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

Directory of Open Access Journals (Sweden)

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.

The Use of 'No Evidence' Statements in Public Health

Directory of Open Access Journals (Sweden)

Louise Cummings

2015-03-01

Full Text Available Public health communication makes extensive use of a linguistic formulation that will be called the “no evidence” statement. This is a written or spoken statement of the form “There is no evidence that P” where P stands for a proposition that typically describes a human health risk. Danger lurks in these expressions for the hearer or reader who is not logically perspicacious, as arguments that use them are only warranted under certain conditions. The extent to which members of the public are able to determine what those conditions are will be considered by examining data obtained from 879 subjects. The role of “no evidence” statements as cognitive heuristics in public health reasoning is considered.

What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?

Directory of Open Access Journals (Sweden)

Kavita Singh

2011-01-01

Full Text Available The accelerating epidemics of noncommunicable diseases (NCDs in India call for a comprehensive public health response which can effectively combat and control them before they peak and inflict severe damage in terms of unaffordable health, economic, and social costs. To synthesize and present recent evidences regarding the effectiveness of several types of public health interventions to reduce NCD burden. Interventions influencing behavioral risk factors (like unhealthy diet, physical inactivity, tobacco and alcohol consumption through policy, public education, or a combination of both have been demonstrated to be effective in reducing the NCD risk in populations as well as in individuals. Policy interventions are also effective in reducing the levels of several major biological risk factors linked to NCDs (high blood pressure; overweight and obesity; diabetes and abnormal blood cholesterol. Secondary prevention along the lines of combination pills and ensuring evidenced based clinical care are also critical. Though the evidence for health promotion and primary prevention are weaker, policy interventions and secondary prevention when combined with these are likely to have a greater impact on reducing national NCD burden. A comprehensive and integrated response to NCDs control and prevention needs a "life course approach." Proven cost-effective interventions need to be integrated in a NCD prevention and control policy framework and implemented through coordinated mechanisms of regulation, environment modification, education, and health care responses.

Mapping the contribution of Allied Health Professions to the wider public health workforce: a rapid review of evidence-based interventions.

Science.gov (United States)

Davis, S Fowler; Enderby, P; Harrop, D; Hindle, L

2017-03-01

The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Public Health-Related Impacts of Climate Change inCalifornia

Energy Technology Data Exchange (ETDEWEB)

Drechsler, D.M.; Motallebi, N.; Kleeman, M.; Cayan, D.; Hayhoe,K.; Kalkstein, L.S.; Miller, N.L.; Jin, J.; VanCuren, R.A.

2005-12-01

In June 2005 Governor Arnold Schwarzenegger issued Executive Order S-3-05 that set greenhouse gas emission reduction targets for California, and directed the Secretary of the California Environmental Protection Agency to report to the governor and the State legislature by January 2006 and biannually thereafter on the impacts to California of global warming, including impacts to water supply, public health, agriculture, the coastline, and forestry, and to prepare and report on mitigation and adaptation plans to combat these impacts. This report is a part of the report to the governor and legislature, and focuses on public health impacts that have been associated with climate change. Considerable evidence suggests that average ambient temperature is increasing worldwide, that temperatures will continue to increase into the future, and that global warming will result in changes to many aspects of climate, including temperature, humidity, and precipitation (McMichael and Githeko, 2001). It is expected that California will experience changes in both temperature and precipitation under current trends. Many of the changes in climate projected for California could have ramifications for public health (McMichael and Githeko, 2001), and this document summarizes the impacts judged most likely to occur in California, based on a review of available peer-reviewed scientific literature and new modeling and statistical analyses. The impacts identified as most significant to public health in California include mortality and morbidity related to temperature, air pollution, vector and water-borne diseases, and wildfires. There is considerable complexity underlying the health of a population with many contributing factors including biological, ecological, social, political, and geographical. In addition, the relationship between climate change and changes in public health is difficult to predict for the most part, although more detailed information is available on temperature-related

Public health emergencies and the public health/managed care challenge.

Science.gov (United States)

Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

2002-01-01

The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

Synthesizing diverse evidence: the use of primary qualitative data analysis methods and logic models in public health reviews.

Science.gov (United States)

Baxter, S; Killoran, A; Kelly, M P; Goyder, E

2010-02-01

The nature of public health evidence presents challenges for conventional systematic review processes, with increasing recognition of the need to include a broader range of work including observational studies and qualitative research, yet with methods to combine diverse sources remaining underdeveloped. The objective of this paper is to report the application of a new approach for review of evidence in the public health sphere. The method enables a diverse range of evidence types to be synthesized in order to examine potential relationships between a public health environment and outcomes. The study drew on previous work by the National Institute for Health and Clinical Excellence on conceptual frameworks. It applied and further extended this work to the synthesis of evidence relating to one particular public health area: the enhancement of employee mental well-being in the workplace. The approach utilized thematic analysis techniques from primary research, together with conceptual modelling, to explore potential relationships between factors and outcomes. The method enabled a logic framework to be built from a diverse document set that illustrates how elements and associations between elements may impact on the well-being of employees. Whilst recognizing potential criticisms of the approach, it is suggested that logic models can be a useful way of examining the complexity of relationships between factors and outcomes in public health, and of highlighting potential areas for interventions and further research. The use of techniques from primary qualitative research may also be helpful in synthesizing diverse document types. Copyright 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

Science.gov (United States)

Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

2017-02-01

The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study.

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Somerville, Claire; Marteau, Theresa M; Kinmonth, Ann Louise; Cohn, Simon

2015-12-01

Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300,000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

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.

Incorporation of a health economic modelling tool into public health commissioning: Evidence use in a politicised context.

Science.gov (United States)

Sanders, Tom; Grove, Amy; Salway, Sarah; Hampshaw, Susan; Goyder, Elizabeth

2017-08-01

This paper explores how commissioners working in an English local government authority (LA) viewed a health economic decision tool for planning services in relation to diabetes. We conducted 15 interviews and 2 focus groups between July 2015 and February 2016, with commissioners (including public health managers, data analysts and council members). Two overlapping themes were identified explaining the obstacles and enablers of using such a tool in commissioning: a) evidence cultures, and b) system interdependency. The former highlighted the diverse evidence cultures present in the LA with politicians influenced by the 'soft' social care agendas affecting their local population and treating local opinion as evidence, whilst public health managers prioritised the scientific view of evidence informed by research. System interdependency further complicated the decision making process by recognizing interlinking with departments and other disease groups. To achieve legitimacy within the commissioning arena health economic modelling needs to function effectively in a highly politicised environment where decisions are made not only on the basis of research evidence, but on grounds of 'soft' data, personal opinion and intelligence. In this context decisions become politicised, with multiple opinions seeking a voice. The way that such decisions are negotiated and which ones establish authority is of importance. We analyse the data using Larson's (1990) discursive field concept to show how the tool becomes an object of research push and pull likely to be used instrumentally by stakeholders to advance specific agendas, not a means of informing complex decisions. In conclusion, LA decision making is underpinned by a transactional business ethic which is a further potential 'pull' mechanism for the incorporation of health economic modelling in local commissioning. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Just-in-Time Training of the Evidence-Based Public Health Framework, Oklahoma, 2016-2017.

Science.gov (United States)

Douglas, Malinda R; Lowry, Jon P; Morgan, Latricia A

2018-03-07

Training of practitioners on evidence-based public health has shown to be beneficial, yet overwhelming. Chunking information and proximate practical application are effective techniques to increase retention in adult learning. Evidence-based public health training for practitioners from African American and Hispanic/Latino community agencies and tribes/tribal nations incorporated these 2 techniques. The community-level practitioners alternated attending training and implementing the steps of the evidence-based public health framework as they planned state-funded programs. One year later, survey results showed that participants reported increased confidence in skills that were reinforced by practical and practiced application as compared with posttraining survey results. In addition, at 1 year, reported confidence in skills that were not fortified by proximate application decreased when compared with posttraining confidence levels. All 7 community programs successfully created individualized evidence-based action plans that included evidence-based practices and policies across socioecological levels that fit with the unique culture and climate of their own community.

What evidence and support do state-level public health practitioners need to address obesity prevention.

Science.gov (United States)

Leeman, Jennifer; Teal, Randall; Jernigan, Jan; Reed, Jenica Huddleston; Farris, Rosanne; Ammerman, Alice

2014-01-01

Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. APPROACH OR DESIGN: Mixed-methods, cross-sectional interviews, and survey. State-level public health obesity prevention programs. Public health practitioners and CDC project officers. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

Danish nationwide registers for public health and health-related research

DEFF Research Database (Denmark)

Erlangsen, Annette; Fedyszyn, Izabela

2015-01-01

AIMS: The Nordic countries have a strong tradition of using nationwide social and health registers for research purposes. The aim of the current paper is to provide an overview of the Danish population-based registers in public health and health-related research, and to discuss their strengths...... and limitations. METHODS: Danish registers on somatic and psychiatric hospital contacts as well as care provided by general practitioners were reviewed. The availability of demographic, individual-level variables of relevance for health-related research was summarized. RESULTS: Since 1968, every person living...... of prescribed medications, and a complete follow-up with respect to causes of death support public health studies surveying trends of prevalence and incidence. Historical data on psychiatric and somatic hospitalizations since 1969 and 1977, respectively, allow an in-depth assessment of the burden of disease...

Periodontal health and global public health

DEFF Research Database (Denmark)

Petersen, Poul E; Baehni, Pierre C

2012-01-01

Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing...... to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal....../oral hygiene, are important and these principal risk factors for periodontal disease are shared by other chronic diseases. The present monograph is devoted to the existing evidence on the practice of public health related to periodontal health. Public health is defined as the process of mobilizing and engaging...

Pandemic H1N1 in Canada and the use of evidence in developing public health policies--a policy analysis.

Science.gov (United States)

Rosella, Laura C; Wilson, Kumanan; Crowcroft, Natasha S; Chu, Anna; Upshur, Ross; Willison, Donald; Deeks, Shelley L; Schwartz, Brian; Tustin, Jordan; Sider, Doug; Goel, Vivek

2013-04-01

When responding to a novel infectious disease outbreak, policies are set under time constraints and uncertainty which can limit the ability to control the outbreak and result in unintended consequences including lack of public confidence. The H1N1 pandemic highlighted challenges in public health decision-making during a public health emergency. Understanding this process to identify barriers and modifiable influences is important to improve the response to future emergencies. The purpose of this study is to examine the H1N1 pandemic decision-making process in Canada with an emphasis on the use of evidence for public health decisions. Using semi-structured key informant interviews conducted after the pandemic (July-November 2010) and a document analysis, we examined four highly debated pandemic policies: use of adjuvanted vaccine by pregnant women, vaccine priority groups and sequencing, school closures and personal protective equipment. Data were analysed for thematic content guided by Lomas' policy decision-making framework as well as indicative coding using iterative methods. We interviewed 40 public health officials and scientific advisors across Canada and reviewed 76 pandemic policy documents. Our analysis revealed that pandemic pre-planning resulted in strong beliefs, which defined the decision-making process. Existing ideological perspectives of evidence strongly influenced how information was used such that the same evidentiary sources were interpreted differently according to the ideological perspective. Participants recognized that current models for public health decision-making failed to make explicit the roles of scientific evidence in relation to contextual factors. Conflict avoidance theory explained policy decisions that went against the prevailing evidence. Clarification of roles and responsibilities within the public health system would reduce duplication and maintain credibility. A more transparent and iterative approach to incorporating evidence

Population mental health: evidence, policy, and public health practice

National Research Council Canada - National Science Library

Cohen, Neal L; Galea, Sandro

2011-01-01

... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

Peer relations, adolescent behavior, and public health research and practice.

Science.gov (United States)

Crosnoe, Robert; McNeely, Clea

2008-01-01

Peer relations are central to adolescent life and, therefore, are crucial to understanding adolescents' engagement in various behaviors. In recent years, public health research has increasingly devoted attention to the implications of peer relations for the kinds of adolescent behaviors that have a direct impact on health. This article advocates for a continuation of this trend. With this aim, we highlight key themes in the rich literature on the general developmental significance of adolescent-peer relations, provide an overview of how these themes have been incorporated into public health research and practice, and suggest future avenues for peer-focused public health research that can inform adolescent health promotion in the United States.

Evidence on the relation between public capital and Government efficiency

OpenAIRE

Francisca Guedes de Oliveira

2010-01-01

This paper intends to contribute to the literature by providing empirical evidence on the relation between public capital stock and government efficiency. We present some objective indicators fo government efficiency and explore the mentioned relation. we find a positive and significant relation between both variables that survives the introduction of controls and robustness checking.

Core public health functions for BC : evidence review : air quality-indoor

Energy Technology Data Exchange (ETDEWEB)

Copes, R.; Ouellette, V.; Lee, K.S.; Brauer, M. [British Columbia Ministry of Health, Victoria, BC (Canada)

2006-04-15

Indoor sources of pollutants can have a major impact on the health of Canadians, as pollutant concentrations are often higher indoors than outdoors. This paper assessed data compiled by public health indoor air interventions. The aim of the study was to identify the current state of evidence on the impacts of indoor pollution in order to develop performance improvement plans for public health programs in British Columbia (BC). The literature review used several databases to review interventions involving humidity control; ventilation; particulate matter; indoor allergens; and environmental tobacco smoke. Results of the review showed that improving inadequate ventilation can significantly decrease the prevalence of sick building syndrome as well as other self-reported symptoms attributed to indoor air pollution. A review of the literature also demonstrated that many building ventilation systems are not functioning to design specifications. The poor quality of studies on the health impacts of particulate matter or dust made it difficult to fully assess the benefits of particle filtration on human health. Studies investigating the impacts of controlling indoor allergens suggested that the avoidance of dust mites may benefit people with allergies. Evidence gained from studies on environmental tobacco smoke showed that banning or restricting smoking will reduce the burden of illness from pollutants in indoor air. 20 refs., 3 tabs.

Core public health functions for BC : evidence review : air quality-indoor

International Nuclear Information System (INIS)

Copes, R.; Ouellette, V.; Lee, K.S.; Brauer, M.

2006-04-01

Indoor sources of pollutants can have a major impact on the health of Canadians, as pollutant concentrations are often higher indoors than outdoors. This paper assessed data compiled by public health indoor air interventions. The aim of the study was to identify the current state of evidence on the impacts of indoor pollution in order to develop performance improvement plans for public health programs in British Columbia (BC). The literature review used several databases to review interventions involving humidity control; ventilation; particulate matter; indoor allergens; and environmental tobacco smoke. Results of the review showed that improving inadequate ventilation can significantly decrease the prevalence of sick building syndrome as well as other self-reported symptoms attributed to indoor air pollution. A review of the literature also demonstrated that many building ventilation systems are not functioning to design specifications. The poor quality of studies on the health impacts of particulate matter or dust made it difficult to fully assess the benefits of particle filtration on human health. Studies investigating the impacts of controlling indoor allergens suggested that the avoidance of dust mites may benefit people with allergies. Evidence gained from studies on environmental tobacco smoke showed that banning or restricting smoking will reduce the burden of illness from pollutants in indoor air. 20 refs., 3 tabs

Public health legal preparedness in Indian country.

Science.gov (United States)

Bryan, Ralph T; Schaefer, Rebecca McLaughlin; DeBruyn, Lemyra; Stier, Daniel D

2009-04-01

American Indian/Alaska Native tribal governments are sovereign entities with inherent authority to create laws and enact health regulations. Laws are an essential tool for ensuring effective public health responses to emerging threats. To analyze how tribal laws support public health practice in tribal communities, we reviewed tribal legal documentation available through online databases and talked with subject-matter experts in tribal public health law. Of the 70 tribal codes we found, 14 (20%) had no clearly identifiable public health provisions. The public health-related statutes within the remaining codes were rarely well integrated or comprehensive. Our findings provide an evidence base to help tribal leaders strengthen public health legal foundations in tribal communities.

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

Directory of Open Access Journals (Sweden)

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

Law and Politics, an Emerging Epidemic: A Call for Evidence-Based Public Health Law.

Science.gov (United States)

Ulrich, Michael R

2016-05-01

As Jacobson v. Massachusetts recognized in 1905, the basis of public health law, and its ability to limit constitutional rights, is the use of scientific data and empirical evidence. Far too often, this important fact is lost. Fear, misinformation, and politics frequently take center stage and drive the implementation of public health law. In the recent Ebola scare, political leaders passed unnecessary and unconstitutional quarantine measures that defied scientific understanding of the disease and caused many to have their rights needlessly constrained. Looking at HIV criminalization and exemptions to childhood vaccine requirements, it becomes clear that the blame cannot be placed on the hysteria that accompanies emergencies. Indeed, these examples merely illustrate an unfortunate array of examples where empirical evidence is ignored in the hopes of quelling paranoia. These policy approaches are not only constitutionally questionable, they generate their own risk to public health. The ability of the law to jeopardize public health approaches to infectious disease control can, and should, be limited through a renewed emphasis on science as the foundation of public health, coordination through all levels and branches of government, and through a serious commitment by the judiciary to provide oversight. Infectious disease creates public anxiety, but this cannot justify unwarranted dogmatic approaches as a response. If we as a society hope to ensure efficient, constitutional control over the spread of disease, it is imperative that science take its rightful place at the forefront of governmental decision-making and judicial review. Otherwise, the law becomes its own public health threat.

Organizational Supports for Research Evidence Use in State Public Health Agencies: A Latent Class Analysis.

Science.gov (United States)

Hu, Hengrui; Allen, Peg; Yan, Yan; Reis, Rodrigo S; Jacob, Rebekah R; Brownson, Ross C

2018-05-30

Use of research evidence in public health decision making can be affected by organizational supports. Study objectives are to identify patterns of organizational supports and explore associations with research evidence use for job tasks among public health practitioners. In this longitudinal study, we used latent class analysis to identify organizational support patterns, followed by mixed logistic regression analysis to quantify associations with research evidence use. The setting included 12 state public health department chronic disease prevention units and their external partnering organizations involved in chronic disease prevention. Chronic disease prevention staff from 12 US state public health departments and partnering organizations completed self-report surveys at 2 time points, in 2014 and 2016 (N = 872). Latent class analysis was employed to identify subgroups of survey participants with distinct patterns of perceived organizational supports. Two classify-analyze approaches (maximum probability assignment and multiple pseudo-class draws) were used in 2017 to investigate the association between latent class membership and research evidence use. The optimal model identified 4 latent classes, labeled as "unsupportive workplace," "low agency leadership support," "high agency leadership support," and "supportive workplace." With maximum probability assignment, participants in "high agency leadership support" (odds ratio = 2.08; 95% CI, 1.35-3.23) and "supportive workplace" (odds ratio = 1.74; 95% CI, 1.10-2.74) were more likely to use research evidence in job tasks than "unsupportive workplace." The multiple pseudo-class draws produced comparable results with odds ratio = 2.09 (95% CI, 1.31-3.30) for "high agency leadership support" and odds ratio = 1.74 (95% CI, 1.07-2.82) for "supportive workplace." Findings suggest that leadership support may be a crucial element of organizational supports to encourage research evidence use. Organizational supports such

Pedagogical Scholarship in Public Health: A Call for Cultivating Learning Communities to Support Evidence-Based Education.

Science.gov (United States)

Merzel, Cheryl; Halkitis, Perry; Healton, Cheryl

Public health education is experiencing record growth and transformation. The current emphasis on learning outcomes necessitates attention to creating and evaluating the best curricula and learning methods for helping public health students develop public health competencies. Schools and programs of public health would benefit from active engagement in pedagogical research and additional platforms to support dissemination and implementation of educational research findings. We reviewed current avenues for sharing public health educational research, curricula, and best teaching practices; we identified useful models from other health professions; and we offered suggestions for how the field of public health education can develop communities of learning devoted to supporting pedagogy. Our goal was to help advance an agenda of innovative evidence-based public health education, enabling schools and programs of public health to evaluate and measure success in meeting the current and future needs of the public health profession.

'Only connect': the case for public health humanities.

Science.gov (United States)

Saffran, Lise

2014-12-01

Humanities in health has until now been primarily understood to mean humanities in medicine and has generally failed to include public health. I will argue in this paper that the common justifications for the former--including increased empathy among practitioners--are at least as applicable, if not more, to the latter. Growing emphasis on the social determinants of health and cultural competency in public health require public health students and professionals to develop a nuanced understanding of the influence of social context on health behaviour and to empathise with people in difficult circumstances. Literary fiction has been demonstrated to have an impact on skills related to empathy and social intelligence. Further, translating epidemiological evidence into public policy is a core task of public health and there is a growing body of research to indicate that statistical evidence is more persuasive when combined with narrative evidence. In this article I explore similarities and differences between proposed humanities in public health and programmes in humanities in medicine and highlight research gaps and possible implications of a more expansive view of humanities in health. 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.

The linkage between work-related factors, employee satisfaction and organisational commitment: Insights from public health professionals

Directory of Open Access Journals (Sweden)

Chengedzai Mafini

2014-08-01

Full Text Available Orientation: The public health sector in South Africa faces a number of human resource– related inundations. Solving these challenges requires the provision of empirically derived information on these matters. Research purpose: This study investigated the relationship between three work-related factors, person-environment fit, work-family balance and perceived job security, and employee satisfaction and organisational commitment. A conceptual framework that links these factors is proposed and tested. Motivation for the study: The prevalence of employee-related challenges involving public health professionals, as evidenced through industrial action and high labour turnover, amongst others, demands further research in order to generate appropriate solutions. Research approach, design and method: A quantitative design using the survey approach was adopted. A six-section questionnaire was administered to a stratified sample of 287 professionals in three public health institutions in Gauteng, South Africa. Data was analysed using descriptive statistics, exploratory factor analysis, Pearson’s correlation analysis and regression analysis. Main findings: Job security and person-environment fit both positively correlated with and predicted employee satisfaction. The association between work-family balance and employee satisfaction was weak and showed no significant predictive validity. Employee satisfaction was strongly correlated to and predicted organisational commitment. Practical/managerial implications: The findings of the current study may be used by managers in public health institutions to improve the level of organisational commitment amongst professionals in the sector, thus preventing further employee-related challenges that negatively affect the provision of outstanding public health services. Contribution: The study provides current evidence on how both work-related and humanrelated factors could contribute to the prosperity of the

Political and institutional influences on the use of evidence in public health policy. A systematic review.

