative methods, we conducted interviews with 51 key informants using an indepth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion What LICslike Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making.

Factors that encourage and discourage policy-making to prevent childhood obesity: Experience in the United States.

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Rutkow, Lainie; Jones-Smith, Jesse; Walters, Hannah J; O'Hara, Marguerite; Bleich, Sara N

2016-12-01

Policy-makers throughout the world seek to address childhood obesity prevention, yet little is known about factors that influence policy-makers' decisions on this topic. From September 2014 to April 2015, we conducted 43 semi-structured interviews about factors that encourage and discourage policy-makers' support for childhood obesity prevention policies. We interviewed policy-makers (n = 12) and two other groups engaged with childhood obesity prevention policies: representatives of non-governmental organizations (n = 24) and academics (n = 7). Factors that encourage policy-makers' support for childhood obesity prevention policies included: positive impact on government finances, an existing evidence base, partnerships with community-based collaborators, and consistency with policy-makers' priorities. Factors that discourage policy-makers' support included the following: perceptions about government's role, food and beverage industry opposition, and policy-makers' beliefs about personal responsibility. As public health practitioners, advocates, and others seek to advance childhood obesity prevention in the U.S. and elsewhere, the factors we identified offer insights into ways to frame proposed policies and strategies to influence policy-makers.

Enhancing Evidence-Based Public Health Policy: Developing and Using Policy Narratives.

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Troy, Lisa M; Kietzman, Kathryn G

2016-06-01

Academic researchers and clinicians have a critical role in shaping public policies to improve the health of an aging America. Policy narratives that pair personal stories with research statistics are a powerful tool to share knowledge generated in academic and clinical settings with policymakers. Effective policy narratives rely on a trustworthy and competent narrator and a compelling story that highlights the personal impact of policies under consideration and academic research that bolsters the story. Awareness of the cultural differences in the motivations, expectations, and institutional constraints of academic researchers and clinicians as information producers and U.S. Congress and federal agencies as information users is critical to the development of policy narratives that impact policy decisions. The current article describes the development and use of policy narratives to bridge cultures and enhance evidence-based public health policies that better meet the needs of older adults. [Journal of Gerontological Nursing, 42(6), 11-17.]. Copyright 2016, SLACK Incorporated.

Evidence-based health information from the users' perspective--a qualitative analysis.

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Hirschberg, Irene; Seidel, Gabriele; Strech, Daniel; Bastian, Hilda; Dierks, Marie-Luise

2013-10-10

Evidence-based information is a precondition for informed decision-making and participation in health. There are several recommendations and definitions available on the generation and assessment of so called evidence-based health information for patients and consumers (EBHI). They stress the importance of objectively informing people about benefits and harms and any uncertainties in health-related procedures. There are also studies on the comprehensibility, relevance and user-friendliness of these informational materials. But to date there has been little research on the perceptions and cognitive reactions of users or lay people towards EBHI. The aim of our study is to define the spectrum of consumers' reaction patterns to written EBHI in order to gain a deeper understanding of their comprehension and assumptions, as well as their informational needs and expectations. This study is based on an external user evaluation of EBHI produced by the German Institute for Quality and Efficiency in Health Care (IQWiG), commissioned by the IQWiG. The EBHI were examined within guided group discussions, carried out with lay people. The test readers' first impressions and their appraisal of the informational content, presentation, structure, comprehensibility and effect were gathered. Then a qualitative text analysis of 25 discussion transcripts involving 94 test readers was performed. Based on the qualitative text analysis a framework for reaction patterns was developed, comprising eight main categories: (i) interest, (ii) satisfaction, (iii) reassurance and trust, (iv) activation, (v) disinterest, (vi) dissatisfaction and disappointment, (vii) anxiety and worry, (viii) doubt. Many lay people are unfamiliar with core characteristics of this special information type. Two particularly critical issues are the description of insufficient evidence and the attendant absence of clear-cut recommendations. Further research is needed to examine strategies to explain the specific

The challenges of nutrition policymaking.

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Slavin, Joanne L

2015-02-07

In my over three decades of work in the field of food and nutrition, I have participated in many efforts that seek new policy initiatives in the hopes that these programs can curb rates of obesity and chronic disease and help consumers make healthier dietary choices. Because of the profound effect that many of these policies have on consumers, the food environment, federal nutrition assistance programs and subsequent policy and regulatory recommendations, it is imperative that only the strongest, best available evidence is used to set policy. This review evaluates methods by which current nutrition policies use scientific research as well as provides recommendations for how best to ensure future nutrition policies are truly science-based and likely to have a meaningful impact on public health. Specifically, this review will: Describe the current food and nutrition policy environment in the US Examine how science is used in federal food and nutrition policymaking efforts, using the Dietary Guidelines for Americans (DGA) as an example Describe strong versus weak science as well as what types of studies are most appropriate for use in policymaking Discuss the potential effects and consequences of making policy recommendations in the absence of scientific consensus or agreement Make recommendations to support the present and ongoing development of science-based policy likely to positively impact public health.

Visualization studies on evidence-based medicine domain knowledge (series 3): visualization for dissemination of evidence based medicine information.

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Shen, Jiantong; Yao, Leye; Li, Youping; Clarke, Mike; Gan, Qi; Li, Yifei; Fan, Yi; Gou, Yongchao; Wang, Li

2011-05-01

To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it's contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor

Why national eHealth programs need dead philosophers: Wittgensteinian reflections on policymakers' reluctance to learn from history.

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Greenhalgh, Trisha; Russell, Jill; Ashcroft, Richard E; Parsons, Wayne

2011-12-01

Policymakers seeking to introduce expensive national eHealth programs would be advised to study lessons from elsewhere. But these lessons are unclear, partly because a paradigm war (controlled experiment versus interpretive case study) is raging. England's $20.6 billion National Programme for Information Technology (NPfIT) ran from 2003 to 2010, but its overall success was limited. Although case study evaluations were published, policymakers appeared to overlook many of their recommendations and persisted with some of the NPfIT's most criticized components and implementation methods. In this reflective analysis, illustrated by a case fragment from the NPfIT, we apply ideas from Ludwig Wittgenstein's postanalytic philosophy to justify the place of the "n of 1" case study and consider why those in charge of national eHealth programs appear reluctant to learn from such studies. National eHealth programs unfold as they do partly because no one fully understands what is going on. They fail when this lack of understanding becomes critical to the programs' mission. Detailed analyses of the fortunes of individual programs, articulated in such a way as to illuminate the contextualized talk and action ("language games") of multiple stakeholders, offer unique and important insights. Such accounts, portrayals rather than models, deliver neither statistical generalization (as with experiments) nor theoretical generalization (as with multisite case comparisons or realist evaluations). But they do provide the facility for heuristic generalization (i.e., to achieve a clearer understanding of what is going on), thereby enabling more productive debate about eHealth programs' complex, interdependent social practices. A national eHealth program is best conceptualized not as a blueprint and implementation plan for a state-of-the-art technical system but as a series of overlapping, conflicting, and mutually misunderstood language games that combine to produce a situation of ambiguity

Evidence-informed capacity building for setting health priorities in low- and middle-income countries: A framework and recommendations for further research [version 1; referees: 2 approved

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Ryan Li

2017-03-01

Full Text Available Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders – not only the technical capacity to “do” research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values; academics need to understand and respond to decision-makers’ needs to produce relevant research. The health system at all levels will need institutional capacity building to incentivise routine generation and use of evidence. Knowledge brokers, including priority-setting agencies (such as England’s National Institute for Health and Care Excellence, and Health Interventions and Technology Assessment Program, Thailand and the media can play an important role in facilitating engagement and knowledge transfer between the various actors. Especially at the outset but at every step, it is critical that patients and the public understand that trade-offs are inherent in priority-setting, and careful efforts should be made to engage them, and to hear their views throughout the process. There is thus no single approach to capacity building; rather a spectrum of activities that recognises the roles and skills of all stakeholders. A range of methods, including formal and informal training, networking and engagement, and support through collaboration on projects, should be flexibly employed (and tailored to specific needs of each country to support institutionalisation of evidence-informed priority-setting. Finally, capacity building should be a two-way process; those who build capacity should also attend to

Exploring the use of research evidence in health-enhancing physical activity policies

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Hämäläinen, Riitta-Maija; Aro, Arja R; van de Goor, L.A.M.; Lau, Cathrine Juel; Jakobsen, Mette Winge; Chereches, Razvan M; Syed, Ahmed M

2015-01-01

BACKGROUND: The gaps observed between the use of research evidence and policy have been reported to be based on the different methods of using research evidence in policymaking by researchers and actual policymakers. Some policies and policymaking processes may therefore be particularly well

Supporting decision-making processes for evidence-based mental health promotion.

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Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian

2011-12-01

The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.

Solar Economics for Policymakers | State, Local, and Tribal Governments |

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NREL Economics for Policymakers Solar Economics for Policymakers The Solar Technical Assistance regions to give policymakers up-to-date, accurate, and unbiased information on solar economics and likely

A realist synthesis of the effect of social accountability interventions on health service providers' and policymakers' responsiveness.

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Lodenstein, Elsbet; Dieleman, Marjolein; Gerretsen, Barend; Broerse, Jacqueline Ew

2013-11-07

Accountability has center stage in the current post-Millennium Development Goals (MDG) debate. One of the effective strategies for building equitable health systems and providing quality health services is the strengthening of citizen-driven or social accountability processes. The monitoring of actions and decisions of policymakers and providers by citizens is regarded as a right in itself but also as an alternative to weak administrative accountability mechanisms, in particular in settings with poor governance. The effects of social accountability interventions are often based on assumptions and are difficult to evaluate because of their complex nature and context sensitivity. This study aims to review and assess the available evidence for the effect of social accountability interventions on policymakers' and providers' responsiveness in countries with medium to low levels of governance capacity and quality. For policymakers and practitioners engaged in health system strengthening, social accountability initiatives and rights-based approaches to health, the findings of this review may help when reflecting on the assumptions and theories of change behind their policies and interventions. Little is known about social accountability interventions, their outcomes and the circumstances under which they produce outcomes for particular groups or issues. In this study, social accountability interventions are conceptualized as complex social interventions for which a realist synthesis is considered the most appropriate method of systematic review. The synthesis is based on a preliminary program theory of social accountability that will be tested through an iterative process of primary study searches, data extraction, analysis and synthesis. Published and non-published (grey) quantitative and qualitative studies in English, French and Spanish will be included. Quality and validity will be enhanced by continuous peer review and team reflection among the reviewers. The

The McMaster Optimal Aging Portal: Usability Evaluation of a Unique Evidence-Based Health Information Website

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Dobbins, Maureen; Haynes, R. Brian; Iorio, Alfonso; Lavis, John N; Raina, Parminder

2016-01-01

Background Increasingly, older adults and their informal caregivers are using the Internet to search for health-related information. There is a proliferation of health information online, but the quality of this information varies, often based on exaggerated or dramatic findings, and not easily comprehended by consumers. The McMaster Optimal Aging Portal (Portal) was developed to provide Internet users with high-quality evidence about aging and address some of these current limitations of health information posted online. The Portal includes content for health professionals coming from three best-in-class resources (MacPLUS, Health Evidence, and Health Systems Evidence) and four types of content specifically prepared for the general public (Evidence Summaries, Web Resource Ratings, Blog Posts, and Twitter messages). Objective Our objectives were to share the findings of the usability evaluation of the Portal with particular focus on the content features for the general public and to inform designers of health information websites and online resources for older adults about key usability themes. Methods Data analysis included task performance during usability testing and qualitative content analyses of both the usability sessions and interviews to identify core themes. Results A total of 37 participants took part in 33 usability testing sessions and 21 focused interviews. Qualitative analysis revealed common themes regarding the Portal’s strengths and challenges to usability. The strengths of the website were related to credibility, applicability, browsing function, design, and accessibility. The usability challenges included reluctance to register, process of registering, searching, terminology, and technical features. Conclusions The study reinforced the importance of including end users during the development of this unique, dynamic, evidence-based health information website. The feedback was applied to iteratively improve website usability. Our findings can be

Health Professionals' Use of Online Information Retrieval Systems and Online Evidence.

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Lialiou, Paschalina; Pavlopoulou, Ioanna; Mantas, John

2016-01-01

Across-sectional survey was designed to determine health professionals' awareness and usage of online evidence retrieval systems in clinical practice. A questionnaire was used to measure professionals' behavior and utilization of online evidences, as well as, reasons and barriers on information retrieval. 439 nurses and physicians from public and private hospitals in Greece formulate the study's sample. The two most common reasons that individuals are using online information systems were for writing scientific manuscripts or filling a knowledge gap. A positive correlation was found between participants with postgraduate studies and information system usage. The majority of them (90,6%) believe that online information systems improves patient care and 67,6% of them had their own experiences on this. More support is needed to nurses and physicians in order to use the online evidence and as a result to improve the provided care and practices.

Employment Precariousness and Poor Mental Health: Evidence from Spain on a New Social Determinant of Health

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Vives, Alejandra; Amable, Marcelo; Ferrer, Montserrat; Moncada, Salvador; Llorens, Clara; Muntaner, Carles; Benavides, Fernando G.; Benach, Joan

2013-01-01

Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondent's sex and age. Prevalence proportion ratios (PPRs) of poor mental health across quintiles of employment precariousness (reference: 1st quintile) were calculated with log-binomial regressions, separately for women and men. Results. Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95–3.31) for women and 2.23 (95% CI: 1.86–2.68) for men. Conclusion. The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making. PMID:23431322

Addressing the changing sources of health information in Iran

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Amir Alishahi Tabriz

2013-01-01

Conclusion : Although during 8 years of study radio and television remained as main source of health information but there is an increasing tendency to use internet especially in men. Policymakers should revise their broadcasting strategies based on people demand.

[GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction].

Science.gov (United States)

Alonso-Coello, Pablo; Schünemann, Holger J; Moberg, Jenny; Brignardello-Petersen, Romina; Akl, Elie A; Davoli, Marina; Treweek, Shaun; Mustafa, Reem A; Rada, Gabriel; Rosenbaum, Sarah; Morelli, Angela; Guyatt, Gordon H; Oxman, Andrew D

Clinicians, guideline developers, and policymakers sometimes neglect important criteria, give undue weight to criteria, and do not use the best available evidence to inform their judgments. Explicit and transparent systems for decision making can help to ensure that all important criteria are considered and that decisions are informed by the best available research evidence. The GRADE Working Group has developed Evidence to Decision (EtD) frameworks for the different type of recommendations or decisions. The purpose of EtD frameworks is to help people use evidence in a structured and transparent way to inform decisions in the context of clinical recommendations, coverage decisions, and health system or public health recommendations and decisions. EtD frameworks have a common structure that includes formulation of the question, an assessment of the evidence, and drawing conclusions, though there are some differences between frameworks for each type of decision. EtD frameworks inform users about the judgments that were made and the evidence supporting those judgments by making the basis for decisions transparent to target audiences. EtD frameworks also facilitate dissemination of recommendations and enable decision makers in other jurisdictions to adopt recommendations or decisions, or adapt them to their context. This article is a translation of the original article published in British Medical Journal. The EtD frameworks are currently used in the Clinical Practice Guideline Programme of the Spanish National Health System, co-ordinated by GuíaSalud. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Evidence-Based Clinical Decision: Key to Improved Patients Care ...

African Journals Online (AJOL)

... materials remain limited to mostly developed countries. There is need to adopt measures to further facilitate dissemination of current information of effective health to care providers and policymakers in resource-poor countries. This review is aimed at re-enforcing the need for applying best-evidence into clinical practice

Mental Health Interventions in the Workplace and Work Outcomes: A Best-Evidence Synthesis of Systematic Reviews.

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Wagner, S L; Koehn, C; White, M I; Harder, H G; Schultz, I Z; Williams-Whitt, K; Warje, O; Dionne, C E; Koehoorn, M; Pasca, R; Hsu, V; McGuire, L; Schulz, W; Kube, D; Wright, M D

2016-01-01

Mental health issues in the workplace are a growing concern among organizations and policymakers, but it remains unclear what interventions are effective in preventing mental health problems and their associated organizational consequences. This synthesis reports on workplace mental health interventions that impact absenteeism, productivity and financial outcomes. To determine the level of evidence supporting mental health interventions as valuable to work outcomes. Databases were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO and TRIP. Grey literature searches included health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. The assessment of articles for inclusion criteria and methodological quality was conducted independently by two or more researchers, with differences resolved through consensus. The search resulted in 3363 titles, of which 3248 were excluded following title/abstract review, with 115 articles retrieved for full-text review. 14 articles finally met the inclusion criteria and are summarized in this synthesis. There is moderate evidence for the effectiveness of workplace mental health interventions on improved workplace outcomes. Certain types of programs, such as those incorporating both mental and physical health interventions, multicomponent mental health and/or psychosocial interventions, and exposure in vivo containing interventions for particular anxiety disorders had a greater level of research evidence to support their effectiveness.

Mental Health Interventions in the Workplace and Work Outcomes: A Best-Evidence Synthesis of Systematic Reviews

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SL Wagner

2016-01-01

Full Text Available Background: Mental health issues in the workplace are a growing concern among organizations and policymakers, but it remains unclear what interventions are effective in preventing mental health problems and their associated organizational consequences. This synthesis reports on workplace mental health interventions that impact absenteeism, productivity and financial outcomes. Objective: To determine the level of evidence supporting mental health interventions as valuable to work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO and TRIP. Grey literature searches included health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC, and Institute for Work and Health. The assessment of articles for inclusion criteria and methodological quality was conducted independently by two or more researchers, with differences resolved through consensus. Results: The search resulted in 3363 titles, of which 3248 were excluded following title/abstract review, with 115 articles retrieved for full-text review. 14 articles finally met the inclusion criteria and are summarized in this synthesis. Conclusion: There is moderate evidence for the effectiveness of workplace mental health interventions on improved workplace outcomes. Certain types of programs, such as those incorporating both mental and physical health interventions, multicomponent mental health and/or psychosocial interventions, and exposure in vivo containing interventions for particular anxiety disorders had a greater level of research evidence to support their effectiveness.

Applying a Health Network approach to translate evidence-informed policy into practice: a review and case study on musculoskeletal health.

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Briggs, Andrew M; Bragge, Peter; Slater, Helen; Chan, Madelynn; Towler, Simon C B

2012-11-14

While translation of evidence into health policy and practice is recognised as critical to optimising health system performance and health-related outcomes for consumers, mechanisms to effectively achieve these goals are neither well understood, nor widely communicated. Health Networks represent a framework which offers a possible solution to this dilemma, particularly in light of emerging evidence regarding the importance of establishing relationships between stakeholders and identifying clinical leaders to drive evidence integration and translation into policy. This is particularly important for service delivery related to chronic diseases. In Western Australia (WA), disease and population-specific Health Networks are comprised of cross-discipline stakeholders who work collaboratively to develop evidence-informed policies and drive their implementation. Since establishment of the Health Networks in WA, over 50 evidence-informed Models of Care (MoCs) have been produced across 18 condition or population-focused Networks. The aim of this paper is to provide an overview of the Health Network framework in facilitating the translation of evidence into policy and practice with a particular focus on musculoskeletal health. A review of activities of the WA Musculoskeletal Health Network was undertaken, focussing on outcomes and the processes used to achieve them in the context of: development of policy, procurement of funding, stakeholder engagement, publications, and projects undertaken by the Network which aligned to implementation of MoCs.The Musculoskeletal Health Network has developed four MoCs which reflect Australian National Health Priority Areas. Establishment of community-based services for consumers with musculoskeletal health conditions is a key recommendation from these MoCs. Through mapping barriers and enablers to policy implementation, working groups, led by local clinical leaders and supported by the broader Network and government officers, have

Applying a Health Network approach to translate evidence-informed policy into practice: A review and case study on musculoskeletal health

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Briggs Andrew M

2012-11-01

Full Text Available Abstract Background While translation of evidence into health policy and practice is recognised as critical to optimising health system performance and health-related outcomes for consumers, mechanisms to effectively achieve these goals are neither well understood, nor widely communicated. Health Networks represent a framework which offers a possible solution to this dilemma, particularly in light of emerging evidence regarding the importance of establishing relationships between stakeholders and identifying clinical leaders to drive evidence integration and translation into policy. This is particularly important for service delivery related to chronic diseases. In Western Australia (WA, disease and population-specific Health Networks are comprised of cross-discipline stakeholders who work collaboratively to develop evidence-informed policies and drive their implementation. Since establishment of the Health Networks in WA, over 50 evidence-informed Models of Care (MoCs have been produced across 18 condition or population-focused Networks. The aim of this paper is to provide an overview of the Health Network framework in facilitating the translation of evidence into policy and practice with a particular focus on musculoskeletal health. Case presentation A review of activities of the WA Musculoskeletal Health Network was undertaken, focussing on outcomes and the processes used to achieve them in the context of: development of policy, procurement of funding, stakeholder engagement, publications, and projects undertaken by the Network which aligned to implementation of MoCs. The Musculoskeletal Health Network has developed four MoCs which reflect Australian National Health Priority Areas. Establishment of community-based services for consumers with musculoskeletal health conditions is a key recommendation from these MoCs. Through mapping barriers and enablers to policy implementation, working groups, led by local clinical leaders and supported by

Information demands of occupational health physicians and their attitude towards evidence-based medicine

NARCIS (Netherlands)

Schaafsma, Frederieke; Hulshof, Carel; van Dijk, Frank; Verbeek, Jos

2004-01-01

Objectives This study assessed the extent and nature of information demands among occupational health physicians and their attitude towards the application of evidence-based medicine in occupational health. Methods A questionnaire survey was carried out among a random sample of 159 physicians

Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process

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McDougall, Lori

2016-01-01

advantage. Global health policy-making is an arena of contested interests, power and ideas, shaped by the interaction of coalitions. Although policy-making is often seen as a process that should be guided by evidence rather than interest-based politics, this study concludes that a participatory process of debate among different actor-coalitions is vital to progress and can lend greater legitimacy, accountability and transparency to the policy process. PMID:27239880

Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process

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Lori McDougall

2016-05-01

of advantage. Global health policy-making is an arena of contested interests, power and ideas, shaped by the interaction of coalitions. Although policy-making is often seen as a process that should be guided by evidence rather than interest-based politics, this study concludes that a participatory process of debate among different actorcoalitions is vital to progress and can lend greater legitimacy, accountability and transparency to the policy process.

Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process.

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McDougall, Lori

2016-01-30

Advocacy coalitions play an increasingly prominent role within the global health landscape, linking actors and institutions to attract political attention and resources. This paper examines how coalitions negotiate among themselves and exercise hidden forms of power to produce policy on the basis of their beliefs and strategic interests. This paper examines the beliefs and behaviours of health advocacy coalitions using Sabatier's Advocacy Coalition Framework (ACF) as an informal theoretical lens. Coalitions are further explored in relation to the concept of transnational advocacy networks (Keck and Sikkink) and of productive power (Shiffman). The ACF focuses on explaining how policy change takes place when there is conflict concerning goals and technical approaches among different actors. This study uses participant observation methods, self-reported survey results and semi-structured qualitative interviews to trace how a major policy project of the Millennium Development Goal (MDG) era, the Global Strategy for Women's and Children's Health, was constructed through negotiations among maternal, newborn, and child health (MNCH) and sexual and reproductive health and rights (SRHR) advocacy coalitions. The Global Strategy represented a new opportunity for high-level political attention. Despite differing policy beliefs, MNCH and SRHR actors collaborated to produce this strategy because of anticipated gains in political attention. While core beliefs did not shift fundamentally and collaboration was primarily a short-term tactical response to a time-bound opportunity, MNCH actors began to focus more on human rights perspectives and SRHR actors adopted greater use of quantifiable indicators and economic argumentation. This shift emphasises the inherent importance of SRHR to maternal and child health survival. As opportunities arise, coalitions respond based on principles and policy beliefs, as well as to perceptions of advantage. Global health policy-making is an arena of

Ingredients for Good Health Policy-Making: Incorporating Power and Politics into the Mix

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Yusra Shawar

2014-05-01

Full Text Available Eggs, flour, sugar, butter, baking soda, milk, and vanilla extract—all ingredients necessary to make a delicious cake. Similarly, good health policy-making can only be successfully pursued and understood by accounting for all of its basic ingredients, including the role of politics and power. Otherwise, the result is simply not good.

Does a ban on informal health providers save lives? Evidence from Malawi

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Godlonton, Susan; Okeke, Edward N.

2015-01-01

Informal health providers ranging from drug vendors to traditional healers account for a large fraction of health care provision in developing countries. They are, however, largely unlicensed and unregulated leading to concern that they provide ineffective and, in some cases, even harmful care. A new and controversial policy tool that has been proposed to alter household health seeking behavior is an outright ban on these informal providers. The theoretical effects of such a ban are ambiguous. In this paper, we study the effect of a ban on informal (traditional) birth attendants imposed by the Malawi government in 2007. To measure the effect of the ban, we use a difference-in-difference strategy exploiting variation across time and space in the intensity of exposure to the ban. Our most conservative estimates suggest that the ban decreased use of traditional attendants by about 15 percentage points. Approximately three quarters of this decline can be attributed to an increase in use of the formal sector and the remainder is accounted for by an increase in relative/friend-attended births. Despite the rather large shift from the informal to the formal sector, we do not find any evidence of a statistically significant reduction in newborn mortality on average. The results are robust to a triple difference specification using young children as a control group. We examine several explanations for this result and find evidence consistent with quality of formal care acting as a constraint on improvements in newborn health. PMID:26681821

Informing Evidence Based Decisions: Usage Statistics for Online Journal Databases

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Alexei Botchkarev

2017-06-01

Full Text Available Abstract Objective – The primary objective was to examine online journal database usage statistics for a provincial ministry of health in the context of evidence based decision-making. In addition, the study highlights implementation of the Journal Access Centre (JAC that is housed and powered by the Ontario Ministry of Health and Long-Term Care (MOHLTC to inform health systems policy-making. Methods – This was a prospective case study using descriptive analysis of the JAC usage statistics of journal articles from January 2009 to September 2013. Results – JAC enables ministry employees to access approximately 12,000 journals with full-text articles. JAC usage statistics for the 2011-2012 calendar years demonstrate a steady level of activity in terms of searches, with monthly averages of 5,129. In 2009-2013, a total of 4,759 journal titles were accessed including 1,675 journals with full-text. Usage statistics demonstrate that the actual consumption was over 12,790 full-text downloaded articles or approximately 2,700 articles annually. Conclusion – JAC’s steady level of activities, revealed by the study, reflects continuous demand for JAC services and products. It testifies that access to online journal databases has become part of routine government knowledge management processes. MOHLTC’s broad area of responsibilities with dynamically changing priorities translates into the diverse information needs of its employees and a large set of required journals. Usage statistics indicate that MOHLTC information needs cannot be mapped to a reasonably compact set of “core” journals with a subsequent subscription to those.

A case study: planning a statewide information resource for health professionals: an evidence-based approach

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Chew, Katherine; Watson, Linda; Parker, Mary

2009-01-01

Question: What is the best approach for implementing a statewide electronic health library (eHL) to serve all health professionals in Minnesota? Setting: The research took place at the University of Minnesota Health Sciences Libraries. Methods: In January 2008, the authors began planning a statewide eHL for health professionals following the five-step process for evidence-based librarianship: formulating the question, finding the best evidence, appraising the evidence, assessing costs and benefits, and evaluating the effectiveness of resulting actions. Main Results: The authors identified best practices for developing a statewide eHL for health professionals relating to audience or population served, information resources, technology and access, funding model, and implementation and sustainability. They were compared to the mission of the eHL project to drive strategic directions by developing recommendations. Conclusion: EBL can guide the planning process for a statewide eHL, but findings must be tailored to the local environment to address information needs and ensure long-term sustainability. PMID:19851487

Oral health information systems--towards measuring progress in oral health promotion and disease prevention

DEFF Research Database (Denmark)

Petersen, Poul Erik; Bourgeois, Denis; Bratthall, Douglas

2005-01-01

and the general public. WHO has developed global and regional oral health databanks for surveillance, and international projects have designed oral health indicators for use in oral health information systems for assessing the quality of oral health care and surveillance systems. Modern oral health information...... been designed by WHO and used by countries worldwide for the surveillance of oral disease and health. Global, regional and national oral health databanks have highlighted the changing patterns of oral disease which primarily reflect changing risk profiles and the implementation of oral health...... programmes oriented towards disease prevention and health promotion. The WHO Oral Health Country/Area Profile Programme (CAPP) provides data on oral health from countries, as well as programme experiences and ideas targeted to oral health professionals, policy-makers, health planners, researchers...