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Liverani, Marco; Hawkins, Benjamin; Parkhurst, Justin O

2013-01-01

There is increasing recognition that the development of evidence-informed health policy is not only a technical problem of knowledge exchange or translation, but also a political challenge. Yet, while political scientists have long considered the nature of political systems, the role of institutional structures, and the political contestation of policy issues as central to understanding policy decisions, these issues remain largely unexplored by scholars of evidence-informed policy making. We conducted a systematic review of empirical studies that examined the influence of key features of political systems and institutional mechanisms on evidence use, and contextual factors that may contribute to the politicisation of health evidence. Eligible studies were identified through searches of seven health and social sciences databases, websites of relevant organisations, the British Library database, and manual searches of academic journals. Relevant findings were extracted using a uniform data extraction tool and synthesised by narrative review. 56 studies were selected for inclusion. Relevant political and institutional aspects affecting the use of health evidence included the level of state centralisation and democratisation, the influence of external donors and organisations, the organisation and function of bureaucracies, and the framing of evidence in relation to social norms and values. However, our understanding of such influences remains piecemeal given the limited number of empirical analyses on this subject, the paucity of comparative works, and the limited consideration of political and institutional theory in these studies. This review highlights the need for a more explicit engagement with the political and institutional factors affecting the use of health evidence in decision-making. A more nuanced understanding of evidence use in health policy making requires both additional empirical studies of evidence use, and an engagement with theories and approaches

Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

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Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

2017-09-01

communication barriers experienced by public health and health care personnel. Forty-eight studies provided evidence on how to create and sustain preparedness systems. Results included how to build social capital across organizations and citizens and how to develop sustainable and useful planning efforts that maintain flexibility and rely on available medical data. Twenty-six studies provided evidence on the usefulness of measurement efforts, such as community and organizational needs assessments, and new methods to learn from the response to critical incidents. In the United States, the field of public health emergency preparedness system research has been supported by the US Centers for Disease Control and Prevention since the release of the 2008 Institute of Medicine letter report. The first definition of public health emergency preparedness appeared in 2007, and before 2008 there was a lack of research and empirical evidence across all 4 research areas identified by the Institute of Medicine. This field can be considered relatively new compared with other research areas in public health; for example, tobacco control research can rely on more than 70 years of knowledge production. However, this review demonstrates that, during the past 7 years, public health emergency preparedness system research has evolved from generic inquiry to the analysis of specific interventions with more empirical studies. Public Health Implications: The results of this review provide an evidence base for public health practitioners responsible for enhancing key components of preparedness and response such as communication, training, and planning efforts.

Working for the public health: politics, localism and epistemologies of practice.

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Phillips, Gemma; Green, Judith

2015-05-01

The recent move of public health back to English local government has reignited debates about the role of a medicalised public health profession. The explicit policy rationale for the move was that local government is the arena in which the social determinants of health can be addressed, and that public health specialists could provide neutral evidence to support action on these. However, if a discourse of 'evidence-based' policy is in principle (if not practice) relatively unproblematic within the health arena, within the more overtly politicised local government space, rather different policy imperatives come to the fore. Responding to calls for research on evidence in practice, this article draws on ethnographic data of local authorities in the first year of the reorganised public health function. Focusing on alcohol policy, we explore how decisions that affect public health are rationalised and enacted through discourses of localism, empiricism and holism. These frame policy outcomes as inevitably plural and contingent: a framing which sits uneasily with normative discourses of evidence-based policy. We argue that locating public health in local government necessitates a refocusing of how evidence for public health is conceptualised, to incorporate multiple, and political, understandings of health and wellbeing. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

[Evidence-based medicine and public health law: statutory health insurance].

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Dreher, Wolfgang

2004-09-01

Beyond all differences in terminology and legal principles between the laws governing private health insurance, the governmental financial support for civil, servants and statutory health insurance the fundamental issues to be solved by the courts in case of litigation are quite similar. But only a part of these refer to the quality of medical services, which is the main concern of Evidence-based Medicine (EbM); EbM, though, is not able to contribute towards answering the equally important question of how to distinguish between "treatment" and "(health-relevant) lifestyle". The respective definitions that have been developed in the particular fields of law are only seemingly divergent from each other and basically unsuitable to aid the physician in his clinical decision-making because the common blanket clauses of public health law are regularly interpreted as rules for the exclusion of certain claims and not as a confirmatory paraphrase of what is clinically necessary. If on the other hand medical quality is what lies at the core of litigation, reference to EbM may become necessary. In fact, it is already common practice in the statutory health insurance system that decision-making processes in the Federal Committee being responsible for quality assurance (Bundesausschuss) are based on EbM principles and that in exceptional cases only the courts have to medically review the Federal Committee's decisions.

Public health medicine: the constant dilemma.

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Eskin, Frada

2002-03-01

There is a well-known quotation by the nineteenth-century sociologist Virchow (quoted in Ref. 1) that aptly captures the dilemma that has confronted public health medicine since the specialty was created as a discrete entity in 1848. Virchow said: 'Medicine is politics and social medicine is politics writ large!' What does this mean in relation to effective public health medicine practice and how is it likely to affect its future? There is increasingly limited freedom of expression within the current context of political correctness, central control and a rapidly burgeoning litigious climate. The purpose of this paper is to explore these issues and to propose a means of maintaining public health medicine integrity within a working environment where action is becoming rapidly constrained by political rigidity. An additional factor to be included in the dialogue is the current context within which public health physicians work. Because the majority of public health doctors are employed within the National Health Service (NHS), they are finding themselves being expected to take on tasks and responsibilities marginal to their essential purpose and function. For example, public health physicians spend a great deal of time involved in detailed deliberations about health service provision. Although there is a great deal of evidence to show that good quality health care provision positively affects the health of the individual, there is no evidence to show that this activity has any effect on the population's health status. The essence of public health medicine practice is the prevention of ill-health and the promotion of the health of the population and, consequently, attention needs to be focused on the root causes of disease. However, as these are outside the aegis of the NHS, public health medicine involvement in such issues as education, nutrition, housing, transport and poverty is regarded as marginal to the NHS corporate agenda.

Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research.

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Brownson, Ross C; Fielding, Jonathan E; Green, Lawrence W

2018-04-01

Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and its application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan, deliver, and evaluate the preventive dose of an evidence-based intervention) to move science to practice. We review principles of EBPH, the importance of capacity building to advance evidence-based approaches, promising approaches for capacity building, and future areas for research and practice. Although there is general agreement among practitioners and scientists on the importance of EBPH, there is less clarity on the definition of evidence, how to find it, and how, when, and where to use it. Capacity for EBPH is needed among both individuals and organizations. Capacity can be strengthened via training, use of tools, technical assistance, assessment and feedback, peer networking, and incentives. Modest investments in EBPH capacity building will foster more effective public health practice.

Geographic information systems (GIS) for Health Promotion and Public Health: a review.

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Nykiforuk, Candace I J; Flaman, Laura M

2011-01-01

The purpose of this literature review is to identify how geographic information system (GIS) applications have been used in health-related research and to critically examine the issues, strengths, and challenges inherent to those approaches from the lenses of health promotion and public health. Through the review process, conducted in 2007, it is evident that health promotion and public health applications of GIS can be generally categorized into four predominant themes: disease surveillance (n = 227), risk analysis (n = 189), health access and planning (n = 138), and community health profiling (n = 115). This review explores how GIS approaches have been used to inform decision making and discusses the extent to which GIS can be applied to address health promotion and public health questions. The contribution of this literature review will be to generate a broader understanding of how GIS-related methodological techniques and tools developed in other disciplines can be meaningfully applied to applications in public health policy, promotion, and practice.

Health-related behaviour among managers of Slovenian hospitals and institutes of public health

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Jerneja Farkas

2015-12-01

Full Text Available Aim: Behavioural risk factors have a significant impact on health. We aimed to assess health-related behaviour, health status, and use of healthcare services among managers of Slovenian hospitals and institutes of public health. Methods: This was a cross-sectional study which included management (directors, scientific directors, directors’ deputies of Slovenian hospitals and institutes of public health (63 respondents; 57% women; overall mean age: 51±7 years; response rate: 74%. Data were obtained using an anonymous self-administered questionnaire. Results: About 35% of respondents were directors. More than half of the respondents were overweight or obese (52%, the majority were not sufficiently physically active (59% and overloaded with stress (87%. Hypercholesterolemia (36%, spinal disease (17%, and arterial hypertension (16% were most common chronic diseases. Whilst only few participants visited their general practitioner due their health complaints, blood pressure (76%, cholesterol (51%, and glucose (54% were measured within last year in most of the respondents. Conclusion: Our findings point to a high prevalence of overweight and obesity as well as workplace-related stress among Slovenian public health managers. Therefore, effective preventive strategies should be focused on stress management along with promotion of healthy behavioural patterns.

Variations of the social: some reflections on public health, social research and the health-society relation

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Patricio Rojas

2015-06-01

Full Text Available The idea of a social dimension of health is widely accepted as unavoidable and relevant for public health. This article proposes a reflection around the notion of the social examining some of the manifold ways in which it might be inherited by researchers, professionals, administrative staff and material settings involved in the practices of public health care. It will be argued that this inheritance has deep consequences for efforts of care inasmuch these different versions of the social characterise, circumscribe and reframe the health-society relation, modifying the scope under which public health issues are tackled or dismissed. To ground this seemingly abstract discussion I will work considering a specific public health problem: the case of frequent attenders in public health. Drawing on two approaches from the Sociology of Health (i.e. illness-behaviour and the user-professional relation and the field of Science and Technology Studies, I will show how these ways of framing the study of frequent attenders assume and simultaneously promote three different versions of the social. The article aims to explore how social research in these traditions participate in the achievement and promotion of specific health-society relations, in which certain notions of the social operate helping or limiting research and care efforts by creating richer or poorer possibilities for posing, examining and facing the problems of public health.

Health-related quality of life of employees of a public university

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María Olga Quintana Zavala

2016-06-01

Full Text Available Introduction: Health-related quality of life is the level of perception that people having of their subjective well-being, considering their health, with measures of physical and mental well-being. Aim: to determine the level of health-related quality of life of employees of a public university of Hermosillo, Mexico. Methodology: quantitative study, transversal and comparative. The sample consisted of 62 participants. Data collection instrument: Questionnaire of biosociodemographic variables and work, and SF 36. The IBM SPSS version 22 was used for the statistical analysis. The U Mann-Whitney test was used to compare two groups, and Spearman correlation was utilized to explore correlations between variables. The significance level admitted was 0.05. We had the support of the University Ethics Committee and an informed consent was elaborated. Results: 51.6% were men, mean age and age were 45.5 (SD = 10.3 and 17.2 (SD = 9.4 respectively, 40.3% perform administrative activities, 75.8% consumed tobacco. The dimension physical role was the best evaluated with an average of 96.8 (SD = 17.8 and general health was the one that had the lowest average with 73.4 (SD = 14.2, tobacco consumption and physical role are related (p = 0.0210, physical function (p = 0.0261 and social function (p = 0.0466 showed differences by sex. Conclusion: most of the dimensions of the health-related quality of life of employees are within the parameters of normality. However, the need for an intervention from the employees’ health services is evident, here the health team may contribute to increasing aspects of occupational health.

Framework for selecting best practices in public health: a systematic literature review

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Eileen Ng

2015-11-01

Full Text Available Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions.

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.

Diffusion theory and knowledge dissemination, utilization, and integration in public health.

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Green, Lawrence W; Ottoson, Judith M; García, César; Hiatt, Robert A

2009-01-01

Legislators and their scientific beneficiaries express growing concerns that the fruits of their investment in health research are not reaching the public, policy makers, and practitioners with evidence-based practices. Practitioners and the public lament the lack of relevance and fit of evidence that reaches them and barriers to their implementation of it. Much has been written about this gap in medicine, much less in public health. We review the concepts that have guided or misguided public health in their attempts to bridge science and practice through dissemination and implementation. Beginning with diffusion theory, which inspired much of public health's work on dissemination, we compare diffusion, dissemination, and implementation with related notions that have served other fields in bridging science and practice. Finally, we suggest ways to blend diffusion with other theory and evidence in guiding a more decentralized approach to dissemination and implementation in public health, including changes in the ways we produce the science itself.

Reframing climate change as a public health issue: an exploratory study of public reactions.

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Maibach, Edward W; Nisbet, Matthew; Baldwin, Paula; Akerlof, Karen; Diao, Guoqing

2010-06-01

Climate change is taking a toll on human health, and some leaders in the public health community have urged their colleagues to give voice to its health implications. Previous research has shown that Americans are only dimly aware of the health implications of climate change, yet the literature on issue framing suggests that providing a novel frame--such as human health--may be potentially useful in enhancing public engagement. We conducted an exploratory study in the United States of people's reactions to a public health-framed short essay on climate change. U.S. adult respondents (n = 70), stratified by six previously identified audience segments, read the essay and were asked to highlight in green or pink any portions of the essay they found "especially clear and helpful" or alternatively "especially confusing or unhelpful." Two dependent measures were created: a composite sentence-specific score based on reactions to all 18 sentences in the essay; and respondents' general reactions to the essay that were coded for valence (positive, neutral, or negative). We tested the hypothesis that five of the six audience segments would respond positively to the essay on both dependent measures. There was clear evidence that two of the five segments responded positively to the public health essay, and mixed evidence that two other responded positively. There was limited evidence that the fifth segment responded positively. Post-hoc analysis showed that five of the six segments responded more positively to information about the health benefits associated with mitigation-related policy actions than to information about the health risks of climate change. Presentations about climate change that encourage people to consider its human health relevance appear likely to provide many Americans with a useful and engaging new frame of reference. Information about the potential health benefits of specific mitigation-related policy actions appears to be particularly compelling. We

Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study.

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Brown, V; Moodie, M; Cobiac, L; Mantilla Herrera, A M; Carter, R

2017-05-04

Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis. Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under "best case" assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2�

Developing an evidence-based public health informatics course.

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Yu, Xinyu; Xie, Yue; Pan, Xuequn; Mayfield-Johnson, Susan; Whipple, Jessica; Azadbakht, Elena

2015-10-01

This study assessed the need to develop a public health informatics (PHI) introductory course and determine contents of such a course. Community assessments employing focus group interviews and an online survey were utilized to determine course need and content. Results revealed a need to provide PHI training to graduate public health students and suggested broad course content requirements. Results indicated lack of awareness of libraries and librarians as sources of public health information. A graduate PHI course was developed and delivered. Additionally, implementation of a subject guide increased the library's profile.

[Glocalization: the outlook for Taiwan evidence based health care].

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Chen, Chiehfeng

2014-12-01

Public attention to evidence-based health care (EBHC) has increased significantly in recent years. Key problems related to applying EBHC in current healthcare practice include the timely update of up-to-date knowledge and skills and the methodology used to implement EBHC in clinical settings. EBHC has been introduced to the Taiwan healthcare system for the past two decades. The annual EBM (Evidence based medicine) National Competition is a unique and important EBHC activity in Taiwan. EBHC has been promoted widely in medicine, nursing, pharmacy, public health and other professions, and EBHC-related organizations such as the Taiwan Evidence Based Medicine Association (TEBMA), and Taiwan Evidence Based Nursing Association (TEBNA), have increased in number and grown in membership. In addition to domestic developments, Taiwan is also actively involved in global organizations, such as the Cochrane Collaboration, East Asian Cochrane Alliance (EACA), and the International Society for Evidence Based Health Care (ISEHC). In Taiwan, most medical professionals work cooperatively to promote EBHC, which facilitates the gradual improvement of healthcare quality.

Realigning government action with public health evidence: the legal and policy environment affecting sex work and HIV in Asia.

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Gruskin, Sofia; Pierce, Gretchen Williams; Ferguson, Laura

2014-01-01

The HIV epidemic has shed light on how government regulation of sex work directly affects the health and well-being of sex workers, their families and communities. A review of the public health evidence highlights the need for supportive legal and policy environments, yet criminalisation of sex work remains standard around the world. Emerging evidence, coupled with evolving political ideologies, is increasingly shaping legal environments that promote the rights and health of sex workers but even as new legislation is created, contradictions often exist with standing problematic legislation. As a region, Asia provides a compelling example in that progressive HIV policies often sit side by side with laws that criminalise sex work. Data from the 21 Asian countries reporting under the UN General Assembly Special Session on HIV in 2010 were analysed to provide evidence of how countries' approach to sex-work regulation might affect HIV-related outcomes. Attention to the links between law and HIV-related outcomes can aid governments to meet their international obligations and ensure appropriate legal environments that cultivate the safe and healthy development and expression of sexuality, ensure access to HIV and other related services and promote and protect human rights.

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

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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.

Framework for Selecting Best Practices in Public Health: A Systematic Literature Review.

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Ng, Eileen; de Colombani, Pierpaolo

2015-11-17

Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions. Significance for public healthBest practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite the

Public policy and the social determinants of health: the challenge of the production and use of scientific evidence

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Alberto Pellegrini Filho

2011-01-01

Full Text Available This article serves as an introduction to the others published in this thematic issue of the Cadernos de Saúde Pública. The author makes a brief historical review of the concepts, approaches and methodologies used to study the relationships between social determinants and health outcomes. By analyzing the current global movement around social determinants of health he emphasizes that the distinctive feature of this movement is the explicit commitment to action through intersectoral public policies that are based on evidence and implemented with the support and participation of broad segments of society. As this special issue of the Cadernos de Saúde Pública is dedicated to presenting the results of research related to social determinants of health, the author focuses on an analysis of the difficulties in the production and use of scientific evidence that supports the definition, implementation and evaluation of policies to combat health inequities through action on social determinants of health. To conclude, he presents some recommendations for overcoming these difficulties.

Education Improves Public Health and Promotes Health Equity.

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Hahn, Robert A; Truman, Benedict I

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. © The Author(s) 2015.

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.

Improving Schools, Improving School Health Education, Improving Public Health: The Role of SOPHE Members

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Birch, David A.

2017-01-01

The reciprocal relationship between health and education has garnered increased attention among public health professionals. The evidence is clear that the level of an individual's education is related to health outcomes in adulthood and that healthier children are more likely to be academically successful than those with health issues. Unpacking…

Reframing climate change as a public health issue: an exploratory study of public reactions

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Baldwin Paula

2010-06-01

Full Text Available Abstract Background Climate change is taking a toll on human health, and some leaders in the public health community have urged their colleagues to give voice to its health implications. Previous research has shown that Americans are only dimly aware of the health implications of climate change, yet the literature on issue framing suggests that providing a novel frame - such as human health - may be potentially useful in enhancing public engagement. We conducted an exploratory study in the United States of people's reactions to a public health-framed short essay on climate change. Methods U.S. adult respondents (n = 70, stratified by six previously identified audience segments, read the essay and were asked to highlight in green or pink any portions of the essay they found "especially clear and helpful" or alternatively "especially confusing or unhelpful." Two dependent measures were created: a composite sentence-specific score based on reactions to all 18 sentences in the essay; and respondents' general reactions to the essay that were coded for valence (positive, neutral, or negative. We tested the hypothesis that five of the six audience segments would respond positively to the essay on both dependent measures. Results There was clear evidence that two of the five segments responded positively to the public health essay, and mixed evidence that two other responded positively. There was limited evidence that the fifth segment responded positively. Post-hoc analysis showed that five of the six segments responded more positively to information about the health benefits associated with mitigation-related policy actions than to information about the health risks of climate change. Conclusions Presentations about climate change that encourage people to consider its human health relevance appear likely to provide many Americans with a useful and engaging new frame of reference. Information about the potential health benefits of specific mitigation-related

Cannabis vaping and public health--some comments on relevance and implications.

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Fischer, Benedikt; Russell, Cayley; Tyndall, Mark W

2015-11-01

Cannabis-vaping entails relevant but probably varied effects for public health: it may reduce certain cannabis use-related health risks, but entice cannabis-naive individuals into use due to "cleaner" imagery. Improved evidence is needed to guide informed and differentiated policies for cannabis-vaping, which emphasizes the urgent need for public health-based cannabis regulation.

Implementing multiple intervention strategies in Dutch public health-related policy networks.

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Harting, Janneke; Peters, Dorothee; Grêaux, Kimberly; van Assema, Patricia; Verweij, Stefan; Stronks, Karien; Klijn, Erik-Hans

2017-10-13

Improving public health requires multiple intervention strategies. Implementing such an intervention mix is supposed to require a multisectoral policy network. As evidence to support this assumption is scarce, we examined under which conditions public health-related policy networks were able to implement an intervention mix. Data were collected (2009-14) from 29 Dutch public health policy networks. Surveys were used to identify the number of policy sectors, participation of actors, level of trust, networking by the project leader, and intervention strategies implemented. Conditions sufficient for an intervention mix (≥3 of 4 non-educational strategies present) were determined in a fuzzy-set qualitative comparative analysis. A multisectoral policy network (≥7 of 14 sectors present) was neither a necessary nor a sufficient condition. In multisectoral networks, additionally required was either the active participation of network actors (≥50% actively involved) or active networking by the project leader (≥monthly contacts with network actors). In policy networks that included few sectors, a high level of trust (positive perceptions of each other's intentions) was needed-in the absence though of any of the other conditions. If the network actors were also actively involved, an extra requirement was active networking by the project leader. We conclude that the multisectoral composition of policy networks can contribute to the implementation of a variety of intervention strategies, but not without additional efforts. However, policy networks that include only few sectors are also able to implement an intervention mix. Here, trust seems to be the most important condition. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study

Directory of Open Access Journals (Sweden)

V. Brown

2017-05-01

Full Text Available Abstract Background Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. Methods A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs were reported and results were tested through sensitivity analysis. Results Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings, measured against a comparator of no additional increase in fuel excise. Under “best case” assumptions, the intervention

Application of scientific criteria to food allergens of public health importance.

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Chung, Y J; Ronsmans, S; Crevel, R W R; Houben, G F; Rona, R J; Ward, R; Baka, A

2012-11-01

Scientific criteria for identifying allergenic foods of public health importance (Björkstén, B., Crevel, R., Hischenhuber, C., Løvik, M., Samuels, F., Strobel, S., Taylor, S.L., Wal, J.-M., Ward, R., 2008. Criteria for identifying allergenic foods of public health importance. Regulatory Toxicology and Pharmacology 51(1), 42-52) have been further refined to incorporate an assessment of the strength of available scientific evidence (van Bilsen, J.H., Ronsmans, S., Crevel, R.W., Rona, R.J., Przyrembel, H., Penninks, A.H., Contor, L., Houben, G.F., 2011. Evaluation of scientific criteria for identifying allergenic food of public health importance. Regulatory Toxicology and Pharmacology 60, 281-289). A multi-disciplinary group was invited to critically test the refined approach. They independently evaluated selected publications on coconut, soy and/or peanut allergy, scored them using the newly developed level of evidence criteria, and debated proposed approaches for combining and utilising the scores to measure the overall impact of an allergen in public health impact assessments. The evaluation of selected publications using the modified criteria produced a relatively consistent result across the experts. These refined criteria were judged to be a way forward for the identification of allergenic foods of public health importance, and for prioritisation of allergen risk management and future data gathering. The debate to combine available evidence when assessing whether an allergenic food is of sufficient public health importance to warrant active management led to proposals on how to weight and combine evidence on allergen severity, potency and prevalence. The refined criteria facilitate a debate to find a meaningful sequence of steps to summarise the available information in relation to a food allergen. Copyright © 2012 ILSI Europe. Published by Elsevier Inc. All rights reserved.

Implications for public health of the religiosity-longevity relation

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Marcelo Saad

Full Text Available Summary A growing body of scientific studies has demonstrated a consistently positive association between religious-spiritual (R/S involvement and beneficial effects on physical health, culminating with increased longevity. This protective effect on the mortality risk is not only statistically significant but also clinically relevant. The mechanisms involved in this association include psycho-neuro-endocrine-immune pathways, greater adherence to healthy behaviors and diverse social factors. Public health strategies could better explore this association. This can be done on an individual (health professionals adopting simple measures or institutional scale (health institutions joining religious organizations. Some evidence suggests that the benefits of R/S to health and longevity would be more present in populations from more religious regions. In this sense, the Americas (Latin and North are privileged places for the exploration of this association, compared to regions where there is certain indifference about R/S practices. Exploring this interface can improve the supply and usage of health care, especially for marginalized populations. To achieve this, health professionals, religious leaders and policy makers need to work together.

Marijuana Legalization: Impact on Physicians and Public Health.

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Wilkinson, Samuel T; Yarnell, Stephanie; Radhakrishnan, Rajiv; Ball, Samuel A; D'Souza, Deepak Cyril

2016-01-01

Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health.

Patterns in PARTNERing across Public Health Collaboratives

Science.gov (United States)

Bevc, Christine A.; Retrum, Jessica H.; Varda, Danielle M.

2015-01-01

Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162), to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships. PMID:26445053

Patterns in PARTNERing across Public Health Collaboratives.

Science.gov (United States)

Bevc, Christine A; Retrum, Jessica H; Varda, Danielle M

2015-10-05

Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162), to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG) models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.

Patterns in PARTNERing across Public Health Collaboratives

Directory of Open Access Journals (Sweden)

Christine A. Bevc

2015-10-01

Full Text Available Inter-organizational networks represent one of the most promising practice-based approaches in public health as a way to attain resources, share knowledge, and, in turn, improve population health outcomes. However, the interdependencies and effectiveness related to the structure, management, and costs of these networks represents a critical item to be addressed. The objective of this research is to identify and determine the extent to which potential partnering patterns influence the structure of collaborative networks. This study examines data collected by PARTNER, specifically public health networks (n = 162, to better understand the structured relationships and interactions among public health organizations and their partners, in relation to collaborative activities. Combined with descriptive analysis, we focus on the composition of public health collaboratives in a series of Exponential Random Graph (ERG models to examine the partnerships between different organization types to identify the attribute-based effects promoting the formation of network ties within and across collaboratives. We found high variation within and between these collaboratives including composition, diversity, and interactions. The findings of this research suggest common and frequent types of partnerships, as well as opportunities to develop new collaborations. The result of this analysis offer additional evidence to inform and strengthen public health practice partnerships.

Best practices for online Canadian prenatal health promotion: A public health approach.

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Chedid, Rebecca A; Terrell, Rowan M; Phillips, Karen P

2017-11-04

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women. Canadian government-hosted websites and online prenatal e-classes were evaluated to determine if accessible, inclusive, comprehensive and evidence-based prenatal health promotion was provided. Using a multijurisdictional approach, federal, provincial/territorial, municipal and public health region-hosted websites, along with affiliated prenatal e-classes, were evaluated based on four criteria: comprehensiveness, evidence-based information, accessibility and inclusivity. Online prenatal e-classes, federal, provincial/territorial and public health-hosted websites generally provided comprehensive and evidence-based promotion of essential prenatal topics, in contrast to municipal-hosted websites which provided very limited prenatal health information. Gaps in online prenatal health promotion were identified as lack of French and multilingual content, targeted information and representations of Indigenous peoples, immigrants and women with disabilities. Canadian online prenatal health promotion is broadly comprehensive and evidence-based, but fails to address the needs of non-Anglophones and represent the diverse population of Canadian pregnant women. It is recommended that agencies enhance the organisation of website pregnancy portals/pages and collaborate with other jurisdictions and community groups to ensure linguistically accessible, culturally-competent and inclusive

Linking public relations processes and organizational effectiveness at a state health department.

Science.gov (United States)

Wise, Kurt

2003-01-01

This qualitative case study explored a state health department's relationships with strategic constituencies from a public relations perspective. The relationships were explored within the theoretical framework of the Excellence Theory, the dominant paradigm in public research. Findings indicate application of the Excellence Theory has the potential to increase organizational effectiveness at public health entities. With respect to the case investigated, findings indicate that the state health department could increase its organizational effectiveness through the adoption of recommendations based on the Excellence Theory.

The Public Health Responsibility Deal: brokering a deal for public health, but on whose terms?

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Panjwani, Clare; Caraher, Martin

2014-02-01

Coalitions of multinational food and drink businesses have pledged to reformulate their products and to market them responsibly. Largely business-led and self-regulated, the integrity of these voluntary initiatives has been questioned. The Public Health Responsibility Deal in England is an example of a voluntary initiative that is government-led. Does this approach provide evidence that with public leadership there is potential for voluntary actions to deliver meaningful results for public health? The subject of the research is the calorie reduction initiative of the Responsibility Deal. Source material was obtained primarily through a series of UK Freedom of Information requests and comprises previously unpublished Department of Health documentation relating to relevant meetings held during 2011 and 2012. The Responsibility Deal approach to calorie reduction deliberately involves the food industry in the specification of the measures it is to implement (reformulation and portion control). Finding the common ground between private and public interests has resulted in the deflection of public health objectives and the preclusion of adequate monitoring and evaluation. The Responsibility Deal approach is fundamentally flawed in its expectation that industry will take voluntary actions that prioritise public health interests above its own. Being government-led counts for little in the absence of sanctions to drive compliance. Instead the initiative affords private interests the opportunity to influence in their favour the public health policies and strategies that affect their products. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Assessing the public health impact of using poison center data for public health surveillance.

Science.gov (United States)

Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua

2017-12-13

The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.

Making public health nutrition relevant to evidence-based action.

OpenAIRE

Brunner, E.; Rayner, M.; Thorogood, M.; Margetts, B.; Hooper, L.; Summerbell, C.D.; Dowler, E.; Hewitt, G.; Robertson, A.; Wiseman, M.

2001-01-01

Public health nutrition enjoyed many breakthroughs in the\\ud 20th century – from the discovery of vitamins and the\\ud metabolic roles of some 60 macro- and micronutrients, to\\ud the effects of maternal and childhood diet on health over\\ud the life course. Moreover, the food shortages in the UK that\\ud were experienced during World War II gave the first\\ud opportunity to show that nutritional science could make a\\ud valuable contribution to public policy. However, public\\ud health nutrition is...

Right Relation and Right Recognition in Public Health Ethics: Thinking Through the Republic of Health.

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Jennings, Bruce

2016-07-01

The further development of public health ethics will be assisted by a more direct engagement with political theory. In this way, the moral vocabulary of the liberal tradition should be supplemented-but not supplanted-by different conceptual and normative resources available from other traditions of political and social thought. This article discusses four lines of further development that the normative conceptual discourse of public health ethics might take. (i) The relational turn. The implications for public health ethics of the new 'ecological' or 'relational' interpretation that is emerging for concepts such as agency, self-identity, autonomy, liberty and justice. (ii) Governing the health commons. The framework of collective action problems is giving way to notions of democratic governance and management of common resources. (iii) The concept of membership. Membership is specified by the notions of equal respect and parity of voice and agency. (iv) The concept of mutuality. Mutuality is specified by the notions of interdependent concern and care.

Public Perception of Extreme Cold Weather-Related Health Risk in a Cold Area of Northeast China.

Science.gov (United States)

Ban, Jie; Lan, Li; Yang, Chao; Wang, Jian; Chen, Chen; Huang, Ganlin; Li, Tiantian

2017-08-01

A need exists for public health strategies regarding extreme weather disasters, which in recent years have become more frequent. This study aimed to understand the public's perception of extreme cold and its related health risks, which may provide detailed information for public health preparedness during an extreme cold weather event. To evaluate public perceptions of cold-related health risk and to identify vulnerable groups, we collected responses from 891 participants in a face-to-face survey in Harbin, China. Public perception was measured by calculating the score for each perception question. Locals perceived that extreme cold weather and related health risks were serious, but thought they could not avoid these risks. The significant difference in perceived acceptance level between age groups suggested that the elderly are a "high health risk, low risk perception" group, meaning that they are relatively more vulnerable owing to their high susceptibility and low awareness of the health risks associated with extreme cold weather. The elderly should be a priority in risk communication and health protective interventions. This study demonstrated that introducing risk perception into the public health field can identify vulnerable groups with greater needs, which may improve the decision-making of public health intervention strategies. (Disaster Med Public Health Preparedness. 2017;11:417-421).

Causal inference in public health.

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Glass, Thomas A; Goodman, Steven N; Hernán, Miguel A; Samet, Jonathan M

2013-01-01

Causal inference has a central role in public health; the determination that an association is causal indicates the possibility for intervention. We review and comment on the long-used guidelines for interpreting evidence as supporting a causal association and contrast them with the potential outcomes framework that encourages thinking in terms of causes that are interventions. We argue that in public health this framework is more suitable, providing an estimate of an action's consequences rather than the less precise notion of a risk factor's causal effect. A variety of modern statistical methods adopt this approach. When an intervention cannot be specified, causal relations can still exist, but how to intervene to change the outcome will be unclear. In application, the often-complex structure of causal processes needs to be acknowledged and appropriate data collected to study them. These newer approaches need to be brought to bear on the increasingly complex public health challenges of our globalized world.

The public health impact of smoking and smoking cessation

NARCIS (Netherlands)

Mulder, I.

2003-01-01

Despite the overwhelming evidence that smoking cessation reduces the risk for several chronic diseases, information on the magnitude of these public health benefits is scarce. It has furthermore been suggested that smoking cessation also improves health-related quality of life, but this has not been

The new frontier of public health education.

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Birnbaum, David; Gretsinger, Kathryn; Ellis, Ursula

2017-02-06

Purpose The aim of this paper is to describe the experience and educational benefits of a course that has several unique educational design features. Design/methodology/approach This includes narrative description of faculty and student experience from participants in a flipped-instructional-design inter-professional education course. Findings "Improving Public Health - An Interprofessional Approach to Designing and Implementing Effective Interventions" is an undergraduate public health course open to students regardless of background. Its student activities mirror the real-life tasks and challenges of working in a public health agency, including team-building and leadership; problem and project definition and prioritization; evidence-finding and critical appraisal; written and oral presentation; and press interviews. Students successfully developed project proposals to address real problems in a wide range of communities and settings and refined those proposals through interaction with professionals from population and public health, journalism and library sciences. Practical implications Undergraduate public health education is a relatively new endeavor, and experience with this new approach may be of value to other educators. Originality/value Students in this course, journalism graduate students who conducted mock interviews with them and instructors who oversaw the course all describe unique aspects and related personal benefit from this novel approach.

[Social capital as a determinant of public health].

Science.gov (United States)

Bravo Vallejos, N D

The concept of Social Capital (SC), originally described by Durkheim (1893), is composed of dimensions related to cohesion and trust between members of a social group, and considered by the Word Health Organization (WHO) as part of the social determinants of public health for the decrease of inequities and inequalities in health provision. To contribute to the dissemination of the concept of SC related to the social determinants of Public Health, in order to offer the reader in-depth content to observe the potential applications and practices in this field. Literature search (Google Academics™, PubMed, Science direct™, Ebsco Host™). A total of 294 full-text publications were obtained, and those selected were the most influential sources on the evolution and application of the concept of Social Capital, socioeconomic development and health in the last decade. Although the current evidence shows that Social Capital is a determinant related to health, standards are still needed for its measurement. This could allow the concept to be measured, and facilitate its integration into the form of actions that exert positive influence and contribute to the implementation of institutional interventions planned for development and public health. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Machismo, public health and sexuality-related stigma in Cartagena.

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Quevedo-Gómez, María Cristina; Krumeich, Anja; Abadía-Barrero, César Ernesto; Pastrana-Salcedo, Eduardo; van den Borne, Hubertus

2012-01-01

This paper reports on an ethnographic study in Cartagena, Colombia. Over a seven-month fieldwork period, 35 men and 35 women between 15 and 60 years of age discussed the social context of HIV/AIDS through in-depth interviews, life histories and drawing. Participants considered the transgression of traditional gender roles as prescribed by machismo a major risk factor for HIV infection. In addition, they integrated public-health concepts of risk groups with these long-standing constructions of gender roles and sexuality-related stigma to create the notion of 'AIDS carriers'. The bricolage between machismo, public health and sexuality-related stigma that participants created and consequent preventive measures (based on an avoidance of sex with people identified as 'AIDS carriers') was a dynamic process in which participants were aware that changes in this particular interpretation of risk were necessary to confront the local epidemic.

Florida Public Health Training Center: Evidence-Based Online Mentor Program

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Frahm, Kathryn A.; Alsac-Seitz, Biray; Mescia, Nadine; Brown, Lisa M.; Hyer, Kathy; Liburd, Desiree; Rogoff, David P.; Troutman, Adewale

2013-01-01

This article describes an Online Mentor Program (OMP) designed to support and facilitate mentorships among and between Florida Department of Health (FDOH) employees and USF College of Public Health students using a Web-based portal. The Florida Public Health Training Center (FPHTC) at the University of South Florida (USF) College of Public Health…

[Terrorism, public health and health services].

Science.gov (United States)

Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

2009-01-01

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

Social capital and health: implications for public health and epidemiology.

Science.gov (United States)

Lomas, J

1998-11-01

Public health and its "basic science", epidemiology, have become colonised by the individualistic ethic of medicine and economics. Despite a history in public health dating back to John Snow that underlined the importance of social systems for health, an imbalance has developed in the attention given to generating "social capital" compared to such things as modification of individual's risk factors. In an illustrative analysis comparing the potential of six progressively less individualised and more community-focused interventions to prevent deaths from heart disease, social support and measures to increase social cohesion faired well against more individual medical care approaches. In the face of such evidence public health professionals and epidemiologists have an ethical and strategic decision concerning the relative effort they give to increasing social cohesion in communities vs expanding access for individuals to traditional public health programs. Practitioners' relative efforts will be influenced by the kind of research that is being produced by epidemiologists and by the political climate of acceptability for voluntary individual "treatment" approaches vs universal policies to build "social capital". For epidemiologists to further our emerging understanding of the link between social capital and health they must confront issues in measurement, study design and analysis. For public health advocates to sensitise the political environment to the potential dividend from building social capital, they must confront the values that focus on individual-level causal models rather than models of social structure (dis)integration. The evolution of explanations for inequalities in health is used to illustrate the nature of the change in values.

Visualizing value for money in public health interventions.

Science.gov (United States)

Leigh-Hunt, Nicholas; Cooper, Duncan; Furber, Andrew; Bevan, Gwyn; Gray, Muir

2018-01-23

The Socio-Technical Allocation of Resources (STAR) has been developed for value for money analysis of health services through stakeholder workshops. This article reports on its application for prioritization of interventions within public health programmes. The STAR tool was used by identifying costs and service activity for interventions within commissioned public health programmes, with benefits estimated from the literature on economic evaluations in terms of costs per Quality-Adjusted Life Years (QALYs); consensus on how these QALY values applied to local services was obtained with local commissioners. Local cost-effectiveness estimates could be made for some interventions. Methodological issues arose from gaps in the evidence base for other interventions, inability to closely match some performance monitoring data with interventions, and disparate time horizons of published QALY data. Practical adjustment for these issues included using population prevalences and utility states where intervention specific evidence was lacking, and subdivision of large contracts into specific intervention costs using staffing ratios. The STAR approach proved useful in informing commissioning decisions and understanding the relative value of local public health interventions. Further work is needed to improve robustness of the process and develop a visualization tool for use by public health departments. © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Earth Science and Public Health: Proceedings of the Second National Conference on USGS Health-Related Research

Science.gov (United States)

Buxton, Herbert T.; Griffin, Dale W.; Pierce, Brenda S.

2007-01-01

The mission of the U.S. Geological Survey (USGS) is to serve the Nation by providing reliable scientific information to describe and understand the earth; minimize loss of life and property from natural disasters; manage water, biological, energy, and mineral resources; and enhance and protect our quality of life. As the Nation?s largest water, earth, and biological science and civilian mapping agency, the USGS can play a significant role in providing scientific knowledge and information that will improve our understanding of the relations of environment and wildlife to human health and disease. USGS human health-related research is unique in the Federal government because it brings together a broad spectrum of natural science expertise and information, including extensive data collection and monitoring on varied landscapes and ecosystems across the Nation. USGS can provide a great service to the public health community by synthesizing the scientific information and knowledge on our natural and living resources that influence human health, and by bringing this science to the public health community in a manner that is most useful. Partnerships with health scientists and managers are essential to the success of these efforts. USGS scientists already are working closely with the public health community to pursue rigorous inquiries into the connections between natural science and public health. Partnering agencies include the Armed Forces Institute of Pathology, Agency for Toxic Substances Disease Registry, Centers for Disease Control and Prevention, U.S. Environmental Protection Agency, Food and Drug Administration, Mine Safety and Health Administration, National Cancer Institute, National Institute of Allergy and Infectious Disease, National Institute of Environmental Health Sciences, National Institute for Occupational Safety and Health, U.S. Public Health Service, and the U.S. Army Medical Research Institute of Infectious Diseases. Collaborations between public

Public awareness of income-related health inequalities in Ontario, Canada

Directory of Open Access Journals (Sweden)

Shankardass Ketan

2012-05-01

Full Text Available Abstract Introduction Continued action is needed to tackle health inequalities in Canada, as those of lower income continue to be at higher risk for a range of negative health outcomes. There is arguably a lack of political will to implement policy change in this respect. As a result, we investigated public awareness of income-related health inequalities in a generally representative sample of Ontarians in late 2010. Methods Data were collected from 2,006 Ontario adults using a telephone survey. The survey asked participants to agree or disagree with various statements asserting that there are or are not health inequalities in general and by income in Ontario, including questions pertaining to nine specific conditions for which inequalities have been described in Ontario. A multi-stage process using binary logistic regression determined whether awareness of health inequalities differed between participant subgroups. Results Almost 73% of this sample of Ontarians agreed with the general premise that not all people are equally healthy in Ontario, but fewer participants were aware of health inequalities between the rich and the poor (53%–64%, depending on the framing of the question. Awareness of income-related inequalities in specific outcomes was considerably lower, ranging from 18% for accidents to 35% for obesity. Conclusions This is the first province-wide study in Canada, and the first in Ontario, to explore public awareness on health inequalities. Given that political will is shaped by public awareness and opinion, these results suggest that greater awareness may be required to move the health equity agenda forward in Ontario. There is a need for health equity advocates, physicians and researchers to increase the effectiveness of knowledge translation activities for studies that identify and explore health inequalities.

Determinants of evidence use in public health policy making : Results from a study across six EU countries

NARCIS (Netherlands)

van de Goor, L.A.M.; Hämäläinen, R.M.; Syed, A.; Juel Lau, C.; Sandu, P.; Spitters, H.; Eklund Karlsson, L.; Dulf, D.; Valente, A.; Castellani, T.; Aro, A.R.

2017-01-01

The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized. Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities,

Tobacco plain packaging: Evidence based policy or public health advocacy?

Science.gov (United States)

McKeganey, Neil; Russell, Christopher

2015-06-01

In December 2012, Australia became the first country to require all tobacco products be sold solely in standardised or 'plain' packaging, bereft of the manufacturers' trademarked branding and colours, although retaining large graphic and text health warnings. Following the publication of Sir Cyril Chantler's review of the evidence on the effects of plain tobacco packaging, the Ministers of the United Kingdom Parliament voted in March 2015 to implement similar legislation. Support for plain packaging derives from the belief that tobacco products sold in plain packs have reduced appeal and so are more likely to deter young people and non-smokers from starting tobacco use, and more likely to motivate smokers to quit and stay quit. This article considers why support for the plain packaging policy has grown among tobacco control researchers, public health advocates and government ministers, and reviews Australian survey data that speak to the possible introductory effect of plain packaging on smoking prevalence within Australia. The article concludes by emphasising the need for more detailed research to be undertaken before judging the capacity of the plain packaging policy to deliver the multitude of positive effects that have been claimed by its most ardent supporters. Copyright © 2015 Elsevier B.V. All rights reserved.