Communicating space weather to policymakers and the wider public

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Ferreira, Bárbara

2014-05-01

As a natural hazard, space weather has the potential to affect space- and ground-based technological systems and cause harm to human health. As such, it is important to properly communicate this topic to policymakers and the general public alike, informing them (without being unnecessarily alarmist) about the potential impact of space-weather phenomena and how these can be monitored and mitigated. On the other hand, space weather is related to interesting phenomena on the Sun such as coronal-mass ejections, and incorporates one of the most beautiful displays in the Earth and its nearby space environment: aurora. These exciting and fascinating aspects of space weather should be cultivated when communicating this topic to the wider public, particularly to younger audiences. Researchers have a key role to play in communicating space weather to both policymakers and the wider public. Space scientists should have an active role in informing policy decisions on space-weather monitoring and forecasting, for example. And they can exercise their communication skills by talking about space weather to school children and the public in general. This presentation will focus on ways to communicate space weather to wider audiences, particularly policymakers. It will also address the role researchers can play in this activity to help bridge the gap between the space science community and the public.

Models of policy-making and their relevance for drug research.

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Ritter, Alison; Bammer, Gabriele

2010-07-01

Researchers are often frustrated by their inability to influence policy. We describe models of policy-making to provide new insights and a more realistic assessment of research impacts on policy. We describe five prominent models of policy-making and illustrate them with examples from the alcohol and drugs field, before drawing lessons for researchers. Policy-making is a complex and messy process, with different models describing different elements. We start with the incrementalist model, which highlights small amendments to policy, as occurs in school-based drug education. A technical/rational approach then outlines the key steps in a policy process from identification of problems and their causes, through to examination and choice of response options, and subsequent implementation and evaluation. There is a clear role for research, as we illustrate with the introduction of new medications, but this model largely ignores the dominant political aspects of policy-making. Such political aspects include the influence of interest groups, and we describe models about power and pressure groups, as well as advocacy coalitions, and the challenges they pose for researchers. These are illustrated with reference to the alcohol industry, and interest group conflicts in establishing a Medically Supervised Injecting Centre. Finally, we describe the multiple streams framework, which alerts researchers to 'windows of opportunity', and we show how these were effectively exploited in policy for cannabis law reform in Western Australia. Understanding models of policy-making can help researchers maximise the uptake of their work and advance evidence-informed policy.

Building policy-making capacity in the Ministry of Health: the Kazakhstan experience.

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Chanturidze, Tata; Adams, Orvill; Tokezhanov, Bolat; Naylor, Mike; Richardson, Erica

2015-01-20

Recent economic growth in Kazakhstan has been accompanied by slower improvements in population health and this has renewed impetus for health system reform. Strengthening strategic planning and policy-making capacity in the Ministry of Health has been identified as an important priority, particularly as the Ministry of Health is leading the health system reform process. The intervention was informed by the United Nations Development Programme (UNDP) framework for capacity building which views capacity building as an ongoing process embedded in local institutions and practices. In response to local needs extra elements were included in the framework to tailor the capacity building programme according to the existing policy and budget cycles and respective competence requirements, and link it with transparent career development structures of the Ministry of Health. This aspect of the programme was informed by the institutional capability assessment model used by the United Kingdom National Health Service (NHS) which was adapted to examine the specific organizational and individual competences of the Ministry of Health in Kazakhstan. There were clear successes in building capacity for policy making and strategic planning within the Ministry of Health in Kazakhstan, including better planned, more timely and in-depth responses to policy assignments. Embedding career development as a part of this process was more challenging. This case study highlights the importance of strong political will and high level support for capacity building in ensuring the sustainability of programmes. It also shows that capacity-building programmes need to ensure full engagement with all local stakeholders, or where this is not possible, programmes need to be targeted narrowly to those stakeholders who will benefit most, for the greatest impact to be achieved. In sum, high quality tailor-made capacity development programmes should be based on thorough needs assessment of individual and

A knowledge management tool for public health: health-evidence.ca

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Dobbins Maureen

2010-08-01

Full Text Available Abstract Background The ultimate goal of knowledge translation and exchange (KTE activities is to facilitate incorporation of research knowledge into program and policy development decision making. Evidence-informed decision making involves translation of the best available evidence from a systematically collected, appraised, and analyzed body of knowledge. Knowledge management (KM is emerging as a key factor contributing to the realization of evidence-informed public health decision making. The goal of health-evidence.ca is to promote evidence-informed public health decision making through facilitation of decision maker access to, retrieval, and use of the best available synthesized research evidence evaluating the effectiveness of public health interventions. Methods The systematic reviews that populate health evidence.ca are identified through an extensive search (1985-present of 7 electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, BIOSIS, and SportDiscus; handsearching of over 20 journals; and reference list searches of all relevant reviews. Reviews are assessed for relevance and quality by two independent reviewers. Commonly-used public health terms are used to assign key words to each review, and project staff members compose short summaries highlighting results and implications for policy and practice. Results As of June 2010, there are 1913 reviews in the health-evidence.ca registry in 21 public health and health promotion topic areas. Of these, 78% have been assessed as being of strong or moderate methodological quality. Health-evidence.ca receives approximately 35,000 visits per year, 20,596 of which are unique visitors, representing approximately 100 visits per day. Just under half of all visitors return to the site, with the average user spending six minutes and visiting seven pages per visit. Public health nurses, program managers, health promotion workers, researchers, and program coordinators are

Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making

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Gwenan M. Knight

2016-01-01

Full Text Available The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy, the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions.

Pathways of undue influence in health policy-making: a main actor's perspective.

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Hernández-Aguado, Ildefonso; Chilet-Rosell, Elisa

2018-02-01

It is crucial to know the extent to which influences lead to policy capture-by which the policy-making process is shifted away from the public interest towards narrow private interests. Using the case study of Spain, our aim was to identify interactions between public administration, civil society and private companies that could influence health policies. 54 semistructured interviews with key actors related to health policy. The interviews were used to gather information on main policy actors as well as on direct and subtle influences that could modify health policies. The analysis identified and described, from the interviewed persons' experiences, both the inappropriate influences exerted on the actors and those that they exerted. Inappropriate influences were identified at all levels of administration and policy. They included actions for personal benefits, pressure for blocking health policies and pressure from high levels of government in favour of private corporations. The private sector played a significant role in these strategies through bribery, personal gifts, revolving doors, negative campaigns and by blocking unfavourable political positions or determining the knowledge agenda. The interviewees reported subtle forms of influence (social events, offers of technical support, invitations, etc) that contributed to the intellectual and cultural capture of health officials. The health policy decision-making processes in Spain are subject to influences by stakeholders that determine a degree of policy capture, which is avoidable. The private sector uses different strategies, from subtle influences to outright corruption, taking advantage in many cases of flexible legislation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness

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Rob Baltussen

2016-11-01

Full Text Available Priority setting of health interventions is generally considered as a valuable approach to support low- and middle-income countries (LMICs in their strive for universal health coverage (UHC. However, present initiatives on priority setting are mainly geared towards the development of more cost-effectiveness information, and this evidence does not sufficiently support countries to make optimal choices. The reason is that priority setting is in reality a value-laden political process in which multiple criteria beyond cost-effectiveness are important, and stakeholders often justifiably disagree about the relative importance of these criteria. Here, we propose the use of ‘evidence-informed deliberative processes’ as an approach that does explicitly recognise priority setting as a political process and an intrinsically complex task. In these processes, deliberation between stakeholders is crucial to identify, reflect and learn about the meaning and importance of values, informed by evidence on these values. Such processes then result in the use of a broader range of explicit criteria that can be seen as the product of both international learning (‘core’ criteria, which include eg, cost-effectiveness, priority to the worse off, and financial protection and learning among local stakeholders (‘contextual’ criteria. We believe that, with these evidence-informed deliberative processes in place, priority setting can provide a more meaningful contribution to achieving UHC.

Qualitative analysis of national documents on health care services and pharmaceuticals` purchasing challenges: evidence from Iran.

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Bastani, Peivand; Samadbeik, Mahnaz; Dinarvand, Rassoul; Kashefian-Naeeini, Sara; Vatankhah, Soudabeh

2018-06-05

Iranian health sector encountered many challenges in resource allocation and health service purchasing during the past decades, the aim of this study was to determine the main challenges of the present process of health service purchasing for national policymakers and other developing countries with the same setting. It was a qualitative study carried out via the complete content analysis of all relevant national documents from 2007 to 2014. In order to retrieve the related documents, we searched the official websites related to the Ministry of Health and Medical Education, four main Iranian insurance organizations, the Health Committee of the Parliament Profile, strategic vice president's site and Supreme Insurance Council. After recognition of documents, their credibility and authenticity were evaluated in terms of their publication or adjustment. For the analysis of documents, the four step-Scott method was used applying MAXQDA version 10. Findings illustrated that health service purchase challenges in the country can be classified in 6 main themes of policy-making, executive, intersectional, natural, legal and informational challenges with 26 subthemes. Furthermore, 5 themes of Basic Benefit Package, Reimbursement,Decision making, Technology and Contract are considered as the main Challenges in pharmaceutical purchasing area containing 13 relevant subthemes. It seems that according to documents, Iran has faced many structural and procedural problems with the purchase of the best health interventions. So it is highly recommended to consider consequences derived from the present challenges and try to use these evidences in their policy making process to decrease the existed problems and move to better procurement of health interventions.

[Good practice guidelines for health information].

Science.gov (United States)

2016-01-01

Evidence-based health information is distinguished by the provision of an unbiased and trustworthy description of the current state of medical knowledge. It enables people to learn more about health and disease, and to make health-related decisions - on their own or together with others - reflecting their attitudes and lifestyle. To adequately serve this purpose, health information must be evidence-based. A working group from the German Network for Evidence-based Medicine (Deutsches Netzwerk Evidenzbasierte Medizin) has developed a first draft of good practice guidelines for health information (Gute Praxis Gesundheitsinformation) with the aim of providing support for authors and publishers of evidence-based health information. The group included researchers, patient representatives, journalists and developers of health information. The criteria for evidence-based health information were developed and agreed upon within this author group, and then made available for public comment. All submitted comments were documented and assessed regarding the need to revise or amend the draft. Changes were subsequently implemented following approval by the author group. Gute Praxis Gesundheitsinformation calls for a transparent methodological approach in the development of health information. To achieve this, evidence-based information must be based on (a) a systematic literature search, (b) a justified selection of evidence, (c) unbiased reporting of relevant results, (d) appropriate factual and linguistic communication of uncertainties, (e) either avoidance of any direct recommendations or a strict division between the reporting of results and the derivation of recommendations, (f) the consideration of current evidence on the communication of figures, risks and probabilities, and (g) transparent information about the authors and publishers of the health information, including their funding sources. Gute Praxis Gesundheitsinformation lists a total of 16 aspects to be addressed

Bridging the gaps in the Health Management Information System in the context of a changing health sector

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Nyamtema Angelo S

2010-06-01

Full Text Available Abstract Background The Health Management Information System (HMIS is crucial for evidence-based policy-making, informed decision-making during planning, implementation and evaluation of health programs; and for appropriate use of resources at all levels of the health system. This study explored the gaps and factors influencing HMIS in the context of a changing health sector in Tanzania. Methods A cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February 2008. A semi-structured questionnaire was used to interview 43 health workers on their knowledge, attitude, practice and factors for change on HMIS and HMIS booklets from these facilities were reviewed for completeness. Results Of all respondents, 81% had never been trained on HMIS, 65% did not properly define this system, 54% didn't know who is supposed to use the information collected and 42% did not use the collected data for planning, budgeting and evaluation of services provision. Although the attitude towards the system was positive among 91%, the reviewed HMIS booklets were never completed in 25% - 55% of the facilities. There were no significant differences in knowledge, attitude and practice on HMIS between clinicians and nurses. The most common type of HMIS booklets which were never filled were those for deliveries (55%. The gaps in the current HMIS were linked to lack of training, inactive supervision, staff workload pressure and the lengthy and laborious nature of the system. Conclusions This research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change in the country's HMIS. It suggests need for new innovations including incorporation of HMIS in the ongoing reviews of the curricula for all cadres of health care providers, development of more user-friendly system and use of evidence-based John Kotter's eight-step process for implementing

From a "perfect storm" to "smooth sailing": policymaker perspectives on implementation and sustainment of an evidence-based practice in two states.

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Willging, Cathleen E; Green, Amy E; Gunderson, Lara; Chaffin, Mark; Aarons, Gregory A

2015-02-01

Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems. © The Author(s) 2014.

Communication and dissemination strategies to facilitate the use of health-related evidence.

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McCormack, Lauren; Sheridan, Stacey; Lewis, Megan; Boudewyns, Vanessa; Melvin, Cathy L; Kistler, Christine; Lux, Linda J; Cullen, Katherine; Lohr, Kathleen N

2013-11-01

This review examined how to best communicate and disseminate evidence, including uncertain evidence, to inform health care decisions. The review focused on three primary objectives--comparing the effectiveness of: (1) communicating evidence in various contents and formats that increase the likelihood that target audiences will both understand and use the information (KQ 1); (2) a variety of approaches for disseminating evidence from those who develop it to those who are expected to use it (KQ 2); and (3) various ways of communicating uncertainty-associated health-related evidence to different target audiences (KQ 3). A secondary objective was to examine how the effectiveness of communication and dissemination strategies varies across target audiences, including evidence translators, health educators, patients, and clinicians. We searched MEDLINE®, the Cochrane Library, Cochrane Central Trials Registry, PsycINFO®, and the Web of Science. We used a variety of medical subject headings (MeSH terms) and major headings, and used free-text and title and abstract text-word searches. The search was limited to studies on humans published from 2000 to March 15, 2013, for communication and dissemination, given the prior systematic reviews, and from 1966 to March 15, 2013, for communicating uncertainty. We used standard Evidence-based Practice Center methods of dual review of abstracts, full-text articles, and abstractions, and quality ratings and group consensus to resolve disagreements. We used group consensus to grade strength of evidence. The search identified 4,152 articles (after removing duplicates) for all three KQs. After dual review at the title/abstract stage and full-text review stage, we retained 61 articles that directly (i.e., head to head) compared strategies to communicate and disseminate evidence. Across the KQs, many of the comparisons yielded insufficient evidence to draw firm conclusions. For KQ 1, we found that investigators frequently blend more than

Developing a conceptual framework of urban health observatories toward integrating research and evidence into urban policy for health and health equity.

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Caiaffa, W T; Friche, A A L; Dias, M A S; Meireles, A L; Ignacio, C F; Prasad, A; Kano, M

2014-02-01

Detailed information on health linked to geographic, sociodemographic, and environmental data are required by city governments to monitor health and the determinants of health. These data are critical for guiding local interventions, resource allocation, and planning decisions, yet they are too often non-existent or scattered. This study aimed to develop a conceptual framework of Urban Health Observatories (UHOs) as an institutional mechanism which can help synthesize evidence and incorporate it into urban policy-making for health and health equity. A survey of a select group of existent UHOs was conducted using an instrument based on an a priori conceptual framework of key structural and functional characteristics of UHOs. A purposive sample of seven UHOs was surveyed, including four governmental, two non-governmental, and one university-based observatory, each from a different country. Descriptive and framework analysis methods were used to analyze the data and to refine the conceptual framework in light of the empirical data. The UHOs were often a product of unique historical circumstances. They were relatively autonomous and capable of developing their own locally sensitive agenda. They often had strong networks for accessing data and were able to synthesize them at the urban level as well as disaggregate them into smaller units. Some UHOs were identified as not only assessing but also responding to local needs. The findings from this study were integrated into a conceptual framework which illustrates how UHOs can play a vital role in monitoring trends in health determinants, outcomes, and equity; optimizing an intersectoral urban information system; incorporating research on health into urban policies and systems; and providing technical guidance on research and evidence-based policy making. In order to be most effective, UHOs should be an integral part of the urban governance system, where multiple sectors of government, the civil society, and businesses can

Moving science into state child and adolescent mental health systems: Illinois' evidence-informed practice initiative.

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Starin, Amy C; Atkins, Marc S; Wehrmann, Kathryn C; Mehta, Tara; Hesson-McInnis, Matthew S; Marinez-Lora, A; Mehlinger, Renee

2014-01-01

In 2005, the Illinois State Mental Health Authority embarked on an initiative to close the gap between research and practice in the children's mental health system. A stakeholder advisory council developed a plan to advance evidence informed practice through policy and program initiatives. A multilevel approach was developed to achieve this objective, which included policy change, stakeholder education, and clinician training. This article focuses on the evidence-informed training process designed following review of implementation research. The training involved in-person didactic sessions and twice-monthly telephone supervision across 6 cohorts of community based clinicians, each receiving 12 months of training. Training content initially included cognitive behavioral therapy and behavioral parent training and was adapted over the years to a practice model based on common element concepts. Evaluation based on provider and parent report indicated children treated by training clinicians generally showed superior outcomes versus both a treatment-as-usual comparison group for Cohorts 1 to 4 and the statewide child population as a whole after 90 days of care for Cohorts 5 to 6. The results indicated primarily moderate to strong effects for the evidence-based training groups. Moving a large public statewide child mental health system toward more effective services is a complex and lengthy process. These results indicate training of community mental health providers in Illinois in evidence-informed practice was moderately successful in positively impacting child-level functional outcomes. These findings also influenced state policy in committing resources to continuing the initiative, even in difficult economic times.

The use of evidence in public governmental reports on health policy: an analysis of 17 Norwegian official reports (NOU).

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Innvaer, Simon

2009-09-28

Governments increasingly require policy documents to be evidence-based. This paper analyses the use of scientific evidence in such documents by reviewing reports from government-appointed committees in Norway to assess the committees' handling of questions of effect. This study uses the 'Index of Scientific Quality' (ISQ) to analyse all Norwegian official reports (NOUs) that were: (1) published by the Norwegian Ministry of Health and Care Services during 1994-1998 (N = 20); and (2) concerned with questions of effect either because these were included in the mandate or as a result of the committee's interpretation of the mandate. The ISQ is based on scientific criteria common in all research concerning questions of effect. The primary outcome measure is an ISQ score on a five-point scale. Three reports were excluded because their mandates, or the committees' interpretations of them, did not address questions of effect. For the remaining 17 NOUs in our study, overall ISQ scores were low for systematic literature search and for explicit validation of research. Two reports had an average score of three or higher, while scores for five other reports were not far behind. How committees assessed the relevant factors was often unclear. The reports' evaluations of health evidence in relation to questions of effect lacked transparency and, overall, showed little use of systematic processes. A systematic, explicit and transparent approach, following the standards laid down in the ISQ, may help generate the evidence-based decision-making that Norway, the UK, the EU and the WHO desire and seek. However, policy-makers may find the ISQ criteria for assessing the scientific quality of a report too narrow to adequately inform policy-making.

Considering economic analyses in the revision of the preventive vaccination law: a new direction for health policy-making in Japan?

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Akazawa, Manabu; Yongue, Julia; Ikeda, Shunya; Satoh, Toshihiko

2014-10-01

Evidence of a significant vaccine policy shift can be witnessed not only in the number of new vaccines available in Japan but also in the way that vaccine policy is being formulated. In 2010, policy makers decided for the first time ever to commission economic analyses as a reference in their consideration of subsidy allocation. This research offers a first hand account of the recent changes in vaccine policies by examining the decision-making process from the perspective of the researchers commissioned to perform the economic evaluations. In order to understand the vaccine policy-making process, a review was made of all the documents that were distributed and discussed during the government committee meetings from February 2010 when the revision of the Preventive Vaccination Law was initially proposed to May 2012 when the final recommendations were made. Economic evaluations were conducted for seven vaccines under consideration in the routine immunization program (Haemophilus influenzae type b or Hib, pneumococcal disease for children and adults, human papillomavirus, varicella, mumps, and hepatitis B). All were cost-effective options, except the Hib and hepatitis B vaccines. Nonetheless, all the vaccines were recommended equally for inclusion in the routine immunization program. While it is significant that policy-makers decided to commission economic assessments at all, various issues remain regarding the influence of external pressure, the choice of evaluation methods and the implications of using cost-effectiveness analyses on the future of Japanese health policy-making. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Assessing the influence of knowledge translation platforms on health system policy processes to achieve the health millennium development goals in Cameroon and Uganda: a comparative case study.

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Ongolo-Zogo, Pierre; Lavis, John N; Tomson, Goran; Sewankambo, Nelson K

2018-05-01

There is a scarcity of empirical data on the influence of initiatives supporting evidence-informed health system policy-making (EIHSP), such as the knowledge translation platforms (KTPs) operating in Africa. To assess whether and how two KTPs housed in government-affiliated institutions in Cameroon and Uganda have influenced: (1) health system policy-making processes and decisions aiming at supporting achievement of the health millennium development goals (MDGs); and (2) the general climate for EIHSP. We conducted an embedded comparative case study of four policy processes in which Evidence Informed Policy Network (EVIPNet) Cameroon and Regional East African Community Health Policy Initiative (REACH-PI) Uganda were involved between 2009 and 2011. We combined a documentary review and semi structured interviews of 54 stakeholders. A framework-guided thematic analysis, inspired by scholarship in health policy analysis and knowledge utilization was used. EVIPNet Cameroon and REACH-PI Uganda have had direct influence on health system policy decisions. The coproduction of evidence briefs combined with tacit knowledge gathered during inclusive evidence-informed stakeholder dialogues helped to reframe health system problems, unveil sources of conflicts, open grounds for consensus and align viable and affordable options for achieving the health MDGs thus leading to decisions. New policy issue networks have emerged. The KTPs indirectly influenced health policy processes by changing how interests interact with one another and by introducing safe-harbour deliberations and intersected with contextual ideational factors by improving access to policy-relevant evidence. KTPs were perceived as change agents with positive impact on the understanding, acceptance and adoption of EIHSP because of their complementary work in relation to capacity building, rapid evidence syntheses and clearinghouse of policy-relevant evidence. This embedded case study illustrates how two KTPs influenced

Building capacity for evidence informed decision making in public health: a case study of organizational change.

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Peirson, Leslea; Ciliska, Donna; Dobbins, Maureen; Mowat, David

2012-02-20

Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM). However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27) with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services), fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.

A difficult balancing act: policy actors' perspectives on using economic evaluation to inform health-care coverage decisions under the Universal Health Insurance Coverage scheme in Thailand.

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Teerawattananon, Yot; Russell, Steve

2008-03-01

In Thailand, policymakers have come under increasing pressure to use economic evaluation to inform health-care resource allocation decisions, especially after the introduction of the Universal Health Insurance Coverage (UC) scheme. This article presents qualitative findings from research that assessed a range of policymakers' perspectives on the acceptability of using economic evaluation for the development of health-care benefit packages in Thailand. The policy analysis examined their opinions about existing decision-making processes for including health interventions in the UC benefit package, their understanding of health economic evaluation, and their attitudes, acceptance, and values relating to the use of the method. Semistructured interviews were conducted with 36 policy actors who play a major role or have some input into health resource allocation decisions within the Thai health-care system. These included 14 senior policymakers at the national level, 5 hospital directors, 10 health professionals, and 7 academics. Policy actors thought that economic evaluation information was relevant for decision-making because of the increasing need for rationing and more transparent criteria for making UC coverage decisions. Nevertheless, they raised several difficulties with using economic evaluation that would pose barriers to its introduction, including distrust in the method, conflicting philosophical positions and priorities compared to that of "health maximization," organizational allegiances, existing decision-making procedures that would be hard to change, and concerns about political pressure and acceptability.

Ethics, equality and evidence in health promotion

DEFF Research Database (Denmark)

Vallgårda, Signild

2014-01-01

Abstract Aim: The Danish National Board of Health has expressed its commitment to social equality in health, evidence-informed health promotion and public health ethics, and has issued guidelines for municipalities on health promotion, in Danish named prevention packages.The aim of this article...... is to analyse whether the Board of Health adheres to ideals of equality, evidence and ethics in these guidelines. Methods: An analysis to detect statements about equity, evidence and ethics in 10 health promotion packages directed at municipalities with the aim of guiding the municipalities towards evidence......-informed disease prevention and health promotion. Results: Despite declared intentions of prioritizing social equality in health, these intentions are largely absent from most of the packages.When health inequalities are mentioned, focus is on the disadvantaged or the marginalized. Several interventions...

Use of national clinical databases for informing and for evaluating health care policies.

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Black, Nick; Tan, Stefanie

2013-02-01

Policy-makers and analysts could make use of national clinical databases either to inform or to evaluate meso-level (organisation and delivery of health care) and macro-level (national) policies. Reviewing the use of 15 of the best established databases in England, we identify and describe four published examples of each use. These show that policy-makers can either make use of the data itself or of research based on the database. For evaluating policies, the major advantages are the huge sample sizes available, the generalisability of the data, its immediate availability and historic information. The principal methodological challenges involve the need for risk adjustment and time-series analysis. Given their usefulness in the policy arena, there are several reasons why national clinical databases have not been used more, some due to a lack of 'push' by their custodians and some to the lack of 'pull' by policy-makers. Greater exploitation of these valuable resources would be facilitated by policy-makers' and custodians' increased awareness, minimisation of legal restrictions on data use, improvements in the quality of databases and a library of examples of applications to policy. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

What supports do health system organizations have in place to facilitate evidence-informed decision-making? A qualitative study.

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Ellen, Moriah E; Léon, Gregory; Bouchard, Gisèle; Lavis, John N; Ouimet, Mathieu; Grimshaw, Jeremy M

2013-08-06

Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making. The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making. In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a 'knowledge broker') in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff's capacity building. This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision-making. Some of the identified supports may increase the use of

Perspectives of Fijian Policymakers on the Obesity Prevention Policy Landscape

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Anna-Marie Hendriks

2015-01-01

Full Text Available In Fiji and other Pacific Island countries, obesity has rapidly increased in the past decade. Therefore, several obesity prevention policies have been developed. Studies show that their development has been hampered by factors within Fiji’s policy landscape such as pressure from industry. Since policymakers in the Fijian national government are primarily responsible for the development of obesity policies, it is important to understand their perspectives; we therefore interviewed 15 policymakers from nine Fijian ministries. By applying the “attractor landscape” metaphor from dynamic systems theory, we captured perceived barriers and facilitators in the policy landscape. A poor economic situation, low food self-sufficiency, power inequalities, inappropriate framing of obesity, limited policy evidence, and limited resource sharing hamper obesity policy developments in Fiji. Facilitators include policy entrepreneurs and policy brokers who were active when a window of opportunity opened and who strengthened intersectoral collaboration. Fiji’s policy landscape can become more conducive to obesity policies if power inequalities are reduced. In Fiji and other Pacific Island countries, this may be achievable through increased food self-sufficiency, strengthened intersectoral collaboration, and the establishment of an explicit functional focal unit within government to monitor and forecast the health impact of policy changes in non-health sectors.

Perspectives of Fijian Policymakers on the Obesity Prevention Policy Landscape

Science.gov (United States)

Hendriks, Anna-Marie; Delai, Mere Y.; Thow, Anne-Marie; Gubbels, Jessica S.; De Vries, Nanne K.; Kremers, Stef P. J.; Jansen, Maria W. J.

2015-01-01

In Fiji and other Pacific Island countries, obesity has rapidly increased in the past decade. Therefore, several obesity prevention policies have been developed. Studies show that their development has been hampered by factors within Fiji's policy landscape such as pressure from industry. Since policymakers in the Fijian national government are primarily responsible for the development of obesity policies, it is important to understand their perspectives; we therefore interviewed 15 policymakers from nine Fijian ministries. By applying the “attractor landscape” metaphor from dynamic systems theory, we captured perceived barriers and facilitators in the policy landscape. A poor economic situation, low food self-sufficiency, power inequalities, inappropriate framing of obesity, limited policy evidence, and limited resource sharing hamper obesity policy developments in Fiji. Facilitators include policy entrepreneurs and policy brokers who were active when a window of opportunity opened and who strengthened intersectoral collaboration. Fiji's policy landscape can become more conducive to obesity policies if power inequalities are reduced. In Fiji and other Pacific Island countries, this may be achievable through increased food self-sufficiency, strengthened intersectoral collaboration, and the establishment of an explicit functional focal unit within government to monitor and forecast the health impact of policy changes in non-health sectors. PMID:26380307

The EVOTION Decision Support System: Utilizing It for Public Health Policy-Making in Hearing Loss.