Marijuana Legalization: Impact on Physicians and Public Health

Science.gov (United States)

Wilkinson, Samuel T.; Yarnell, Stephanie; Radhakrishnan, Rajiv; Ball, Samuel A.; D'Souza, Deepak Cyril

2016-01-01

Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health. PMID:26515984

[Health services research for the public health service (PHS) and the public health system].

Science.gov (United States)

Hollederer, A; Wildner, M

2015-03-01

There is a great need for health services research in the public health system and in the German public health service. However, the public health service is underrepresented in health services research in Germany. This has several structural, historical and disciplinary-related reasons. The public health service is characterised by a broad range of activities, high qualification requirements and changing framework conditions. The concept of health services research is similar to that of the public health service and public health system, because it includes the principles of multidisciplinarity, multiprofessionalism and daily routine orientation. This article focuses on a specified system theory based model of health services research for the public health system and public health service. The model is based on established models of the health services research and health system research, which are further developed according to specific requirements of the public health service. It provides a theoretical foundation for health services research on the macro-, meso- and microlevels in public health service and the public health system. Prospects for public health service are seen in the development from "old public health" to "new public health" as well as in the integration of health services research and health system research. There is a significant potential for development in a better linkage between university research and public health service as is the case for the "Pettenkofer School of Public Health Munich". © Georg Thieme Verlag KG Stuttgart · New York.

Management accounting use and financial performance in public health-care organisations: evidence from the Italian National Health Service.

Science.gov (United States)

Macinati, Manuela S; Anessi-Pessina, E

2014-07-01

Reforms of the public health-care sector have emphasised the role of management accounting (MA). However, there is little systematic evidence on its use and benefits. To fill this gap, we propose a contingency-based model which addresses three related issues, that is, whether: (i) MA use is influenced by contextual variables and MA design; (ii) top-management satisfaction with MA mediates the relationship between MA design and MA use; and (iii) financial performance is influenced by MA use. A questionnaire was mailed out to all Italian public health-care organisations. Structural equation modelling was performed to validate the research hypotheses. The response rate was 49%. Our findings suggest that: (i) cost-containment strategies encourage more sophisticated MA designs; (ii) MA use is directly and indirectly influenced by contingency, organisational, and behavioural variables; (iii) a weakly significant positive relationship exists between MA use and financial performance. These findings are relevant from the viewpoint of both top managers and policymakers. The former must make sure that MA is not only technically advanced, but also properly understood and appreciated by users. The latter need to be aware that MA may improve performance in ways and along dimensions that may not fully translate into better financial results. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The role of sleep hygiene in promoting public health: A review of empirical evidence.

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Irish, Leah A; Kline, Christopher E; Gunn, Heather E; Buysse, Daniel J; Hall, Martica H

2015-08-01

The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) improve sleep? Is there still a use for sleep hygiene? Global public health concern over sleep has increased demand for sleep promotion strategies accessible to the population. However, the extent to which sleep hygiene strategies apply outside clinical settings is not well known. The present review sought to evaluate the empirical evidence for sleep hygiene recommendations regarding exercise, stress management, noise, sleep timing, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

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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.

Teaching seven principles for public health ethics: towards a curriculum for a short course on ethics in public health programmes.

Science.gov (United States)

Schröder-Bäck, Peter; Duncan, Peter; Sherlaw, William; Brall, Caroline; Czabanowska, Katarzyna

2014-10-07

Teaching ethics in public health programmes is not routine everywhere - at least not in most schools of public health in the European region. Yet empirical evidence shows that schools of public health are more and more interested in the integration of ethics in their curricula, since public health professionals often have to face difficult ethical decisions. The authors have developed and practiced an approach to how ethics can be taught even in crowded curricula, requiring five to eight hours of teaching and learning contact time. In this way, if programme curricula do not allow more time for ethics, students of public health can at least be sensitised to ethics and ethical argumentation. This approach - focusing on the application of seven mid-level principles to cases (non-maleficence, beneficence, health maximisation, efficiency, respect for autonomy, justice, proportionality) - is presented in this paper. Easy to use 'tools' applying ethics to public health are presented. The crowded nature of the public health curriculum, and the nature of students participating in it, required us to devise and develop a short course, and to use techniques that were likely to provide a relatively efficient introduction to the processes, content and methods involved in the field of ethics.

Economics methods in Cochrane systematic reviews of health promotion and public health related interventions.

Science.gov (United States)

Shemilt, Ian; Mugford, Miranda; Drummond, Michael; Eisenstein, Eric; Mallender, Jacqueline; McDaid, David; Vale, Luke; Walker, Damian

2006-11-15

Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as well as regular dialogue between Cochrane reviewers and economists to

Economics methods in Cochrane systematic reviews of health promotion and public health related interventions

Directory of Open Access Journals (Sweden)

McDaid David

2006-11-01

Full Text Available Abstract Background Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. Methods The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Results Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. Conclusion There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as

Reporting of MMR evidence in professional publications: 1988–2007

Science.gov (United States)

Hilton, S; Hunt, K; Langan, M; Hamilton, V; Petticrew, M

2009-01-01

Objective: To examine how journals and magazines disseminate research evidence and guidance on best practice to health professionals by aligning commentaries on measles, mumps, and rubella vaccine (MMR) evidence in journals with key events in the MMR controversy. Design: Content analysis. Data sources: Comment articles in six commonly read UK publications. Main outcome measures: Number of comment pieces by publication, year and article type; trends in the focus, tone and inclusion of recommendations on MMR. Results: 860 articles met the inclusion criteria (BMJ n = 104, Community Practitioner n = 45, Health Visitor n = 24, Practice Nurse n = 61, Nursing Standard n = 61 and Pulse n = 565). Of these 860 comment pieces, 264 made some reference to evidence endorsing the safety of MMR. Around one in 10 were rated as negative (10.9%, n = 29) or neutral (11.3%, n = 30) in relation to MMR safety, and nearly a quarter (22.7%, n = 60) were rated as mixed. Following the publication of Wakefield et al’s 1998 paper there was a period of neutrality. In 2000, despite growing public concerns and widespread media coverage, fewer than 20 comment pieces were published. Less than a quarter of comment pieces (n = 196, 22.7%) included recommendations. Conclusion: While a period of neutrality may reflect a professional response to uncertainty by holding back until consensus emerges, it may also represent a missed opportunity to promote evidence-based practice. PMID:19414434

Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review.

Science.gov (United States)

Woodman, J P; Moore, N R

2012-01-01

Complementary medicine and alternative approaches to chronic and intractable health conditions are increasingly being used, and require critical evaluation. The aim of this review was to systematically evaluate available evidence for the effectiveness and safety of instruction in the Alexander Technique in health-related conditions. PUBMED, EMBASE, PSYCHINFO, ISI Web-of-Knowledge, AMED, CINHAL-plus, Cochrane library and Evidence-based Medicine Reviews were searched to July 2011. Inclusion criteria were prospective studies evaluating Alexander Technique instruction (individual lessons or group delivery) as an intervention for any medical indication/health-related condition. Studies were categorised and data extracted on study population, randomisation method, nature of intervention and control, practitioner characteristics, validity and reliability of outcome measures, completeness of follow-up and statistical analyses.   Of 271 publications identified, 18 were selected: three randomised, controlled trials (RCTs), two controlled non-randomised studies, eight non-controlled studies, four qualitative analyses and one health economic analysis. One well-designed, well-conducted RCT demonstrated that, compared with usual GP care, Alexander Technique lessons led to significant long-term reductions in back pain and incapacity caused by chronic back pain. The results were broadly supported by a smaller, earlier RCT in chronic back pain. The third RCT, a small, well-designed, well-conducted study in individuals with Parkinson's disease, showed a sustained increased ability to carry out everyday activities following Alexander lessons, compared with usual care. The 15 non-RCT studies are also reviewed. Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson's-associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the

Conflicts of Interest: Manipulating Public Health

Science.gov (United States)

Stein, Richard; Davis, Devra Lee

2014-01-01

Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, public health, and historical implications. The history of public health is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…

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

Directory of Open Access Journals (Sweden)

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

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.

Implementing a Public Health Objective for Alcohol Premises Licensing in Scotland: A Qualitative Study of Strategies, Values, and Perceptions of Evidence

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Niamh Fitzgerald

2017-02-01

Full Text Available The public health objective for alcohol premises licensing, established in Scotland in 2005, is unique globally. We explored how public health practitioners engaged with the licensing system following this change, and what helped or hindered their efforts. Semi-structured interviews were conducted with 13 public health actors, audio-recorded, and analysed using an inductive framework approach. Many interviewees viewed the new objective as synonymous with reducing population-level alcohol consumption; however, this view was not always shared by licensing actors, some of whom did not accept public health as a legitimate goal of licensing, or prioritised economic development instead. Some interviewees were surprised that the public health evidence they presented to licensing boards did not result in their hoped-for outcomes; they reported that licensing officials did not always understand or value health data or statistical evidence. While some tried to give “impartial” advice to licensing boards, this was not always easy; others were clear that their role was one of “winning hearts and minds” through relationship-building with licensing actors over time. Notwithstanding the introduction of the public health objective, there remain significant, and political, challenges in orienting local premises licensing boards towards decisions to reduce the availability of alcohol in Scotland.

Evaluation of poultry processing practices, related public health laws ...

African Journals Online (AJOL)

Evaluation of poultry processing practices, related public health laws and diseases of chickens at slaughter: A pilot study in Kaduna state. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more ...

Use of Comparative Case Study Methodology for US Public Health Policy Analysis: A Review.

Science.gov (United States)

Dinour, Lauren M; Kwan, Amy; Freudenberg, Nicholas

There is growing recognition that policies influence population health, highlighting the need for evidence to inform future policy development and reform. This review describes how comparative case study methodology has been applied to public health policy research and discusses the methodology's potential to contribute to this evidence. English-language, peer-reviewed articles published between 1995 and 2012 were sought from 4 databases. Articles were included if they described comparative case studies addressing US public health policy. Two researchers independently assessed the 20 articles meeting review criteria. Case-related characteristics and research design tactics utilized to minimize threats to reliability and validity, such as the use of multiple sources of evidence and a case study protocol, were extracted from each article. Although comparative case study methodology has been used to analyze a range of public health policies at all stages and levels, articles reported an average use of only 3.65 (out of 10) research design tactics. By expanding the use of accepted research design tactics, public health policy researchers can contribute to expanding the evidence needed to advance health-promoting policies.

Museums and art galleries as partners for public health interventions.

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Camic, Paul M; Chatterjee, Helen J

2013-01-01

The majority of public health programmes are based in schools, places of employment and in community settings. Likewise, nearly all health-care interventions occur in clinics and hospitals. An underdeveloped area for public health-related planning that carries international implications is the cultural heritage sector, and specifically museums and art galleries. This paper presents a rationale for the use of museums and art galleries as sites for public health interventions and health promotion programmes through discussing the social role of these organisations in the health and well-being of the communities they serve. Recent research from several countries is reviewed and integrated into a proposed framework for future collaboration between cultural heritage, health-care and university sectors to further advance research, policy development and evidence-based practice.

Radiological protection and public health: crossbreeding

International Nuclear Information System (INIS)

Smeesters, Patrick; Pinak, Miroslav

2008-01-01

Full text: This paper summarizes the scope of activities, ongoing experience and current results of the Expert Group on the Public Health Perspective in Radiological Protection (EGPH) of the Committee of Radiological Protection and Public Health, OECD Nuclear Energy Agency. While the prime and general task of the EGPH group is looking at how the public health and radiation protection can better take an advantage of their respective perspectives, the following four areas have been explored in detail: a) Exposure to radon; b) Justification of medical exposures; c) Public health judgement and decision making based on new scientific evidence; and d) Management of individual differences. In most of these areas, a targeted telephone survey on public policies in selected countries was used for collecting information from stake holders (public, consumers groups, public health and radiation protection regulators, governmental bodies, medical practitioners, patients, scientific communities, NGOs, etc.). The presented paper also highlights key issues of collected information and summarises existing approaches and policies. The case study on exposure to radon collects national information on approaches to the management of domestic radon risks, focusing on the integration of radiation protection and public health aspects (quality of dwellings, overall quality of indoor air, perception of radon levels, position of radon risk in the pool of other risks). In the case of justification of medical exposures, the Group studies the applications of the justification principle in opportunistic screenings (responsibilities, management of the situation, risk assessment). The precautionary principle and its impact on policy judgement in the light of significant scientific uncertainties can have a large influence on radiological-protection decision making. The case study on public health judgement and decision making based on new scientific evidence is exploring how these uncertainties and

Environmentally induced epigenetic toxicity: potential public health concerns.

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Marczylo, Emma L; Jacobs, Miriam N; Gant, Timothy W

2016-09-01

Throughout our lives, epigenetic processes shape our development and enable us to adapt to a constantly changing environment. Identifying and understanding environmentally induced epigenetic change(s) that may lead to adverse outcomes is vital for protecting public health. This review, therefore, examines the present understanding of epigenetic mechanisms involved in the mammalian life cycle, evaluates the current evidence for environmentally induced epigenetic toxicity in human cohorts and rodent models and highlights the research considerations and implications of this emerging knowledge for public health and regulatory toxicology. Many hundreds of studies have investigated such toxicity, yet relatively few have demonstrated a mechanistic association among specific environmental exposures, epigenetic changes and adverse health outcomes in human epidemiological cohorts and/or rodent models. While this small body of evidence is largely composed of exploratory in vivo high-dose range studies, it does set a precedent for the existence of environmentally induced epigenetic toxicity. Consequently, there is worldwide recognition of this phenomenon, and discussion on how to both guide further scientific research towards a greater mechanistic understanding of environmentally induced epigenetic toxicity in humans, and translate relevant research outcomes into appropriate regulatory policies for effective public health protection.

The relation between wealth and health: Evidence from a world panel of countries

DEFF Research Database (Denmark)

Worm Hansen, Casper

2012-01-01

Based on a world sample of countries, this paper presents panel data evidence that documents a U-shaped relation between GDP per capita (wealth) and life expectancy (health). The evidence also shows that excluding the possibility of a nonmonotonic relationship induces erroneous conclusions about...... the time-varying wealth-health correlation. (C) 2011 Elsevier B.V. All rights reserved....

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

Directory of Open Access Journals (Sweden)

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.

Internet use by the public to search for health-related information.

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AlGhamdi, Khalid M; Moussa, Noura A

2012-06-01

The use of the Internet to search for health-related information (HRI) has become a common practice worldwide. Our literature review failed to find any evidence of previous studies on this topic from Saudi Arabia. To determine the public use of the Internet in Saudi Arabia to search for HRI and to evaluate patients' perceptions of the quality of the information available on the Internet compared to that provided by their health care providers. A self-administered questionnaire about Internet use to search for HRI was distributed randomly to male and female outpatients and visitors attending a public University Hospital in Riyadh, Saudi Arabia from January to May 2010. A Chi-squared test was used to assess the association between different categorical variables. Multiple logistic regression was used to relate the use of the Internet to search for HRI with various socio-demographic variables. The questionnaire response was 80.1%, with completion of 801 of the 1000 distributed questionnaires; 50% (400/801) of respondents were males. The mean age of respondents was 32±11 years. The majority of respondents used the Internet in general (87.8%), and 58.4% of them (363/622) used the Internet to search for HRI. The majority stated a doctor was their primary source of HRI (89.3%, 654/732). This practice was considered useful by 84.2%, and the main reason behind it was sheer curiosity (92.7%, 418/451). Other reasons included not getting enough information from their doctor (58.5%, 227/413) and not trusting the information given by their doctor (28.2%, 101/443). Forty-four percent (205/466) searched for HRI before coming to the clinic; 72.5% of those discussed the information with their doctors and 71.7% (119/166) of those who did so believed that this positively affected their relationship with their doctor. Searching the Internet for health information was observed more frequently among the 30-39 year age group (OR=2.0, 95% CI 1.1-3.7), females (OR=3.8, 95% CI 2

Health-related direct-to-consumer genetic tests: a public health assessment and analysis of practices related to Internet-based tests for risk of thrombosis.

Science.gov (United States)

Goddard, K A B; Robitaille, J; Dowling, N F; Parrado, A R; Fishman, J; Bradley, L A; Moore, C A; Khoury, M J

2009-01-01

Recent years have seen increased concern about direct-to-consumer (DTC) genetic testing (i.e., the sale and use of genetic tests without involving a health care provider). Numerous professional organizations have developed policies in this area. However, little systematic evidence exists to inform public policy about these tests. We conducted a systematic search to identify genetic tests that are sold DTC without involving a health care provider. We evaluated the practices of companies offering DTC genetic tests for risk of thrombosis using criteria from multiple sources and a minimal set of key practices. We identified 84 instances of currently available health-related DTC genetic tests sold on 27 Web sites; the most common were for pharmacogenomics (12), risk of thrombosis (10), and nutrigenomics (10). For the DTC genetic tests for risk of thrombosis, we found low adherence to recommendations. Online information was frequently incomplete and had low agreement with professional recommendations. Our findings document the rapid growth in the availability of health-related DTC genetic tests and highlight the need to improve the delivery of DTC genetic tests. A major implication of this study is the need for the scientific and medical community to develop consistent recommendations to increase their impact. Copyright 2008 S. Karger AG, Basel.

Healthy publics: enabling cultures and environments for health

Science.gov (United States)

Hinchliffe, Stephen; Jackson, Mark A.; Wyatt, Katrina; Barlow, Anne E.; Barreto, Manuela; Clare, Linda; Depledge, Michael H.; Durie, Robin; Fleming, Lora E.; Groom, Nick; Morrissey, Karyn; Salisbury, Laura; Thomas, Felicity

2018-01-01

Despite extraordinary advances in biomedicine and associated gains in human health and well-being, a growing number of health and well-being related challenges have remained or emerged in recent years. These challenges are often ‘more than biomedical’ in complexion, being social, cultural and environmental in terms of their key drivers and determinants, and underline the necessity of a concerted policy focus on generating healthy societies. Despite the apparent agreement on this diagnosis, the means to produce change are seldom clear, even when the turn to health and well-being requires sizable shifts in our understandings of public health and research practices. This paper sets out a platform from which research approaches, methods and translational pathways for enabling health and well-being can be built. The term ‘healthy publics’ allows us to shift the focus of public health away from ‘the public’ or individuals as targets for intervention, and away from the view that culture acts as a barrier to efficient biomedical intervention, towards a greater recognition of the public struggles that are involved in raising health issues, questioning what counts as healthy and unhealthy and assembling the evidence and experience to change practices and outcomes. Creating the conditions for health and well-being, we argue, requires an engaged research process in which public experiments in building and repairing social and material relations are staged and sustained even if, and especially when, the fates of those publics remain fragile and buffeted by competing and often more powerful public formations. PMID:29862036

Evidence for Public Health Risks of Wastewater and Excreta Management Practices in Southeast Asia: A Scoping Review

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Steven Lam

2015-10-01

Full Text Available The use of wastewater and excreta in agriculture is a common practice in Southeast Asia; however, concerns remain about the potential public health risks of this practice. We undertook a scoping review to examine the extent, range, and nature of literature, as well as synthesize the evidence for associations between wastewater and excreta management practices and public health risks in Southeast Asia. Three electronic databases (PubMed, CAB Direct, and Web of Science were searched and a total of 27 relevant studies were included and evaluated. The available evidence suggested that possible occupational health risks of wastewater and excreta management practices include diarrhea, skin infection, parasitic infection, bacterial infection, and epilepsy. Community members can be at risk for adverse health outcomes through consuming contaminated fish, vegetables, or fruits. Results suggested that practices including handling, treatment, and use of waste may be harmful to human health, particularly farmer’s health. Many studies in this review, however, had limitations including lack of gender analyses, exposure assessment, and longitudinal study designs. These findings suggest that more studies on identifying, quantitatively assessing, and mitigating health risks are needed if sustainable benefits are to be obtained from wastewater and excreta reuse in agriculture in Southeast Asia.

Evidence for Public Health Risks of Wastewater and Excreta Management Practices in Southeast Asia: A Scoping Review.

Science.gov (United States)

Lam, Steven; Nguyen-Viet, Hung; Tuyet-Hanh, Tran Thi; Nguyen-Mai, Huong; Harper, Sherilee

2015-10-15

The use of wastewater and excreta in agriculture is a common practice in Southeast Asia; however, concerns remain about the potential public health risks of this practice. We undertook a scoping review to examine the extent, range, and nature of literature, as well as synthesize the evidence for associations between wastewater and excreta management practices and public health risks in Southeast Asia. Three electronic databases (PubMed, CAB Direct, and Web of Science) were searched and a total of 27 relevant studies were included and evaluated. The available evidence suggested that possible occupational health risks of wastewater and excreta management practices include diarrhea, skin infection, parasitic infection, bacterial infection, and epilepsy. Community members can be at risk for adverse health outcomes through consuming contaminated fish, vegetables, or fruits. Results suggested that practices including handling, treatment, and use of waste may be harmful to human health, particularly farmer's health. Many studies in this review, however, had limitations including lack of gender analyses, exposure assessment, and longitudinal study designs. These findings suggest that more studies on identifying, quantitatively assessing, and mitigating health risks are needed if sustainable benefits are to be obtained from wastewater and excreta reuse in agriculture in Southeast Asia.

Public health and public trust: Survey evidence from the Ebola Virus Disease epidemic in Liberia.