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Katrakazas, Panagiotis; Trenkova, Lyubov; Milas, Josip; Brdaric, Dario; Koutsouris, Dimitris

2017-01-01

As Decision Support Systems start to play a significant role in decision making, especially in the field of public-health policy making, we present an initial attempt to formulate such a system in the concept of public health policy making for hearing loss related problems. Justification for the system's conceptual architecture and its key functionalities are presented. The introduction of the EVOTION DSS sets a key innovation and a basis for paradigm shift in policymaking, by incorporating relevant models, big data analytics and generic demographic data. Expected outcomes for this joint effort are discussed from a public-health point of view.

Negotiating multisectoral evidence: a qualitative study of knowledge exchange at the intersection of transport and public health

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Cornelia Guell

2017-01-01

Full Text Available Abstract Background For the prevention and control of chronic diseases, two strategies are frequently highlighted: that public health should be evidence based, and that it should develop a multisectoral approach. At the end of a natural experimental study of the health impacts of new transport infrastructure, we took the opportunity of a knowledge exchange forum to explore how stakeholders assessed, negotiated and intended to apply multisectoral evidence in policy and practice at the intersection of transport and health. We aimed to better understand the challenges they faced in knowledge exchange, as well as their everyday experiences with working in multisectoral remits. Methods In 2015, we conducted participant observation during an interactive event with 41 stakeholders from national and local government, the third sector and academia in Cambridge, UK. Formal and informal interactions between stakeholders were recorded in observational field notes. We also conducted 18 semistructured interviews reflecting on the event and on knowledge exchange in general. Results We found that stakeholders negotiated a variety of challenges. First, stakeholders had to negotiate relatively new formal and informal multisectoral remits; and how to reconcile the differing expectations of transport specialists, who tended to emphasise the importance of precedence in guiding action, and health specialists’ concern for the rigour and synthesis of research evidence. Second, research in this field involved complex study designs, and often produced evidence with uncertain transferability to other settings. Third, health outcomes of transport schemes had political traction and were used strategically but not easily translated into cost-benefit ratios. Finally, knowledge exchange meant multiple directions of influence. Stakeholders were concerned that researchers did not always have skills to translate their findings into understandable evidence, and some stakeholders

Building capacity for evidence informed decision making in public health: a case study of organizational change

Directory of Open Access Journals (Sweden)

Peirson Leslea

2012-02-01

Full Text Available Abstract Background Core competencies for public health in Canada require proficiency in evidence informed decision making (EIDM. However, decision makers often lack access to information, many workers lack knowledge and skills to conduct systematic literature reviews, and public health settings typically lack infrastructure to support EIDM activities. This research was conducted to explore and describe critical factors and dynamics in the early implementation of one public health unit's strategic initiative to develop capacity to make EIDM standard practice. Methods This qualitative case study was conducted in one public health unit in Ontario, Canada between 2008 and 2010. In-depth information was gathered from two sets of semi-structured interviews and focus groups (n = 27 with 70 members of the health unit, and through a review of 137 documents. Thematic analysis was used to code the key informant and document data. Results The critical factors and dynamics for building EIDM capacity at an organizational level included: clear vision and strong leadership, workforce and skills development, ability to access research (library services, fiscal investments, acquisition and development of technological resources, a knowledge management strategy, effective communication, a receptive organizational culture, and a focus on change management. Conclusion With leadership, planning, commitment and substantial investments, a public health department has made significant progress, within the first two years of a 10-year initiative, towards achieving its goal of becoming an evidence informed decision making organization.

Evidence-informed primary health care workforce policy: are we asking the right questions?

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Naccarella, Lucio; Buchan, Jim; Brooks, Peter

2010-01-01

Australia is facing a primary health care workforce shortage. To inform primary health care (PHC) workforce policy reforms, reflection is required on ways to strengthen the evidence base and its uptake into policy making. In 2008 the Australian Primary Health Care Research Institute funded the Australian Health Workforce Institute to host Professor James Buchan, Queen Margaret University, UK, an expert in health services policy research and health workforce planning. Professor Buchan's visit enabled over forty Australian PHC workforce mid-career and senior researchers and policy stakeholders to be involved in roundtable policy dialogue on issues influencing PHC workforce policy making. Six key thematic questions emerged. (1) What makes PHC workforce planning different? (2) Why does the PHC workforce need to be viewed in a global context? (3) What is the capacity of PHC workforce research? (4) What policy levers exist for PHC workforce planning? (5) What principles can guide PHC workforce planning? (6) What incentives exist to optimise the use of evidence in policy making? The emerging themes need to be discussed within the context of current PHC workforce policy reforms, which are focussed on increasing workforce supply (via education/training programs), changing the skill mix and extending the roles of health workers to meet patient needs. With the Australian government seeking to reform and strengthen the PHC workforce, key questions remain about ways to strengthen the PHC workforce evidence base and its uptake into PHC workforce policy making.

Cochrane Rapid Reviews Methods Group to play a leading role in guiding the production of informed high-quality, timely research evidence syntheses.

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Garritty, Chantelle; Stevens, Adrienne; Gartlehner, Gerald; King, Valerie; Kamel, Chris

2016-10-28

Policymakers and healthcare stakeholders are increasingly seeking evidence to inform the policymaking process, and often use existing or commissioned systematic reviews to inform decisions. However, the methodologies that make systematic reviews authoritative take time, typically 1 to 2 years to complete. Outside the traditional SR timeline, "rapid reviews" have emerged as an efficient tool to get evidence to decision-makers more quickly. However, the use of rapid reviews does present challenges. To date, there has been limited published empirical information about this approach to compiling evidence. Thus, it remains a poorly understood and ill-defined set of diverse methodologies with various labels. In recent years, the need to further explore rapid review methods, characteristics, and their use has been recognized by a growing network of healthcare researchers, policymakers, and organizations, several with ties to Cochrane, which is recognized as representing an international gold standard for high-quality, systematic reviews. In this commentary, we introduce the newly established Cochrane Rapid Reviews Methods Group developed to play a leading role in guiding the production of rapid reviews given they are increasingly employed as a research synthesis tool to support timely evidence-informed decision-making. We discuss how the group was formed and outline the group's structure and remit. We also discuss the need to establish a more robust evidence base for rapid reviews in the published literature, and the importance of promoting registration of rapid review protocols in an effort to promote efficiency and transparency in research. As with standard systematic reviews, the core principles of evidence-based synthesis should apply to rapid reviews in order to minimize bias to the extent possible. The Cochrane Rapid Reviews Methods Group will serve to establish a network of rapid review stakeholders and provide a forum for discussion and training. By facilitating

The HIV epidemic and sexual and reproductive health policy integration: views of South African policymakers.

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Cooper, Diane; Mantell, Joanne E; Moodley, Jennifer; Mall, Sumaya

2015-03-04

Integration of sexual and reproductive health (SRH) and HIV policies and services delivered by the same provider is prioritised worldwide, especially in sub-Saharan Africa where HIV prevalence is highest. South Africa has the largest antiretroviral treatment (ART) programme in the world, with an estimated 2.7 million people on ART, elevating South Africa's prominence as a global leader in HIV treatment. In 2011, the Southern African HIV Clinicians Society published safer conception guidelines for people living with HIV (PLWH) and in 2013, the South African government published contraceptive guidelines highlighting the importance of SRH and fertility planning services for people living with HIV. Addressing unintended pregnancies, safer conception and maternal health issues is crucial for improving PLWH's SRH and combatting the global HIV epidemic. This paper explores South African policymakers' perspectives on public sector SRH-HIV policy integration, with a special focus on the need for national and regional policies on safer conception for PLWH and contraceptive guidelines implementation. It draws on 42 in-depth interviews with national, provincial and civil society policymakers conducted between 2008-2009 and 2011-2012, as the number of people on ART escalated. Interviews focused on three key domains: opinions on PLWH's childbearing; the status of SRH-HIV integration policies and services; and thoughts and suggestions on SRH-HIV integration within the restructuring of South African primary care services. Data were coded and analysed according to themes. Participants supported SRH-HIV integrated policy and services. However, integration challenges identified included a lack of policy and guidelines, inadequately trained providers, vertical programming, provider work overload, and a weak health system. Participants acknowledged that SRH-HIV integration policies, particularly for safer conception, contraception and cervical cancer, had been neglected. Policymakers

Low-Level Evidence Suggests that Perceived Ability to Evaluate and Trust Online Health Information is Associated with Low Health Literacy

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Lindsay Alcock

2016-04-01

Full Text Available Objective – To review, based on research evidence, the correlation between low health literacy and four outcomes of interest: (1 the ability to evaluate online health information based on (2 perceived reliability and accuracy, (3 trust in the Internet as an information source, and (4 the application of established evaluation criteria. Design – Systematic review and narrative synthesis. Setting –MEDLINE, PsycInfo, Web of Science, CINAHL, and Communication and Mass-media Complete as well as articles discovered through the snowball method. Subjects – 38 studies identified through a systematic literature search. Methods – An exhaustive list of potential articles was gathered through searching five online databases and Google Scholar, and hand searching of references. Inclusion and exclusion criteria were applied in a two-phase screening process in which two researchers participated to address reliability. Data, including study characteristics and metadata, predictors, assessment methods, and outcomes, were extracted from relevant studies, and then synthesized narratively. Main Results – Following duplication removal 13,632 records were retrieved, 254 of which were identified for full-text assessment. Thirty-eight studies met the eligibility criteria. All studies were non-experimental and therefore graded as a low level of evidence; 35 were cross-sectional designs, 1 a focus group, and 2 were observational studies. Studies varied widely in population definition and sample size and were published between 2001 and 2013, primarily in North America. Overall, a positive association was identified between health literacy and outcomes related to the ability to evaluate or trust Internet health information, while findings were inconsistent related to perceived quality of information and the application of evaluative criteria. Four studies examined the impact of health literacy levels on one or more of the outcomes of interest. The most prevalent

A survey tool for measuring evidence-based decision making capacity in public health agencies

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Jacobs Julie A

2012-03-01

Full Text Available Abstract Background While increasing attention is placed on using evidence-based decision making (EBDM to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. Methods Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. Results In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. Conclusions The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence

Using secondary analysis of qualitative data of patient experiences of health care to inform health services research and policy.

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Ziebland, Sue; Hunt, Kate

2014-07-01

Qualitative research is recognized as an important method for including patients' voices and experiences in health services research and policy-making, yet the considerable potential to analyse existing qualitative data to inform health policy and practice has been little realized. This failure may partly be explained by: a lack of awareness amongst health policy makers of the increasing wealth of qualitative data available; and around 15 years of internal debates among qualitative researchers on the strengths, limitations and validity of re-use of qualitative data. Whilst acknowledging the challenges of qualitative secondary data analysis, we argue that there is a growing imperative to be pragmatic and to undertake analysis of existing qualitative data collections where they have the potential to contribute to health policy formulation. Time pressures are inherent in the policy-making process and in many circumstances it is not possible to seek funding, conduct and analyse new qualitative studies of patients' experiences in time to inform a specific policy. The danger then is that the patient voice, and the experiences of relatives and carers, is either excluded or included in a way that is easily dismissed as 'unrepresentative'. We argue that secondary analysis of qualitative data collections may sometimes be an effective means to enable patient experiences to inform policy decision-making. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis.

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Aarons, Gregory A; Wells, Rebecca S; Zagursky, Karen; Fettes, Danielle L; Palinkas, Lawrence A

2009-11-01

We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Implementation of EBP is a complex process. Cross-system-level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns.

Knowledge and power in policy-making for child survival in Niger.

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Dalglish, Sarah L; Rodríguez, Daniela C; Harouna, Abdoutan; Surkan, Pamela J

2017-03-01

Calls to enhance the use of scientific evidence in international health and development policy have increased in recent years; however, analytic frameworks for understanding evidence use focus narrowly on scientific research and were created using data and observations nearly exclusively from Western countries. We examine processes of health policy development in a case study of Niger, a low-income West African country that adopted integrated community case management of childhood illness (iCCM) beginning in 2007, resulting in measurable declines in child mortality. Data collection included in-depth interviews with policy actors in Niger (N = 32), document review (N = 103) and direct observation of policy forums (N = 3). Data analysis used process tracing methodology and applied an Aristotelian definition of "knowledge" as 1) episteme (facts), 2) techne (skills) and 3) phronesis (practical wisdom), while also using a critical perspective to understand issues of power. We found sharp differentials in policy-makers' possession and use of codified forms of knowledge (episteme), with Nigerien policy officers' access highly mediated by actors at international agencies. Government policy-makers possessed skills and capacities (techne) to negotiate with donors and deliberate and weigh conflicting considerations; however they lacked capacity and resources to formally evaluate and document programs and thus reliably draw lessons from them. Practical wisdom (phronesis) emerged as key to the iCCM policy enterprise, particularly among Nigerien government actors, who used logical and ethical arguments to make decisions later found to be critical to iCCM's success. While codified knowledge confers power on members of policy discussions who can access it, this represents only one form of knowledge used in the policy process and perhaps not the most important. Future research on evidence-based policy should use broader definitions of evidence or knowledge, examine on how

Health status of and health-care provision to asylum seekers in Germany: protocol for a systematic review and evidence mapping of empirical studies.

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Schneider, Christine; Mohsenpour, Amir; Joos, Stefanie; Bozorgmehr, Kayvan

2014-11-29

There are more than 100,000 asylum seekers registered in Germany, who are granted limited access to health services. This study aims to provide a systematic overview of the empirical literature on the health status of and health-care provision to asylum seekers in Germany in order to consolidate knowledge, avoid scientific redundance, and identify research gaps. A systematic review and evidence mapping of empirical literature on the health status of and health-care provision to asylum seekers in Germany will be performed. We will apply a three-tiered search strategy: 1. search in databases (PubMed/MEDLINE, Web of Science, IBSS, Sociological Abstracts, Worldwide Political Science Abstracts, CINAHL, Sowiport, Social Sciences Citation Index, ASSIA, MedPilot, DNB), dissertation and theses databases, and the internet (Google); 2. screening references of included studies; 3. contacting authors and civil society organizations for grey literature. Included will be studies which report quantitative and/or qualitative data or review articles on asylum seekers in Germany, published in German or English language. Outcome measures will include physical, mental, or social well-being, and all aspects of health-care provision (access, availability, affordability, and quality). Search results will be screened for eligibility by screening titles, abstracts and full texts. Data extraction comprises information on study characteristics, research aims, and domains of health or health-care services analyzed. The quality of studies will be appraised and documented by appropriate assessment tools. A descriptive evidence map will be drawn by categorizing all included articles by research design and the health conditions and/or domains of health-care provision analyzed. The body of evidence will be evaluated, and a narrative evidence synthesis will be performed by means of a multi-level approach, whereby quantitative and qualitative evidence are analyzed as separate streams and the product

Using Evidence to Reduce Health Inequalities in East and Southern ...

International Development Research Centre (IDRC) Digital Library (Canada)

... and use research that will help policymakers implement stronger health systems. ... health inequities -allocating resources to ensure essential health services in ... IWRA/IDRC webinar on climate change and adaptive water management.

Knowledge brokering between researchers and policymakers in Fiji to develop policies to reduce obesity: a process evaluation.

Science.gov (United States)

Waqa, Gade; Mavoa, Helen; Snowdon, Wendy; Moodie, Marj; Schultz, Jimaima; McCabe, Marita; Kremer, Peter; Swinburn, Boyd

2013-07-01

The importance of using research evidence in decisionmaking at the policy level has been increasingly recognized. However, knowledge brokering to engage researchers and policymakers in government and non-government organizations is challenging. This paper describes and evaluates the knowledge exchange processes employed by the Translational Research on Obesity Prevention in Communities (TROPIC) project that was conducted from July 2009 to April 2012 in Fiji. TROPIC aimed to enhance: the evidence-informed decisionmaking skills of policy developers; and awareness and utilization of local and other obesity-related evidence to develop policies that could potentially improve the nation's food and physical activity environments. The specific research question was: Can a knowledge brokering approach advance evidence-informed policy development to improve eating and physical activity environments in Fiji. The intervention comprised: recruiting organizations and individuals; mapping policy environments; analyzing organizational capacity and support for evidence-informed policymaking (EIPM); developing EIPM skills; and facilitating development of evidence-informed policy briefs. Flexible timetabling of activities was essential to accommodate multiple competing priorities at both individual and organizational levels. Process diaries captured the duration, frequency and type of each interaction and/or activity between the knowledge brokering team and participants or their organizations. Partnerships were formalized with high-level officers in each of the six participating organization. Participants (n = 49) developed EIPM skills (acquire, assess, adapt and apply evidence) through a series of four workshops and applied this knowledge to formulate briefs with ongoing one-to-one support from TROPIC team members. A total of 55% of participants completed the 12 to18 month intervention, and 63% produced one or more briefs (total = 20) that were presented to higher

Evidence-informed health policy 2 - survey of organizations that support the use of research evidence.

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Lavis, John N; Paulsen, Elizabeth J; Oxman, Andrew D; Moynihan, Ray

2008-12-17

Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs) or undertake health technology assessments (HTAs). Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs) that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs). We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE) collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone. We received completed questionnaires from 152 (86%) organizations. More than one-half of the organizations (and particularly HTA agencies) reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer) full-time equivalent (FTE) staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations do not collect data systematically about

Harnessing information technology to improve women's health information: evidence from Pakistan.

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Zakar, Rubeena; Zakar, Muhammad Z; Qureshi, Shazia; Fischer, Florian

2014-09-04

More than half of Pakistani women are illiterate, marginalized, and experience myriad health problems. These women are also disadvantaged in terms of their restricted mobility and limited access to public space. Nonetheless, user-friendly information and communication technologies (ICTs) have opened up new opportunities to provide them with information that is essential for their health and well-being. We established an Information and Communication Centre (ICC) in a village in Sialkot (Pakistan) on a pilot basis in 2009. The basic philosophy of the ICC was to provide women with health-related information by exposing them to modern sources of information on their doorstep. By design, the ICC was a community-based and community-managed institution where women could access information through online (e.g., internet, mobile phone etc.) and offline (e.g., CDs, TV etc.) resources. The ICC was managed by a group of local volunteer women who had the capacity and skills to use the devices and tools of modern ICTs. We noted an overwhelming participation and interest from local women in the activities of the ICC. The women wanted to receive information on a wide range of issues, from family planning, antenatal care, and childcare to garbage disposal and prevention of domestic violence. Overall, the ICC was successful in initiating a meaningful "information dialogue" at community level, where much-needed information was retrieved, negotiated, mediated, and disseminated through intimate and trusted relations. We conclude that ICTs have the capacity to cross the barriers of illiteracy and can reach out to disadvantaged women living under a conservative patriarchal regime.

Barriers in implementing evidence-informed health decisions in rural rehabilitation settings: a mixed methods pilot study.

Science.gov (United States)

Prakash, V; Hariohm, K; Balaganapathy, M

2014-08-01

Literature on the barriers to implementing research findings into physiotherapy practice are often urban centric, using self report based on the hypothetical patient scenario. The objective of this study was to investigate the occurrence of barriers, encountered by evidence informed practice-trained physiotherapists in the management of "real world" patients in rural rehabilitation settings. A mixed-methods research design was used. Physiotherapists working in rural outpatient rehabilitation settings participated in the study. In the first phase, we asked all participants (N = 5) to maintain a log book for a 4-week period to record questions that arose during their routine clinical encounters and asked them also to follow first four of the five steps of evidence-informed practice (ask, access, appraise and apply). In the second phase (after 4 weeks), we conducted a semistructured, direct interviews with the participants exploring their experiences involved in the process of implementing evidence-informed clinical decisions made during the study period. At the end of 4 weeks, 30 questions were recorded. For 17 questions, the participants found evidence but applied that evidence into their practice only in 9 instances. Being generalist practitioners, lack of outcomes specific to the patients were reported as barriers more so than time constraints in implementing evidence-informed practice. Practice setting, lack of patient-centered research and evidence-informed practice competency of physiotherapists can be significant barriers to implementing evidence-informed health decisions in rural rehabilitation setting. © 2014 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

"GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

Science.gov (United States)

Karame, P., Sr.; Dushimiyimana, V.

2016-12-01

" Championing GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health

Racial and Ethnic Differences in Tobacco Information Seeking and Information Sources: Findings From the 2015 Health Information National Trends Survey.

Science.gov (United States)

Nguyen, Anh B; Robinson, Joelle; O'Brien, Erin Keely; Zhao, Xiaoquan

2017-09-01

This article describes sources of health information, types of tobacco information sought, and trust in sources of tobacco information among U.S. racial/ethnic groups (Whites, Blacks, Hispanics, Asian and Pacific Islanders, and Other). Cross-sectional data (N = 3,788) from a nationally representative survey, HINTS-FDA 2015, were analyzed to examine unadjusted and adjusted associations between race/ethnicity and (a) first source of health information, (b) tobacco information seeking, and (c) trust in sources of tobacco information. Adjusted associations controlled for current tobacco product use and sociodemographic variables. Findings indicated that the Internet was the most common first source of health information while health care providers were the second most common source for all racial/ethnic groups. Tobacco-related health information seeking was more prevalent than other tobacco product information seeking. Unadjusted analyses indicated that a higher proportion of Whites sought other tobacco product information compared to Asians and Pacific Islanders. Trust was rated highest for doctors while trust for health organizations was rated second highest. Asians and Pacific Islanders had higher trust in the government compared to all other groups. Blacks had higher trust in religious organizations compared to all other groups besides Hispanics. Blacks had higher trust for tobacco companies compared to Whites and Other. Many of these differences were attenuated in adjusted analyses. This research has implications for tobacco control practice and policymaking by identifying potential dissemination strategies.

Patients at the centre: methodological considerations for evaluating evidence from health interventions involving patients use of web-based information systems.

Science.gov (United States)

Cummings, Elizabeth; Turner, Paul

2010-09-15

Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions.Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences.Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the 'patient at the centre' by engaging them in their own care and/or 'empowering' them through the use of information systems.This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients' interests and outcomes are measured, defined and evaluated within health interventions that involve them using web-based information systems

Patients at the Centre: Methodological Considerations for Evaluating Evidence from Health Interventions Involving Patients Use of Web-Based Information Systems

Science.gov (United States)

Cummings, Elizabeth; Turner, Paul

2010-01-01

Building an evidence base for healthcare interventions has long been advocated as both professionally and ethically desirable. By supporting meaningful comparison amongst different approaches, a good evidence base has been viewed as an important element in optimising clinical decision-making and the safety and quality of care. Unsurprisingly, medical research has put considerable effort into supporting the development of this evidence base, and the randomised controlled trial has become the dominant methodology. Recently however, a body of research has begun to question, not just this methodology per se, but also the extent to which the evidence it produces may marginalise individual patient experiences, priorities and perceptions. Simultaneously, the widespread adoption and utilisation of information systems (IS) in health care has also prompted initiatives to develop a stronger base of evidence about their impacts. These calls have been stimulated both by numerous system failures and research expressing concerns about the limitations of information systems methodologies in health care environments. Alongside the potential of information systems to produce positive, negative and unintended consequences, many measures of success, impact or benefit appear to have little to do with improvements in care, health outcomes or individual patient experiences. Combined these methodological concerns suggest the need for more detailed examination. This is particularly the case, given the prevalence within contemporary clinical and IS discourses on health interventions advocating the need to put the ‘patient at the centre’ by engaging them in their own care and/or ‘empowering’ them through the use of information systems. This paper aims to contribute to these on-going debates by focusing on the socio-technical processes by which patients’ interests and outcomes are measured, defined and evaluated within health interventions that involve them using web

Implementation of a health policy advisory committee as a knowledge translation platform: the Nigeria experience

Science.gov (United States)

Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Ezeoha, Abel Abeh; Uro-Chukwu, Henry Chukwuemeka; Ezeonu, Chinonyelum Thecla

2015-01-01

Background: In recent times, there has been a growing demand internationally for health policies to be based on reliable research evidence. Consequently, there is a need to strengthen institutions and mechanisms that can promote interactions among researchers, policy-makers and other stakeholders who can influence the uptake of research findings. The Health Policy Advisory Committee (HPAC) is one of such mechanisms that can serve as an excellent forum for the interaction of policy-makers and researchers. Therefore, the need to have a long term mechanism that allows for periodic interactions between researchers and policy-makers within the existing government system necessitated our implementation of a newly established HPAC in Ebonyi State Nigeria, as a Knowledge Translation (KT) platform. The key study objective was to enhance the capacity of the HPAC and equip its members with the skills/competence required for the committee to effectively promote evidence informed policy-making and function as a KT platform. Methods: A series of capacity building programmes and KT activities were undertaken including: i) Capacity building of the HPAC using Evidence-to-Policy Network (EVIPNet) SUPPORT tools; ii) Capacity enhancement mentorship programme of the HPAC through a three-month executive training programme on health policy/health systems and KT in Ebonyi State University Abakaliki; iii) Production of a policy brief on strategies to improve the performance of the Government’s Free Maternal and Child Health Care Programme in Ebonyi State Nigeria; and iv) Hosting of a multi-stakeholders policy dialogue based on the produced policy brief on the Government’s Free Maternal and Child Health Care Programme. Results: The study findings indicated a noteworthy improvement in knowledge of evidence-to-policy link among the HPAC members; the elimination of mutual mistrust between policy-makers and researchers; and an increase in the awareness of importance of HPAC in the Ministry

Implementation of a Health Policy Advisory Committee as a Knowledge Translation Platform: The Nigeria Experience

Directory of Open Access Journals (Sweden)

Chigozie Jesse Uneke

2015-03-01

Full Text Available Background In recent times, there has been a growing demand internationally for health policies to be based on reliable research evidence. Consequently, there is a need to strengthen institutions and mechanisms that can promote interactions among researchers, policy-makers and other stakeholders who can influence the uptake of research findings. The Health Policy Advisory Committee (HPAC is one of such mechanisms that can serve as an excellent forum for the interaction of policy-makers and researchers. Therefore, the need to have a long term mechanism that allows for periodic interactions between researchers and policy-makers within the existing government system necessitated our implementation of a newly established HPAC in Ebonyi State Nigeria, as a Knowledge Translation (KT platform. The key study objective was to enhance the capacity of the HPAC and equip its members with the skills/competence required for the committee to effectively promote evidence informed policy-making and function as a KT platform. Methods A series of capacity building programmes and KT activities were undertaken including: i Capacity building of the HPAC using Evidence-to-Policy Network (EVIPNet SUPPORT tools; ii Capacity enhancement mentorship programme of the HPAC through a three-month executive training programme on health policy/health systems and KT in Ebonyi State University Abakaliki; iii Production of a policy brief on strategies to improve the performance of the Government’s Free Maternal and Child Health Care Programme in Ebonyi State Nigeria; and iv Hosting of a multi-stakeholders policy dialogue based on the produced policy brief on the Government’s Free Maternal and Child Health Care Programme. Results The study findings indicated a noteworthy improvement in knowledge of evidence-to-policy link among the HPAC members; the elimination of mutual mistrust between policy-makers and researchers; and an increase in the awareness of importance of HPAC in the

Perspectives on econometric modelling to inform policy: a UK qualitative case study of minimum unit pricing of alcohol.