Science.gov (United States)

Blair, Robert A; Morse, Benjamin S; Tsai, Lily L

2017-01-01

Trust in government has long been viewed as an important determinant of citizens' compliance with public health policies, especially in times of crisis. Yet evidence on this relationship remains scarce, particularly in the developing world. We use results from a representative survey conducted during the 2014-15 Ebola Virus Disease (EVD) epidemic in Monrovia, Liberia to assess the relationship between trust in government and compliance with EVD control interventions. We find that respondents who expressed low trust in government were much less likely to take precautions against EVD in their homes, or to abide by government-mandated social distancing mechanisms designed to contain the spread of the virus. They were also much less likely to support potentially contentious control policies, such as "safe burial" of EVD-infected bodies. Contrary to stereotypes, we find no evidence that respondents who distrusted government were any more or less likely to understand EVD's symptoms and transmission pathways. While only correlational, these results suggest that respondents who refused to comply may have done so not because they failed to understand how EVD is transmitted, but rather because they did not trust the capacity or integrity of government institutions to recommend precautions and implement policies to slow EVD's spread. We also find that respondents who experienced hardships during the epidemic expressed less trust in government than those who did not, suggesting the possibility of a vicious cycle between distrust, non-compliance, hardships and further distrust. Finally, we find that respondents who trusted international non-governmental organizations (INGOs) were no more or less likely to support or comply with EVD control policies, suggesting that while INGOs can contribute in indispensable ways to crisis response, they cannot substitute for government institutions in the eyes of citizens. We conclude by discussing the implications of our findings for future

Breastfeeding as a public health responsibility: a review of the evidence.

Science.gov (United States)

Brown, A

2017-12-01

Although intention to breastfeed in Western culture is high, many women stop breastfeeding before they are ready. From a physiological perspective, rates of primary milk insufficiency or contraindications to breastfeed should be low. However, numerous women encounter numerous barriers to breastfeeding, many of which occur at the social, cultural and political level and are therefore outside of maternal control. This review identifies and examines the impact of these barriers and considers how public health services should play a central role in creating a supportive breastfeeding environment. A narrative review to synthesise themes in the literature was conducted, using Web of Science, PubMed and Science Direct. Barriers to breastfeeding at the societal rather than individual level were identified (e.g. in relation to health services, policies and economic factors). Only English language papers were included. Many barriers to breastfeeding exist at the societal rather than individual level. These influences are typically outside mothers' control. Five core themes were identified; the need for investment in (i) health services; (ii) population level health promotion; (iii) supporting maternal legal rights; (iv) protection of maternal wellbeing; and (v) reducing the reach of the breast milk substitute industry. Although individual support is important, breastfeeding must be considered a public health issue that requires investment at a societal level. Focusing solely on solving individual issues will not lead to the cultural changes needed to normalise breastfeeding. Countries that have adopted a multicomponent public heath strategy to increase breastfeeding levels have had significant success. These strategies must be emulated more widely. © 2017 The British Dietetic Association Ltd.

A typology of health marketing research methods--combining public relations methods with organizational concern.

Science.gov (United States)

Rotarius, Timothy; Wan, Thomas T H; Liberman, Aaron

2007-01-01

Research plays a critical role throughout virtually every conduit of the health services industry. The key terms of research, public relations, and organizational interests are discussed. Combining public relations as a strategic methodology with the organizational concern as a factor, a typology of four different research methods emerges. These four health marketing research methods are: investigative, strategic, informative, and verification. The implications of these distinct and contrasting research methods are examined.

Social determinants and lifestyles: integrating environmental and public health perspectives.

Science.gov (United States)

Graham, H; White, P C L

2016-12-01

Industrialization and urbanization have been associated with an epidemiological transition, from communicable to non-communicable disease, and a geological transition that is moving the planet beyond the stable Holocene epoch in which human societies have prospered. The lifestyles of high-income countries are major drivers of these twin processes. Our objective is to highlight the common causes of chronic disease and environmental change and, thereby, contribute to shared perspectives across public health and the environment. Integrative reviews focused on social determinants and lifestyles as two 'bridging' concepts between the fields of public health and environmental sustainability. We drew on established frameworks to consider the position of the natural environment within social determinants of health (SDH) frameworks and the position of social determinants within environmental frameworks. We drew on evidence on lifestyle factors central to both public health and environmental change (mobility- and diet-related factors). We investigated how public health's focus on individual behaviour can be enriched by environmental perspectives that give attention to household consumption practices. While SDH frameworks can incorporate the biophysical environment, their causal structure positions it as a determinant and one largely separate from the social factors that shape it. Environmental frameworks are more likely to represent the environment and its ecosystems as socially determined. A few frameworks also include human health as an outcome, providing the basis for a combined public health/environmental sustainability framework. Environmental analyses of household impacts broaden public health's concern with individual risk behaviours, pointing to the more damaging lifestyles of high-income households. The conditions for health are being undermined by rapid environmental change. There is scope for frameworks reaching across public health and environmental

Evidence development and publication planning: strategic process.

Science.gov (United States)

Wittek, Michael R; Jo Williams, Mary; Carlson, Angeline M

2009-11-01

A number of decisions in the health care field rely heavily on published clinical evidence. A systematic approach to evidence development and publication planning is required to develop a portfolio of evidence that includes at minimum information on efficacy, safety, durability of effect, quality of life, and economic outcomes. The approach requires a critical assessment of available literature, identification of gaps in the literature, and a strategic plan to fill the gaps to ensure the availability of evidence demanded for clinical decisions, coverage/payment decisions and health technology assessments. The purpose of this manuscript is to offer a six-step strategic process leading to a portfolio of evidence that meets the informational needs of providers, payers, and governmental agencies concerning patient access to a therapy.

Policy, politics and public health.

Science.gov (United States)

Greer, Scott L; Bekker, Marleen; de Leeuw, Evelyne; Wismar, Matthias; Helderman, Jan-Kees; Ribeiro, Sofia; Stuckler, David

2017-10-01

If public health is the field that diagnoses and strives to cure social ills, then understanding political causes and cures for health problems should be an intrinsic part of the field. In this article, we argue that there is no support for the simple and common, implicit model of politics in which scientific evidence plus political will produces healthy policies. Efforts to improve the translation of evidence into policy such as knowledge transfer work only under certain circumstances. These circumstances are frequently political, and to be understood through systematic inquiry into basic features of the political economy such as institutions, partisanship and the organization of labour markets. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Recommendations for international gambling harm-minimisation guidelines: comparison with effective public health policy.

Science.gov (United States)

Gainsbury, Sally M; Blankers, Matthijs; Wilkinson, Claire; Schelleman-Offermans, Karen; Cousijn, Janna

2014-12-01

Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of basing policy on empirical evidence, international conventions exist for policy on alcohol, tobacco, and illegal substances. This paper examines the evidence of best practice policies to provide recommendations for international guidelines for harm-minimisation policy for gambling, including specific consideration of the specific requirements for policies on Internet gambling. Evidence indicates that many of the public health policies implemented for addictive substances can be adapted to address gambling-related harms. Specifically, a minimum legal age of at least 18 for gambling participation, licensing of gambling venues and activities with responsible gambling and consumer protection strategies mandated, and brief interventions should be available for those at-risk for and experiencing gambling-related problems. However, there is mixed evidence on the effectiveness of limits on opening hours and gambling venue density and increased taxation to minimise harms. Given increases in trade globalisation and particularly the global nature of Internet gambling, it is recommended that jurisdictions take actions to harmonise gambling public health policies.

Air Quality Strategies on Public Health and Health Equity in Europe-A Systematic Review.

Science.gov (United States)

Wang, Li; Zhong, Buqing; Vardoulakis, Sotiris; Zhang, Fengying; Pilot, Eva; Li, Yonghua; Yang, Linsheng; Wang, Wuyi; Krafft, Thomas

2016-12-02

Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO₂) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO₂ were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no

Air Quality Strategies on Public Health and Health Equity in Europe—A Systematic Review

Directory of Open Access Journals (Sweden)

Li Wang

2016-12-01

Full Text Available Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI, were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO2 and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter and NO2 were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined

Air Quality Strategies on Public Health and Health Equity in Europe—A Systematic Review

Science.gov (United States)

Wang, Li; Zhong, Buqing; Vardoulakis, Sotiris; Zhang, Fengying; Pilot, Eva; Li, Yonghua; Yang, Linsheng; Wang, Wuyi; Krafft, Thomas

2016-01-01

Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO2) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO2 were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent

Public Hospital Spending in England: Evidence from National Health Service Administrative Records

OpenAIRE

Kelly, E.; Stoye, G.; Vera-Hernández, M.

2016-01-01

© 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spendi...

Public hospital spending in England: Evidence from National Health Service administrative records

OpenAIRE

Kelly, Elaine; Stoye, George; Vera-Hernández, Marcos

2015-01-01

Health spending per capita in England has more than doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the lifecycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after...

Machine-Learning Algorithms to Code Public Health Spending Accounts.

Science.gov (United States)

Brady, Eoghan S; Leider, Jonathon P; Resnick, Beth A; Alfonso, Y Natalia; Bishai, David

Government public health expenditure data sets require time- and labor-intensive manipulation to summarize results that public health policy makers can use. Our objective was to compare the performances of machine-learning algorithms with manual classification of public health expenditures to determine if machines could provide a faster, cheaper alternative to manual classification. We used machine-learning algorithms to replicate the process of manually classifying state public health expenditures, using the standardized public health spending categories from the Foundational Public Health Services model and a large data set from the US Census Bureau. We obtained a data set of 1.9 million individual expenditure items from 2000 to 2013. We collapsed these data into 147 280 summary expenditure records, and we followed a standardized method of manually classifying each expenditure record as public health, maybe public health, or not public health. We then trained 9 machine-learning algorithms to replicate the manual process. We calculated recall, precision, and coverage rates to measure the performance of individual and ensembled algorithms. Compared with manual classification, the machine-learning random forests algorithm produced 84% recall and 91% precision. With algorithm ensembling, we achieved our target criterion of 90% recall by using a consensus ensemble of ≥6 algorithms while still retaining 93% coverage, leaving only 7% of the summary expenditure records unclassified. Machine learning can be a time- and cost-saving tool for estimating public health spending in the United States. It can be used with standardized public health spending categories based on the Foundational Public Health Services model to help parse public health expenditure information from other types of health-related spending, provide data that are more comparable across public health organizations, and evaluate the impact of evidence-based public health resource allocation.

Public health nurses' perception of their roles in relation to psychotropic drug use by adolescents: a phenomenographic study.

Science.gov (United States)

Steffenak, Anne Kjersti Myhrene; Nordström, Gun; Hartz, Ingeborg; Wilde-Larsson, Bodil

2015-04-01

The purpose of the paper was to describe the perceptions of public health nurses' roles in relation to psychotropic drug use by adolescents. Mental health problems among adolescents are documented with studies indicating an increased use of psychotropic drugs. In Norway, care for such adolescents may fall naturally into the remit of public health nurses. A phenomenographic approach was used to analyse the data. A qualitative interview study was made of 20 Norwegian public health nurses, strategically chosen using phenomenographic methodology. The public health nurses described three categories: discovering public health nurses who become aware of psychotropic drug use in the health dialogue with adolescents and choose to either act or not act in relation to psychotropic drug use. Those public health nurses who take action are cooperating public health nurses, who cooperate with adolescents, their families, schools and others. If cooperation has been established, supporting public health nurses teach and support the adolescent in relation to psychotropic drug use. The public health nurses who do not act can hinder or delay further treatment. Public health nurses need to acquire knowledge about psychotropic drugs, to fulfil their role in nursing mental health problems among adolescents and the increasing use of psychotropic drugs. The results demonstrated that public health nurses, working in health centres and schools, have the responsibility and the opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others, e.g. parents and siblings. Intervention studies are needed with regard to health promotion programmes aimed at fortifying young people's mental health. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Public health nurses’ perception of their roles in relation to psychotropic drug use by adolescents: a phenomenographic study

Science.gov (United States)

Steffenak, Anne Kjersti Myhrene; Nordström, Gun; Hartz, Ingeborg; Wilde-Larsson, Bodil

2015-01-01

Aims and objectives The purpose of the paper was to describe the perceptions of public health nurses’ roles in relation to psychotropic drug use by adolescents. Background Mental health problems among adolescents are documented with studies indicating an increased use of psychotropic drugs. In Norway, care for such adolescents may fall naturally into the remit of public health nurses. Design A phenomenographic approach was used to analyse the data. Method A qualitative interview study was made of 20 Norwegian public health nurses, strategically chosen using phenomenographic methodology. Results The public health nurses described three categories: discovering public health nurses who become aware of psychotropic drug use in the health dialogue with adolescents and choose to either act or not act in relation to psychotropic drug use. Those public health nurses who take action are cooperating public health nurses, who cooperate with adolescents, their families, schools and others. If cooperation has been established, supporting public health nurses teach and support the adolescent in relation to psychotropic drug use. Conclusion The public health nurses who do not act can hinder or delay further treatment. Public health nurses need to acquire knowledge about psychotropic drugs, to fulfil their role in nursing mental health problems among adolescents and the increasing use of psychotropic drugs. Relevance to clinical practice The results demonstrated that public health nurses, working in health centres and schools, have the responsibility and the opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others, e.g. parents and siblings. Intervention studies are needed with regard to health promotion programmes aimed at fortifying young people's mental health. PMID:25639291

Randomised controlled trial of a theoretically grounded tailored intervention to diffuse evidence-based public health practice [ISRCTN23257060

Directory of Open Access Journals (Sweden)

Nordheim Lena

2003-03-01

Full Text Available Abstract Background Previous studies have shown that Norwegian public health physicians do not systematically and explicitly use scientific evidence in their practice. They work in an environment that does not encourage the integration of this information in decision-making. In this study we investigate whether a theoretically grounded tailored intervention to diffuse evidence-based public health practice increases the physicians' use of research information. Methods 148 self-selected public health physicians were randomised to an intervention group (n = 73 and a control group (n = 75. The intervention group received a multifaceted intervention while the control group received a letter declaring that they had access to library services. Baseline assessments before the intervention and post-testing immediately at the end of a 1.5-year intervention period were conducted. The intervention was theoretically based and consisted of a workshop in evidence-based public health, a newsletter, access to a specially designed information service, to relevant databases, and to an electronic discussion list. The main outcome measure was behaviour as measured by the use of research in different documents. Results The intervention did not demonstrate any evidence of effects on the objective behaviour outcomes. We found, however, a statistical significant difference between the two groups for both knowledge scores: Mean difference of 0.4 (95% CI: 0.2–0.6 in the score for knowledge about EBM-resources and mean difference of 0.2 (95% CI: 0.0–0.3 in the score for conceptual knowledge of importance for critical appraisal. There were no statistical significant differences in attitude-, self-efficacy-, decision-to-adopt- or job-satisfaction scales. There were no significant differences in Cochrane library searching after controlling for baseline values and characteristics. Conclusion Though demonstrating effect on knowledge the study failed to provide support for

[Public relations in institutions and establishments of the health administration system].

Science.gov (United States)

Martynenko, A V

2002-01-01

The article is dedicated to development of directions and specific functions of the health system bodies/institutions public relations (PR) activities. Priorities are set forth depending on the form of property thereof. A complex use of approaches toward carrying out of PR activities permits optimizing work both within the system itself and relations with the society as a whole.

Fighting obesity or obese persons? Public perceptions of obesity-related health messages.

Science.gov (United States)

Puhl, R; Peterson, J L; Luedicke, J

2013-06-01

This study examined public perceptions of obesity-related public health media campaigns with specific emphasis on the extent to which campaign messages are perceived to be motivating or stigmatizing. In summer 2011, data were collected online from a nationally representative sample of 1014 adults. Participants viewed a random selection of 10 (from a total of 30) messages from major obesity public health campaigns from the United States, the United Kingdom and Australia, and rated each campaign message according to positive and negative descriptors, including whether it was stigmatizing or motivating. Participants also reported their familiarity with each message and their intentions to comply with the message content. Participants responded most favorably to messages involving themes of increased fruit and vegetable consumption, and general messages involving multiple health behaviors. Messages that have been publicly criticized for their stigmatizing content received the most negative ratings and the lowest intentions to comply with message content. Furthermore, messages that were perceived to be most positive and motivating made no mention of the word 'obesity' at all, and instead focused on making healthy behavioral changes without reference to body weight. These findings have important implications for framing messages in public health campaigns to address obesity, and suggest that certain types of messages may lead to increased motivation for behavior change among the public, whereas others may be perceived as stigmatizing and instill less motivation to improve health.

Ethics in public health: call for shared moral public health literacy.

Science.gov (United States)

Maeckelberghe, Els L M; Schröder-Bäck, Peter

2017-10-01

Public Health (PH) in Europe has become much more vocal about its moral understandings since 1992. The rising awareness that PH issues were inseparable from issues of human rights and social justice almost self-evidently directed the agenda of EUPHA and the European Public Health (EPH)-conferences. Problems of cultural and behavioural change, and environmental issues on a global scale were also added. The Section Ethics in PH invited the EPH community to join in 'arm chair thinking': coming together at conferences not only to share the 'how' and 'what' of PH research, practices and policies but also the 'why'. Time has been reserved to genuinely discuss what moral values are at stake in the work of PH and to actively develop a moral language and framework for PH Ethics. The challenge for the next decades is to find ways to involve the general public in the cultivation of a shared moral PH literacy. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations

Directory of Open Access Journals (Sweden)

Kim D. Raine

2018-01-01

Full Text Available Introduction: Unhealthy foods are widely available in public settings across Canada, contributing to diet-related chronic diseases, such as obesity. This is a concern given that public facilities often provide a significant amount of food for consumption by vulnerable groups, including children and seniors. Healthy food procurement policies, which support procuring, distributing, selling, and/or serving healthier foods, have recently emerged as a promising strategy to counter this public health issue by increasing access to healthier foods. Although numerous Canadian health and scientific organizations have recommended such policies, they have not yet been broadly implemented in Canada. Methods: To inform further policy action on healthy food procurement in a Canadian context, we: (1 conducted an evidence synthesis to assess the impact of healthy food procurement policies on health outcomes and sales, intake, and availability of healthier food, and (2 hosted a consensus conference in September 2014. The consensus conference invited experts with public health/nutrition policy research expertise, as well as health services and food services practitioner experience, to review evidence, share experiences, and develop a consensus statement/recommendations on healthy food procurement in Canada. Results: Findings from the evidence synthesis and consensus recommendations for healthy food procurement in Canada are described. Specifically, we outline recommendations for governments, publicly funded institutions, decision-makers and professionals, citizens, and researchers. Conclusion: Implementation of healthy food procurement policies can increase Canadians’ access to healthier foods as part of a broader vision for food policy in Canada.

Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations

Science.gov (United States)

Kim D., Raine; Kayla, Atkey; Dana Lee, Dana Lee; Alexa R., Ferdinands; Dominique, Beaulieu; Susan, Buhler; Norm, Campbell; Brian, Cook; Mary, L’Abbé; Ashley, Lederer; David, Mowat; Joshna, Maharaj; Candace, Nykiforuk; Jacob, Shelley; Jacqueline, Street

2018-01-01

Abstract Introduction: Unhealthy foods are widely available in public settings across Canada, contributing to diet-related chronic diseases, such as obesity. This is a concern given that public facilities often provide a significant amount of food for consumption by vulnerable groups, including children and seniors. Healthy food procurement policies, which support procuring, distributing, selling, and/or serving healthier foods, have recently emerged as a promising strategy to counter this public health issue by increasing access to healthier foods. Although numerous Canadian health and scientific organizations have recommended such policies, they have not yet been broadly implemented in Canada. Methods: To inform further policy action on healthy food procurement in a Canadian context, we: (1) conducted an evidence synthesis to assess the impact of healthy food procurement policies on health outcomes and sales, intake, and availability of healthier food, and (2) hosted a consensus conference in September 2014. The consensus conference invited experts with public health/nutrition policy research expertise, as well as health services and food services practitioner experience, to review evidence, share experiences, and develop a consensus statement/recommendations on healthy food procurement in Canada. Results: Findings from the evidence synthesis and consensus recommendations for healthy food procurement in Canada are described. Specifically, we outline recommendations for governments, publicly funded institutions, decision-makers and professionals, citizens, and researchers. Conclusion: Implementation of healthy food procurement policies can increase Canadians’ access to healthier foods as part of a broader vision for food policy in Canada. PMID:29323862

An overview of public health service health-related activities as they relate to the Department of Energy's environmental restoration program

International Nuclear Information System (INIS)

Kocher, P.L.; Bashor, M.M.

1991-01-01

The Agency for Toxic Substances and Disease Registry (ATSDR) was created by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) as an agency of the Public Health Service. Under the Superfund Amendments and Reauthorization Act of 1986 (SARA; CERCLA as amended), the public health responsibilities of ATSDR were greatly expanded. Among the responsibilities are (1) preparing health assessments for each site proposed for or listed on the National Priorities List (NPL) established by the US Environmental Protection Agency; (2) conducting epidemiologic and other health studies around NPL sites; (3) establishing registries of exposed individuals; (4) establishing health surveillance programs; (5) developing toxicological profiles for hazardous substances; (6) performing health and emergency response consultations; and (7) performing other health-related activities (e.g., health education). In October 1990, ATSDR signed a memorandum of understanding (MOU) with the Department of Energy (DOE) headquarters requiring that DOE operations offices sign interagency agreements (IAGs) with ATSDR for its conduct of 104(i) health activities at DOE sites. These activities include health assessments, related health studies such as surveillance programs, epidemiologic studies, and registries of exposed persons, and toxicological profiles of hazardous substances unique to DOE sites. ATSDR's studies will focus more on an assessment of the health risk to human populations residing in and around DOE sites than on an evaluation of the health risk to workers on site. Nevertheless, CERCLA, the MOU, and site-specific IAGs authorize ATSDR's access to health and environmental data concerning each site. The IAGs contemplate that ATSDR work closely with DOE operations offices in their implementation of their respective environmental restoration programs

Gambling and the Health of the Public: Adopting a Public Health Perspective.

Science.gov (United States)

Korn, David A.; Shaffer, Howard J.

1999-01-01

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

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...

Health needs and public health functions addressed in scientific publications in Francophone sub-Saharan Africa.

Science.gov (United States)

Benie-Bi, J; Cambon, L; Grimaud, O; Kivits, J; Alla, F

2013-09-01

To describe the reporting of public health research in Francophone sub-Saharan Africa (FSA). A bibliometric research study of scientific public health publications in FSA, which includes 24 countries and approximately 260 million people. Two researchers analysed original articles published in 2007 in the medical or social sciences fields and indexed in Scopus. At least one co-author of articles had to be based in FSA. The analysis focused on research field, public health function (WHO classification), FSA country author's affiliation, language, journal type and global burden of disease (WHO classification). Of 1047 articles retrieved by the search, 212 were from the public health field. The number of articles per country varied from 0 to 36. Public health functions examined were health service research (24.5%), health monitoring (27.4%), prevention (15%) and legislation (0.5%). The distribution of health needs described in the articles was close to that of the WHO data for Africa for 2004: infectious and parasitic diseases (70% vs 54%), maternal and perinatal conditions (15% vs 17%), non-communicable diseases (15.6% vs 21%), and injuries (0.5% vs 8%). The areas reported in published articles from sub-Saharan Africa reflect the health needs distribution in Africa; however, the number of publications is low, particularly for prevention. In light of the current focus on evidence-based public health, this study questions whether the international scientific community adequately considers the expertise and perspectives of African researchers and professionals. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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.

Knowledge brokering in public health: a tale of two studies.

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Traynor, R; DeCorby, K; Dobbins, M

2014-06-01

A Knowledge Broker is one approach for facilitating the integration of evidence-informed decision making in public health practice. In this paper, the findings from two studies investigating a Knowledge Broker intervention as a means of enhancing capacity for evidence-informed decision making are presented. Contextual factors that facilitate this strategy are also identified. This paper describes work done through a single mixed-methods study (randomized controlled trial with a qualitative component) and a case study. The Health Evidence team conducted two studies examining Knowledge Broker impact in Canadian public health departments. The effectiveness of knowledge translation strategies of varying intensities for promoting the use of research evidence in decisions related to child obesity prevention were explored via a randomized controlled trial with a fundamental descriptive component (2003-2007). In a case study (2010-2013), the authors partnered with three health departments to develop and implement tailored strategies targeted at the organization. Knowledge Brokers worked with designated staff in these studies via one-on-one consultations, small group meetings, and/or workshops and presentations. The Knowledge Broker role was assessed by analysing data from close-ended surveys, interviews, organizational documents, and reflective journals. In this paper, the authors focus on findings from the qualitative analysis of implementing the Knowledge Broker role in both studies and explore several contextual factors that impacted study outcomes. Knowledge Brokers were shown to enhance individual capacity by improving knowledge and skill in searching for, critically appraising, and applying research evidence to practice-based issues. Organizational capacity was also enhanced with strong management support and policies. Effective Knowledge Broker attributes included both expertise in research methodology and public health, as well as intangible traits such as

Relational conceptions of paternalism: a way to rebut nanny-state accusations and evaluate public health interventions.

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Carter, S M; Entwistle, V A; Little, M

2015-08-01

'Nanny-state' accusations can function as powerful rhetorical weapons against interventions intended to promote public health. Public health advocates often lack effective rebuttals to these criticisms. Nanny-state accusations are largely accusations of paternalism. They conjure up emotive concern about undue governmental interference undermining peoples' autonomy. But autonomy can be understood in various ways. We outline three main conceptions of autonomy, argue that these that can underpin three different conceptions of paternalism, and consider implications for responses to nanny-state accusations and the assessment of public health interventions. Detailed conceptual analysis. The conceptions of paternalism implicit in nanny-state accusations generally depend on libertarian conceptions of autonomy. These reflect unrealistic views of personal independence and do not discriminate sufficiently between trivial and important freedoms. Decisional conceptions of paternalism, like their underlying decisional conceptions of autonomy, have limited applicability in public health contexts. Relational conceptions of paternalism incorporate relational conceptions of autonomy, so recognize that personal autonomy depends on socially shaped skills, self-identities and self-evaluations as well as externally structured opportunities. They encourage attention to the various ways that social interactions and relationships, including disrespect, stigmatization and oppression, can undermine potential for autonomy. While nanny-state accusations target any interference with negative freedom, however trivial, relational conceptions direct concerns to those infringements of negative freedom, or absences of positive freedom, serious enough to undermine self-determination, self-governance and/or self-authorization. Relational conceptions of autonomy and paternalism offer public health policymakers and practitioners a means for rebutting nanny-state accusations, and can support more nuanced

Feminism and public health nursing: partners for health.

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Leipert, B D

2001-01-01

It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for public health nursing. In this article, I articulate the relevance of feminism for public health nursing knowledge and practice. First, I define and describe feminism and public health nursing and then I discuss the importance of feminism for public health nursing practice. The importance of feminism for the metaparadigm concepts of public health nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and public health nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of public health nursing and for public health care.

Health-related quality of life outcomes and level of evidence in pediatric neurosurgery.

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Hansen, Daniel; Vedantam, Aditya; Briceño, Valentina; Lam, Sandi K; Luerssen, Thomas G; Jea, Andrew

2016-10-01

OBJECTIVE The emphasis on health-related quality of life (HRQOL) outcomes is increasing, along with an emphasis on evidence-based medicine. However, there is a notable paucity of validated HRQOL instruments for the pediatric population. Furthermore, no standardization or consensus currently exists concerning which HRQOL outcome measures ought to be used in pediatric neurosurgery. The authors wished to identify HRQOL outcomes used in pediatric neurosurgery research over the past 10 years, their frequency, and usage trends. METHODS Three top pediatric neurosurgical journals were reviewed for the decade from 2005 to 2014 for clinical studies of pediatric neurosurgical procedures that report HRQOL outcomes. Similar studies in the peer-reviewed journal Pediatrics were also used as a benchmark. Publication year, level of evidence, and HRQOL outcomes were collected for each article. RESULTS A total of 31 HRQOL studies were published in the pediatric neurosurgical literature over the study period. By comparison, there were 55 such articles in Pediatrics. The number of publications using HRQOL instruments showed a significant positive trend over time for Pediatrics (B = 0.62, p = 0.02) but did not increase significantly over time for the 3 neurosurgical journals (B = 0.12, p = 0.5). The authors identified a total of 46 different HRQOL instruments used across all journals. Within the neurosurgical journals, the Hydrocephalus Outcome Questionnaire (HOQ) (24%) was the most frequently used, followed by the Health Utilities Index (HUI) (16%), the Pediatric Quality of Life Inventory (PedsQL) (12%), and the 36-Item Short Form Health Survey (SF-36) (12%). Of the 55 articles identified in Pediatrics, 22 (40%) used a version of the PedsQL. No neurosurgical study reached above Level 4 on the Oxford Centre for Evidence-Based Medicine (OCEBM) system. However, multiple studies from Pediatrics achieved OCEBM Level 3, several were categorized as Level 2, and one reached Level 1

Consumer attitudes towards evidence based mental health services among American mental health consumers.

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Teh, Lisa B; Hayashi, Kentaro; Latner, Janet; Mueller, Charles W

2016-10-01

The Consumer Attitudes towards Evidence Based Services (CAEBS) scale is a 29-item questionnaire designed to assess public views on the role of science in helping to guide mental health treatment. The aim of the current study was to assess the Factor structure the CAEBS in an online sample of adults seeking information about mental health services. The CAEBS was administered to a nationwide sample of participants from websites offering classified advertisements for mental health related study participation (n = 312). An Exploratory Factor Analysis (EFA) suggested four factors based on 26 of the items: Beliefs Regarding Therapists' Practices, Attitudes about Mental Health Policy, Negative Personal-Level Attitudes toward EBPs, and Negative Societal-Level Attitudes towards EBPs. In order to increase consumer empowerment within the mental health-care system and develop policies supporting EBP usage, mental health professionals need to increase communication with the public to address these concerns and leverage positive attitudes. © 2016 Australian College of Mental Health Nurses Inc.

Public mental health: the time is ripe for translation of evidence into practice

OpenAIRE

Wahlbeck, Kristian

2015-01-01

Public mental health deals with mental health promotion, prevention of mental disorders and suicide, reducing mental health inequalities, and governance and organization of mental health service provision. The full impact of mental health is largely unrecognized within the public health sphere, despite the increasing burden of disease attributable to mental and behavioral disorders. Modern public mental health policies aim at improving psychosocial health by addressing determinants of mental ...

Public health: disconnections between policy, practice and research

Directory of Open Access Journals (Sweden)

Kok Gerjo

2010-12-01

Full Text Available Abstract Background Public health includes policy, practice and research but to sufficiently connect academic research, practice and public health policy appears to be difficult. Collaboration between policy, practice and research is imperative to obtaining more solid evidence in public health. However, the three domains do not easily work together because they emanate from three more or less independent 'niches'. Work cycles of each niche have the same successive steps: problem recognition, approach formulation, implementation, and evaluation, but are differently worked out. So far, the research has focused on agenda-setting which belongs to the first step, as expressed by Kingdon, and on the use of academic knowledge in policy makers' decision-making processes which belongs to the fourth step, as elaborated by Weiss. In addition, there are more steps in the policy-making process where exchange is needed. Method A qualitative descriptive research was conducted by literature search. We analyzed the four steps of the policy, practice and research work cycles. Next, we interpreted the main conflicting aspects as disconnections for each step. Results There are some conspicuous differences that strengthen the niche character of each domain and hamper integration and collaboration. Disconnections ranged from formulating priorities in problem statements to power roles, appraisal of evidence, work attitudes, work pace, transparency of goals, evaluation and continuation strategies and public accountability. Creating awareness of these disconnections may result in more compatibility between researchers, policy makers and practitioners. Conclusion We provide an analysis that can be used by public health services-related researchers, practitioners and policy makers to be aware of the risk for disconnections. A synthesis of the social, practical and scientific relevance of public health problems should be the starting point for a dialogue that seeks to

Experiences and attitudes towards evidence-informed policy-making among research and policy stakeholders in the Canadian agri-food public health sector.

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Young, I; Gropp, K; Pintar, K; Waddell, L; Marshall, B; Thomas, K; McEwen, S A; Rajić, A

2014-12-01

Policy-makers working at the interface of agri-food and public health often deal with complex and cross-cutting issues that have broad health impacts and socio-economic implications. They have a responsibility to ensure that policy-making based on these issues is accountable and informed by the best available scientific evidence. We conducted a qualitative descriptive study of agri-food public health policy-makers and research and policy analysts in Ontario, Canada, to understand their perspectives on how the policy-making process is currently informed by scientific evidence and how to facilitate this process. Five focus groups of 3-7 participants and five-one-to-one interviews were held in 2012 with participants from federal and provincial government departments and industry organizations in the agri-food public health sector. We conducted a thematic analysis of the focus group and interview transcripts to identify overarching themes. Participants indicated that the following six key principles are necessary to enable and demonstrate evidence-informed policy-making (EIPM) in this sector: (i) establish and clarify the policy objectives and context; (ii) support policy-making with credible scientific evidence from different sources; (iii) integrate scientific evidence with other diverse policy inputs (e.g. economics, local applicability and stakeholder interests); (iv) ensure that scientific evidence is communicated by research and policy stakeholders in relevant and user-friendly formats; (V) create and foster interdisciplinary relationships and networks across research and policy communities; and (VI) enhance organizational capacity and individual skills for EIPM. Ongoing and planned efforts in these areas, a supportive culture, and additional education and training in both research and policy realms are important to facilitate evidence-informed policy-making in this sector. Future research should explore these findings further in other countries and contexts. �

The role of public relations for image creating in health services: a sample patient satisfaction survey.

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Kirdar, YalçIn

2007-01-01

This study discusses the role of public relations for image creating in health services. Hospitals require public relations activities to distinguish them from competitors, provide bidirectional communication between the society and the hospital, and assist to create of a strong hospital image and culture. A satisfaction survey was conducted on 264 patients who have received health services at Maltepe University Hospital. The research focused on how the Hospital's examination, care, catering and physical services; doctor and nurse politeness towards patients and patient relatives, their attitudes and behaviors; examination, check-in, bedding and discharge operations; public relations activities in and out of the hospital were perceived. Another subject of the study was the degree of recommendation of patients who have been served by the hospital's health services to prospective patients seeking treatment.

Using public relations strategies to prompt populations at risk to seek health information: the Hanford Community Health Project.

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Thomas, Gregory D; Smith, Stephen M; Turcotte, Joseph A

2009-01-01

The Hanford Community Health Project (HCHP) addressed health concerns among "downwinders" exposed to releases of radioactive iodine (I-131) from the Hanford Nuclear Reservation in the 1940s and 1950s. After developing educational materials and conducting initial outreach, HCHP had to decide whether to apply its limited resources to an advertising or public relations approach. The decision to apply public relations strategies was effective in driving awareness of the risk communication message at the community level, reinvigorating the affected community, and ultimately increasing the number of people who sought information about their risk of exposure and related health issues. HCHP used a series of communication tools to reach out to local and regional media, medical and health professionals, and community organizations. The campaign was successful in increasing the number of unique visitors to HCHP Web site and educating and activating the medical community around the releases of I-131 and patient care choices.

Results from a psychometric assessment of a new tool for measuring evidence-based decision making in public health organizations.

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Stamatakis, Katherine A; Ferreira Hino, Adriano Akira; Allen, Peg; McQueen, Amy; Jacob, Rebekah R; Baker, Elizabeth A; Brownson, Ross C

2017-02-01

In order to better understand how to improve evidence-based decision making (EBDM) in state health departments, measurement tools are needed to evaluate changes in EBDM. The purpose of this study was to test the psychometric properties of a new measurement tool to assess EBDM in public health practice settings. A questionnaire was developed, pilot-tested and refined in an iterative process with the input of public health practitioners with the aim of identifying a set of specific measures representing different components of EBDM. Data were collected in a national survey of state health department chronic disease practitioners. The final dataset (n=879) for psychometric testing was comprised of 19 EBDM items that were first examined using exploratory factor analysis, and then confirmatory factor analysis. The final model from confirmatory factor analysis includes five latent factors representing components of EBDM: capacity for evaluation, expectations and incentives for EBDM, access to evidence and resources for EBDM, participatory decision making, and leadership support and commitment. This study addresses the need for empirically tested and theory-aligned measures that may be used to assess the extent to which EBDM is currently implemented, and further, to gauge the success of strategies to improve EBDM, in public health settings. This EBDM measurement tool may help identify needed supports for enhanced capacity and implementation of effective strategies. Copyright © 2016. Published by Elsevier Ltd.

National guidelines for high-cost drugs in Brazil: achievements and constraints of an innovative national evidence-based public health policy.

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Picon, Paulo D; Beltrame, Alberto; Banta, David

2013-04-01

The translation of best evidence into practice has become an important purpose of policy making in health care. In Brazil, a country of continental dimensions with widespread regional and social inequalities, the dissemination and use of the best-evidence in policy making is a critical issue for the healthcare system. The main purpose of this study is to describe an evidence-based public health policy with special emphasis on guidelines creation for high-cost medicines. We also describe how that strategy was diffused to the judiciary system and to other parts of the healthcare system. We present an 11-year follow-up of a national project for creating and updating guidelines for high-cost medicines in Brazil. A total of 109 national guidelines were published (new or updated versions) for 66 selected diseases, the first such effort in Brazilian history. The project influenced the Brazilian legislature, which has recently established a Federal Law requiring national guidelines for any new technology listed for payment by the Brazilian public healthcare system. We were able to involve many different stakeholders in a partnership between academia and policy makers, which made possible the widespread dissemination of the clinical practice guidelines. Problems and constraints were also encountered. This evolving public health strategy might be useful for other developing countries.

Obesity stigma: important considerations for public health.

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Puhl, Rebecca M; Heuer, Chelsea A

2010-06-01

Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health.

Real-World Evidence, Public Participation, and the FDA.

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Schwartz, Jason L

2017-11-01

For observers of pharmaceutical regulation and the Food and Drug Administration, these are uncertain times. Events in late 2016 raised concerns that the FDA's evidentiary standards were being weakened, compromising the agency's ability to adequately perform its regulatory and public health responsibilities. Two developments most directly contributed to these fears-the approval of eteplirsen, a treatment for Duchenne muscular dystrophy, against the recommendations of both FDA staff and an advisory committee and the December 2016 signing of the 21st Century Cures Act, which encouraged greater use by the FDA of "real-world" evidence not obtained through randomized controlled trials. The arrival of the Trump administration-with its deregulatory, industry-friendly approach-has only amplified concerns over the future of the FDA. It is too early to know whether the recent developments are truly harbingers of an FDA less likely to prevent unsafe or ineffective products from reaching the market. But elements in the two events-the role of patient narratives in deliberations regarding eteplirsen and the enthusiasm for real-world evidence in the 21st Century Cures Act-raise critical issues for the future of evidence in the FDA's work. The rigorous, inclusive approach under way to consider issues related to real-world evidence provides a model for a similarly needed inquiry regarding public participation in FDA decision-making. © 2017 The Hastings Center.

Workshop salutogenesis and the future of health promotion and public health.

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Lindström, Bengt

2018-02-01

This presentation is a synthesis of a workshop on Salutogenesis and the Future of Health Promotion and Public Health at the Nordic Health Promotion Research Conference in June 2016. A brief historical review of Public Health and Health Promotion development in a Nordic perspective is included. However, the main thrust of the article is to present how the salutogenic theory and approach could strengthen society's organised efforts to prevent disease, promote health and prolong life. A critical view based on existing evidence is maintained through the presentation that arrives at the conclusion it would be worthwhile to invest in effective theory driven approaches to the development of Public Health and Health Promotion in the future.

Educating the future public health workforce: do schools of public health teach students about the private sector?

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Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon

2013-01-01

Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.

An evaluation of the International Monetary Fund's claims about public health.

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Stuckler, David; Basu, Sanjay; Gilmore, Anna; Batniji, Rajaie; Ooms, Gorik; Marphatia, Akanksha A; Hammonds, Rachel; McKee, Martin

2010-01-01

The International Monetary Fund's recent claims concerning its impact on public health are evaluated against available data. First, the IMF claims that health spending either does not change or increases with IMF-supported programs, but there is substantial evidence to the contrary. Second, the IMF claims to have relaxed strict spending requirements in response to the 2008-9 financial crisis, but there is no evidence supporting this claim, and some limited evidence from the Center for Economic Policy Research contradicting it. Third, the IMF states that wage ceilings on public health are no longer part of its explicit conditionalities to poor countries, as governments can choose how to achieve public spending targets; but in practice, ministers are left with few viable alternatives than to reduce health budgets to achieve specific IMF-mandated targets, so the result effectively preserves former policy. Fourth, the IMF's claim that it has increased aid to poor countries also seems to be contradicted by its policies of diverting aid to reserves, as well as evidence that a very small fraction of the Fund's new lending in response to the financial crisis has reached poor countries. Finally, the IMF's claim that it follows public health standards in tobacco control contrasts with its existing policies, which fail to follow the guidelines recommended by the World Bank and World Health Organization. The authors recommend that the IMF (1) become more transparent in its policies, practices, and data to allow improved independent evaluations of its impact on public health (including Health Impact Assessment) and (2) review considerable public health evidence indicating a negative association between its current policies and public health outcomes.

How the "Understanding Research Evidence" Web-Based Video Series From the National Collaborating Centre for Methods and Tools Contributes to Public Health Capacity to Practice Evidence-Informed Decision Making: Mixed-Methods Evaluation.

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Chan, Linda; Mackintosh, Jeannie; Dobbins, Maureen

2017-09-28

The National Collaborating Centre for Methods and Tools (NCCMT) offers workshops and webinars to build public health capacity for evidence-informed decision-making. Despite positive feedback for NCCMT workshops and resources, NCCMT users found key terms used in research papers difficult to understand. The Understanding Research Evidence (URE) videos use plain language, cartoon visuals, and public health examples to explain complex research concepts. The videos are posted on the NCCMT website and YouTube channel. The first four videos in the URE web-based video series, which explained odds ratios (ORs), confidence intervals (CIs), clinical significance, and forest plots, were evaluated. The evaluation examined how the videos affected public health professionals' practice. A mixed-methods approach was used to examine the delivery mode and the content of the videos. Specifically, the evaluation explored (1) whether the videos were effective at increasing knowledge on the four video topics, (2) whether public health professionals were satisfied with the videos, and (3) how public health professionals applied the knowledge gained from the videos in their work. A three-part evaluation was conducted to determine the effectiveness of the first four URE videos. The evaluation included a Web-based survey, telephone interviews, and pretest and posttests, which evaluated public health professionals' experience with the videos and how the videos affected their public health work. Participants were invited to participate in this evaluation through various open access, public health email lists, through informational flyers and posters at the Canadian Public Health Association (CPHA) conference, and through targeted recruitment to NCCMT's network. In the Web-based surveys (n=46), participants achieved higher scores on the knowledge assessment questions from watching the OR (P=.04), CI (P=.04), and clinical significance (P=.05) videos but not the forest plot (P=.12) video, as

System impact research - increasing public health and health care system performance.

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Malmivaara, Antti

2016-01-01

Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

Incidence of online health information search: a useful proxy for public health risk perception.