Science.gov (United States)

Katikireddi, Srinivasa V; Bond, Lyndal; Hilton, Shona

2014-06-01

Novel policy interventions may lack evaluation-based evidence. Considerations to introduce minimum unit pricing (MUP) of alcohol in the UK were informed by econometric modelling (the 'Sheffield model'). We aim to investigate policy stakeholders' views of the utility of modelling studies for public health policy. In-depth qualitative interviews with 36 individuals involved in MUP policy debates (purposively sampled to include civil servants, politicians, academics, advocates and industry-related actors) were conducted and thematically analysed. Interviewees felt familiar with modelling studies and often displayed detailed understandings of the Sheffield model. Despite this, many were uneasy about the extent to which the Sheffield model could be relied on for informing policymaking and preferred traditional evaluations. A tension was identified between this preference for post hoc evaluations and a desire for evidence derived from local data, with modelling seen to offer high external validity. MUP critics expressed concern that the Sheffield model did not adequately capture the 'real life' world of the alcohol market, which was conceptualized as a complex and, to some extent, inherently unpredictable system. Communication of modelling results was considered intrinsically difficult but presenting an appropriate picture of the uncertainties inherent in modelling was viewed as desirable. There was general enthusiasm for increased use of econometric modelling to inform future policymaking but an appreciation that such evidence should only form one input into the process. Modelling studies are valued by policymakers as they provide contextually relevant evidence for novel policies, but tensions exist with views of traditional evaluation-based evidence. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association.

Collaborating to embrace evidence-informed management practices within Canada's health system.

Science.gov (United States)

Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

2007-01-01

In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces." This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers (by Shamian and El-Jardali and by Clements, Dault and Priest) and brings to life evidence-informed management practices.

Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy.

Science.gov (United States)

Chang, Lenisa V

2018-05-02

In the wake of strong, although later refuted, claims of a link between autism and the measles-mumps-rubella (MMR) vaccine, I examine whether fewer parents immunized or delayed vaccinations for their children and if there was a differential response by mother's education level. Using various controls and a differencing strategy that compares in MMR take-up with other vaccines, I find that the MMR-autism controversy led to a decline in the immediate years and that there were negative spillovers onto other vaccines. I also find evidence that more highly educated mothers responded more strongly to the controversy either by not immunizing their children altogether or, to a lesser degree, delaying vaccination. Moreover, the educational gap was greater in states where there was greater media attention devoted to the controversy. This is consistent with the health allocative efficiency hypothesis whereby part of the education gradient in health outcomes is due to more-educated individuals absorbing and responding to health information more quickly. However, unlike in the United Kingdom, where previous studies find that the gap was eliminated after the link was refuted, the evidence for the United States suggests that the educational gap persisted. Copyright © 2018 John Wiley & Sons, Ltd.

Usability Evaluation and Implementation of a Health Information Technology Dashboard of Evidence-Based Quality Indicators.

Science.gov (United States)

Schall, Mark Christopher; Cullen, Laura; Pennathur, Priyadarshini; Chen, Howard; Burrell, Keith; Matthews, Grace

2017-06-01

Health information technology dashboards that integrate evidence-based quality indicators can efficiently and accurately display patient risk information to promote early intervention and improve overall quality of patient care. We describe the process of developing, evaluating, and implementing a dashboard designed to promote quality care through display of evidence-based quality indicators within an electronic health record. Clinician feedback was sought throughout the process. Usability evaluations were provided by three nurse pairs and one physician from medical-surgical areas. Task completion times, error rates, and ratings of system usability were collected to compare the use of quality indicators displayed on the dashboard to the indicators displayed in a conventional electronic health record across eight experimental scenarios. Participants rated the dashboard as "highly usable" following System Usability Scale (mean, 87.5 [SD, 9.6]) and Poststudy System Usability Questionnaire (mean, 1.7 [SD, 0.5]) criteria. Use of the dashboard led to reduced task completion times and error rates in comparison to the conventional electronic health record for quality indicator-related tasks. Clinician responses to the dashboard display capabilities were positive, and a multifaceted implementation plan has been used. Results suggest application of the dashboard in the care environment may lead to improved patient care.

Evidence and argument in policymaking: development of workplace smoking legislation

Directory of Open Access Journals (Sweden)

Bero Lisa A

2009-06-01

Full Text Available Abstract Background We sought to identify factors that affect the passage of public health legislation by examining the use of arguments, particularly arguments presenting research evidence, in legislative debates regarding workplace smoking restrictions. Methods We conducted a case-study based content analysis of legislative materials used in the development of six state workplace smoking laws, including written and spoken testimony and the text of proposed and passed bills and amendments. We coded testimony given before legislators for arguments used, and identified the institutional affiliations of presenters and their position on the legislation. We compared patterns in the arguments made in testimony to the relative strength of each state's final legislation. Results Greater discussion of scientific evidence within testimony given was associated with the passage of workplace smoking legislation that provided greater protection for public health, regardless of whether supporters outnumbered opponents or vice versa. Conclusion Our findings suggest that an emphasis on scientific discourse, relative to other arguments made in legislative testimony, might help produce political outcomes that favor public health.

A Call to Digital Health Practitioners: New Guidelines Can Help Improve the Quality of Digital Health Evidence.

Science.gov (United States)

Agarwal, Smisha; Lefevre, Amnesty E; Labrique, Alain B

2017-10-06

Despite the rapid proliferation of health interventions that employ digital tools, the evidence on the effectiveness of such approaches remains insufficient and of variable quality. To address gaps in the comprehensiveness and quality of reporting on the effectiveness of digital programs, the mHealth Technical Evidence Review Group (mTERG), convened by the World Health Organization, proposed the mHealth Evidence Reporting and Assessment (mERA) checklist to address existing gaps in the comprehensiveness and quality of reporting on the effectiveness of digital health programs. We present an overview of the mERA checklist and encourage researchers working in the digital health space to use the mERA checklist for reporting their research. The development of the mERA checklist consisted of convening an expert group to recommend an appropriate approach, convening a global expert review panel for checklist development, and pilot-testing the checklist. The mERA checklist consists of 16 core mHealth items that define what the mHealth intervention is (content), where it is being implemented (context), and how it was implemented (technical features). Additionally, a 29-item methodology checklist guides authors on reporting critical aspects of the research methodology employed in the study. We recommend that the core mERA checklist is used in conjunction with an appropriate study-design specific checklist. The mERA checklist aims to assist authors in reporting on digital health research, guide reviewers and policymakers in synthesizing evidence, and guide journal editors in assessing the completeness in reporting on digital health studies. An increase in transparent and rigorous reporting can help identify gaps in the conduct of research and understand the effects of digital health interventions as a field of inquiry. ©Smisha Agarwal, Amnesty E Lefevre, Alain B Labrique. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 06.10.2017.

Ethics, equality and evidence in health promotion Danish guidelines for municipalities.

Science.gov (United States)

Vallgårda, Signild

2014-06-01

The Danish National Board of Health has expressed its commitment to social equality in health, evidence-informed health promotion and public health ethics, and has issued guidelines for municipalities on health promotion, in Danish named prevention packages. The aim of this article is to analyse whether the Board of Health adheres to ideals of equality, evidence and ethics in these guidelines. An analysis to detect statements about equity, evidence and ethics in 10 health promotion packages directed at municipalities with the aim of guiding the municipalities towards evidence-informed disease prevention and health promotion. Despite declared intentions of prioritizing social equality in health, these intentions are largely absent from most of the packages. When health inequalities are mentioned, focus is on the disadvantaged or the marginalized. Several interventions are recommended, where there is no evidence to support them, notwithstanding the ambition of interventions being evidence-informed. Ethical considerations are scanty, scattered and unsystematically integrated. Further, although some packages mention the importance of avoiding stigmatization, there is little indicating how this could be done. Including reduction of health inequalities and evidence-informed and ethically defendable interventions in health promotion is a challenge, which is not yet fully met by the National Board of Health. When judged from liberal ethical principles, only few of the suggested interventions are acceptable, i.e., those concerning information, but from a paternalistic view, all interventions that may actually benefit the citizens are justified. © 2014 the Nordic Societies of Public Health.

Evidence-informed health policy 2 – Survey of organizations that support the use of research evidence

Directory of Open Access Journals (Sweden)

Oxman Andrew D

2008-12-01

Full Text Available Abstract Background Previous surveys of organizations that support the development of evidence-informed health policies have focused on organizations that produce clinical practice guidelines (CPGs or undertake health technology assessments (HTAs. Only rarely have surveys focused at least in part on units that directly support the use of research evidence in developing health policy on an international, national, and state or provincial level (i.e., government support units, or GSUs that are in some way successful or innovative or that support the use of research evidence in low- and middle-income countries (LMICs. Methods We drew on many people and organizations around the world, including our project reference group, to generate a list of organizations to survey. We modified a questionnaire that had been developed originally by the Appraisal of Guidelines, Research and Evaluation in Europe (AGREE collaboration and adapted one version of the questionnaire for organizations producing CPGs and HTAs, and another for GSUs. We sent the questionnaire by email to 176 organizations and followed up periodically with non-responders by email and telephone. Results We received completed questionnaires from 152 (86% organizations. More than one-half of the organizations (and particularly HTA agencies reported that examples from other countries were helpful in establishing their organization. A higher proportion of GSUs than CPG- or HTA-producing organizations involved target users in the selection of topics or the services undertaken. Most organizations have few (five or fewer full-time equivalent (FTE staff. More than four-fifths of organizations reported providing panels with or using systematic reviews. GSUs tended to use a wide variety of explicit valuation processes for the research evidence, but none with the frequency that organizations producing CPGs, HTAs, or both prioritized evidence by its quality. Between one-half and two-thirds of organizations

"Championing GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

Science.gov (United States)

Karame, P., Sr.

2016-12-01

"GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health sector

Top priorities of Canadian and American policymakers for conservation science

Science.gov (United States)

We summarize the content of America's "top 40" conservation research questions and how they can inform policy and management needs that emerged from informal interviews with senior policymakers and other decision makers

Strategies for successful evaluation and policy-making toward health care technology on the move : The case of medical lasers

NARCIS (Netherlands)

Banta, H.D.; Vondeling, H.

1994-01-01

Evaluating new health care technology that is rapidly diffusing is one of the greatest challenges to researchers and policy-makers. If no evaluation is done until the technology is mature, evaluation will not influence processes of diffusion. If evaluation is done early, it may be irrelevant when it

The Global Heat Health Information Network (GHHIN): Putting the Pieces Together

Science.gov (United States)

Jones, H.; Shumake, J.; Trtanj, J.

2017-12-01

Human exposure to extreme heat is one of the principal and most manageable impacts of climate on human health. Yet, every year worldwide, tens of thousands of people die as a result of avoidable heat-induced health consequences and countless others experience reduced labor productivity, physiological stress and ill health. The IPCC predicts with high confidence, that the observed trend of longer lasting, more frequent, more intense, and earlier onset heat waves will continue into the future. This situation requires the global health community to aggressively confront this recognized risk. Many countries and cities worldwide have developed heat action plans or heat health early warning systems, but these efforts are only connected in an ad-hoc fashion, use a broad range of non-standardized tools, methods, and approaches, and lack a clear mechanism to learn from each other in order to more rapidly advance health protection. To address this gap and accelerate heat health protection, the Global Heat Health Information Network (GHHIN) was launched in June 2016, by the WMO/WHO joint office for Climate and Health and the NOAA Climate Program Office. GHHIN is envisioned to be an independent, voluntary, member driven forum of scientists, professionals, and policymakers focused on enhancing and multiplying the global and local learning and resilience-building for heat health that is already occurring. GHHIN seeks to serve as a catalyst, knowledge broker, disseminator of good practices, and a forum for facilitating exchange and identifying needs. GHHIN will promote evidence-driven interventions, shared-learning, co-production of information, synthesis of priorities and capacity building to empower actors to take more effective and informed life-saving preparedness and planning measures. GHHIN is working toward several activities in 2018. The first Global Heat Health Synthesis report will be published to synthesize the state of science and practice to monitor, predict, and

[The Bellagio Model: an evidence-informed, international framework for population-oriented primary care. First experiences].

Science.gov (United States)

Schlette, Sophia; Lisac, Melanie; Wagner, Ed; Gensichen, Jochen

2009-01-01

The Bellagio Model for Population-oriented Primary Care is an evidence-informed framework to assess accessible care for sick, vulnerable, and healthy people. The model was developed in spring 2008 by a multidisciplinary group of 24 experts from nine countries. The purpose of their gathering was to determine success factors for effective 21st century primary care based on state-of-the-art research findings, models, and empirical experience, and to assist with its implementation in practice, management, and health policy. Against the backdrop of "partialization", fragmentation in open health care systems, and the growing numbers of chronically ill or fragile people or those in need of any other kind of care, today's health care systems do not provide the much needed anchor point for continuing coordination and assistance prior, during and following an episode of illness. The Bellagio Model consists of ten key elements, which can make a substantial contribution to identify and overcome current gaps in primary care by using a synergetic approach. These elements are Shared Leadership, Public Trust, Horizontal and Vertical Integration, Networking of Professionals, Standardized Measurement, Research and Development, Payment Mix, Infrastructure, Programmes for Practice Improvement, and Population-oriented Management. All of these elements, which have been identified as being equally necessary, are also alike in that they involve all those responsible for health care: providers, managers, and policymakers.

Evidence-informed massage therapy - an Australian practitioner perspective.

Science.gov (United States)

Ooi, Soo Liang; Smith, Lauren; Pak, Sok Cheon

2018-05-01

Massage therapy (MT) is the most popular complementary and alternative medicine therapy used by the Australian public. With the growing emphasis by the Australian health authority on evidence-informed healthcare decision-making, there is an increasing demand for massage therapists to move towards the evidence-informed practice (EIP). With MT research gaining significant attention over the last 30 years, clinical evidence exists to support the efficacies of MT on many health conditions, including chronic low back pain. This growing body of research supports MT to become an evidence-informed therapeutic modality. The evidence utilization process of asking clinical questions, searching for available research evidence, and appraising the evidence critically can be incorporated into the clinical practice of MT. Moreover, integrating practitioners' skills and experience with research evidence enables the best treatment plan to address the clients' needs and stated goals. No dichotomy exists between scientific research and the humanistic client care of MT. A massage therapist can gain greater confidence in practice, improve critical thinking and decision-making skills, and increase career satisfaction through EIP. Despite its high public utilization, massage therapists in Australia remain a low-paying profession dominated by part-time workers who rarely utilize research evidence in practice. Professional associations of massage therapists in Australia need to play a key role in promoting EIP through continuing professional education, providing the access to research information and resources, as well as fostering a culture of EIP. Copyright © 2018 Elsevier Ltd. All rights reserved.

Health Information Systems

International Development Research Centre (IDRC) Digital Library (Canada)

the technology and expertise to process and share ... services. GEHS supports efforts that reach beyond healthcare institutions to capture evidence ... Health information systems are a foundation for quality care, and can increase accountability ...

Health-care quality and information failure: Evidence from Nigeria.

Science.gov (United States)

Evans, David K; Welander Tärneberg, Anna

2018-03-01

Low-quality health services are a problem across low- and middle-income countries. Information failure may contribute, as patients may have insufficient knowledge to discern the quality of health services. That decreases the likelihood that patients will sort into higher quality facilities, increasing demand for better health services. This paper presents results from a health survey in Nigeria to investigate whether patients can evaluate health service quality effectively. Specifically, this paper demonstrates that although more than 90% of patients agree with any positive statement about the quality of their local health services, satisfaction is significantly associated with the diagnostic ability of health workers at the facility. Satisfaction is not associated with more superficial characteristics such as infrastructure quality or prescriptions of medicines. This suggests that patients may have sufficient information to discern some of the most important elements of quality, but that alternative measures are crucial for gauging the overall quality of care. Copyright © The World Bank Health Economics © 2017 John Wiley & Sons, Ltd.

Communicating Science to Policymakers: Lessons from a Year on Capitol Hill

Science.gov (United States)

Trapani, J.

2006-12-01

Geoscientists communicate with policymakers for many reasons, including providing policymakers with scientific information that may help inform decision-making, and emphasizing the importance of their research in the context of funding needs. I spent the last year as the American Geophysical Union Congressional Fellow, and will discuss the fellowship program and my experiences communicating science to policymakers as a fellow working full-time on the legislative staff of Senator Dianne Feinstein (D-CA). In particular, I will compare and contrast the issues I faced as a fellow with those scientists may face in communicating with their elected officials and their staffs. As a fellow, my duties in the Senator's office with respect to handling scientific information boiled down to three essential functions: 1) synthesis: I was called upon to survey and synthesize scientific information related to various policy issues; 2) translation: I was expected to explain technical concepts and place scientific information in policy-relevant context; and 3) fact-checking: I was asked to assess the quality of scientific information. These are functions that most Congressional staff members cannot perform because they lack the background to do so. I will talk about how a Congressional office is organized, where I fit in, and my successes and failures in trying to put scientific information in policy context. One of the main limitations I faced was that I worked only to advance the legislative agenda of my host office, rather than more broadly to help policymakers understand and use science in their decision- making. Scientists who wish to communicate with their elected officials will not face this limitation, but may need to work to establish and maintain access. Successfully scheduling, meeting, and establishing a relationship with policymakers (and their staffs) is outside the usual experience of many scientists. I will discuss how and when to schedule a meeting, how to prepare

Stewart's maxims: eight "do's" for successfully communicating silviculture to policymakers

Science.gov (United States)

R. E. Stewart

1997-01-01

Technical specialists may experience difficulties in presenting information to non-technical policymakers and having that information used. Eight maxims are discussed that should help the silviculturist successfully provide technical information to non-technical audiences so that it will be considered in the formulation of policy.

Engaging policy-makers, heath system managers, and policy analysts in the knowledge synthesis process: a scoping review.

Science.gov (United States)

Tricco, Andrea C; Zarin, Wasifa; Rios, Patricia; Nincic, Vera; Khan, Paul A; Ghassemi, Marco; Diaz, Sanober; Pham, Ba'; Straus, Sharon E; Langlois, Etienne V

2018-02-12

It is unclear how to engage a wide range of knowledge users in research. We aimed to map the evidence on engaging knowledge users with an emphasis on policy-makers, health system managers, and policy analysts in the knowledge synthesis process through a scoping review. We used the Joanna Briggs Institute guidance for scoping reviews. Nine electronic databases (e.g., MEDLINE), two grey literature sources (e.g., OpenSIGLE), and reference lists of relevant systematic reviews were searched from 1996 to August 2016. We included any type of study describing strategies, barriers and facilitators, or assessing the impact of engaging policy-makers, health system managers, and policy analysts in the knowledge synthesis process. Screening and data abstraction were conducted by two reviewers independently with a third reviewer resolving discrepancies. Frequency and thematic analyses were conducted. After screening 8395 titles and abstracts followed by 394 full-texts, 84 unique documents and 7 companion reports fulfilled our eligibility criteria. All 84 documents were published in the last 10 years, and half were prepared in North America. The most common type of knowledge synthesis with knowledge user engagement was a systematic review (36%). The knowledge synthesis most commonly addressed an issue at the level of national healthcare system (48%) and focused on health services delivery (17%) in high-income countries (86%). Policy-makers were the most common (64%) knowledge users, followed by healthcare professionals (49%) and government agencies as well as patients and caregivers (34%). Knowledge users were engaged in conceptualization and design (49%), literature search and data collection (52%), data synthesis and interpretation (71%), and knowledge dissemination and application (44%). Knowledge users were most commonly engaged as key informants through meetings and workshops as well as surveys, focus groups, and interviews either in-person or by telephone and emails

Harnessing information technology to improve women’s health information: evidence from Pakistan

Science.gov (United States)

2014-01-01

Background More than half of Pakistani women are illiterate, marginalized, and experience myriad health problems. These women are also disadvantaged in terms of their restricted mobility and limited access to public space. Nonetheless, user-friendly information and communication technologies (ICTs) have opened up new opportunities to provide them with information that is essential for their health and well-being. Methods We established an Information and Communication Centre (ICC) in a village in Sialkot (Pakistan) on a pilot basis in 2009. The basic philosophy of the ICC was to provide women with health-related information by exposing them to modern sources of information on their doorstep. By design, the ICC was a community-based and community-managed institution where women could access information through online (e.g., internet, mobile phone etc.) and offline (e.g., CDs, TV etc.) resources. The ICC was managed by a group of local volunteer women who had the capacity and skills to use the devices and tools of modern ICTs. Results We noted an overwhelming participation and interest from local women in the activities of the ICC. The women wanted to receive information on a wide range of issues, from family planning, antenatal care, and childcare to garbage disposal and prevention of domestic violence. Overall, the ICC was successful in initiating a meaningful “information dialogue” at community level, where much-needed information was retrieved, negotiated, mediated, and disseminated through intimate and trusted relations. Conclusion We conclude that ICTs have the capacity to cross the barriers of illiteracy and can reach out to disadvantaged women living under a conservative patriarchal regime. PMID:25189632

How can knowledge exchange portals assist in knowledge management for evidence-informed decision making in public health?

Science.gov (United States)

Quinn, Emma; Huckel-Schneider, Carmen; Campbell, Danielle; Seale, Holly; Milat, Andrew J

2014-05-12

Knowledge exchange portals are emerging as web tools that can help facilitate knowledge management in public health. We conducted a review to better understand the nature of these portals and their contribution to knowledge management in public health, with the aim of informing future development of portals in this field. A systematic literature search was conducted of the peer-reviewed and grey literature to identify articles that described the design, development or evaluation of Knowledge Exchange Portals KEPs in the public health field. The content of the articles was analysed, interpreted and synthesised in light of the objectives of the review. The systematic search yielded 2223 articles, of which fifteen were deemed eligible for review, including eight case studies, six evaluation studies and one commentary article. Knowledge exchange portals mainly included design features to support knowledge access and creation, but formative evaluation studies examining user needs suggested collaborative features supporting knowledge exchange would also be useful. Overall web usage statistics revealed increasing use of some of these portals over time; however difficulties remain in retaining users. There is some evidence to suggest that the use of a knowledge exchange portal in combination with tailored and targeted messaging can increase the use of evidence in policy and program decision making at the organisational level. Knowledge exchange portals can be a platform for providing integrated access to relevant content and resources in one location, for sharing and distributing information and for bringing people together for knowledge exchange. However more performance evaluation studies are needed to determine how they can best support evidence-informed decision making in public health.

NLM Evidence-based Information at Your Fingertips - NBNA

Energy Technology Data Exchange (ETDEWEB)

Womble, R.

2010-08-06

The workshop titled, National Library of Medicine: Evidence-based Information At Your Fingertips, is a computer training class designed to meet the needs of nurses who require access to information on specific medical topics and on the adverse health effects of exposure to hazardous substances. The Specialized Information Services Division of the National Library of Medicine (NLM) is sponsoring this workshop for the National Black Nurses Association to increase the awareness of health professionals of the availability and value of the free NLM medical, environmental health, and toxicology databases.

The impact of health information technology on patient safety

Directory of Open Access Journals (Sweden)

Yasser K. Alotaibi

2017-12-01

Full Text Available Since the original Institute of Medicine (IOM report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety. This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient’s safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

The impact of health information technology on patient safety.

Science.gov (United States)

Alotaibi, Yasser K; Federico, Frank

2017-12-01

Since the original Institute of Medicine (IOM) report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety.  This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient's safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety. Healthcare organizations need to be selective in which technology to invest in, as literature shows that some technologies have limited evidence in improving patient safety outcomes.

The paradox of non-evidence based, publicly funded complementary alternative medicine in the English National Health Service: An explanation.

Science.gov (United States)

Sheppard, Maria K

2015-10-01

Despite the unproven effectiveness of many practices that are under the umbrella term 'complementary alternative medicine' (CAM), there is provision of CAM within the English National Health Service (NHS). Moreover, although the National Institute for Health and Care Excellence was established to promote scientifically validated medicine in the NHS, the paradox of publicly funded, non-evidence based CAM can be explained as linked with government policy of patient choice and specifically patient treatment choice. Patient choice is useful in the political and policy discourse as it is open to different interpretations and can be justified by policy-makers who rely on the traditional NHS values of equity and universality. Treatment choice finds expression in the policy of personalised healthcare linked with patient responsibilisation which finds resonance in the emphasis CAM places on self-care and self-management. More importantly, however, policy-makers also use patient choice and treatment choice as a policy initiative with the objective of encouraging destabilisation of the entrenched healthcare institutions and practices considered resistant to change. This political strategy of system reform has the unintended, paradoxical consequence of allowing for the emergence of non-evidence based, publicly funded CAM in the NHS. The political and policy discourse of patient choice thus trumps evidence based medicine, with patients that demand access to CAM becoming the unwitting beneficiaries. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Towards safe information technology in health care

NARCIS (Netherlands)

J.E.C.M. Aarts (Jos)

2011-01-01

textabstractHealth information technology is widely accepted to increase patient safety and reduce medical errors. The widespread implementation makes evident that health information technology has become of a complex sociotechnical system that is health care. Design and implementation may result in

Policy dialogues - the "bolts and joints" of policy-making: experiences from Cabo Verde, Chad and Mali.

Science.gov (United States)

Dovlo, Delanyo; Nabyonga-Orem, Juliet; Estrelli, Yolanda; Mwisongo, Aziza

2016-07-18

Policy processes that yield good outcomes are inherently complex, requiring interactions of stakeholders in problem identification, generation of political will and selection of practical solutions. To make policy processes rational, policy dialogues are increasingly being used as a policy-making tool. Despite their increasing use for policy-making in Africa, evidence is limited on how they have evolved and are being used on the continent or in low and middle income countries elsewhere. This was an exploratory study using qualitative methods. It utilised data related to policy dialogues for three specific policies and strategies to understand the interplay between policy dialogue and policy-making in Cabo Verde, Chad and Mali. The specific methods used to gather data were key informant interviews and document review. Data were analysed inductively and deductively using thematic content analysis. Participation in the policy dialogues was inclusive, and in some instances bottom-up participatory approaches were used. The respondents felt that the execution of the policy dialogues had been seamless, and the few divergent views expressed often were resolved in a unanimous manner. The policies and strategies developed were seen by all stakeholders as relating to priority issues. Other specific process factors that contributed to the success of the dialogues included the use of innovative approaches, good facilitation, availability of resources for the dialogues, good communication, and consideration of the different opinions. Among the barriers were contextual issues, delays in decision-making and conflicting coordination roles and mandates. Policy dialogues have proved to be an effective tool in health sector management and could be a crucial component of the governance dynamics of the sector. The policy dialogue process needs to be institutionalised for continuity and maintenance of institutional intelligence. Other essential influencing factors include building

Mobile health technology evaluation: the mHealth evidence workshop.

Science.gov (United States)

Kumar, Santosh; Nilsen, Wendy J; Abernethy, Amy; Atienza, Audie; Patrick, Kevin; Pavel, Misha; Riley, William T; Shar, Albert; Spring, Bonnie; Spruijt-Metz, Donna; Hedeker, Donald; Honavar, Vasant; Kravitz, Richard; Lefebvre, R Craig; Mohr, David C; Murphy, Susan A; Quinn, Charlene; Shusterman, Vladimir; Swendeman, Dallas

2013-08-01

Creative use of new mobile and wearable health information and sensing technologies (mHealth) has the potential to reduce the cost of health care and improve well-being in numerous ways. These applications are being developed in a variety of domains, but rigorous research is needed to examine the potential, as well as the challenges, of utilizing mobile technologies to improve health outcomes. Currently, evidence is sparse for the efficacy of mHealth. Although these technologies may be appealing and seemingly innocuous, research is needed to assess when, where, and for whom mHealth devices, apps, and systems are efficacious. In order to outline an approach to evidence generation in the field of mHealth that would ensure research is conducted on a rigorous empirical and theoretic foundation, on August 16, 2011, researchers gathered for the mHealth Evidence Workshop at NIH. The current paper presents the results of the workshop. Although the discussions at the meeting were cross-cutting, the areas covered can be categorized broadly into three areas: (1) evaluating assessments; (2) evaluating interventions; and (3) reshaping evidence generation using mHealth. This paper brings these concepts together to describe current evaluation standards, discuss future possibilities, and set a grand goal for the emerging field of mHealth research. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

Evidence gap maps -- a tool for promoting evidence-informed policy and prioritizing future research

OpenAIRE

Snilstveit, Birte; Vojtkova, Martina; Bhavsar, Ami; Gaarder, Marie

2013-01-01

Evidence-gap maps present a new addition to the tools available to support evidence-informed policy making. Evidence-gap maps are thematic evidence collections covering a range of issues such as maternal health, HIV/AIDS, and agriculture. They present a visual overview of existing systematic reviews or impact evaluations in a sector or subsector, schematically representing the types of int...

Strengthening health systems through linking research evidence to ...

African Journals Online (AJOL)

informed policies. Accordingly, a critical way of addressing these challenges facing health systems in the region is through the linking of health research findings to policy. Keywords: Evidence; Sub-Saharan Africa; Health Policy; Health Systems ...

Evidence-based adaptation and scale-up of a mobile phone health information service.

Science.gov (United States)

L'Engle, Kelly; Plourde, Kate F; Zan, Trinity

2017-01-01

The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best practices for successfully scaling mHealth interventions is not keeping pace, despite the availability of frameworks for adapting and scaling health programs. m4RH-Mobile for Reproductive Health-is an SMS, or text message-based, health information service that began in two countries and over a period of 7 years has been adapted and scaled to new population groups and new countries. Success can be attributed to following key principles for scaling up health programs, including continuous stakeholder engagement; ongoing monitoring, evaluation, and research including extensive content and usability testing with the target audience; strategic dissemination of results; and use of marketing and sustainability principles for social initiatives. This article investigates how these factors contributed to vertical, horizontal, and global scale-up of the m4RH program. Vertical scale of m4RH is demonstrated in Tanzania, where the early engagement of stakeholders including the Ministry of Health catalyzed expansion of m4RH content and national-level program reach. Ongoing data collection has provided real-time data for decision-making, information about the user base, and peer-reviewed publications, yielding government endorsement and partner hand-off for sustainability of the m4RH platform. Horizontal scale-up and adaptation of m4RH has occurred through expansion to new populations in Rwanda, Uganda, and Tanzania, where best practices for design and implementation of mHealth programs were followed to ensure the platform meets the needs of target populations. m4RH also has been modified and packaged for global scale-up through licensing and toolkit

Working conditions and health among employees at information technology--enabled services: a review of current evidence.

Science.gov (United States)

Kesavachandran, C; Rastogi, S K; Das, Mohan; Khan, Asif M

2006-07-01

Workers in information technology (IT)-enabled services like business process outsourcing and call centers working with visual display units are reported to have various health and psycho-social disorders. Evidence from previously published studies in peer- reviewed journals and internet sources were examined to explore health disorders and psycho-social problems among personnel employed in IT-based services, for a systematic review on the topic. In addition, authors executed a questionnaire- based pilot study. The available literature and the pilot study, both suggest health disorders and psychosocial problems among workers of business process outsourcing. The details are discussed in the review.

Explaining health care expenditure variation: large-sample evidence using linked survey and health administrative data.

Science.gov (United States)

Ellis, Randall P; Fiebig, Denzil G; Johar, Meliyanni; Jones, Glenn; Savage, Elizabeth

2013-09-01

Explaining individual, regional, and provider variation in health care spending is of enormous value to policymakers but is often hampered by the lack of individual level detail in universal public health systems because budgeted spending is often not attributable to specific individuals. Even rarer is self-reported survey information that helps explain this variation in large samples. In this paper, we link a cross-sectional survey of 267 188 Australians age 45 and over to a panel dataset of annual healthcare costs calculated from several years of hospital, medical and pharmaceutical records. We use this data to distinguish between cost variations due to health shocks and those that are intrinsic (fixed) to an individual over three years. We find that high fixed expenditures are positively associated with age, especially older males, poor health, obesity, smoking, cancer, stroke and heart conditions. Being foreign born, speaking a foreign language at home and low income are more strongly associated with higher time-varying expenditures, suggesting greater exposure to adverse health shocks. Copyright © 2013 John Wiley & Sons, Ltd.

An approach for setting evidence-based and stakeholder-informed research priorities in low- and middle-income countries.

Science.gov (United States)

Rehfuess, Eva A; Durão, Solange; Kyamanywa, Patrick; Meerpohl, Joerg J; Young, Taryn; Rohwer, Anke

2016-04-01

To derive evidence-based and stakeholder-informed research priorities for implementation in African settings, the international research consortium Collaboration for Evidence-Based Healthcare and Public Health in Africa (CEBHA+) developed and applied a pragmatic approach. First, an online survey and face-to-face consultation between CEBHA+ partners and policy-makers generated priority research areas. Second, evidence maps for these priority research areas identified gaps and related priority research questions. Finally, study protocols were developed for inclusion within a grant proposal. Policy and practice representatives were involved throughout the process. Tuberculosis, diabetes, hypertension and road traffic injuries were selected as priority research areas. Evidence maps covered screening and models of care for diabetes and hypertension, population-level prevention of diabetes and hypertension and their risk factors, and prevention and management of road traffic injuries. Analysis of these maps yielded three priority research questions on hypertension and diabetes and one on road traffic injuries. The four resulting study protocols employ a broad range of primary and secondary research methods; a fifth promotes an integrated methodological approach across all research activities. The CEBHA+ approach, in particular evidence mapping, helped to formulate research questions and study protocols that would be owned by African partners, fill gaps in the evidence base, address policy and practice needs and be feasible given the existing research infrastructure and expertise. The consortium believes that the continuous involvement of decision-makers throughout the research process is an important means of ensuring that studies are relevant to the African context and that findings are rapidly implemented.

Applying behavioural economics to health systems of low- and middle-income countries: what are policymakers' and practitioners' views?

Science.gov (United States)

Trujillo, Antonio J; Glassman, Amanda; Fleisher, Lisa K; Nair, Divya; Duran, Denizhan

2015-07-01

Interest in behavioural economics has soared in recent years, particularly because of its application to several areas of public policy, now including international development, education, and health. Yet, little is known about how the policy and political implications of behavioural economics are perceived among stakeholders. Using an innovative vignette-based online survey, we assessed the opinions of 520 policymakers and practitioners around the world about health policy recommendations emanating from behavioural economics principles that are relevant to low- and middle-income country settings. We also determined the sources of disagreement among the respondents. The results suggest that there is strong support for health policies based on the concepts of framing choices to overcome present bias, providing periodic information to form habits, and messaging to promote social norms. There is less support for policies which use cash rewards as extrinsic motivators either to change individual behaviour related to the management of chronic conditions or to mitigate risky sexual behaviour. The sources of disagreement for these policy prescriptions derive mainly from normative concerns and perceived lack of effectiveness of such interventions. Addressing these disagreements may require developing a broader research agenda to explore the policy and political implications of these prescriptions. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Maritime Governance and Policy-Making

CERN Document Server

Roe, Michael

2013-01-01

A close analysis of the framework of existing governance and the existing jurisdictional arrangements for shipping and ports reveals that while policy-making is characterized by national considerations through flags, institutional representation at all jurisdictions and the inviolability of the state, the commercial, financial, legal and operational environment of the sector is almost wholly global. This governance mismatch means that in practice the maritime industry can avoid policies which it dislikes by trading nations off against one another, while enjoying the freedoms and benefits of a globalized economy. A Post-modern interpretation of this globalized society prompts suggestions for change in maritime policy-making so that the governance of the sector better matches more closely the environment in which shipping and ports operate. Maritime Governance and Policy-Making is a controversial commentary on the record of policy-making in the maritime sector and assesses whether the reason for continued polic...

Applying policy network theory to policy-making in China: the case of urban health insurance reform.

Science.gov (United States)

Zheng, Haitao; de Jong, Martin; Koppenjan, Joop

2010-01-01

In this article, we explore whether policy network theory can be applied in the People's Republic of China (PRC). We carried out a literature review of how this approach has already been dealt with in the Chinese policy sciences thus far. We then present the key concepts and research approach in policy networks theory in the Western literature and try these on a Chinese case to see the fit. We follow this with a description and analysis of the policy-making process regarding the health insurance reform in China from 1998 until the present. Based on this case study, we argue that this body of theory is useful to describe and explain policy-making processes in the Chinese context. However, limitations in the generic model appear in capturing the fundamentally different political and administrative systems, crucially different cultural values in the applicability of some research methods common in Western countries. Finally, we address which political and cultural aspects turn out to be different in the PRC and how they affect methodological and practical problems that PRC researchers will encounter when studying decision-making processes.

Public, private and personal: qualitative research on policymakers' opinions on smokefree interventions to protect children in 'private' spaces.

Science.gov (United States)

Rouch, Gareth; Thomson, George; Wilson, Nick; Hudson, Sheena; Edwards, Richard; Gifford, Heather; Lanumata, Tolotea

2010-12-31

Governments use law to constrain aspects of private activities for purposes of protecting health and social wellbeing. Policymakers have a range of perceptions and beliefs about what is public or private. An understanding of the possible drivers of policymaker decisions about where government can or should intervene for health is important, as one way to better guide appropriate policy formation. Our aim was to identify obstacles to, and opportunities for, government smokefree regulation of private and public spaces to protect children. In particular, to seek policymaker opinions on the regulation of smoking in homes, cars and public parks and playgrounds in a country with incomplete smokefree laws (New Zealand). Case study, using structured interviews to ask policymakers (62 politicians and senior officials) about their opinions on new smokefree legislation for public and private places. Supplementary data was obtained from the Factiva media database, on the views of New Zealand local authority councillors about policies for smokefree outdoor public places. Overall, interviewees thought that government regulation of smoking in private places was impractical and unwise. However, there were some differences on what was defined as 'private', particularly for cars. Even in public parks, smoking was seen by some as a 'personal' decision, and unlikely to be amenable to regulation. Most participants believed that educative, supportive and community-based measures were better and more practical means of reducing smoking in private places, compared to regulation. The constrained view of the role of regulation of smoking in public and private domains may be in keeping with current political discourse in New Zealand and similar Anglo-American countries. Policy and advocacy options to promote additional smokefree measures include providing a better voice for childrens' views, increasing information to policymakers about the harms to children from secondhand smoke and the

Consumer Engagement in Health IT: Distinguishing Rhetoric from Reality.

Science.gov (United States)

Gold, Marsha; Hossain, Mynti; Mangum, Amy

2015-01-01

Policymakers want health information technology (health IT) to support consumer engagement to help achieve national health goals. In this paper, we review the evidence to compare the rhetoric with the reality of current practice. Our environmental scan shows that consumer demand exists for electronic access to personal health information, but that technical and system or political barriers still limit the value of the available information and its potential benefits. There is a gap between current reality and the goals for consumer engagement. Actions that may help bridge this gap include: (1) resolving technical barriers to health information exchange (HIE); (2) developing more consumer-centric design and functionality; (3) reinforcing incentives that attract provider support by showing that consumer engagement is in their interest; and (4) building a stronger empirical case to convince decision makers that consumer engagement will lead to better care, improved health outcomes, and lower costs.

Using Web 2.0 technologies to enhance evidence-based medical information.

Science.gov (United States)

Metzger, Miriam J; Flanagin, Andrew J

2011-01-01

This article invokes research on information seeking and evaluation to address how providers of evidence-based medical information can use Web 2.0 technologies to increase access to, enliven users' experiences with, and enrich the quality of the information available. In an ideal scenario, evidence-based medical information can take appropriate advantage of community intelligence spawned by Web 2.0 technologies, resulting in the ideal combination of scientifically sound, high-quality information that is imbued with experiential insights from a multitude of individuals. To achieve this goal, the authors argue that people will engage with information that they can access easily, and that they perceive as (a) relevant to their information-seeking goals and (b) credible. The authors suggest the utility of Web 2.0 technologies for engaging stakeholders with evidence-based medical information through these mechanisms, and the degree to which the information provided can and should be trusted. Last, the authors discuss potential problems with Web 2.0 information in relation to decision making in health contexts, and they conclude with specific and practical recommendations for the dissemination of evidence-based health information via Web 2.0 technologies.

Intersectionality in European Union policymaking

DEFF Research Database (Denmark)

Lombardo, Emanuela; Agustin, Lise Rolandsen

2016-01-01

is particularly apt to deal with equality and diversity in policymaking. By analysing a selection of European Union policy documents on gender-based violence in the period 2000–2014, we attend to the question of what intersectionality can bring to policymaking in terms of strengthening inclusiveness and address...

Contestations and complexities of nurses’ participation in policy-making in South Africa

Directory of Open Access Journals (Sweden)

Prudence Ditlopo

2014-12-01

Full Text Available Background: There has been increased emphasis globally on nurses’ involvement in health policy and systems development. However, there has been limited scholarly attention on nurses’ participation in policy-making in South Africa. Objective: This paper analyses the dynamics, strengths, and weaknesses of nurses’ participation in four national health workforce policies: the 2008 Nursing Strategy, revision of the Scope of Practice for nurses, the new Framework for Nursing Qualifications, and the Occupation-Specific Dispensation (OSD remuneration policy. Design: Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 frontline nurses in four South African provinces. Thematic content analysis was done using the Atlas.ti software. Results: The study found that nurses’ participation in policy-making is both contested and complex. The contestation relates to the extent and nature of nurses’ participation in nursing policies. There was a disjuncture between nursing leadership and frontline nurses in their levels of awareness of the four policies. The latter group was generally unaware of these policies with the exception of the OSD remuneration policy as it affected them directly. There was also limited consensus on which nursing group legitimately represented nursing issues in the policy arena. Shifting power relationships influenced who participated, how the participation happened, and the degree to which nurses’ views and inputs were considered and incorporated. Conclusions: The South African health system presents major opportunities for nurses to influence and direct policies that affect them. This will require a combination of proactive leadership, health policy capacity and skills development among nurses, and strong support from the national nursing association.

Understanding Health and Health-Related Behavior of Users of Internet Health Information.

Science.gov (United States)

Wimble, Matt

2016-10-01

Little is known about how actual use of Internet health-related information is associated with health or health-related behavior. Using a nationally representative sample of 34,525 from 2012, this study examined the demographics of users of Internet health-related information (users), reports estimates of association with several health and behavioral outcomes adjusting for demographic factors, and analyzed the sample by education level, race, gender, and age. Analysis of a large nationally representative sample shows evidence that users of health-related information (users) on the Internet are younger, more educated, more likely to be insured, more likely to be female, and less likely to be African American. After adjusting for demographic differences, users are more likely to have been diagnosed with hypertension, cancer, stroke, and high cholesterol, but no evidence of current hypertension, weight-related issues, or being in fair or poor health. Users are less likely to smoke and among smokers are more likely to attempt quitting. Users are more likely to exercise, get a flu shot, pap smear, mammogram, HIV test, colon cancer screening, blood pressure check, and cholesterol check, but likely to be heavy drinkers. With few exceptions, results appear robust across gender, age groups, level of education, and ethnicity. Use is generally positively associated with prior diagnosis for several conditions and behaviors related to improved health, but I find no relationship with existing health status. The association between use of health-related Internet information and health-related behavior seems robust across levels of education, age, gender, and race.

Clinical validation of a public health policy-making platform for hearing loss (EVOTION): protocol for a big data study.

Science.gov (United States)

Dritsakis, Giorgos; Kikidis, Dimitris; Koloutsou, Nina; Murdin, Louisa; Bibas, Athanasios; Ploumidou, Katherine; Laplante-Lévesque, Ariane; Pontoppidan, Niels Henrik; Bamiou, Doris-Eva

2018-02-15

The holistic management of hearing loss (HL) requires an understanding of factors that predict hearing aid (HA) use and benefit beyond the acoustics of listening environments. Although several predictors have been identified, no study has explored the role of audiological, cognitive, behavioural and physiological data nor has any study collected real-time HA data. This study will collect 'big data', including retrospective HA logging data, prospective clinical data and real-time data via smart HAs, a mobile application and biosensors. The main objective is to enable the validation of the EVOTION platform as a public health policy-making tool for HL. This will be a big data international multicentre study consisting of retrospective and prospective data collection. Existing data from approximately 35 000 HA users will be extracted from clinical repositories in the UK and Denmark. For the prospective data collection, 1260 HA candidates will be recruited across four clinics in the UK and Greece. Participants will complete a battery of audiological and other assessments (measures of patient-reported HA benefit, mood, cognition, quality of life). Patients will be offered smart HAs and a mobile phone application and a subset will also be given wearable biosensors, to enable the collection of dynamic real-life HA usage data. Big data analytics will be used to detect correlations between contextualised HA usage and effectiveness, and different factors and comorbidities affecting HL, with a view to informing public health decision-making. Ethical approval was received from the London South East Research Ethics Committee (17/LO/0789), the Hippokrateion Hospital Ethics Committee (1847) and the Athens Medical Center's Ethics Committee (KM140670). Results will be disseminated through national and international events in Greece and the UK, scientific journals, newsletters, magazines and social media. Target audiences include HA users, clinicians, policy-makers and the

Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool

Science.gov (United States)

Albert, Dayna; Fortin, Rebecca; Herrera, Christine; Hanning, Rhona; Lessio, Anne; Rush, Brian

2013-01-01

In public health and chronic disease prevention there is increasing priority for effective use of evidence in practice. In Ontario, Canada, despite various models being advanced, public health practitioners are seeking ways to identify and apply evidence in their work in practical and meaningful ways. In a companion article, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Assessment Tool,” we describe use of a tool to assess and strengthen program planning and implementation processes using 19 criteria derived from best and promising practices literature. In this article, we describe use of a complementary Program Evidence Tool to identify, synthesize, and apply a range of evidence sources to strengthen the content of chronic disease prevention programming. The Program Evidence Tool adapts tools of evidence-based medicine to the unique contexts of community-based health promotion and chronic disease prevention. Knowledge management tools and a guided dialogue process known as an Evidence Forum enable community stakeholders to make appropriate use of evidence in diverse social, political, and structural contexts. Practical guidelines and worksheets direct users through 5 steps: 1) define an evidence question, 2) develop a search strategy, 3) collect and synthesize evidence, 4) interpret and adapt evidence, and 5) implement and evaluate. We describe the Program Evidence Tool’s benefits, strengths, challenges, and what was learned from its application in 4 Ontario public health departments. The Program Evidence Tool contributes to the development and understanding of the complex use of evidence in community-based chronic disease prevention. PMID:23721788

Towards Evidence Based Usability in Health Informatics?

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Marcilly, Romaric; Peute, Linda W.; Beuscart-Zephir, Marie-Catherine; Jaspers, Monique W.

2015-01-01

In a Health Information Technology (HIT) regulatory context in which the usability of this technology is more and more a critical issue, there is an increasing need for evidence based usability practice. However, a clear definition of evidence based usability practice and how to achieve it is still

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological review of health technology assessments

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Bethany Shinkins

2017-04-01

Full Text Available Abstract Background Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1 what evidence aside from test accuracy was searched for and synthesised, 2 which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3 how/whether threshold effects were explored, 4 how the potential dependency between multiple tests in a pathway was accounted for, and 5 for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings

Consumer Engagement in Health IT: Distinguishing Rhetoric from Reality

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Gold, Marsha; Hossain, Mynti; Mangum, Amy

2015-01-01

Rationale: Policymakers want health information technology (health IT) to support consumer engagement to help achieve national health goals. In this paper, we review the evidence to compare the rhetoric with the reality of current practice. Current Reality and Barriers: Our environmental scan shows that consumer demand exists for electronic access to personal health information, but that technical and system or political barriers still limit the value of the available information and its potential benefits. Conclusions and Policy Implications: There is a gap between current reality and the goals for consumer engagement. Actions that may help bridge this gap include: (1) resolving technical barriers to health information exchange (HIE); (2) developing more consumer-centric design and functionality; (3) reinforcing incentives that attract provider support by showing that consumer engagement is in their interest; and (4) building a stronger empirical case to convince decision makers that consumer engagement will lead to better care, improved health outcomes, and lower costs. PMID:26665120

Integrating microfinance and health strategies: examining the evidence to inform policy and practice.

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Leatherman, Sheila; Metcalfe, Marcia; Geissler, Kimberley; Dunford, Christopher

2012-03-01

Single solutions continue to be inadequate in confronting the prevalent problems of poverty, ill health and insufficient health system capacity worldwide. The poor need access to an integrated set of financial and health services to have income security and better health. Over 3500 microfinance institutions (MFIs) provide microcredit and financial services to more than 155 million households worldwide. Conservative estimates indicate that at least 34 million of these households are very poor by the definition in the Millennium Development Goals, representing around 170 million people, many in remote areas beyond the reach of health agencies, both private and governmental. A small but increasing number of MFIs offer health-related services, such as education, clinical care, community health workers, health-financing and linkages to public and private health providers. Multiple studies indicate the effectiveness of microfinance and its impact on poverty. A small but growing number of studies also attempt to show that MFIs are capable of contributing to health improvement by increasing knowledge that leads to behavioural changes, and by enhancing access to health services through addressing financial, geographic and other barriers. While these studies are of uneven quality, they indicate positive health benefits in diverse areas such as maternal and child health, malaria and other infectious disease, and domestic violence. While more rigorous research is needed to inform policy and guide programme implementation to integrate microfinance and health interventions that can reliably enhance the well-being of the poor, there is useful evidence to support the design and delivery of integrated programmes now. Worldwide, current public health programmes and health systems are proving to be inadequate to meet population needs. The microfinance sector offers an underutilized opportunity for delivery of health-related services to many hard-to-reach populations.

Information seeking for making evidence-informed decisions: a social network analysis on the staff of a public health department in Canada

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Yousefi-Nooraie Reza

2012-05-01

Full Text Available Abstract Background Social network analysis is an approach to study the interactions and exchange of resources among people. It can help understanding the underlying structural and behavioral complexities that influence the process of capacity building towards evidence-informed decision making. A social network analysis was conducted to understand if and how the staff of a public health department in Ontario turn to peers to get help incorporating research evidence into practice. Methods The staff were invited to respond to an online questionnaire inquiring about information seeking behavior, identification of colleague expertise, and friendship status. Three networks were developed based on the 170 participants. Overall shape, key indices, the most central people and brokers, and their characteristics were identified. Results The network analysis showed a low density and localized information-seeking network. Inter-personal connections were mainly clustered by organizational divisions; and people tended to limit information-seeking connections to a handful of peers in their division. However, recognition of expertise and friendship networks showed more cross-divisional connections. Members of the office of the Medical Officer of Health were located at the heart of the department, bridging across divisions. A small group of professional consultants and middle managers were the most-central staff in the network, also connecting their divisions to the center of the information-seeking network. In each division, there were some locally central staff, mainly practitioners, who connected their neighboring peers; but they were not necessarily connected to other experts or managers. Conclusions The methods of social network analysis were useful in providing a systems approach to understand how knowledge might flow in an organization. The findings of this study can be used to identify early adopters of knowledge translation interventions, forming

Information seeking for making evidence-informed decisions: a social network analysis on the staff of a public health department in Canada

Science.gov (United States)

2012-01-01

Background Social network analysis is an approach to study the interactions and exchange of resources among people. It can help understanding the underlying structural and behavioral complexities that influence the process of capacity building towards evidence-informed decision making. A social network analysis was conducted to understand if and how the staff of a public health department in Ontario turn to peers to get help incorporating research evidence into practice. Methods The staff were invited to respond to an online questionnaire inquiring about information seeking behavior, identification of colleague expertise, and friendship status. Three networks were developed based on the 170 participants. Overall shape, key indices, the most central people and brokers, and their characteristics were identified. Results The network analysis showed a low density and localized information-seeking network. Inter-personal connections were mainly clustered by organizational divisions; and people tended to limit information-seeking connections to a handful of peers in their division. However, recognition of expertise and friendship networks showed more cross-divisional connections. Members of the office of the Medical Officer of Health were located at the heart of the department, bridging across divisions. A small group of professional consultants and middle managers were the most-central staff in the network, also connecting their divisions to the center of the information-seeking network. In each division, there were some locally central staff, mainly practitioners, who connected their neighboring peers; but they were not necessarily connected to other experts or managers. Conclusions The methods of social network analysis were useful in providing a systems approach to understand how knowledge might flow in an organization. The findings of this study can be used to identify early adopters of knowledge translation interventions, forming Communities of Practice, and

Entrepreneurship development policymaking factors: An exploratory survey of tourism in Iran

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Saeed Jafari Moghaddam

2017-01-01

Full Text Available Widespread presence of small and medium enterprise (SME and entrepreneurial businesses (EB as well as governments' key role in tourism sphere, especially in developing countries. As a result, the importance of policymaking in SME and EB has been growing through last decade. This study is trying to identify and prioritize the factors influencing SME and EB policy in Iran tourism scope. For this research, data were collected via exploratory mixed method in two steps. Firstly, qualitative techniques such as literature review has been done to find all scholarly work and then using qualitative content analysis, factors influencing SME policy in tourism has been identified. In second step, quantitative methods, namely survey and Statistical techniques were used for analysis. Population of this study comprised policymaking and tourism entrepreneurship experts of Iran. The survey results showed there were 40 variables into six factors under two main dimensions influence on SME and EB. Factors identified in this study can be used to formulate macro policies in the tourism industry and national policymakers can utilize these concepts for entrepreneurship and SME's development in tourism. This research contributes to the existing literature in the field of entrepreneurship policymaking by introduce a systematic framework. This new framework can provide better insights and inform thinking in the area of entrepreneurship policymaking.

Entrepreneurship development policymaking factors: An exploratory survey of tourism in Iran

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Saeed Jafari Moghaddam

2016-01-01

Full Text Available Widespread presence of small and medium enterprise (SME and entrepreneurial businesses (EB as well as governments' key role in tourism sphere, especially in developing countries. As a result, the importance of policymaking in SME and EB has been growing through last decade. This study is trying to identify and prioritize the factors influencing SME and EB policy in Iran tourism scope. For this research, data were collected via exploratory mixed method in two steps. Firstly, qualitative techniques such as literature review has been done to find all scholarly work and then using qualitative content analysis, factors influencing SME policy in tourism has been identified. In second step, quantitative methods, namely survey and Statistical techniques were used for analysis. Population of this study comprised policymaking and tourism entrepreneurship experts of Iran. The survey results showed there were 40 variables into six factors under two main dimensions influence on SME and EB. Factors identified in this study can be used to formulate macro policies in the tourism industry and national policymakers can utilize these concepts for entrepreneurship and SME's development in tourism. This research contributes to the existing literature in the field of entrepreneurship policymaking by introduce a systematic framework. This new framework can provide better insights and inform thinking in the area of entrepreneurship policymaking.

Supporting Evidence-Informed Teaching in Biomedical and Health Professions Education Through Knowledge Translation: An Interdisciplinary Literature Review.

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Tractenberg, Rochelle E; Gordon, Morris

2017-01-01

Phenomenon: The purpose of "systematic" reviews/reviewers of medical and health professions educational research is to identify best practices. This qualitative article explores the question of whether systematic reviews can support "evidence informed" teaching and contrasts traditional systematic reviewing with a knowledge translation (KT) approach to this objective. Degrees of freedom analysis (DOFA) is used to examine the alignment of systematic review methods with educational research and the pedagogical strategies and approaches that might be considered with a decision-making framework developed to support valid assessment. This method is also used to explore how KT can be used to inform teaching and learning. The nature of educational research is not compatible with most (11/14) methods for systematic review. The inconsistency of systematic reviewing with the nature of educational research impedes both the identification and implementation of "best-evidence" pedagogy and teaching. This is primarily because research questions that do support the purposes of review do not support educational decision making. By contrast to systematic reviews of the literature, both a DOFA and KT are fully compatible with informing teaching using evidence. A DOFA supports the translation of theory to a specific teaching or learning case, so could be considered a type of KT. The DOFA results in a test of alignment of decision options with relevant educational theory, and KT leads to interventions in teaching or learning that can be evaluated. Examples of how to structure evaluable interventions are derived from a KT approach that are simply not available from a systematic review. Insights: Systematic reviewing of current empirical educational research is not suitable for deriving or supporting best practices in education. However, both "evidence-informed" and scholarly approaches to teaching can be supported as KT projects, which are inherently evaluable and can generate

Human resource information systems in health care: a systematic evidence review.