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Liang, Bo; Scammon, Debra L

2013-06-17

Internet users use search engines to look for information online, including health information. Researchers in medical informatics have found a high correlation of the occurrence of certain search queries and the incidence of certain diseases. Consumers' search for information about diseases is related to current health status with regard to a disease and to the social environments that shape the public's attitudes and behaviors. This study aimed to investigate the extent to which public health risk perception as demonstrated by online information searches related to a health risk can be explained by the incidence of the health risk and social components of a specific population's environment. Using an ecological perspective, we suggest that a population's general concern for a health risk is formed by the incidence of the risk and social (eg, media attention) factors related with the risk. We constructed a dataset that included state-level data from 32 states on the incidence of the flu; a number of social factors, such as media attention to the flu; private resources, such as education and health insurance coverage; public resources, such as hospital beds and primary physicians; and utilization of these resources, including inpatient days and outpatient visits. We then explored whether online information searches about the flu (seasonal and pandemic flu) can be predicted using these variables. We used factor analysis to construct indexes for sets of social factors (private resources, public resources). We then applied panel data multiple regression analysis to exploit both time-series and cross-sectional variation in the data over a 7-year period. Overall, the results provide evidence that the main effects of independent variables-the incidence of the flu (Phealth lifestyles (P=.009); and public resources, such as hospital care utilization (P=.008) and public health funds (P=.02)-have significant effects on Web searches for queries related to the flu. After

Twitter and Public Health (Part 2): Qualitative Analysis of How Individual Health Professionals Outside Organizations Use Microblogging to Promote and Disseminate Health-Related Information.

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Hart, Mark; Stetten, Nichole; Islam, Sabrina; Pizarro, Katherine

2017-10-04

Twitter is the most popular form of microblogging that is being utilized in public health to engage audiences and to communicate health-related information. Although there is some research showing the various forms of Twitter use in public health, little is known about how individual public health professionals are using their personal Twitter accounts to disseminate health information. The purpose of this research was to categorize public health professionals' tweets to evaluate how individual public health professionals are furthering the mission of public health. Twitter accounts held by public health professionals were identified, and researchers proceeded to record 6 months' worth of each individual's Twitter feed. During the 6-month period, a total of 15,236 tweets were collected and analyzed using the constant comparison method. A total of 23 tweet categories among the 15,236 tweets were initially identified. Some of the most common topics among the 23 categories included the following: health nutrition (n=2008), conferences (n=815), Ebola (n=789), Affordable Care Act (ACA)/health care (n=627), and social justice (n=626). Each of these categories were then stratified into one of four themes: (1) informing and educating, (2) monitoring health statuses and trends, (3) social justice, and (4) professional development. Using Twitter, public health professionals are helping dispel misinformation through education and by translating technical research into lay terms, advocating for health inequalities, and using it as a means to promote professional development. ©Mark Hart, Nichole Stetten, Sabrina Islam, Katherine Pizarro. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 04.10.2017.

Billing and insurance-related administrative costs in United States' health care: synthesis of micro-costing evidence.

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Jiwani, Aliya; Himmelstein, David; Woolhandler, Steffie; Kahn, James G

2014-11-13

The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs. Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012. We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies settings, so extrapolated from known sectors. We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated "added" BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses. BIR costs in the U.S. health care system totaled approximately $471 ($330 - $597) billion in 2012. This includes $70 ($54 - $76) billion in physician practices, $74 ($58 - $94) billion in hospitals, an estimated $94 ($47 - $141) billion in settings providing other health services and supplies, $198 ($154 - $233) billion in private insurers, and $35 ($17 - $52) billion in public insurers. Compared to simplified financing, $375

Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making.

Science.gov (United States)

Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

2008-12-18

In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health.

Institutional public private partnerships for core health services: evidence from Italy

Directory of Open Access Journals (Sweden)

Longo Francesco

2011-04-01

Full Text Available Abstract Background Public-private partnerships (PPPs are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. Methods A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN. The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4 currently in force in one Italian region as the unit of analysis: (i a rehabilitation hospital, (ii, an orthopaedic-centre, (iii a primary care and ambulatory services facility, and (iv a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Results Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i a strategic market orientation to a specialised service area with sufficient potential demand, (ii the allocation of public capital assets and the consistent financial involvement of the private partner, (iii the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv clear regulation of the workforce to align the contracts with the organisational culture. Conclusions Findings

Institutional public private partnerships for core health services: evidence from Italy.

Science.gov (United States)

Cappellaro, Giulia; Longo, Francesco

2011-04-19

Public-private partnerships (PPPs) are potential instruments to enable private collaboration in the health sector. Despite theoretical debate, empirical analyses have thus far tended to focus on the contractual or project dimension, overlooking institutional PPPs, i.e., formal legal entities run by proper corporate-governance mechanisms and jointly owned by public and private parties for the provision of public-health goods. This work aims to fill this gap by carrying out a comparative analysis of the reasons for the adoption of institutional PPPs and the governance and managerial features necessary to establish them as appropriate arrangements for public-health services provisions. A qualitative analysis is carried out on experiences of institutional PPPs within the Italian National Health Service (Sistema Sanitario Nazionale, SSN). The research question is addressed through a contextual and comparative embedded case study design, assuming the entire population of PPPs (4) currently in force in one Italian region as the unit of analysis: (i) a rehabilitation hospital, (ii), an orthopaedic-centre, (iii) a primary care and ambulatory services facility, and (iv) a health- and social-care facility. Internal validity is guaranteed by the triangulation of sources in the data collection phase, which included archival and interview data. Four governance and managerial issues were found to be critical in determining the positive performance of the case examined: (i) a strategic market orientation to a specialised service area with sufficient potential demand, (ii) the allocation of public capital assets and the consistent financial involvement of the private partner, (iii) the adoption of private administrative procedures in a regulated setting while guaranteeing the respect of public administration principles, and (iv) clear regulation of the workforce to align the contracts with the organisational culture. Findings suggests that institutional PPPs enable national health

Cannabis for therapeutic purposes and public health and safety: a systematic and critical review.

Science.gov (United States)

Sznitman, Sharon R; Zolotov, Yuval

2015-01-01

The use of Cannabis for Therapeutic Purposes (CTP) has recently become legal in many places. These policy and legal modifications may be related to changes in cannabis perceptions, availability and use and in the way cannabis is grown and sold. This may in turn have effects on public health and safety. To better understand the potential effects of CTP legalization on public health and safety, the current paper synthesizes and critically discusses the relevant literature. Twenty-eight studies were identified by a comprehensive search strategy, and their characteristics and main findings were systematically reviewed according to the following content themes: CTP and illegal cannabis use; CTP and other public health issues; CTP, crime and neighbourhood disadvantage. The research field is currently limited by a lack of theoretical and methodological rigorous studies. The review shows that the most prevalent theme of investigation so far has been the relation between CTP and illegal cannabis use. In addition, the literature review shows that there is an absence of evidence to support many common concerns related to detrimental public health and safety effects of CTP legalization. Although lack of evidence provides some reassurance that CTP legalization may not have posed a substantial threat to public health and safety, this conclusion needs to be examined in light of the limitations of studies conducted so far. Furthermore, as CTP policy continues to evolve, including incorporation of greater commercialization, it is possible that the full effects of CTP legalization have yet to take place. Ensuring study quality will allow future research to better investigate the complex role that CTP plays in relation to society at large, and public health and safety in particular. Copyright © 2014 Elsevier B.V. All rights reserved.

Why Do People Work in Public Health? Exploring Recruitment and Retention Among Public Health Workers.

Science.gov (United States)

Yeager, Valerie A; Wisniewski, Janna M; Amos, Kathleen; Bialek, Ron

2016-01-01

The public health workforce is critical to the functioning of the public health system and protection of the population's health. Ensuring a sufficient workforce depends on effectively recruiting and retaining workers. This study examines factors influencing decisions to take and remain in jobs within public health, particularly for workers employed in governmental public health. This cross-sectional study employed a secondary data set from a 2010 national survey of US public health workers. Survey respondents were included in this study if they responded to at least 1 survey item related to recruitment and retention. A total of 10 859 survey responses fit this criterion. Data examined demographics of public health workers and factors that influenced decisions to take jobs in and remain in public health. Job security (β = 0.42; 95% confidence interval [CI], 0.28-0.56) and competitive benefits (β = 0.49; 95% CI, 0.28-0.70) were significantly and positively associated with governmental employees' decisions to take positions with their current employers compared with public health workers employed by other types of organizations. The same finding held with regard to retention: job security (β = 0.40; 95% CI, 0.23-0.57) and competitive benefits (β = 0.53; 95% CI, 0.24-0.83). Two personal factors, personal commitment to public service (β = 0.30; 95% CI, 0.17-0.42) and wanted a job in the public health field (β = 0.44; 95% CI, 0.18-0.69), were significantly and positively related to governmental employees deciding to remain with their current employers. It is important to recognize the value of competitive benefits for both current and potential employees. Public health agencies should maintain these if possible and make the value of these benefits known to policy makers or other agencies setting these benefit policies. Job security associated with governmental public health jobs also appears to offer public health an advantage in recruiting and retaining employees.

The Developing Role of Evidence-Based Environmental Health

Directory of Open Access Journals (Sweden)

Surindar Dhesi

2015-10-01

Full Text Available There has been renewed recognition that proactive strategies and interventions can address the social determinants of health, and the environmental health profession is well placed to effect positive change in many of these determinants. This qualitative research has revealed differences in the perceptions, experiences, and understandings of evidence-based practice among public health professionals from different backgrounds across different services in health care and local government in England. The absence of a strong tradition of evidence-based practice in environmental health appears to be a disadvantage in securing funding and playing a full role, as it has become the expectation in the new public health system. This has, at times, resulted in tensions between professionals with different backgrounds and frustration on the part of environmental health practitioners, who have a tradition of responding quickly to new challenges and “getting on with the job.” There is generally a willingness to develop evidence-based practice in environmental health; however, this will take time and investment.

Public health safety and environment in inadequate hospital and healthcare settings: a review.

Science.gov (United States)

Baguma, D

2017-03-01

Public health safety and environmental management are concerns that pose challenges worldwide. This paper briefly assesses a selected impact of the environment on public health. The study used an assessment of environmental mechanism to analyse the underlying different pathways in which the health sector is affected in inadequate hospital and health care settings. We reviewed the limited available evidence of the association between the health sector and the environment, and the likely pathways through which the environment influences health. The paper also models the use of private health care as a function of costs and benefits relative to public care and no care. The need to enhancing policies to improve the administration of health services, strengthening interventions on environment using international agreements, like Rio Conventions, including measures to control hospital-related infection, planning for human resources and infrastructure construction development have linkage to improve environment care and public health. The present study findings partly also demonstrate the influence of demand for health on the environment. The list of possible interventions includes enhancing policies to improve the administration of health services, strengthening Rio Conventions implementation on environmental concerns, control of environmental hazards and public health. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

"Black Magic" and "Gold Dust": The Epistemic and Political Uses of Evidence Tools in Public Health Policy Making

Science.gov (United States)

Stewart, Ellen; Smith, Katherine E.

2015-01-01

Concerns about the limited influence of research on decision making have prompted the development of tools intended to mediate evidence for policy audiences. This article focuses on three examples, prominent in public health: impact assessments; systematic reviews; and economic decision-making tools (cost-benefit analysis and scenario modelling).…

Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program

OpenAIRE

Meagher, Karen M.; Lee, Lisa M.

2016-01-01

Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation—deliberative public bioethics—into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bio...

Smoker-free workplace policies: developing a model of public health consequences of workplace policies barring employment to smokers.

Science.gov (United States)

Houle, B; Siegel, M

2009-02-01

A marked shift in tobacco-related workplace health promotion intervention involves the adoption of policies barring employment to smokers. We discuss the potential public health consequences of these policies on those affected-smokers, their families, the surrounding community and society at large. We find a lack of published evidence evaluating the effectiveness and consequences of these policies. By developing a model of policy effects, we outline possible unintended consequences. With such large gaps in the evidence base and the potential for deleterious consequences, we argue for increased discussion about the use of smoker-free employment policies as a public health intervention and for increased engagement of employers by the public health community in worksite health promotion.

Power relations and contrasting conceptions of evidence in patient-involvement processes used to inform health funding decisions in Australia.

Science.gov (United States)

Lopes, Edilene; Carter, Drew; Street, Jackie

2015-06-01

We collected and analysed views of key stakeholders on the processes used to involve patient organisations in health care funding decision making in Australia. We conducted 12 semi-structured interviews with patient organisation representatives and members of Advisory Committees that provide advice to the Australian Department of Health and employ Health Technology Assessment (HTA) as an evaluation framework. Using two theoretical frameworks, we analysed structural and contextual elements pertaining to the involvement processes. The findings reported in this article relate to interviewees' perspectives on contextual elements, analysed using a Foucauldian lens. These elements include: the perspectives of marginalised voices; the diversity of views on what ought to be considered valid evidence in a HTA setting; and the relationships between stakeholders, along with how these relationships impact on involvement processes and the outcomes of those processes. The findings demonstrate that the involvement processes currently used are deemed inadequate by both patient organisation representatives and Advisory Committee members, but for different reasons connected to how different stakeholders conceptualise evidence. Advisory Committee members viewed evidence as encompassing clinical outcomes and patient preferences, whereas patient organisation representatives tended to view evidence as encompassing aspects not directly related to a disease entity, such as the social and emotional aspects of patients' experiences in living with illness. Patient organisation representatives reported interacting with other stakeholders (especially industry) to increase the influence of their conception of evidence on decision making. The use of this strategy by interviewees illustrates how power struggles occur in government decision-making processes which involve both medical expertise and patients' accounts. Such struggles, and the power differentials they reflect, need to be considered

The Use of Evidence in Public Debates in the Media: The Case of Swiss Direct-Democratic Campaigns in the Health Policy Sector

Science.gov (United States)

Stucki, Iris

2016-01-01

This article analyses the reporting of evidence in Swiss direct-democratic campaigns in the health policy sector, assuming that an informed public helps democracy function successfully. A content analysis of the media's news reporting shows that of 5030 media items retrieved, a reference to evidence is found in 6.8%. The voter receives evidence in…

Lessons learned from evaluating Maryland's anti-drunk driving campaign: assessing the evidence for cognitive, behavioral, and public health impact.

Science.gov (United States)

Beck, Kenneth H

2009-07-01

The evidence concerning Maryland's anti-drunk driving program, Checkpoint Strikeforce, is reviewed. To date, there is no evidence to indicate that this campaign, which involves a number of sobriety checkpoints and media activities to promote these efforts, has had any impact on public perceptions, driver behaviors, or alcohol-related motor vehicle crashes and injuries. This conclusion is drawn after examining statistics for alcohol-related crashes, police citations for impaired driving, and public perceptions of alcohol-impaired driving risk. Comparisons are also made with other states in the mid-Atlantic region, where similar campaign activities have occurred. Reasons for this failure in Maryland include insufficient levels of enforcement (e.g., too few sobriety checkpoints and vehicle contacts occurred to raise public perceptions of risk pertaining to impaired driving) and inadequate publicity surrounding this campaign. Suggestions for overcoming these problems are offered.

Alcohol and public health in Africa: can we prevent alcohol-related harm from increasing?

Science.gov (United States)

Ferreira-Borges, Carina; Dias, Sonia; Babor, Thomas; Esser, Marissa B; Parry, Charles D H

2015-09-01

According to the World Health Organization (WHO), the total amount of alcohol consumed in the African region is expected to increase due to the growth of new alcohol consumers, especially young people and women. With the changing alcohol environment, increases in the alcohol-attributable burden of disease are inevitable. To our knowledge, there has not been a comprehensive analysis of the factors that could be driving those increases. The objective of this study was to examine the evidence from peer reviewed literature regarding the factors that could be instrumental in this process, in order to inform strategic policy-related decisions. A narrative review was conducted using a thematic analysis approach. We searched papers published between January 2000 and July 2014 in PubMed, the WHO's Global Health Library and African Journals Online. Our analysis identified seven factors (demographics, rapid urbanization, economic development, increased availability, corporate targeting, weak policy infrastructure and trade agreements) which are potentially tied to changes in alcohol consumption in Africa. Driven largely by globalization, a potential convergence of these various factors is likely to be associated with continued growth in alcohol consumption and alcohol-related morbidity and mortality. To address the emerging risk factors associated with increased alcohol consumption, African governments need to take a more active role in protecting the public's health. In particular, important strategic shifts are needed to increase implementation of intersectoral strategies, community involvement in the policy dialogue, health services re-orientation and better regulation of the alcohol beverage industry. © 2015 Society for the Study of Addiction.

What makes health public?: a critical evaluation of moral, legal, and political claims in public health

National Research Council Canada - National Science Library

Coggon, John

2012-01-01

.... Covering important works from legal, moral, and political theory, public health, public health law and ethics, and bioethics, this is a foundational text for scholars, practitioners and policy bodies interested in freedoms, rights and responsibilities relating to health"--

Systematic review of public health branding.

Science.gov (United States)

Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L

2008-12-01

Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on public health brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on public health branding available through all relevant, major online publication databases. Public health branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of public health and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.

Public health human resources: a comparative analysis of policy documents in two Canadian provinces

Science.gov (United States)

2014-01-01

Background Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. Methods A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Results Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. Conclusion This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be

Public health human resources: a comparative analysis of policy documents in two Canadian provinces.

Science.gov (United States)

Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy

2014-02-24

Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing

East African Journal of Public Health

African Journals Online (AJOL)

The East African Journal of Public Health is a multi-disciplinary journal publishing scientific research work from a range of public health related disciplines including community medicine, epidemiology, nutrition, behavioural sciences, health promotion, health education, communicable and non-communicable disease.

Public strategies for improving eHealth integration and long‐term sustainability in public health care systems: Findings from an Italian case study

Science.gov (United States)

Nuti, Sabina

2017-01-01

Summary eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long‐term sustainability. In a public health care system, the public actor is among the main “buyers” eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a “buyer”) improve long‐term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win‐win strategies should be followed. Investments should take into account the need to long‐term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the “platform approach” emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. PMID:28791771

Establishing evidence-informed core intervention competencies in psychological first aid for public health personnel.

Science.gov (United States)

Parker, Cindy L; Everly, George S; Barnett, Daniel J; Links, Jonathan M

2006-01-01

A full-scale public health response to disasters must attend to both the physical and mental health needs of affected communities. Public health preparedness efforts can be greatly expanded to address the latter set of needs, particularly in light of the high ratio of psychological to physical casualties that often rapidly overwhelms existing mental health response resources in a large-scale emergency. Psychological first aid--the provision of basic psychological care in the short term aftermath of a traumatic event--is a mental health response skill set that public health personnel can readily acquire with proper training. The application of psychological first aid by public health workers can significantly augment front-line community-based mental health responses during the crisis phase of an event. To help achieve this augmented response, we have developed a set of psychological first aid intervention competencies for public health personnel. These competencies, empirically grounded and based on best practice models and consensus statements from leading mental health organizations, represent a necessary step for developing a public health workforce that can better respond to the psychological needs of impacted populations in disasters.

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

Science.gov (United States)

Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

2017-01-01

Context: Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. Objective: The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. Methods: In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. Results: A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. Conclusion: The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. PMID:28277203

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare.

Science.gov (United States)

Price, Alex; Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

2017-02-01

Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. Copyright © 2017 Longwoods Publishing.

Genomics in Public Health: Perspective from the Office of Public Health Genomics at the Centers for Disease Control and Prevention (CDC

Directory of Open Access Journals (Sweden)

Ridgely Fisk Green

2015-09-01

Full Text Available The national effort to use genomic knowledge to save lives is gaining momentum, as illustrated by the inclusion of genomics in key public health initiatives, including Healthy People 2020, and the recent launch of the precision medicine initiative. The Office of Public Health Genomics (OPHG at the Centers for Disease Control and Prevention (CDC partners with state public health departments and others to advance the translation of genome-based discoveries into disease prevention and population health. To do this, OPHG has adopted an “identify, inform, and integrate” model: identify evidence-based genomic applications ready for implementation, inform stakeholders about these applications, and integrate these applications into public health at the local, state, and national level. This paper addresses current and future work at OPHG for integrating genomics into public health programs.

Genomics in Public Health: Perspective from the Office of Public Health Genomics at the Centers for Disease Control and Prevention (CDC).

Science.gov (United States)

Green, Ridgely Fisk; Dotson, W David; Bowen, Scott; Kolor, Katherine; Khoury, Muin J

2015-01-01

The national effort to use genomic knowledge to save lives is gaining momentum, as illustrated by the inclusion of genomics in key public health initiatives, including Healthy People 2020, and the recent launch of the precision medicine initiative. The Office of Public Health Genomics (OPHG) at the Centers for Disease Control and Prevention (CDC) partners with state public health departments and others to advance the translation of genome-based discoveries into disease prevention and population health. To do this, OPHG has adopted an "identify, inform, and integrate" model: identify evidence-based genomic applications ready for implementation, inform stakeholders about these applications, and integrate these applications into public health at the local, state, and national level. This paper addresses current and future work at OPHG for integrating genomics into public health programs.

A strategic approach to workforce development for local public health.

Science.gov (United States)

Bryant, Beverley; Ward, Megan

2017-11-09

In 2009, Peel Public Health set a vision to transform the work of public health from efficient delivery of public health services as defined by provincial mandate to the robust analysis of the health status of the local population and selection and implementation of programming to achieve best health outcomes. A strategic approach to the workforce was a key enabler. PPH is a public health unit in Ontario that serves 1.4 million people. An organization-wide strategic workforce development program was instituted. It is theory-based, evidence-informed and data-driven. A first step was a conceptual framework, followed by interventions in workforce planning, human resources management, and capacity development. The program was built on evidence reviews, theory, and public health core competencies. Interventions spread across the employee work-life span. Capacity development based on the public health core competencies is a main focus, particularly analytical capacity to support decision-making. Employees gain skill and knowledge in comprehensive population health. Leadership evolves as work shifts to the analysis of health status and development of interventions. Effective human resource processes ensure appropriate job design, recruitment and orientation. Analysis of the workforce leads to vigorous employee development to ensure a strong pool of potential leadership successors. Theory, research evidence, and data provide a robust foundation for workforce development. Competencies are important inputs to job descriptions, recruitment, training, and human resource processes. A comprehensive workforce development strategy enables the development of a skilled workforce capable of responding to the needs of the population it serves.