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Tursunbayeva, Aizhan; Bunduchi, Raluca; Franco, Massimo; Pagliari, Claudia

2017-05-01

This systematic review aimed to: (1) determine the prevalence and scope of existing research on human resource information systems (HRIS) in health organizations; (2) analyze, classify, and synthesize evidence on the processes and impacts of HRIS development, implementation, and adoption; and (3) generate recommendations for HRIS research, practice, and policy, with reference to the needs of different stakeholders. A structured search strategy was used to interrogate 10 electronic databases indexing research from the health, social, management, technology, and interdisciplinary sciences, alongside gray literature sources and reference lists of qualifying studies. There were no restrictions on language or publication year. Two reviewers screened publications, extracted data, and coded findings according to the innovation stages covered in the studies. The Critical Appraisal Skills Program checklist was adopted to assess study quality. The process of study selection was charted using a Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) diagram. Of the 6824 publications identified by the search strategy, 68, covering 42 studies, were included for final analysis. Research on HRIS in health was interdisciplinary, often atheoretical, conducted primarily in the hospital sector of high-income economies, and largely focused uncritically on use and realized benefits. While studies of HRIS in health exist, the overall lack of evaluative research raises unanswered questions about their capacity to improve quality and efficiency and enable learning health systems, as well as how sociotechnical complexity influences implementation and effectiveness. We offer this analysis to decision makers and managers considering or currently implementing an HRIS, and make recommendations for further research. International Prospective Register of Systematic Reviews (PROSPERO): CRD42015023581. http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015023581#.VYu1BPl

Climate for evidence-informed health systems: a profile of systematic review production in 41 low- and middle-income countries, 1996-2008.

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Law, Tyler; Lavis, John; Hamandi, Ali; Cheung, Andrew; El-Jardali, Fadi

2012-01-01

To describe systematic review production in 41 countries in Africa, the Americas, Asia and the eastern Mediterranean to understand one dimension of the climate for evidence-informed health systems and to provide a baseline for an evaluation of knowledge translation initiatives. Our focus was systematic reviews published between 1996 and 2008 that had a corresponding author based in, or that appeared to target, one of the countries in these regions. We searched both Medline and Embase using validated search strategies, identified citations with a country name in the corresponding author's institutional affiliation or as a textword (i.e., an explicit mention in the title or abstract) or keyword, and coded articles describing a systematic review. We followed the same citation identification procedure for Health Systems Evidence, a database containing systematic reviews about health systems. Systematic review production increased between three-fold (for Africa in Medline) and 110-fold (for Asia in Embase) between the first period (1996-2002) and second period (2003-2008). In the second period, China was more often the home of corresponding authors and the target of reviews than any other country. No systematic reviews were produced by a corresponding author based in nine countries, or appeared to target five countries. Only 48 reviews identified through Medline and Embase addressed health systems, and 35 health systems reviews identified through Health Systems Evidence addressed these countries. In many countries, those seeking to support evidence-informed health systems cannot turn to experienced local systematic reviewers to help them to find and use systematic reviews or to conduct reviews on high priority topics when none exists. These findings suggest the need for local capacity-building initiatives.

Iranian adolescent girls' barriers in accessing sexual and reproductive health information and services: a qualitative study.

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Shariati, Mohammed; Babazadeh, Raheleh; Mousavi, Seyed Abbas; Najmabadi, Khadijeh Mirzaii

2014-10-01

Adolescence is a critical period of transition from childhood to adulthood. In today's world, to pass through this period successfully it is necessary to have adequate information and knowledge about sexual and reproductive health (SRH) issues. In Iran, it is crucial that special attention be paid to reproductive health services for adolescents, especially for girls. This study aimed to explore the views and experiences of adolescent girls and key adults around the barriers to access of Iranian adolescent girls to SRH information and services. In this qualitative study, data were gathered through focus groups and semi-structured interviews with 247 adolescent girls and 71 key adults including mothers, teachers, health providers, governmental, nongovernmental and international managers of health programmes, health policymakers, sociologists and clergy in four Iranian cities. Data were coded and categorised using content analysis by MAXQDA10. The main barriers identified were classified in four categories: (1) social and cultural barriers such as taboos; (2) structural and administrative barriers such as inappropriate structure of the health system; (3) political barriers such as lack of an adopted strategy by the government and (4) non-use of religious potential. Adolescent SRH in Iran should be firmly established as a priority for government leaders and policymakers. They should try to provide those services that are consistent with the community's cultural and religious values for adolescent girls. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Developing an evidence-based approach to Public Health Nutrition: translating evidence into policy.

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Margetts, B; Warm, D; Yngve, A; Sjöström, M

2001-12-01

The aim of this paper is to highlight the importance of an evidence-based approach to the development, implementation and evaluation of policies aimed at improving nutrition-related health in the population. Public Health Nutrition was established to realise a population-level approach to the prevention of the major nutrition-related health problems world-wide. The scope is broad and integrates activity from local, national, regional and international levels. The aim is to inform and develop coherent and effective policies that address the key rate-limiting steps critical to improving nutrition-related public health. This paper sets out the rationale for an evidence-based approach to Public Health Nutrition developed under the umbrella of the European Network for Public Health Nutrition.

The Registry of Knowledge Translation Methods and Tools: a resource to support evidence-informed public health.

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Peirson, Leslea; Catallo, Cristina; Chera, Sunita

2013-08-01

This paper examines the development of a globally accessible online Registry of Knowledge Translation Methods and Tools to support evidence-informed public health. A search strategy, screening and data extraction tools, and writing template were developed to find, assess, and summarize relevant methods and tools. An interactive website and searchable database were designed to house the registry. Formative evaluation was undertaken to inform refinements. Over 43,000 citations were screened; almost 700 were full-text reviewed, 140 of which were included. By November 2012, 133 summaries were available. Between January 1 and November 30, 2012 over 32,945 visitors from more than 190 countries accessed the registry. Results from 286 surveys and 19 interviews indicated the registry is valued and useful, but would benefit from a more intuitive indexing system and refinements to the summaries. User stories and promotional activities help expand the reach and uptake of knowledge translation methods and tools in public health contexts. The National Collaborating Centre for Methods and Tools' Registry of Methods and Tools is a unique and practical resource for public health decision makers worldwide.

Facilitating health information exchange in low- and middle-income countries: conceptual considerations, stakeholders perspectives and deployment strategies illustrated through an in-depth case study of Pakistan

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Akhlaq, Ather

2016-01-01

Background Health information exchange (HIE) may help healthcare professionals and policymakers make informed decisions to improve patient and population health outcomes. There is, however, limited uptake of HIE in many low- and middle-income countries (LMICs). While resource constraints are an obvious barrier to implementation of HIE, it is important to explore what other political, structural, technical, environmental, legal and cultural factors may be involved. In particu...

Are Health-Related Tweets Evidence Based? Review and Analysis of Health-Related Tweets on Twitter.

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Alnemer, Khalid A; Alhuzaim, Waleed M; Alnemer, Ahmed A; Alharbi, Bader B; Bawazir, Abdulrahman S; Barayyan, Omar R; Balaraj, Faisal K

2015-10-29

Health care professionals are utilizing Twitter to communicate, develop disease surveillance systems, and mine health-related information. The immediate users of this health information is the general public, including patients. This necessitates the validation of health-related tweets by health care professionals to ensure they are evidence based and to avoid the use of noncredible information as a basis for critical decisions. The aim of this study was to evaluate health-related tweets on Twitter for validity (evidence based) and to create awareness in the community regarding the importance of evidence-based health-related tweets. All tweets containing health-related information in the Arabic language posted April 1-5, 2015, were mined from Twitter. The tweets were classified based on popularity, activity, interaction, and frequency to obtain 25 Twitter accounts (8 physician accounts, 10 nonofficial health institute accounts, 4 dietitian accounts, and 3 government institute accounts) and 625 tweets. These tweets were evaluated by 3 American Board-certified medical consultants and a score was generated (true/false) and interobserver agreement was calculated. A total of 625 health-related Arabic-language tweets were identified from 8 physician accounts, 10 nonofficial health institute accounts, 4 dietician accounts, and 3 government institute accounts. The reviewers labeled 320 (51.2%) tweets as false and 305 (48.8%) tweets as true. Comparative analysis of tweets by account type showed 60 of 75 (80%) tweets by government institutes, 124 of 201 (61.7%) tweets by physicians, and 42 of 101 (41.6%) tweets by dieticians were true. The interobserver agreement was moderate (range 0.78-0.22). More than half of the health-related tweets (169/248, 68.1%) from nonofficial health institutes and dietician accounts (59/101, 58.4%) were false. Tweets by the physicians were more likely to be rated "true" compared to other groups (PTwitter were found to be false based on expert

Politics, policies and processes: a multidisciplinary and multimethods research programme on policies on the social determinants of health inequity in Australia.

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Baum, Fran; Friel, Sharon

2017-12-21

The development and implementation of multisectoral policy to improve health and reduce health inequities has been slow and uneven. Evidence is largely focused on the facts of health inequities rather than understanding the political and policy processes. This 5-year funded programme of research investigates how these processes could function more effectively to improve equitable population health. The programme of work is organised in four work packages using four themes (macroeconomics and infrastructure, land use and urban environments, health systems and racism) related to the structural drivers shaping the distribution of power, money and resources and daily living conditions. Policy case studies will use publicly available documents (policy documents, published evaluations, media coverage) and interviews with informants (policy-makers, former politicians, civil society, private sector) (~25 per case). NVIVO software will be used to analyse the documents to see how 'social and health equity' is included and conceptualised. The interview data will include qualitative descriptive and theory-driven critical discourse analysis. Our quantitative methodological work assessing the impact of public policy on health equity is experimental that is in its infancy but promises to provide the type of evidence demanded by policy-makers. Our programme is recognising the inherently political nature of the uptake, formulation and implementation of policy. The early stages of our work indicate its feasibility. Our work is aided by a Critical Policy Reference Group. Multiple ethics approvals have been obtained with the foundation approval from the Social and Behavioural Ethics Committee, Flinders University (Project No: 6786).The theoretical, methodological and policy engagement processes established will provide improved evidence for policy-makers who wish to reduce health inequities and inform a new generation of policy savvy knowledge on social determinants. © Article author

Daring to dream: reactions to tobacco endgame ideas among policy-makers, media and public health practitioners

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Wilson Nick

2011-07-01

Full Text Available Abstract Background Tobacco control strategies have mainly targeted reducing demand. Supply-side focused measures, though less familiar, deserve consideration, particularly to achieve 'endgame' tobacco control aims (e.g. achieving close to zero smoking prevalence. We explored attitudes towards supply-side focused 'endgame' tobacco control approaches and how they can be best communicated with senior policymakers, journalists, and public health practitioners. Methods We identified five supply-side focused approaches which could potentially lead to the tobacco endgame: two structural models and three discrete actions. The structural models were: (i a Nicotine Authority to coordinate tobacco control activities and regulate the nicotine/tobacco market for public health aims; and (ii a Tobacco Supply Agency acting as a monopoly purchaser of tobacco products and controlling the tobacco supply for public health aims. The actions were: (a allocating progressively reducing tobacco product import quotas (the 'sinking lid' until importation and commercial sale of tobacco products ceased; (b making tobacco companies responsible for reducing smoking prevalence with stringent financial penalties if targets were missed; and (c new laws to facilitate litigation against tobacco companies. These approaches were presented as means to achieve a tobacco free New Zealand by 2020 to 19 senior policymakers, journalists, and public health physicians in two focus groups and eight interviews, and their reactions sought. Results The tobacco-free vision was widely supported. Participants engaged fully with the proposed tobacco control approaches, which were viewed as interesting or even intriguing. Most supported increasing the focus on supply-side measures. Views differed greatly about the desirability, feasibility and likely effectiveness of each approach. Participants identified a range of potential barriers to implementation and challenges to successfully advocating and

Global Forum 2015 dialogue on "From evidence to policy - thinking outside the box": perspectives to improve evidence uptake and good practices in the African Region.

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Kirigia, Joses Muthuri; Pannenborg, Charles Ok; Amore, Luis Gabriel Cuervo; Ghannem, Hassen; IJsselmuiden, Carel; Nabyonga-Orem, Juliet

2016-07-18

The Global Forum 2015 panel session dialogue entitled "From evidence to policy - thinking outside the box" was held on 26 August 2015 in the Philippines to debate why evidence was not fully translated into policy and practice and what could be done to increase its uptake. This paper reports the reasons and possible actions for increasing the uptake of evidence, and highlights the actions partners could take to increase the use of evidence in the African Region. The Global Forum 2015 debate attributed African Region's low uptake of evidence to the big gap in incentives and interests between research for health researchers and public health policy-makers; limited appreciation on the side of researchers that public health decisions are based on multiple and complex considerations; perception among users that research evidence is not relevant to local contexts; absence of knowledge translation platforms; sub-optimal collaboration and engagement between industry and research institutions; lack of involvement of civil society organizations; lack of engagement of communities in the research process; failure to engage the media; limited awareness and debate in national and local parliaments on the importance of investing in research and innovation; and dearth of research and innovation parks in the African Region. The actions needed in the Region to increase the uptake of evidence in policy and practice include strengthening NHRS governance; bridging the motivation gap between researchers and health policy-makers; restoring trust between researchers and decision-makers; ensuring close and continuous intellectual intercourse among researchers, ministry of health policy-makers and technocrats during the life course of research projects or programmes; proactive collaboration between academia and industry; regular briefings of civil society, media, relevant parliamentary committees and development partners; development of vibrant knowledge translation platforms; development of

Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England.

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Ovseiko, Pavel V; O'Sullivan, Catherine; Powell, Susan C; Davies, Stephen M; Buchan, Alastair M

2014-11-08

Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N = 17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the

Determinants of enrollment of informal sector workers in cooperative based health scheme in Bangladesh

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Sarker, Abdur Razzaque; Sultana, Marufa; Mahumud, Rashidul Alam; Ahmed, Sayem; Islam, Ziaul; Morton, Alec; Khan, Jahangir A. M.

2017-01-01

Background Providing access to affordable health care for the informal sector remains a considerable challenge for low income countries striving to make progress towards universal health coverage. The objective of the study is to identify the factors shaping the decision to enroll in a cooperative based health scheme for informal workers in Bangladesh and also help to identify the features of informal workers without health schemes and their likelihood of being insured. Methods Data were derived from a cross-sectional in-house survey within the catchment area of a cooperative based health scheme in Bangladesh during April–June 2014, covering a total of 784 households (458 members and 326 non-members). Multivariate logistic regression model was used to identify factors associated with cooperative based health scheme and explanatory variables. Findings This study found that a number of factors were significant determinants of health scheme participation including sex of household head, household composition, occupational category as well as involvement social financial safety net programs. Conclusion Findings from this study can be suggestive for policy-makers interested in scaling up health insurance for informal workers in Bangladesh. Shared funding from this large informal sector can generate new resources for healthcare, which is in line with the healthcare financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of the path to Universal Health Coverage. PMID:28750052

Determinants of enrollment of informal sector workers in cooperative based health scheme in Bangladesh.

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Abdur Razzaque Sarker

Full Text Available Providing access to affordable health care for the informal sector remains a considerable challenge for low income countries striving to make progress towards universal health coverage. The objective of the study is to identify the factors shaping the decision to enroll in a cooperative based health scheme for informal workers in Bangladesh and also help to identify the features of informal workers without health schemes and their likelihood of being insured.Data were derived from a cross-sectional in-house survey within the catchment area of a cooperative based health scheme in Bangladesh during April-June 2014, covering a total of 784 households (458 members and 326 non-members. Multivariate logistic regression model was used to identify factors associated with cooperative based health scheme and explanatory variables.This study found that a number of factors were significant determinants of health scheme participation including sex of household head, household composition, occupational category as well as involvement social financial safety net programs.Findings from this study can be suggestive for policy-makers interested in scaling up health insurance for informal workers in Bangladesh. Shared funding from this large informal sector can generate new resources for healthcare, which is in line with the healthcare financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of the path to Universal Health Coverage.

More Health Expenditure, Better Economic Performance? Empirical Evidence From OECD Countries

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Fuhmei Wang PhD

2015-08-01

Full Text Available Recent economic downturns have led many countries to reduce health spending dramatically, with the World Health Organization raising concerns over the effects of this, in particular among the poor and vulnerable. With the provision of appropriate health care, the population of a country could have better health, thus strengthening the nation’s human capital, which could contribute to economic growth through improved productivity. How much should countries spend on health care? This study aims to estimate the optimal health care expenditure in a growing economy. Applying the experiences of countries from the Organization for Economic Co-Operation and Development (OECD over the period 1990 to 2009, this research introduces the method of system generalized method of moments (GMM to derive the design of the estimators of the focal variables. Empirical evidence indicates that when the ratio of health spending to gross domestic product (GDP is less than the optimal level of 7.55%, increases in health spending effectively lead to better economic performance. Above this, more spending does not equate to better care. The real level of health spending in OECD countries is 5.48% of GDP, with a 1.87% economic growth rate. The question which is posed by this study is a pertinent one, especially in the current context of financially constrained health systems around the world. The analytical results of this work will allow policymakers to better allocate scarce resources to achieve their macroeconomic goals.

More Health Expenditure, Better Economic Performance? Empirical Evidence From OECD Countries

Science.gov (United States)

Wang, Fuhmei

2015-01-01

Recent economic downturns have led many countries to reduce health spending dramatically, with the World Health Organization raising concerns over the effects of this, in particular among the poor and vulnerable. With the provision of appropriate health care, the population of a country could have better health, thus strengthening the nation’s human capital, which could contribute to economic growth through improved productivity. How much should countries spend on health care? This study aims to estimate the optimal health care expenditure in a growing economy. Applying the experiences of countries from the Organization for Economic Co-Operation and Development (OECD) over the period 1990 to 2009, this research introduces the method of system generalized method of moments (GMM) to derive the design of the estimators of the focal variables. Empirical evidence indicates that when the ratio of health spending to gross domestic product (GDP) is less than the optimal level of 7.55%, increases in health spending effectively lead to better economic performance. Above this, more spending does not equate to better care. The real level of health spending in OECD countries is 5.48% of GDP, with a 1.87% economic growth rate. The question which is posed by this study is a pertinent one, especially in the current context of financially constrained health systems around the world. The analytical results of this work will allow policymakers to better allocate scarce resources to achieve their macroeconomic goals. PMID:26310501

IMPROVING THE EFFECTIVENESS AND EFFICIENCY OF EVIDENCE PRODUCTION FOR HEALTH TECHNOLOGY ASSESSMENT.

Science.gov (United States)

Facey, Karen; Henshall, Chris; Sampietro-Colom, Laura; Thomas, Sarah

2015-01-01

Health Technology Assessment (HTA) needs to address the challenges posed by high cost, effective technologies, expedited regulatory approaches, and the opportunities provided by collaborative real-world evaluation of technologies. The Health Technology Assessment International (HTAi) Policy Forum met to consider these issues and the implications for evidence production to inform HTA. This paper shares their discussion to stimulate further debate. A background paper, presentations, group discussions, and stakeholder role play at the 2015 HTAi Policy Forum meeting informed this paper. HTA has an important role to play in helping improve evidence production and ensuring that the health service is ready to adopt effective technologies. It needs to move from simply informing health system decisions to also working actively to align stakeholder expectations about realistic evidence requirements. Processes to support dialogue over the health technology life cycle need to be developed that are mindful of limited resources, operate across jurisdictions and learn from past processes. Collaborations between health technology developers and health systems in different countries should be encouraged to develop evidence that will inform decision making. New analytical techniques emerging for real-world data should be harnessed to support modeling for HTA. A paradigm shift (to "Health Innovation System 2.0") is suggested where HTA adopts a more central, proactive role to support alignment within and amongst stakeholders over the whole life cycle of the technology. This could help ensure that evidence production is better aligned with patient and health system needs and so is more effective and efficient.

Uncertainty in macroeconomic policy-making: art or science?

Science.gov (United States)

Aikman, David; Barrett, Philip; Kapadia, Sujit; King, Mervyn; Proudman, James; Taylor, Tim; de Weymarn, Iain; Yates, Tony

2011-12-13

Uncertainty is pervasive in economic policy-making. Modern economies share similarities with other complex systems in their unpredictability. But economic systems also differ from those in the natural sciences because outcomes are affected by the state of beliefs of the systems' participants. The dynamics of beliefs and how they interact with economic outcomes can be rich and unpredictable. This paper relates these ideas to the recent crisis, which has reminded us that we need a financial system that is resilient in the face of the unpredictable and extreme. It also highlights how such uncertainty puts a premium on sound communication strategies by policy-makers. This creates challenges in informing others about the uncertainties in the economy, and how policy is set in the face of those uncertainties. We show how the Bank of England tries to deal with some of these challenges in its communications about monetary policy.

Conflicting health information: a critical research need.

Science.gov (United States)

Carpenter, Delesha M; Geryk, Lorie L; Chen, Annie T; Nagler, Rebekah H; Dieckmann, Nathan F; Han, Paul K J

2016-12-01

Conflicting health information is increasing in amount and visibility, as evidenced most recently by the controversy surrounding the risks and benefits of childhood vaccinations. The mechanisms through which conflicting information affects individuals are poorly understood; thus, we are unprepared to help people process conflicting information when making important health decisions. In this viewpoint article, we describe this problem, summarize insights from the existing literature on the prevalence and effects of conflicting health information, and identify important knowledge gaps. We propose a working definition of conflicting health information and describe a conceptual typology to guide future research in this area. The typology classifies conflicting information according to four fundamental dimensions: the substantive issue under conflict, the number of conflicting sources (multiplicity), the degree of evidence heterogeneity and the degree of temporal inconsistency. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis.

Science.gov (United States)

El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan

2014-08-20

Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary

India's "tryst" with universal health coverage: reflections on ethnography in Indian health policymaking.

Science.gov (United States)

Nambiar, Devaki

2013-12-01

In 2011, India stood at the crossroads of potentially major health reform. A High Level Expert Group (HLEG) on universal health coverage (UHC), convened by the Indian Planning Commission, proposed major changes in the structure and functioning of the country's health system. This paper presents reflections on the role of ethnography in policy-based social change for health in India, drawing from year-long participation in the aforementioned policy development process. It theorizes that international discourses have been (re)appropriated in the Indian case by recourse to both experience and evidence, resulting in a plurality of concepts that could be prioritized for Indian health reform. This articulation involved HLEG members exerting para-ethnographic labour and paying close attention to context, suggesting that ethnographic sensibilities can reside within the interactive and knowledge production practices among experts oriented toward policy change. Copyright © 2013 Elsevier Ltd. All rights reserved.

Evidence summary: The relationship between oral diseases and diabetes

OpenAIRE

D Aiuto, F.; Gable, D.; Syed, Z.; Allen, Y.; Wanyonyi, K. L.; White, S.; Gallagher, J. E.

2017-01-01

Introduction This paper is the third of four rapid reviews undertaken to explore the relationships between oral health and general medical conditions in order to support teams within Public Health England, health practitioners and policymakers.Aims This review aimed to explore the nature of the association between poor oral health and diabetes when found in the same individuals or populations, having reviewed the most contemporary evidence in the field.Methods The reviews were undertaken by f...

What constitutes evidence-based patient information? Overview of discussed criteria.

Science.gov (United States)

Bunge, Martina; Mühlhauser, Ingrid; Steckelberg, Anke

2010-03-01

To survey quality criteria for evidence-based patient information (EBPI) and to compile the evidence for the identified criteria. Databases PubMed, Cochrane Library, PsycINFO, PSYNDEX and Education Research Information Center (ERIC) were searched to update the pool of criteria for EBPI. A subsequent search aimed to identify evidence for each criterion. Only studies on health issues with cognitive outcome measures were included. Evidence for each criterion is presented using descriptive methods. 3 systematic reviews, 24 randomized-controlled studies and 1 non-systematic review were included. Presentation of numerical data, verbal presentation of risks and diagrams, graphics and charts are based on good evidence. Content of information and meta-information, loss- and gain-framing and patient-oriented outcome measures are based on ethical guidelines. There is a lack of studies on quality of evidence, pictures and drawings, patient narratives, cultural aspects, layout, language and development process. The results of this review allow specification of EBPI and may help to advance the discourse among related disciplines. Research gaps are highlighted. Findings outline the type and extent of content of EBPI, guide the presentation of information and describe the development process. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Transparency in practice: Evidence from 'verification analyses' issued by the Polish Agency for Health Technology Assessment in 2012-2015.

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Ozierański, Piotr; Löblová, Olga; Nicholls, Natalia; Csanádi, Marcell; Kaló, Zoltán; McKee, Martin; King, Lawrence

2018-01-08

Transparency is recognised to be a key underpinning of the work of health technology assessment (HTA) agencies, yet it has only recently become a subject of systematic inquiry. We contribute to this research field by considering the Polish Agency for Health Technology Assessment (AHTAPol). We situate the AHTAPol in a broader context by comparing it with the National Institute for Health and Care Excellence (NICE) in England. To this end, we analyse all 332 assessment reports, called verification analyses, that the AHTAPol issued from 2012 to 2015, and a stratified sample of 22 Evidence Review Group reports published by NICE in the same period. Overall, by increasingly presenting its key conclusions in assessment reports, the AHTAPol has reached the transparency standards set out by NICE in transparency of HTA outputs. The AHTAPol is more transparent than NICE in certain aspects of the HTA process, such as providing rationales for redacting assessment reports and providing summaries of expert opinions. Nevertheless, it is less transparent in other areas of the HTA process, such as including information on expert conflicts of interest. Our findings have important implications for understanding HTA in Poland and more broadly. We use them to formulate recommendations for policymakers.

Family Caregivers and Consumer Health Information Technology.

Science.gov (United States)

Wolff, Jennifer L; Darer, Jonathan D; Larsen, Kevin L

2016-01-01

Health information technology has been embraced as a strategy to facilitate patients' access to their health information and engagement in care. However, not all patients are able to access, or are capable of using, a computer or mobile device. Although family caregivers assist individuals with some of the most challenging and costly health needs, their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of engaging family caregivers through the use of consumer-oriented health information technology. We compile existing evidence to make the case that involving family caregivers in health information technology as desired by patients is technically feasible and consistent with the principles of patient-centered and family-centered care. We discuss how more explicit and purposeful engagement of family caregivers in health information technology could advance clinical quality and patient safety by increasing the transparency, accuracy, and comprehensiveness of patient health information across settings of care. Finally, we describe how clarifying and executing patients' desires to involve family members or friends through health information technology would provide family caregivers greater legitimacy, convenience, and timeliness in health system interactions, and facilitate stronger partnerships between patients, family caregivers, and health care professionals.

State of the Nigerian child - neglect of child and adolescent mental health: a review.

Science.gov (United States)

Atilola, O; Ayinde, O O; Emedoh, C T; Oladimeji, O

2015-05-01

As most child health initiatives in Nigeria lack a child and adolescent mental health (CAMH) strategy, CAMH issues have remained obscure to the country's policy-makers. The lack of current and representative epidemiological data on the mental health of Nigerian children continues to be a barrier to advocacy for CAMH policy initiatives. In view of the importance of CAMH to national development, there must be a continued search for ways of bringing the state of CAMH in Nigeria to the attention of policy-makers. To use information from UNICEF's State of the World's Children as proxy data to speculate on the state of child mental health in Nigeria. With a view to discussing its CAMH implications, social and health indicators in the Nigerian child were extracted from UNICEF's 2012 edition. Most of the social and health indicators assessed reflect significant mental health risks. Up to 65% of households live on less than US$1·25 per day, child malnutrition is evident in up to 40% of children, and the primary and secondary school net enrolment ratios are only 63% and 25%, respectively. In addition, the rate of attendance for antenatal care was 45%, and only 39% of deliveries were supervised by skilled birth attendants. Child labour and under-age marriage is very common. A literature review demonstrates that children living in these circumstances are at significant risk of mental health problems. Current data on the state of Nigerian children contain indices that can serve as proxy information for the state of CAMH in the country. Policy-makers need to invest more in pre-emptive child health initiatives as a way of preserving the physical and mental health of children.

Defensive medicine: No wonder policymakers are confused.

Science.gov (United States)

Kapp, Marshall B

2016-01-01

Discussions regarding defensive medical practice often result in proposals for public policy actions. Such proposals generally are premised on assumptions about defensive medicine, namely, that it (a) is driven by physicians' legal anxieties, (b) constitutes bad medical practice, (c) drives up health care costs, (d) varies depending on a jurisdiction's particular tort law climate, (e) depends on medical specialty and a physician's own prior experience as a malpractice defendant, and (f) is a rational response to actual legal risks confronting physicians. This article examines a sample of recent literature focusing on defensive medicine and finds that the messages conveyed vary widely, helping to explain the confusion experienced by many policymakers trying to improve the quality and affordability of health care.

Evidence-Based Scholarly Communication: Information Professionals Unlocking Translational Research

OpenAIRE

Philip J. Kroth; Holly E. Phillips; Jonathan D. Eldredge

2010-01-01

The Evidence-Based Scholarly Communication Conference (EBSCC) was held March 11-12, 2010 in Albuquerque, NM. The conference addressed the perceived gap in knowledge and training for scholarly communication principles in the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) Program. The EBSCC brought together librarians and information specialists to share evidence based strategies for developing effective local scholarly communication support and training and...

Women's autonomy and reproductive health care utilisation: empirical evidence from Tajikistan.

Science.gov (United States)

Kamiya, Yusuke

2011-10-01

Women's autonomy is widely considered to be a key to improving maternal health in developing countries, whereas there is no consistent empirical evidence to support this claim. This paper examines whether or not and how women's autonomy within the household affects the use of reproductive health care, using a household survey data from Tajikistan. Estimation is performed by the bivariate probit model whereby woman's use of health services and the level of women's autonomy are recursively and simultaneously determined. The data is from a sample of women aged 15-49 from the Tajikistan Living Standard Measurement Survey 2007. Women's autonomy as measured by women's decision-making on household financial matters increase the likelihood that a woman receives antenatal and delivery care, whilst it has a negative effect on the probability of attending to four or more antenatal consultations. The hypothesis that women's autonomy and reproductive health care utilisation are independently determined is rejected for most of the estimation specifications, indicating the importance of taking into account the endogenous nature of women's autonomy when assessing its effect on health care use. The empirical results reconfirm the assertion that women's status within the household is closely linked to reproductive health care utilisation in developing countries. Policymakers therefore need not only to implement not only direct health interventions but also to focus on broader social policies which address women's empowerment. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries

Science.gov (United States)

Tambo, Ernest; Ugwu, Chidiebere E.; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

2016-01-01

in quality care delivery, effective programs coverage and efficiency, preparedness and emergency response is needed in transforming African health information systems, and local health governance structures and management in emerging epidemics. Furthermore, innovative evidence of operational joint solutions and strategies are critical in advancing healthcare delivery, and further enhancing Universal Health Care, and Sustainable Development Goals to attain global health improvements and economic prosperity. PMID:28058199

Optimizing the efficacy of multimedia consumer health information.

Science.gov (United States)

Monkman, Helen; Kushniruk, Andre W

2015-01-01

Using two or more communication methods (e.g., text, narration, pictures, animation, video) is known as multimedia. Multimedia has been used in a broad range of domains. Not surprisingly, multimedia is gaining popularity in the field of consumer health information as its benefits are being recognized. However, there is a large body of evidence in the cognitive literature that could be used to inform and optimize multimedia presentation of consumer health information. This paper outlines the Cognitive Theory of Multimedia Learning (CTML) and presents the application of this model for consumer health informatics. The CTML is a valuable resource for the development and revision of consumer health information to optimize its efficacy. Current research on multimedia and consumer health information is described. Finally, the outstanding opportunities to leverage the CTML for consumer health information are discussed.

China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries.

Science.gov (United States)

Tambo, Ernest; Ugwu, Chidiebere E; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

2016-01-01

emergency response is needed in transforming African health information systems, and local health governance structures and management in emerging epidemics. Furthermore, innovative evidence of operational joint solutions and strategies are critical in advancing healthcare delivery, and further enhancing Universal Health Care, and Sustainable Development Goals to attain global health improvements and economic prosperity.

Maori challenges and crown responsibilities: Maori policymaker ideas on smokefree policy options.

Science.gov (United States)

Gifford, Heather; Parata, Kiri; Thomson, George

2010-11-26

To determine obstacles/opportunities within policy processes, for smokefree interventions appropriate to Maori. In particular, to explore Maori policymakers' ideas on how to achieve progress on smokefree homes, cars and community property. Documents and interviews with 16 senior Maori officials and Members of Parliament, and nine interviews in two case studies, were used to explore Maori policymakers' ideas for (i) Progress, within relevant policy processes, on smoking in homes, cars and community property; (ii) Particular interventions that the interviewees felt were most and least effective, practical, sustainable, politically feasible or desirable in some way; (iii) The context, and obstacles and opportunities for such interventions. The case studies were of a Maori health service and a group of Maori District Health Board managers. Several key themes emerged from the research including, (i) children as drivers for change, (ii) strong national and local indigenous leadership needed for change, (iii) delivering smokefree messages as part of wider healthy living approaches, (iv) targeting of the messages for greatest impact for Maori, (v) need for a Maori approach, not a general approach, (vi) central and local government having a significant role in the prevention of tobacco harm, (vii) ideas on how tobacco tax revenue should be spent on tobacco control, and (viii) the rights of children to smokefree environments. Results indicate that indigenous specific approaches and indigenous leadership are critical for Maori tobacco-free advances. Harnessing indigenous values and principles related to health, family and children was the preferred method of these Maori policymakers for delivering social marketing messages.

Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform.

Science.gov (United States)

Guyon, Ak'ingabe; Perreault, Robert

2016-10-20

Public health is currently being weakened in several Canadian jurisdictions. Unprecedented and arbitrary cuts to the public health budget in Quebec in 2015 were a striking example of this. In order to support public health leaders and citizens in their capacity to advocate for evidence-informed public health reforms, we propose a knowledge synthesis of elements of public health systems that are significantly associated with improved performance. Research consistently and significantly associates four elements of public health systems with improved productivity: 1) increased financial resources, 2) increased staffing per capita, 3) population size between 50,000 and 500,000, and 4) specific evidence-based organizational and administrative features. Furthermore, increased financial resources and increased staffing per capita are significantly associated with improved population health outcomes. We contend that any effort at optimization of public health systems should at least be guided by these four evidence-informed factors. Canada already has existing capacity in carrying out public health systems and services research. Further advancement of our academic and professional expertise on public health systems will allow Canadian public health jurisdictions to be inspired by the best public health models and become stronger advocates for public health's resources, interventions and outcomes when they need to be celebrated or defended.

Promoting Evidence to Policy Link on the Control of Infectious Diseases of Poverty in Nigeria: Outcome of A Multi-Stakeholders Policy Dialogue

Science.gov (United States)

Uneke, Chigozie Jesse; Ebeh Ezeoha, Abel; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima

2015-01-01

Background: In Nigeria, malaria, schistosomiasis and lymphatic filariasis are among infectious diseases of poverty (IDP) with severe health burden and require effective policy strategies for their control. In this study, we investigated the value of policy brief and policy dialogue as excellent policymaking mechanisms that enable policymakers to adapt effective evidence informed policy for IDP control. Methods: A policy brief was developed on the control of malaria, schistosomiasis and lymphatic filariasis and subjected to deliberations in a one-day multi-stakeholder policy dialogue held in Ebonyi State Nigeria. A modified cross sectional intervention study design was used in this investigation. Structured pre-tested questionnaires were used to evaluate the policy brief document and policy dialogue process at the end of the policy dialogue. Results: Forty-seven policymakers participated in the dialogue. An analysis of the response on the policy brief regarding context, different features of the problem; policy options and key implementation considerations indicated the mean ratings (MNRs) mostly ranged from 6.40-6.85 on 7 point scale. The over-all assessment of the policy brief had MNR at 6.54. The analysis of the response on the policy dialogue regarding the level of priority of policy issue, opportunity to discuss different features of the problem and options for addressing the problem, and the MNRs mostly ranged from 6.50-6.82. The overall assessment of the policy dialogue had MNR at 6.72. Conclusion: Policy dialogues can allow research evidence to be considered together with views, experiences and tacit knowledge of policymakers and can enhance evidence-to-policy link. PMID:26290826

Interventions to improve employee health and well-being within health care organizations: A systematic review.

Science.gov (United States)

Williams, Stephen P; Malik, Humza T; Nicolay, Christopher R; Chaturvedi, Sankalp; Darzi, Ara; Purkayastha, Sanjay

2018-04-01

In response to an increasing body of evidence on the importance of employee health and well-being (HWB) within health care, there has been a shift in focus from both policymakers and individual organizations toward improving health care employee HWB. However, there is something of a paucity of evidence regarding the impact and value of specific HWB interventions within a health care setting. The aim of this article was to systematically review the literature on this topic utilizing the EMBASE, Global Health, Health Management Information Consortium, MEDLINE, and PsycINFO databases. Forty-four articles were identified and, due to a large degree of heterogeneity, were considered under different headings as to the type of intervention employed: namely, those evaluating changing ways of working, physical health promotion, complementary and alternative medicine, and stress management interventions, and those utilizing multimodal interventions. Our results consider both the efficacy and reliability of each intervention in turn and reflect on the importance of careful study design and measure selection when evaluating the impact of HWB interventions. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

Developing evidence-informed decision making in a hospice: an evaluation of organisational readiness.

Science.gov (United States)

Morris, Jenny; Stewart, Amy; Richardson, Janet

2013-06-01

Multiprofessional home care and hospice teams should play a part in evidence-informed decision making. To assess organisational readiness to adopt evidence-informed decision making in a hospice in England. A mixed-methods approach was used. Clinical staff were surveyed regarding their attitudes to and skills in using evidence, and senior managers completed an organisation-based self-assessment tool recording the readiness of the organisation to embrace an evidence-informed focus. 81% of the staff completed the survey. Staff were committed to the principles of evidence-informed decision making, but overall lacked the necessary knowledge and skills. Information obtained from the management self-assessment highlighted that a priority was to develop an evidence-informed decision-making culture focusing on education, training, and policy development. The process used in this evaluation may be applicable to other areas of health care when assessing an organisation's readiness to incorporate evidence-informed decision making into policy and procedure.

The effects of corporate restructuring on hospital policymaking.

Science.gov (United States)

Alexander, J A; Morlock, L L; Gifford, B D

1988-01-01

Hospital corporate restructuring is the segmentation of assets or functions of the hospital into separate corporations. While these functions are almost always legally separated from the hospital, their impact on hospital policymaking may be far more direct. This study examines the effects of corporate restructuring by community hospitals on the structure, composition, and activity of hospital governing boards. In general, we expect that the policymaking function of the hospital will change to adapt to the multicorporate structure implemented under corporate restructuring, as well as the overlapping boards and diversified business responsibilities of the new corporate entity. Specifically, we hypothesize that the hospital board under corporate restructuring will conform more to the "corporate" model found in the business/industrial sector and less to the "philanthropic" model common to most community hospitals to date. Analysis of survey data from 1,037 hospitals undergoing corporate restructuring from 1979-1985 and a comparison group of 1,883 noncorporately restructured hospitals suggests general support for this hypothesis. Implications for health care governance and research are discussed. PMID:3384671

The effects of corporate restructuring on hospital policymaking.

Science.gov (United States)

Alexander, J A; Morlock, L L; Gifford, B D

1988-06-01

Hospital corporate restructuring is the segmentation of assets or functions of the hospital into separate corporations. While these functions are almost always legally separated from the hospital, their impact on hospital policymaking may be far more direct. This study examines the effects of corporate restructuring by community hospitals on the structure, composition, and activity of hospital governing boards. In general, we expect that the policymaking function of the hospital will change to adapt to the multicorporate structure implemented under corporate restructuring, as well as the overlapping boards and diversified business responsibilities of the new corporate entity. Specifically, we hypothesize that the hospital board under corporate restructuring will conform more to the "corporate" model found in the business/industrial sector and less to the "philanthropic" model common to most community hospitals to date. Analysis of survey data from 1,037 hospitals undergoing corporate restructuring from 1979-1985 and a comparison group of 1,883 noncorporately restructured hospitals suggests general support for this hypothesis. Implications for health care governance and research are discussed.

Low health literacy and evaluation of online health information: a systematic review of the literature.

Science.gov (United States)

Diviani, Nicola; van den Putte, Bas; Giani, Stefano; van Weert, Julia Cm

2015-05-07

Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review

Implementing a routine health management information system in ...

African Journals Online (AJOL)

South Sudan has recently acquired statehood. Planning and management of the health care system, based on evidence, requires a constant flow of information from health services. The Division of Monitoring and Evaluation (M&E) of the Ministry of Health developed the framework for the health sector of the country in 2008.

Practice-centred evaluation and the privileging of care in health information technology evaluation.

Science.gov (United States)

Darking, Mary; Anson, Rachel; Bravo, Ferdinand; Davis, Julie; Flowers, Steve; Gillingham, Emma; Goldberg, Lawrence; Helliwell, Paul; Henwood, Flis; Hudson, Claire; Latimer, Simon; Lowes, Paul; Stirling, Ian

2014-06-05

Our contribution, drawn from our experience of the case study provided, is a protocol for practice-centred, participative evaluation of technology in the clinical setting that privileges care. In this context 'practice-centred' evaluation acts as a scalable, coordinating framework for evaluation that recognises health information technology supported care as an achievement that is contingent and ongoing. We argue that if complex programmes of technology-enabled service innovation are understood in terms of their contribution to patient care and supported by participative, capability-building evaluation methodologies, conditions are created for practitioners and patients to realise the potential of technologies and make substantive contributions to the evidence base underpinning health innovation programmes. Electronic Patient Records (EPRs) and telemedicine are positioned by policymakers as health information technologies that are integral to achieving improved clinical outcomes and efficiency savings. However, evaluating the extent to which these aims are met poses distinct evaluation challenges, particularly where clinical and cost outcomes form the sole focus of evaluation design. We propose that a practice-centred approach to evaluation - in which those whose day-to-day care practice is altered (or not) by the introduction of new technologies are placed at the centre of evaluation efforts - can complement and in some instances offer advantages over, outcome-centric evaluation models. We carried out a regional programme of innovation in renal services where a participative approach was taken to the introduction of new technologies, including: a regional EPR system and a system to support video clinics. An 'action learning' approach was taken to procurement, pre-implementation planning, implementation, ongoing development and evaluation. Participants included clinicians, technology specialists, patients and external academic researchers. Whilst undergoing these

Integrating Information and Communication Technology for Health Information System Strengthening: A Policy Analysis.

Science.gov (United States)

Marzuki, Nuraidah; Ismail, Saimy; Al-Sadat, Nabilla; Ehsan, Fauziah Z; Chan, Chee-Khoon; Ng, Chiu-Wan

2015-11-01

Despite the high costs involved and the lack of definitive evidence of sustained effectiveness, many low- and middle-income countries had begun to strengthen their health information system using information and communication technology in the past few decades. Following this international trend, the Malaysian Ministry of Health had been incorporating Telehealth (National Telehealth initiatives) into national health policies since the 1990s. Employing qualitative approaches, including key informant interviews and document review, this study examines the agenda-setting processes of the Telehealth policy using Kingdon's framework. The findings suggested that Telehealth policies emerged through actions of policy entrepreneurs within the Ministry of Health, who took advantage of several simultaneously occurring opportunities--official recognition of problems within the existing health information system, availability of information and communication technology to strengthen health information system and political interests surrounding the national Multimedia Super Corridor initiative being developed at the time. The last was achieved by the inclusion of Telehealth as a component of the Multimedia Super Corridor. © 2015 APJPH.

Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya.

Science.gov (United States)

Jessani, Nasreen S; Boulay, Marc G; Bennett, Sara C

2016-06-01

The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role-serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, we administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks. We identified academic KBs using social network analysis (SNA) in a two-step approach: First, we ranked individuals based on (1) number of policymakers in their network; (2) number of academic peers who report seeking them out for advice on knowledge translation and (3) their network position as 'inter-group connectors'. Second, we triangulated the three scores and re-ranked individuals. Academic faculty scoring within the top decile across all three measures were classified as KBs. Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, we identified 7 KBs in 4 of the 6 SPHs. Those scoring high on the first measure were not necessarily the same individuals scoring high on the second. KBs were also situated in a wide range along the 'connector/betweenness' measure. We propose that a composite score rather than traditional 'betweenness centrality', provides an alternative means of identifying KBs within these networks. In conclusion, SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health policies. © The

Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity.

Science.gov (United States)

Tugwell, Peter; Petkovic, Jennifer; Welch, Vivian; Vincent, Jennifer; Bhutta, Zulfiqar A; Churchill, Rachel; deSavigny, Don; Mbuagbaw, Lawrence; Pantoja, Tomas

2017-12-02

A focus on equity in health can be seen in many global development goals and reports, research and international declarations. With the development of a relevant framework and methods, the Campbell and Cochrane Equity Methods Group has encouraged the application of an 'equity lens' to systematic reviews, and many organizations publish reviews intended to address health equity. The purpose of the Evidence for Equity (E4E) project was to conduct a priority-setting exercise and apply an equity lens by developing a knowledge translation product comprising summaries of systematic reviews from the Cochrane Library. E4E translates evidence from systematic reviews into 'friendly front end' summaries for policy makers. The following topic areas with high burdens of disease globally, were selected for the pilot: diabetes/obesity, HIV/AIDS, malaria, nutrition, and mental health/depression. For each topic area, a "stakeholder panel" was assembled that included policymakers and researchers. A systematic search of Cochrane reviews was conducted for each area to identify equity-relevant interventions with a meaningful impact. Panel chairs developed a rating sheet which was used by all panels to rank the importance of these interventions by: 1) Ease of Implementation; 2) Health System Requirements; 3)Universality/Generalizability/Share of Burden; and 4) Impact on Inequities/Effect on equity. The ratings of panel members were averaged for each intervention and criterion, and interventions were ordered according to the average overall ratings. Stakeholder panels identified the top 10 interventions from their respective topic areas. The evidence on these interventions is being summarized with an equity focus and the results posted online, at http://methods.cochrane.org/equity/e4e-series . This method provides an explicit approach to setting priorities by systematic review groups and funders for providing decision makers with evidence for the most important equity

The evolution of social networks through the implementation of evidence-informed decision-making interventions: a longitudinal analysis of three public health units in Canada.

Science.gov (United States)

Yousefi-Nooraie, Reza; Dobbins, Maureen; Marin, Alexandra; Hanneman, Robert; Lohfeld, Lynne

2015-12-03

We studied the evolution of information-seeking networks over a 2-year period during which an organization-wide intervention was implemented to promote evidence-informed decision-making (EIDM) in three public health units in Ontario, Canada. We tested whether engagement of staff in the intervention and their EIDM behavior were associated with being chosen as information source and how the trend of inter-divisional communications and the dominance of experts evolved over time. Local managers at each health unit selected a group of staff to get engage in Knowledge Broker-led workshops and development of evidence summaries to address local public health problems. The staff were invited to answer three online surveys (at baseline and two annual follow-ups) including name generator questions eliciting the list of the staff they would turn to for help integrating research evidence into practice. We used stochastic actor-oriented modeling to study the evolution of networks. We tested the effect of engagement in the intervention, EIDM behavior scores, organizational divisions, and structural dynamics of social networks on the tendency of staff to select information sources, and the change in its trend between year 1 and year 2 of follow-up. In all the three health units, and especially in the two units with higher levels of engagement in the intervention, the network evolved towards a more centralized structure, with an increasing significance of already central staff. The staff showed greater tendencies to seek information from peers with higher EIDM behavior scores. In the public health unit that had highest engagement and stronger leadership support, the engaged staff became more central. In all public health units, the engaged staff showed an increasing tendency towards forming clusters. The staff in the three public health units showed a tendency towards limiting their connections within their divisions. The longitudinal analysis provided us with a means to study the

Regional Competitive Intelligence: Benchmarking and Policymaking

OpenAIRE

Huggins , Robert

2010-01-01

Benchmarking exercises have become increasingly popular within the sphere of regional policymaking in recent years. The aim of this paper is to analyse the concept of regional benchmarking and its links with regional policymaking processes. It develops a typology of regional benchmarking exercises and regional benchmarkers, and critically reviews the literature, both academic and policy oriented. It is argued that critics who suggest regional benchmarking is a flawed concept and technique fai...

Withholding differential risk information on legal consumer nicotine/tobacco products: The public health ethics of health information quarantines.

Science.gov (United States)

Kozlowski, Lynn T; Sweanor, David

2016-06-01

The United States provides an example of a country with (a) legal tobacco/nicotine products (e.g., snus, other smokeless tobacco, cigarettes) differing greatly in risks to health and (b) respected health information websites that continue to omit or provide incorrect differential risk information. Concern for the principles of individual rights, health literacy, and personal autonomy (making decisions for oneself), which are key principles of public health ethics, has been countered by utilitarian arguments for the use of misleading or limited information to protect public health overall. We argue that omitting key health relevant information for current or prospective consumers represents a kind of quarantine of health-relevant information. As with disease quarantines, the coercive effects of quarantining information on differential risks need to be justified, not merely by fears of net negative public health effects, but by convincing evidence that such measures are actually warranted, that public health overall is in imminent danger and that the danger is sufficient to override principles of individual autonomy. Omitting such health-relevant information for consumers of such products effectively blindfolds them and impairs their making informed personal choices. Moral psychological issues that treat all tobacco/nicotine products similarly may also be influencing the reluctance to inform on differential risks. In countries where tobacco/nicotine products are legally sold and also differ greatly in disease risks compared to cigarettes (e.g., smokeless tobacco and vape), science-based, comprehensible, and actionable health information (consistent with health literacy principles) on differential risks should be available and only reconsidered if it is established that this information is causing losses to population health overall. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Impact of new information technologies on training and continuing education for rural health professionals.

Science.gov (United States)

Crandall, L A; Coggan, J M

1994-01-01

Recently developed and emerging information and communications technologies offer the potential to move the clinical training of physicians and other health professionals away from the resource intensive urban academic health center, with its emphasis on tertiary care, and into rural settings that may be better able to place emphasis on the production of badly needed primary care providers. These same technologies also offer myriad opportunities to enhance the continuing education of health professionals in rural settings. This article explores the effect of new technologies for rural tele-education by briefly reviewing the effect of technology on health professionals' education, describing ongoing applications of tele-education, and discussing the likely effect of new technological developments on the future of tele-education. Tele-education has tremendous potential for improving the health care of rural Americans, and policy-makers must direct resources to its priority development in rural communities.

Evidence acquisition and evaluation for evidence summit on enhancing provision and use of maternal health services through financial incentives.

Science.gov (United States)

Higgs, Elizabeth S; Stammer, Emily; Roth, Rebecca; Balster, Robert L

2013-12-01

Recognizing the need for evidence to inform US Government and governments of the low- and middle-income countries on efficient, effective maternal health policies, strategies, and programmes, the US Government convened the Evidence Summit on Enhancing Provision and Use of Maternal Health Services through Financial Incentives in April 2012 in Washington, DC, USA. This paper summarizes the background and methods for the acquisition and evaluation of the evidence used for achieving the goals of the Summit. The goal of the Summit was to obtain multidisciplinary expert review of literature to inform both US Government and governments of the low- and middle-income countries on evidence-informed practice, policies, and strategies for financial incentives. Several steps were undertaken to define the tasks for the Summit and identify the appropriate evidence for review. The process began by identifying focal questions intended to inform governments of the low-and middle-income countries and the US Government about the efficacy of supply- and demand-side financial incentives for enhanced provision and use of quality maternal health services. Experts were selected representing the research and programme communities, academia, relevant non-governmental organizations, and government agencies and were assembled into Evidence Review Teams. This was followed by a systematic process to gather relevant peer-reviewed literature that would inform the focal questions. Members of the Evidence Review Teams were invited to add relevant papers not identified in the initial literature review to complete the bibliography. The Evidence Review Teams were asked to comply with a specific evaluation framework for recommendations on practice and policy based on both expert opinion and the quality of the data. Details of the search processes and methods used for screening and quality reviews are described.

Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

Science.gov (United States)

Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

2016-01-01

Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.

They aren't all first cousins: Bedouin marriage and health policies in Lebanon.

Science.gov (United States)

Mansour, Nisrine; Chatty, Dawn; El-Kak, Faysal; Yassin, Nasser

2014-01-01

Fertility and consanguineous marriages among the Bedouin tribes of the Middle East have long generated interest particularly around health outcomes and social relations. In particular, Bedouin in Lebanon have increasingly embraced the Lebanese national bio-medical health system in the past two decades, while Lebanese policy-makers' responses continue to be minimal and ill-informed. This paper investigates the mismatch between policy-makers' formulations of Bedouin consanguineous marriages and the Bedouins's actual reproductive practices and discusses the implications of these formulations on the Bedouins's access to health services. The findings are drawn from the data collected as part of the Bedouin Health Project, an EU-funded five-year study (2005-2010), aiming at assessing access to reproductive and child health care among the Bedouin in Lebanon. The data was collected from 6 clusters representing the main Bedouin informal and unrecognized settlements in the Bekaa Valley of Lebanon. The data consists of 111 socioeconomic questionnaires with Bedouin women users of local public, private, and nongovernmental reproductive and child health-focused clinics, in addition to 40 in-depth interviews with Bedouin women across the clusters and 17 semi-structured interviews with policy-makers. The findings suggest a gap between the perceptions of policy-makers and the incidence of consanguineous marriages and reproductive practices among the Bedouin. While there was no national data available for the Bedouin populations, policy-makers relied on a constructed 'Bedouin reproductive profile' that portrayed them as 'a problematic health group'. The national policy formulation of the Bedouin reproductive profile has an exclusionary impact on the Bedouin population as they are ignored from any targeted health policies or provided with politically motivated palliative care provision. These findings highlight the importance of addressing stereotyping and discrimination among health

Using social media for knowledge translation, promotion of evidence-based medicine and high-quality information on health.

Science.gov (United States)

Puljak, Livia

2016-02-02

Knowledge translation activities may be targeted towards all participants in healthcare practices, including patients, consumers, and policy makers. Hereby, use of social media, namely social network Facebook, as a tool for knowledge translation, promotion of evidence-based medicine and high-quality information on health is described. In March 2013, a Facebook page of the Croatian Cochrane Branch was created and its main content are translated plain language summaries (PLS) of the systematic reviews produced by The Cochrane Collaboration. Since the page was created it has gained 1441 followers, mostly from Croatia and neighboring countries with similar language. Most of the page followers are women aged 25 to 44 and the most popular content is related to pregnancy, childbirth and breastfeeding. Page followers are lay persons, health professionals and journalists, who further disseminate the page content. In summary, social media enables multiple possibilities to engage with target audience and to disseminate the evidence-based medicine content. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[An overview of the definition and implementation of the Brazilian National Policy on Health Data and Information Technology].

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Cavalcante, Ricardo Bezerra; Kerr-Pinheiro, Marta Macedo; Guimarães, Eliete Albano de Azevedo; Miranda, Richardson Machado

2015-05-01

The This qualitative study aimed to analyze the development and implementation of the Brazilian National Policy on Health Data and Information Technology (NPIIH). We analyzed documents and applied an online questionnaire to the experts involved in developing the policy. The data were submitted to content analysis using the categorical thematic modality. The PNIIS is the target of debate and proposals at various levels. Provisions have appeared in parallel to regulate measures on health data and information technology. Community participation in developing this policy and the convergence of laws, standards, resolutions, and policy-making levels in a common and broadly acknowledged and enforced policy are challenges, in addition to linking the public and private sectors. The study concludes that the National Policy on Health Data and Information Technology is making gradual progress, predominantly in theoretical debates, revisions, and updates. There are numerous challenges for its implementation and a prevailing need for legitimation.

Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso

Science.gov (United States)

2015-01-01

Policy entrepreneurs are individuals who attempt to influence the policy process and its outcomes through their opportunistic or incremental actions. Their success in the policy-making process has been associated with the convergence of four factors: behavioural traits; institutional factors; network position and political capital. Policy entrepreneurs have received little study in low- and middle-income country policy research despite observations of individualized decision-making, informal institutions and the unequal distribution and exercise of power in policymaking. This article aims to identify whether policy entrepreneurs were present in the policy process around integrated community case management (iCCM) in Burkina Faso, whether they were successful in achieving policy change, and whether success or failure can be explained using existing policy entrepreneur frameworks from high-income polities. This mixed methods policy study collected data from in-depth qualitative interviews and social network surveys of actors involved in iCCM policymaking [known locally as C-integrated management of childhood illness (IMCI)]; data were analysed based on the framework categories. Interview data pointed to one key individual who played a significant role in the inclusion of pneumonia treatment into the country’s iCCM policy, an issue that had been a point of contention between government policy elites and development partners. Social network data confirmed that this actor was strategically located in the policy network to be able to reach the most other actors and to be able to control the flow of information. Although some development partner actors were as strategically located, none had the same level of authority or trust as was imbued by being a member of the government civil service. The entrepreneur’s mid-level rank in the health ministry may have encouraged him/her to invest political capital and take risks that would not have been feasible or attractive to

High-performance work systems in health care management, part 1: development of an evidence-informed model.

Science.gov (United States)

Garman, Andrew N; McAlearney, Ann Scheck; Harrison, Michael I; Song, Paula H; McHugh, Megan

2011-01-01

: Although management practices are recognized as important factors in improving health care quality and efficiency, most research thus far has focused on individual practices, ignoring or underspecifying the contexts within which these practices are operating. Research from other industries, which has increasingly focused on systems rather than individual practices, has yielded results that may benefit health services management. : Our goal was to develop a conceptual model on the basis of prior research from health care as well as other industries that could be used to inform important contextual considerations within health care. : Using theoretical frameworks from A. Donabedian (1966), P. M. Wright, T. M. Gardner, and L. M. Moynihan (2003), and B. Schneider, D. B. Smith, and H. W. Goldstein (2000) and review methods adapted from R. Pawson (2006b), we reviewed relevant research from peer-reviewed and other industry-relevant sources to inform our model. The model we developed was then reviewed with a panel of practitioners, including experts in quality and human resource management, to assess the applicability of the model to health care settings. : The resulting conceptual model identified four practice bundles, comprising 14 management practices as well as nine factors influencing adoption and perceived sustainability of these practices. The mechanisms by which these practices influence care outcomes are illustrated using the example of hospital-acquired infections. In addition, limitations of the current evidence base are discussed, and an agenda for future research in health care settings is outlined. : Results may help practitioners better conceptualize management practices as part of a broader system of work practices. This may, in turn, help practitioners to prioritize management improvement efforts more systematically.

How to do (or not to do) … translation of national health accounts data to evidence for policy making in a low resourced setting.

Science.gov (United States)

Price, Jennifer A; Guinness, Lorna; Irava, Wayne; Khan, Idrish; Asante, Augustine; Wiseman, Virginia

2016-05-01

For more than a decade, the Organization for Economic Co-operation and Development (OECD), the World Health Organization (WHO) and the World Bank have promoted the international standardization of National Health Accounts (NHA) for reporting global statistics on public, private and donor health expenditure and improve the quality of evidence-based decision-making at country level. A 2010-2012 World Bank review of NHA activity in 50 countries found structural and technical constraints (rather than cost) were key impediments to institutionalizing NHA in many low- and middle-income countries (LMICs). Pilot projects focused resources on data production, neglecting longer-term capacity building for analysing the data, developing ownership among local stakeholders and establishing routine production, utilization and dissemination of NHA data. Hence, genuine institutionalization of NHA in most LMICs has been slow to materialize. International manuals focus on the production of NHA data and do not include practical, incremental and low-cost strategies to guide countries in translating the data into evidence for policy-making. The main aim of this article is to recommend strategies for bridging this divide between production and utilization of NHA data in low-resource settings. The article begins by discussing the origins and purpose of NHA, including factors currently undermining their uptake. The focus then turns to the development and application of strategies to assist LMICs in 'unlocking' the hidden value of their NHA. The article draws on the example of Fiji, a country currently attempting to integrate their NHA data into policy formulation, despite minimal resources, training and familiarity with economic analysis of health systems. Simple, low cost recommendations such as embedding health finance indicators in planning documents, a user-friendly NHA guide for evaluating local health priorities, and sharing NHA data for collaborative research have helped translate

Towards evidence-based, GIS-driven national spatial health information infrastructure and surveillance services in the United Kingdom

Directory of Open Access Journals (Sweden)

Boulos Maged

2004-01-01

Full Text Available Abstract The term "Geographic Information Systems" (GIS has been added to MeSH in 2003, a step reflecting the importance and growing use of GIS in health and healthcare research and practices. GIS have much more to offer than the obvious digital cartography (map functions. From a community health perspective, GIS could potentially act as powerful evidence-based practice tools for early problem detection and solving. When properly used, GIS can: inform and educate (professionals and the public; empower decision-making at all levels; help in planning and tweaking clinically and cost-effective actions, in predicting outcomes before making any financial commitments and ascribing priorities in a climate of finite resources; change practices; and continually monitor and analyse changes, as well as sentinel events. Yet despite all these potentials for GIS, they remain under-utilised in the UK National Health Service (NHS. This paper has the following objectives: (1 to illustrate with practical, real-world scenarios and examples from the literature the different GIS methods and uses to improve community health and healthcare practices, e.g., for improving hospital bed availability, in community health and bioterrorism surveillance services, and in the latest SARS outbreak; (2 to discuss challenges and problems currently hindering the wide-scale adoption of GIS across the NHS; and (3 to identify the most important requirements and ingredients for addressing these challenges, and realising GIS potential within the NHS, guided by related initiatives worldwide. The ultimate goal is to illuminate the road towards implementing a comprehensive national, multi-agency spatio-temporal health information infrastructure functioning proactively in real time. The concepts and principles presented in this paper can be also applied in other countries, and on regional (e.g., European Union and global levels.

Evidence Translation in a Youth Mental Health Service

Directory of Open Access Journals (Sweden)

Alan P. Bailey

2016-02-01

Full Text Available An evidence–practice gap is well established in the mental health field, and knowledge translation is identified as a key strategy to bridge the gap. This study outlines a knowledge translation strategy, which aims to support clinicians in using evidence in their practice within a youth mental health service (headspace. We aim to evaluate the strategy by exploring clinicians’ experiences and preferences. The translation strategy includes the creation and dissemination of evidence translation resources that summarize the best available evidence and practice guidelines relating to the management of young people with mental disorders. Semi-structured interviews were conducted with 14 youth mental health clinicians covering three topics: experiences with evidence translation resources, preferences for evidence presentation, and suggestions regarding future translation efforts. Interviews were recorded, transcribed verbatim, coded, and analyzed using thematic analysis. Themes were both predetermined by interview topic and identified freely from the data. Clinicians described their experiences with the evidence translation resources as informing decision making, providing a knowledge base, and instilling clinical confidence. Clinicians expressed a preference for brief, plain language summaries and for involvement and consultation during the creation and dissemination of resources. Suggestions to improve the dissemination strategy and the development of new areas for evidence resources were identified. The knowledge translation efforts described support clinicians in the provision of mental health services for young people. The preferences and experiences described have valuable implications for services implementing knowledge translation strategies.

The impact of public employment on health and health inequalities: evidence from China.

Science.gov (United States)

Zhang, Wei

2011-01-01

Because the public and private sectors often operate with different goals, individuals employed by the two sectors may receive different levels of welfare. This can potentially lead to different health status. As such, employment sector offers an important perspective for understanding labor market outcomes. Using micro-level data from a recent Chinese household survey, this study empirically evaluated the impact of employment sector on health and within-sector health inequalities. It found that public sector employment generated better health outcomes than private sector employment, controlling for individual characteristics. The provision of more job security explained an important part of the association between public sector employment and better health. The study also found less health inequality by social class within the public sector. These findings suggest that policymakers should think critically about the "conventional wisdom" that private ownership is almost always superior, and should adjust their labor market policies accordingly.

Childhood socioeconomic conditions and teeth in older adulthood: Evidence from SHARE wave 5

NARCIS (Netherlands)

Listl, S.; Broadbent, J.M.; Thomson, W.M.; Stock, C.; Shen, J.; Steele, J.; Wildman, J.; Heilmann, A.; Watt, R.G.; Tsakos, G.; Peres, Marco A.; Heijden, G. van der; Jurges, H.

2018-01-01

OBJECTIVES: Dental diseases are the most common chronic diseases worldwide. Healthy teeth are vital for quality of life, particularly diet and nutrition. However, little information exists to inform health policymakers about potentially long-lasting influences of early-life conditions. The purpose

Childhood socioeconomic conditions and teeth in older adulthood : Evidence from SHARE wave 5

NARCIS (Netherlands)

Listl, S.; Broadbent, J.M.; Thomson, W.M.; Stock, C.; Shen, J.; Steele, J.; Wildman, J.; Heilmann, A.; Watt, R.G.; Tsakos, G.; Peres, M.A.; van der Heijden, G.; Jürges, H.

2018-01-01

Objectives: Dental diseases are the most common chronic diseases worldwide. Healthy teeth are vital for quality of life, particularly diet and nutrition. However, little information exists to inform health policymakers about potentially long-lasting influences of early-life conditions. The purpose

Street-Level Bureaucrats as Individual Policymakers:

DEFF Research Database (Denmark)

Baviskar, Siddhartha; Winter, Søren

2016-01-01

Lipsky (1980) pointed out that street-level bureaucrats (SLBs) are important policymakers due to the discretion they exercise and argued from a structural perspective that these workers manifest relatively similar coping behaviors owing to their shared working conditions, characterized by chronic......Lipsky (1980) pointed out that street-level bureaucrats (SLBs) are important policymakers due to the discretion they exercise and argued from a structural perspective that these workers manifest relatively similar coping behaviors owing to their shared working conditions, characterized...

Assessing availability of scientific journals, databases, and health library services in Canadian health ministries: a cross-sectional study.

Science.gov (United States)

Léon, Grégory; Ouimet, Mathieu; Lavis, John N; Grimshaw, Jeremy; Gagnon, Marie-Pierre

2013-03-21

Evidence-informed health policymaking logically depends on timely access to research evidence. To our knowledge, despite the substantial political and societal pressure to enhance the use of the best available research evidence in public health policy and program decision making, there is no study addressing availability of peer-reviewed research in Canadian health ministries. To assess availability of (1) a purposive sample of high-ranking scientific journals, (2) bibliographic databases, and (3) health library services in the fourteen Canadian health ministries. From May to October 2011, we conducted a cross-sectional survey among librarians employed by Canadian health ministries to collect information relative to availability of scientific journals, bibliographic databases, and health library services. Availability of scientific journals in each ministry was determined using a sample of 48 journals selected from the 2009 Journal Citation Reports (Sciences and Social Sciences Editions). Selection criteria were: relevance for health policy based on scope note information about subject categories and journal popularity based on impact factors. We found that the majority of Canadian health ministries did not have subscription access to key journals and relied heavily on interlibrary loans. Overall, based on a sample of high-ranking scientific journals, availability of journals through interlibrary loans, online and print-only subscriptions was estimated at 63%, 28% and 3%, respectively. Health Canada had a 2.3-fold higher number of journal subscriptions than that of the provincial ministries' average. Most of the organisations provided access to numerous discipline-specific and multidisciplinary databases. Many organisations provided access to the library resources described through library partnerships or consortia. No professionally led health library environment was found in four out of fourteen Canadian health ministries (i.e. Manitoba Health, Northwest

European Working Time Directive and doctors’ health: a systematic review of the available epidemiological evidence

Science.gov (United States)

Rodriguez-Jareño, Maria Cruz; Demou, Evangelia; Vargas-Prada, Sergio; Sanati, Kaveh A; Škerjanc, Alenka; Reis, Pedro G; Helimäki-Aro, Ritva; Macdonald, Ewan B; Serra, Consol

2014-01-01

Objective To summarise the available scientific evidence on the health effects of exposure to working beyond the limit number of hours established by the European Working Time Directive (EWTD) on physicians. Design A systematic literature search was conducted in PubMed and EMBASE. Study selection, quality appraisal and data extraction were carried out by independent pairs of researchers using pre-established criteria. Setting Physicians of any medical, surgical or community specialty, working in any possible setting (hospitals, primary healthcare, etc), as well as trainees, residents, junior house officers or postgraduate interns, were included. Participants The total number of participants was 14 338. Primary and secondary outcome measures Health effects classified under the International Classification of Diseases (ICD-10). Results Over 3000 citations and 110 full articles were reviewed. From these, 11 studies of high or intermediate quality carried out in North America, Europe and Japan met the inclusion criteria. Six studies included medical residents, junior doctors or house officers and the five others included medical specialists or consultants, medical, dental, and general practitioners and hospital physicians. Evidence of an association was found between percutaneous injuries and road traffic accidents with extended long working hours (LWH)/days or very LWH/weeks. The evidence was insufficient for mood disorders and general health. No studies on other health outcomes were identified. Conclusions LWH could increase the risk of percutaneous injuries and road traffic accidents, and possibly other incidents at work through the same pathway. While associations are clear, the existing evidence does not allow for an established causal or ‘dose–response’ relationship between LWH and incidents at work, or for a threshold number of extended hours above which there is a significantly higher risk and the hours physicians could work and remain safe and healthy

The impact of eHealth on the quality and safety of health care: a systematic overview.

Science.gov (United States)

Black, Ashly D; Car, Josip; Pagliari, Claudia; Anandan, Chantelle; Cresswell, Kathrin; Bokun, Tomislav; McKinstry, Brian; Procter, Rob; Majeed, Azeem; Sheikh, Aziz

2011-01-18

There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment

The impact of eHealth on the quality and safety of health care: a systematic overview.

Directory of Open Access Journals (Sweden)

Ashly D Black

Full Text Available BACKGROUND: There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care. METHODS AND FINDINGS: We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1 storing, managing, and transmission of data; (2 clinical decision support; and (3 facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice

GRADE: Assessing the quality of evidence in environmental and occupational health.

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Morgan, Rebecca L; Thayer, Kristina A; Bero, Lisa; Bruce, Nigel; Falck-Ytter, Yngve; Ghersi, Davina; Guyatt, Gordon; Hooijmans, Carlijn; Langendam, Miranda; Mandrioli, Daniele; Mustafa, Reem A; Rehfuess, Eva A; Rooney, Andrew A; Shea, Beverley; Silbergeld, Ellen K; Sutton, Patrice; Wolfe, Mary S; Woodruff, Tracey J; Verbeek, Jos H; Holloway, Alison C; Santesso, Nancy; Schünemann, Holger J

2016-01-01

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are

Information Seeking When Problem Solving: Perspectives of Public Health Professionals.

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Newman, Kristine; Dobbins, Maureen; Yost, Jennifer; Ciliska, Donna

2017-04-01

Given the many different types of professionals working in public health and their diverse roles, it is likely that their information needs, information-seeking behaviors, and problem-solving abilities differ. Although public health professionals often work in interdisciplinary teams, few studies have explored their information needs and behaviors within the context of teamwork. This study explored the relationship between Canadian public health professionals' perceptions of their problem-solving abilities and their information-seeking behaviors with a specific focus on the use of evidence in practice settings. It also explored their perceptions of collaborative information seeking and the work contexts in which they sought information. Key Canadian contacts at public health organizations helped recruit study participants through their list-servs. An electronic survey was used to gather data about (a) individual information-seeking behaviors, (b) collaborative information-seeking behaviors, (c) use of evidence in practice environments, (d) perceived problem-solving abilities, and (e) demographic characteristics. Fifty-eight public health professionals were recruited, with different roles and representing most Canadian provinces and one territory. A significant relationship was found between perceived problem-solving abilities and collaborative information-seeking behavior (r = -.44, p public health professionals take a shared, active approach to problem solving, maintain personal control, and have confidence, they are more likely collaborate with others in seeking information to complete a work task. Administrators of public health organizations should promote collaboration by implementing effective communication and information-seeking strategies, and by providing information resources and retrieval tools. Public health professionals' perceived problem-solving abilities can influence how they collaborate in seeking information. Educators in public health

The Importance of Community Consultations for Generating Evidence for Health Reform in Ukraine

Directory of Open Access Journals (Sweden)

Olena Hankivsky

2017-03-01

Full Text Available Background The paper presents the results of community consultations about the health needs and healthcare experiences of the population of Ukraine. The objective of community consultations is to engage a community in which a research project is studying, and to gauge feedback, criticism and suggestions. It is designed to seek advice or information from participants directly affected by the study subject of interest. The purpose of this study was to collect first-hand perceptions about daily life, health concerns and experiences with the healthcare system. This study provides policy-makers with additional evidence to ensure that health reforms would include a focus not only on health system changes but also social determinants of health (SDH. Methods The data collection consisted of the 21 community consultations conducted in 2012 in eleven regions of Ukraine in a mix of urban and rural settings. The qualitative data was coded in MAXQDA 11 software and thematic analysis was used as a method of summarizing and interpreting the results. Results The key findings of this study point out the importance of the SDH in the lives of Ukrainians and how the residents of Ukraine perceive that health inequities and premature mortality are shaped by the circumstances of their daily lives, such as: political and economic instability, environmental pollution, low wages, poor diet, insufficient physical activity, and unsatisfactory state of public services. Study participants repeatedly discussed these conditions as the reasons for the perceived health crisis in Ukraine. The dilapidated state of the healthcare system was discussed as well; high out-of-pocket (OOP payments and lack of trust in doctors appeared as significant barriers in accessing healthcare services. Additionally, the consultations highlighted the economic and health gaps between residents of rural and urban areas, naming rural populations among the most vulnerable social groups in Ukraine

Policy-making in the European Union

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Pollack, Mark A; Young, Alasadair R

2015-01-01

Constantly evolving, and with far-reaching implications, European Union policy-making is of central importance to the politics of the European Union. From defining the processes, institutions and modes through which policy-making operates, the text moves on to situate individual policies within these modes, detail their content, and analyse how they are implemented, navigating policy in all its complexities. The first part of the text examines processes, institutions, and the theoretical and analytical underpinnings of policy-making, while the second part considers a wide range of policy areas, from economics to the environment, and security to the single market. Throughout the text, theoretical approaches sit side by side with the reality of key events in the EU, including enlargement, the ratification of the Lisbon Treaty, and the financial crisis and resulting euro area crisis, exploring what determines how policies are made and implemented. In the final part, the editors consider trends in EU policy-makin...

Evidence-Based Scholarly Communication: Information Professionals Unlocking Translational Research

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Philip J. Kroth

2010-12-01

Full Text Available The Evidence-Based Scholarly Communication Conference (EBSCC was held March 11-12, 2010 in Albuquerque, NM. The conference addressed the perceived gap in knowledge and training for scholarly communication principles in the National Institutes of Health (NIH Clinical and Translational Science Award (CTSA Program. The EBSCC brought together librarians and information specialists to share evidence based strategies for developing effective local scholarly communication support and training and, it is hoped, to form new coalitions to address this topic at the local and national levels. This brief communication summarizes the need for theconference, highlights the general sessions in order of presentation, and introduces the EBSCC research papers appearing in this issue of Evidence Based Library and Information Practice (EBLIP. It also includes a description of a unique peer-review process methodology pioneered at EBSCC.

Dynamics behind the scale up of evidence-based obesity prevention: protocol for a multi-site case study of an electronic implementation monitoring system in health promotion practice.

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Conte, Kathleen P; Groen, Sisse; Loblay, Victoria; Green, Amanda; Milat, Andrew; Persson, Lina; Innes-Hughes, Christine; Mitchell, Jo; Thackway, Sarah; Williams, Mandy; Hawe, Penelope

2017-12-06

The effectiveness of many interventions to promote health and prevent disease has been well established. The imperative has therefore shifted from amassing evidence about efficacy to scale-up to maximise population-level health gains. Electronic implementation monitoring, or 'e-monitoring', systems have been designed to assist and track the delivery of preventive policies and programs. However, there is little evidence on whether e-monitoring systems improve the dissemination, adoption, and ongoing delivery of evidence-based preventive programs. Also, given considerable difficulties with e-monitoring systems in the clinical sector, scholars have called for a more sophisticated re-examination of e-monitoring's role in enhancing implementation. In the state of New South Wales (NSW), Australia, the Population Health Information Management System (PHIMS) was created to support the dissemination of obesity prevention programs to 6000 childcare centres and elementary schools across all 15 local health districts. We have established a three-way university-policymaker-practice research partnership to investigate the impact of PHIMS on practice, how PHIMS is used, and how achievement of key performance indicators of program adoption may be associated with local contextual factors. Our methods encompass ethnographic observation, key informant interviews and participatory workshops for data interpretation at a state and local level. We use an on-line social network analysis of the collaborative relationships across local health district health promotion teams to explore the relationship between PHIMS use and the organisational structure of practice. Insights will be sensitised by institutional theory, practice theory and complex adaptive system thinking, among other theories which make sense of socio-technical action. Our working hypothesis is that the science of getting evidence-based programs into practice rests on an in-depth understanding of the role they play in the on

Overweight and obesity: can we reconcile evidence about supermarkets and fast food retailers for public health policy?

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Viola, Deborah; Arno, Peter S; Maroko, Andrew R; Schechter, Clyde B; Sohler, Nancy; Rundle, Andrew; Neckerman, Kathryn M; Maantay, Juliana

2013-08-01

The aim of this study is to determine whether access to fast food outlets and supermarkets is associated with overweight and obesity in New York City neighborhoods. We use a Bayesian ecologic approach for spatial prediction. Consistent with prior research, we find no association between fast food density and overweight or obesity. Consistent with prior research, we find that supermarket access has a salutary impact on overweight and obesity. Given the lack of empirical evidence linking fast food retailers with adverse health outcomes, policymakers should be encouraged to adopt policies that incentivize the establishment of supermarkets and the modification of existing food store markets and retailers to offer healthier choices. Reaching within neighborhoods and modifying the physical environment and public health prevention and intervention efforts based on the characteristics of those neighborhoods may play a key role in creating healthier communities.

Reflections on the use of the World Health Organization’s (WHO OneHealth Tool: Implications for health planning in low and middle income countries (LMICs [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

John Q. Wong

2018-02-01

Full Text Available The World Health Organization (WHO launched the OneHealth Tool (OHT to help low and middle income countries to develop their capacities for sector-wide priority setting. In 2016, we sought to use the OHT to aid the Philippine Health Insurance Corporation (PHIC, the national health insurer of the Philippines, in decisions to expand benefit packages using cost-effectiveness analyses. With technical support from the WHO, we convened health planning officers from the Philippine Department of Health (DOH and the Philippine Health Insurance Corporation (PHIC conduct generalized cost-effective analyses (GCEA of selected un-financed noncommunicable disease interventions using OHT. We collected epidemiological and cost data through health facility surveys, review of literature such as cost libraries and clinical practice guidelines, and expert consultations. Although we were unable to use GCEA results directly to set policy, we learnt important policy lessons which we outline here that might help inform other countries looking to inform service coverage decisions. Additionally, the entire process and GCEA visualizations helped high-level policymakers in the health sector, who have traditionally relied on ad hoc decision making, to realize the need for a systematic and transparent priority-setting process that can continuously provide the evidence needed to inform service coverage decisions.

Reduction of inequalities in health: assessing evidence-based tools

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Shea Beverley

2006-09-01

Full Text Available Abstract Background The reduction of health inequalities is a focus of many national and international health organisations. The need for pragmatic evidence-based approaches has led to the development of a number of evidence-based equity initiatives. This paper describes a new program that focuses upon evidence- based tools, which are useful for policy initiatives that reduce inequities. Methods This paper is based on a presentation that was given at the "Regional Consultation on Policy Tools: Equity in Population Health Reports," held in Toronto, Canada in June 2002. Results Five assessment tools were presented. 1. A database of systematic reviews on the effects of educational, legal, social, and health interventions to reduce unfair inequalities is being established through the Cochrane and Campbell Collaborations. 2 Decision aids and shared decision making can be facilitated in disadvantaged groups by 'health coaches' to help people become better decision makers, negotiators, and navigators of the health system; a pilot study in Chile has provided proof of this concept. 3. The CIET Cycle: Combining adapted cluster survey techniques with qualitative methods, CIET's population based applications support evidence-based decision making at local and national levels. The CIET map generates maps directly from survey or routine institutional data, to be used as evidence-based decisions aids. Complex data can be displayed attractively, providing an important tool for studying and comparing health indicators among and between different populations. 4. The Ottawa Equity Gauge is applying the Global Equity Gauge Alliance framework to an industrialised country setting. 5 The Needs-Based Health Assessment Toolkit, established to assemble information on which clinical and health policy decisions can be based, is being expanded to ensure a focus on distribution and average health indicators. Conclusion Evidence-based planning tools have much to offer the

VALUE-BASED EVIDENCES TO FACE THE NEW CHALLENGES OF HEALTH PROMOTION IN A SUSTAINABLE HEALTHCARE SYSTEM.

Directory of Open Access Journals (Sweden)

Claudia Marotta

2017-10-01

Full Text Available Thirty years ago, starting from a new awareness of the limits of biomedical power and healthcare services to solve all population’ health problems, the Ottawa Conference coined a New Public Health by defining Health Promotion (HP as “the process of enabling people to increase control over and to improve their health and well-being”. Since then and over the next 30 years, several programs have been developed all over the world to translate HP concepts into practical actions and many health successes have been achieved as well. Nowadays, even if the global health context has strongly changed, the original principles of HP still provide a solid ground for action, being the community engagement and empowerment of women and men still at the heart of any health strategy, in a shared responsibility of all society’s sectors approach. However, since now HP promotion efforts have been directed toward priority health problems in a issue- settings-based approach, but in a sustainable and ethical prospective this will be not enough now: a deeper attention on effectiveness is request and an evidence- and value-based HP approach is needed to support the Public Health community and the policy-making, including the new challenges related to Public Health Genomics.

Strengthening capacity for local evidence to inform local responders to HIV in a remote Solomon Island health service

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David MacLaren

2015-04-01

Full Text Available Background: Documenting specific knowledge and attitudes about HIV in the culturally diverse nation of Solomon Islands is essential to inform locally targeted public health responses. As part of a large capacity-strengthening project at Atoifi Adventist Hospital in East Kwaio, Solomon Islands, researchers, using a ‘learn-by-doing’ process, worked with participants in public health research methods. Methods: Overall, 43 people attended research capacity building workshops in 2011; eight joined the HIV study group. A cross-sectional survey including semi-structured interviews on HIV was conducted by the group. In February 2014, a hospital administrator was interviewed about how the 2011 study informed local HIV responses. Results: Of the 53 survey participants, 64% self-assessed as having little or no HIV knowledge, but 90% knew HIV could be transmitted between men and women during sex. Less than 50% knew HIV could be transmitted between two men having sex, 45% thought HIV could be transmitted by mosquitoes and 55% agreed condoms help protect from HIV. Most participants reported negative attitudes towards people with HIV. Three years later the health administrator reported ad hoc responses to HIV because of low HIV prevalence, increasing noncommunicable diseases, staff turnover and resource shortages. Discussion: This HIV study was used to strengthen research skills in local health professionals and community members in Solomon Islands. It showed that community members require accurate information about HIV transmission and that entrenched stigma is an issue. Although results provided local evidence for local response, ongoing health system challenges and little local HIV transmission meant HIV services remain rudimentary.

How well does climate change and human health research match the demands of policymakers? A scoping review.

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Hosking, Jamie; Campbell-Lendrum, Diarmid

2012-08-01

In 2008, the World Health Organization (WHO) Member States passed a World Health Assembly resolution that identified the following five priority areas for research and pilot projects on climate change and human health: health vulnerability, health protection, health impacts of mitigation and adaptation policies, decision-support and other tools, and costs of health protection from climate change. To assess the extent to which recently published research corresponds to these priorities, we undertook a scoping review of original research on climate change and human health. Scoping reviews address topics that are too broad for a systematic review and commonly aim to identify research gaps in existing literature. We also assessed recent publication trends for climate change and health research. We searched for original quantitative research published from 2008 onward. We included disease burden studies that were specific to climate change and health and included intervention studies that focused on climate change and measured health outcomes. We used MEDLINE, Embase, and Web of Science databases and extracted data on research priority areas, geographic regions, health fields, and equity (systematic differences between advantaged and disadvantaged social groups). We identified 40 eligible studies. Compared with other health topics, the number of climate change publications has grown rapidly, with a larger proportion of reviews or editorials. Recent original research addressed four of the five priority areas identified by the WHO Member States, but we found no eligible studies of health adaptation interventions, and most of the studies focused on high-income countries. Climate change and health is a rapidly growing area of research, but quantitative studies remain rare. Among recently published studies, we found gaps in adaptation research and a deficit of studies in most developing regions. Funders and researchers should monitor and respond to research gaps to help