Experiences of Knowledge Brokering for Evidence-Informed Public Health Policy and Practice: Three Years of the Scottish Collaboration for Public Health Research and Policy

Science.gov (United States)

Frost, Helen; Geddes, Rosemary; Haw, Sally; Jackson, Caroline A.; Jepson, Ruth; Mooney, John D.; Frank, John

2012-01-01

Despite a burgeoning literature on, and widespread interest in, knowledge translation and exchange in public health, few articles provide an account of the actual experiences of knowledge brokerage organisations. The Scottish Collaboration for Public Health Research and Policy (SCPHRP) was formed in 2008 to: identify public health interventions…

Public Report on Health (India) - Phase II | IDRC - International ...

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

The Public Report on Health aims to draw federal and state attention to the health needs of ordinary people, so as to develop evidence-based solutions for meeting those needs. The Intensive Village Study carried out during the first phase of ... Outputs. Reports. Public report on health : final technical report. Download PDF ...

Reception of the Interpersonal Relations Series of the Continuing Education Project for Public Health Workers in North Carolina.

Science.gov (United States)

Dutton, Donnie

Research was conducted on reactions of North Carolina public health workers to the telecasts, study manuals, and group discussion sessions used for seven programs (Introduction, Group Discussion, Communication, Cooperation, Culture and Public Health, Our Public Image, and Questions and Answers, respectively) in the interpersonal relations series…

Addressing the critical health problem of adolescent substance use through health care, research, and public policy.

Science.gov (United States)

Feinstein, Emily C; Richter, Linda; Foster, Susan E

2012-05-01

The use of addictive substances-tobacco, alcohol, and other drugs-during adolescence interferes with brain development and increases the risk of serious health and mental health conditions, including addiction. Yet, adolescents live in a culture in which family, social, community, and media influences regularly bombard them with pro-substance use messages, creating an environment in which substance use is considered an expected behavior, rather than a considerable health risk. To prevent the significant harm that falls to teens and young adults because of substance use, The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) undertook a study to explore how adolescent brain development relates to the risk of substance use and addiction; the cultural influences that create an environment in which substance use is considered normative behavior; individual factors that make some teens more disposed to substance use and addiction; and evidence-based prevention and treatment strategies for addressing this problem. The recently published report Adolescent Substance Use: America's #1 Public Health Problem concludes that risky substance use is a major public health problem that can be ameliorated through evidence-based public health measures, including education about the disease and its risk factors, screenings, and clinical interventions, and that addiction can be treated and managed effectively within routine health care practice and specialty care. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Evidence for Mental Health Occupational Therapy

Directory of Open Access Journals (Sweden)

Danielle Hitch

2015-09-01

Full Text Available This article reports on the evidence for mental health occupational therapy in peer-reviewed journals from 2000 to 2013. Descriptive and inductive methods were used to address this question, with evidence from CINAHL, OTDBase, PSYCInfo, SCOPUS, and Google Scholar® included. Many articles (n = 1,747 were found that met the inclusion and exclusion criteria. A total of 47 different methods were used to develop evidence for mental health occupational therapy, and evidence appeared in 300 separate peer-reviewed journals. It takes on average 7 months for an article to progress from submission to acceptance, and a further 7 months to progress from acceptance to publication. More than 95% of articles published between 2000 and 2002 were cited at least once in the following decade, and around 70% of these citations were recorded in non-occupational therapy journals. The current evidence base for mental health occupational therapy is both substantial and diverse.

Work-related violence and its association with self-rated general health among public sector employees in Sweden.

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Vaez, Marjan; Josephson, Malin; Vingård, Eva; Voss, Margaretha

2014-01-01

Work-related violence is one of the most serious threats to employee safety and health. To ascertain the extent of self-reported violence or threats of violence at work in relation to the general health of public sector employees. The study population comprised 9,611 female (83%) and male public employees in Sweden. A questionnaire based on items derived mainly from validated instruments was constructed to cover aspects such as health, lifestyle, and physical and psychosocial work conditions. One in three employees reported work-related violence, with the highest proportions among psychiatric nurses (79%) and psychiatric attendants (75%). Work-related violence more often affected those who were worked worked nights, or reported poor health. Regardless of gender, age, hours of work, night work, and type of occupation, exposure to work-related violence was associated with less than good general health, and this relationship was strongest for psychiatric nurses (OR=3.19; 95% CI=1.28-7.98), medical doctors/dentists (OR=2.46; 95% CI=1.35-4.49), compulsory school teachers (OR=2.14; 95% CI=1.33-3.45), and other nurses (OR=1.87; 95% CI=1.23-2.84). Work-related violence was frequently reported by employees in the most common public sector occupations, and it was associated with poor health in both genders.

Public health and Plowshare

Energy Technology Data Exchange (ETDEWEB)

Terrill, Jr, J G [Consumer Protection and Environmental Health Service, U.S. PubIic Health Service, Washington, DC (United States)

1969-07-01

The protection of public health and safety is a principal area of concern in any application of nuclear energy. A health and safety analysis must be conducted and reviewed by appropriate agencies and the final results made available to interested agencies and groups, both public and private, prior to the application. This is especially important for the Plowshare Program - the peaceful uses of nuclear explosives - where the public is to be the ultimate beneficiary. Because public health must be a primary concern in the Plowshare Program, it is essential that the potential risk be weighed against the expected benefits to the public. Public health agencies must play an increasingly important role in the planning and operational stages of the peaceful applications of nuclear explosives and in the final stage of consumer use of Plowshare-generated products. There are many long term and long distance ramifications of the Plowshare Program, such a the potential radiological contamination of consumer products that may reach the consumer at long times after the event or at great distances from the site of the event. Criteria for evaluating public exposure to radiation from these products need to be developed based on sound scientific research. Standards for radioactivity in consumer products must be developed in relation to potential exposure of the public. Above all, a clear benefit to the public with a minimum of risk must be shown. The major purpose of this Symposium on the Public Health Aspects of Peaceful Uses of Nuclear-Explosives is to focus attention on the health and safety aspects, present the results of safety analyses accomplished to date and other information necessary to an understanding of the public health aspects, and to identify areas where additional research is required. A general overview of the total symposium content is presented with emphasis on the relationship of the topics to public health. (author)

Public health and Plowshare

International Nuclear Information System (INIS)

Terrill, J.G. Jr.

1969-01-01

The protection of public health and safety is a principal area of concern in any application of nuclear energy. A health and safety analysis must be conducted and reviewed by appropriate agencies and the final results made available to interested agencies and groups, both public and private, prior to the application. This is especially important for the Plowshare Program - the peaceful uses of nuclear explosives - where the public is to be the ultimate beneficiary. Because public health must be a primary concern in the Plowshare Program, it is essential that the potential risk be weighed against the expected benefits to the public. Public health agencies must play an increasingly important role in the planning and operational stages of the peaceful applications of nuclear explosives and in the final stage of consumer use of Plowshare-generated products. There are many long term and long distance ramifications of the Plowshare Program, such a the potential radiological contamination of consumer products that may reach the consumer at long times after the event or at great distances from the site of the event. Criteria for evaluating public exposure to radiation from these products need to be developed based on sound scientific research. Standards for radioactivity in consumer products must be developed in relation to potential exposure of the public. Above all, a clear benefit to the public with a minimum of risk must be shown. The major purpose of this Symposium on the Public Health Aspects of Peaceful Uses of Nuclear-Explosives is to focus attention on the health and safety aspects, present the results of safety analyses accomplished to date and other information necessary to an understanding of the public health aspects, and to identify areas where additional research is required. A general overview of the total symposium content is presented with emphasis on the relationship of the topics to public health. (author)

Nuclear education in public health and nursing

International Nuclear Information System (INIS)

Winder, A.E.; Stanitis, M.A.

1988-01-01

Twenty-three public health schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty public health schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of public health report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention

Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review.

Science.gov (United States)

Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J; Demiris, George

2013-07-01

There is a critical need for public health interventions to support the independence of older adults as the world's population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. One thousand, six hundred and thirty-nine candidate articles were identified. Thirty-one studies from the years 1998-2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of them used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults; social support; and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Public health workforce research in review: a 25-year retrospective.

Science.gov (United States)

Hilliard, Tracy M; Boulton, Matthew L

2012-05-01

The Robert Wood Johnson Foundation commissioned a systematic review of public health workforce literature in fall 2010. This paper reviews public health workforce articles published from 1985 to 2010 that support development of a public health workforce research agenda, and address four public health workforce research themes: (1) diversity; (2) recruitment, retention, separation, and retirement; (3) education, training, and credentialing; and (4) pay, promotion, performance, and job satisfaction. PubMed, ERIC, and Web of Science databases were used to search for articles; Google search engine was used to identify gray literature. The study used the following inclusion criteria: (1) articles written in English published in the U.S.; (2) the main theme(s) of the article relate to at least one of the four public health workforce research themes; and (3) the document focuses on the domestic public health workforce. The literature suggests that the U.S. public health workforce is facing several urgent priorities that should be addressed, including: (1) developing an ethnically/racially diverse membership to meet the needs of an increasingly diverse nation; (2) recruiting and retaining highly trained, well-prepared employees, and succession planning to replace retirees; (3) building public health workforce infrastructure while also confronting a major shortage in the public health workforce, through increased education, training, and credentialing; and (4) ensuring competitive salaries, opportunities for career advancement, standards for workplace performance, and fostering organizational cultures which generate high levels of job satisfaction for effective delivery of services. Additional research is needed in all four thematic areas reviewed to develop well-informed, evidence-based strategies for effectively addressing critical issues facing the public health workforce. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights

Developing Evidence for Public Health Policy and Practice: The Implementation of a Knowledge Translation Approach in a Staged, Multi-Methods Study in England, 2007-09

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South, Jane; Cattan, Mima

2014-01-01

Effective knowledge translation processes are critical for the development of evidence-based public health policy and practice. This paper reports on the design and implementation of an innovative approach to knowledge translation within a mixed methods study on lay involvement in public health programme delivery. The study design drew on…

Conventional and ecological public health.

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Rayner, G

2009-09-01

This paper suggests that current models of public health are no longer sufficient as a means for understanding the health challenges of the anthropogenic age, and argues for an alternative based upon an ecological model. The roots of this perspective originated within the Victorian era, although it found only limited expression at that time. Ecological thinking in public health has only been revived relatively recently. Derived from an analysis of obesity, this paper proposes the development of an approach to ecological public health based on four dimensions of existence: the material, the physiological, the social and the cultural-cognitive. The implications for public policy are considered.

Qualitative research and dental public health

Directory of Open Access Journals (Sweden)

Roslind Preethi George

2012-01-01

Full Text Available The use of Qualitative Research (QR methods are now getting common in various aspects of health and healthcare research and they can be used to interpret, explore, or obtain a deeper understanding of certain aspects of human beliefs, attitudes, or behavior through personal experiences and perspectives. The potential scope of QR in the field of dental public health is immense, but unfortunately, it has remained underutilized. However, there are a number of studies which have used this type of research to probe into some unanswered questions in the field of public health dentistry ranging from workforce issues to attitudes of patients. In recent health research, evidence gathered through QR methods provide understanding to the social, cultural, and economic factors affecting the health status and healthcare of an individual and the population as a whole. This study will provide an overview of what QR is and discuss its contributions to dental public health research.

Does air pollution pose a public health problem for New Zealand?

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Scoggins, Amanda

2004-02-01

Air pollution is increasingly documented as a threat to public health and a major focus of regulatory activity in developed and developing countries. Air quality indicators suggest New Zealand has clean air relative to many other countries. However, media releases such as 'Christchurch wood fires pump out deadly smog' and 'Vehicle pollution major killer' have sparked public health concern regarding exposure to ambient air pollution, especially in anticipation of increasing emissions and population growth. Recent evidence is presented on the effects of air quality on health, which has been aided by the application of urban airshed models and Geographic Information Systems (GIS). Future directions for research into the effects of air quality on health in New Zealand are discussed, including a national ambient air quality management project: HAPINZ--Health and Air Pollution in New Zealand.

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review

Science.gov (United States)

Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo

2017-01-01

Background The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. Aim The goal of this scoping review is to delineate and “map” the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. Methods A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O’Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. Results The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. Discussion The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

Science.gov (United States)

Hurlimann, Thierry; Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo; Godard, Béatrice

2017-01-01

The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

Directory of Open Access Journals (Sweden)

Thierry Hurlimann

Full Text Available The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc. contexts.The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise.A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications.The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented.The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these

Incidence of Online Health Information Search: A Useful Proxy for Public Health Risk Perception

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Scammon, Debra L

2013-01-01

Background Internet users use search engines to look for information online, including health information. Researchers in medical informatics have found a high correlation of the occurrence of certain search queries and the incidence of certain diseases. Consumers’ search for information about diseases is related to current health status with regard to a disease and to the social environments that shape the public’s attitudes and behaviors. Objective This study aimed to investigate the extent to which public health risk perception as demonstrated by online information searches related to a health risk can be explained by the incidence of the health risk and social components of a specific population’s environment. Using an ecological perspective, we suggest that a population’s general concern for a health risk is formed by the incidence of the risk and social (eg, media attention) factors related with the risk. Methods We constructed a dataset that included state-level data from 32 states on the incidence of the flu; a number of social factors, such as media attention to the flu; private resources, such as education and health insurance coverage; public resources, such as hospital beds and primary physicians; and utilization of these resources, including inpatient days and outpatient visits. We then explored whether online information searches about the flu (seasonal and pandemic flu) can be predicted using these variables. We used factor analysis to construct indexes for sets of social factors (private resources, public resources). We then applied panel data multiple regression analysis to exploit both time-series and cross-sectional variation in the data over a 7-year period. Results Overall, the results provide evidence that the main effects of independent variables—the incidence of the flu (Psearches for queries related to the flu. After controlling for the number of reported disease cases and Internet access rate by state, we estimate the

Persisting problems related to race and ethnicity in public health and epidemiology research

Directory of Open Access Journals (Sweden)

Jean-Claude Moubarac

2013-02-01

Full Text Available A recent and comprehensive review of the use of race and ethnicity in research that address health disparities in epidemiology and public health is provided. First it is described the theoretical basis upon which race and ethnicity differ drawing from previous work in anthropology, social science and public health. Second, it is presented a review of 280 articles published in high impacts factor journals in regards to public health and epidemiology from 2009-2011. An analytical grid enabled the examination of conceptual, theoretical and methodological questions related to the use of both concepts. The majority of articles reviewed were grounded in a theoretical framework and provided interpretations from various models. However, key problems identified include a a failure from researchers to differentiate between the concepts of race and ethnicity; b an inappropriate use of racial categories to ascribe ethnicity; c a lack of transparency in the methods used to assess both concepts; and d failure to address limits associated with the construction of racial or ethnic taxonomies and their use. In conclusion, future studies examining health disparities should clearly establish the distinction between race and ethnicity, develop theoretically driven research and address specific questions about the relationships between race, ethnicity and health. One argue that one way to think about ethnicity, race and health is to dichotomize research into two sets of questions about the relationship between human diversity and health.

Public health research: lost in translation or speaking the wrong language?

Science.gov (United States)

Kansagra, Susan M; Farley, Thomas A

2011-12-01

Public health leaders, like physicians, need to make decisions that impact health based on strong evidence. To generate useful evidence for public health leaders, research must focus on interventions that have potential to impact population-level health. Often policy and environmental changes are the interventions with the greatest potential impact on population health, but studying these is difficult because of limitations in the methods typically used and emphasized in health research. To create useful evidence for policy and environmental interventions, other research methods are needed, including observational studies, the use of surveillance data for evaluation, and predictive mathematical modeling. More emphasis is needed on these types of study designs by researchers, funding agencies, and scientific journals.

[Work regulation in the context of new public versus private relations in health].

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Barbosa, Nelson Bezerra

2010-08-01

This work discusses the management of the work relations in the context of the new systems of public vs. private relation in health, having as reference the experience of the habilitation of Social Organizations (SO), responsible for the administration of a group of hospitals in the state of São Paulo. The urgency in this kind of management supported on the legal figure of the SO has implications in the management of Human Resources in Health (HRH) through the adoption of flexibilization mechanisms which include ways of selection, hiring and dismissal, payment rules and functional progression similar to the actions adopted by the market. The establishment of this sort of administration refers to the new paradigm proposed by the managerial administrative reform which suggests the exhaustion of the bureaucratic model to promote adjustment of the public administration to the transformations originated in the new stage of internationalization of the economy and its unfolding in the work world, as well as to the new standards of requirements of performance of the public field. Aspects related to the management of HHR are approached in the two ruling modalities in the Secretaria de Estado da Saúde de São Paulo: Direct Administration Hospitals (DAH) and units organized under the SO model (SOH).

Evaluation of an online training for improving self-reported evidence-based decision-making skills in cancer control among public health professionals.

Science.gov (United States)

Morshed, A B; Ballew, P; Elliott, M B; Haire-Joshu, D; Kreuter, M W; Brownson, R C

2017-11-01

The purpose of this evaluation was to assess the effect of the online evidence-based cancer control (EBCC) training on improving the self-reported evidence-based decision-making (EBDM) skills in cancer control among Nebraska public health professionals. Cross-sectional group comparison. Previously developed EBDM measures were administered via online surveys to 201 public health professionals at baseline (comparison group) and 123 professionals who took part in the training. Respondents rated the importance of and their skill level in 18 EBCC skills. Differences were examined using analysis of variance models adjusted for gender, age, years at agency, and years in position, and stratified by respondent educational attainment. Among professionals without an advanced degree, training participants reported higher overall skill scores (P = .016) than the baseline non-participant group, primarily driven by differences in the partnerships and collaboration and evaluation domains. No differences in importance ratings were observed. Among professionals with advanced degrees, there were no differences in skill scores and small differences in importance scores in the expected direction (P studies. EBCC led to improved self-reported EBDM skills among public health professionals without an advanced degree, though a gap remained between the self-reported skills and the perceived importance of the skills. Further research on training content and modalities for professionals with higher educational attainment and baseline skill scores is needed. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The early NHS and the crisis of public health nursing.

Science.gov (United States)

Webster, C

2000-01-01

Establishment of the NHS in 1948 is rightly seen as a major turning point in health care in the United Kingdom. Notwithstanding conditions of severe austerity, the NHS succeeded remarkably well in its basic remit to make all essential medical care available to the entire population, free at point of delivery. The benefits of the new system extended across the entire front of its services. However, it is important to recognise that the reforms of 1948 were uniformly advantageous. It has for instance long been recognised that the NHS failed to bring about the expected transformation in standards of general medical practice. In this short paper the author argues that public health represented a further major sphere of underdevelopment. The fact that, with minor exceptions, public health is the least studied aspect of the early NHS is itself suggestive of its status as the Cinderella of the modern health services. The author also underlines the adverse implications of this inferior position for domiciliary midwifery, district nursing and health visiting. These constituted small but strategically important sectors of nursing, all of which fell under public health administration in the new health service. The author concentrates on the first phase of the NHS, the period between 1948 and 1974, now often regarded as its golden age. For the purposes of this discussion, most of the evidence relates to the formative phase of the new service, when many major policy questions relating to public health were first confronted. It is suggested that the early neglect of public health and its constituent nursing functions has left a legacy of problems that have still not entirely been resolved. For the purposes of this paper the term will be used to embrace the totality of health functions administered by departments of local government in the period from 1948 to 1974. Most of these services fell within the public health departments of local government, headed by the Medical Office

Management of clandestine drug laboratories: need for evidence-based environmental health policies.

Science.gov (United States)

Al-Obaidi, Tamara A; Fletcher, Stephanie M

2014-01-01

Clandestine drug laboratories (CDLs) have been emerging and increasing as a public health problem in Australia, with methamphetamine being the dominant illegally manufactured drug. However, management and remediation of contaminated properties are still limited in terms of regulation and direction, especially in relation to public and environmental health practice. Therefore, this review provides an update on the hazards and health effects associated with CDLs, with a specific look at the management of these labs from an Australian perspective. Particularly, the paper attempts to describe the policy landscape for management of CDLs, and identifies current gaps and how further research may be utilised to advance understanding and management of CDLs and inform public health policies. The paper highlights a significant lack of evidence-based policies and guidelines to guide regulatory authority including environmental health officers in Australia. Only recently, the national Clandestine Drug Laboratory Guidelines were developed to assist relevant authority and specialists manage and carry out investigations and remediation of contaminated sites. However, only three states have developed state-based guidelines, some of which are inadequate to meet environmental health requirements. The review recommends well-needed inter-sectoral collaborations and further research to provide an evidence base for the development of robust policies and standard operating procedures for safe and effective environmental health management and remediation of CDLs.

Developing a taxonomy for the science of improvement in public health.

Science.gov (United States)

Riley, William; Lownik, Beth; Halverson, Paul; Parrotta, Carmen; Godsall, Jonathan R; Gyllstrom, Elizabeth; Gearin, Kimberly J; Mays, Glen

2012-11-01

Quality improvement (QI) methods have been used for almost a decade in public health departments to increase effectiveness and efficiency. Although results are rapidly accumulating, the evidence for the science of improvement is shallow and limited. To advance the use and effectiveness of QI in public health, it is important to develop a science of improvement using practice-based research to build an evidence base for QI projects. This purpose of this study is to advance the science of improvement in public health departments with 3 objectives: (1) establish a taxonomy of QI projects in public health, (2) categorize QI projects undertaken in health departments using the taxonomy, and (3) create an opportunity modes and effects analysis. This study is a qualitative analysis of archival data from 2 separate large databases consisting of 51 QI projects undertaken in public health departments over the last 5 years. The study involves 2 separate QI collaboratives. One includes Minnesota health departments; the other is a national collaborative. We propose a standardized case definition, common metrics, and a taxonomy of QI projects to begin building the evidence base for QI in public health and to advance the science of continuous quality improvement. All projects created an aim statement and used metrics while 53% used a specific QI model with an average of 3.25 QI techniques per project. Approximately 40% of the projects incorporated a process control methodology, and 60% of the projects identified the process from beginning to end, while 11 of 12 PHAB (Public Health Accreditation Board) domains were included. The findings provide a baseline for QI taxonomy to operationalize a science of improvement for public health departments.

Navigating the evidentiary turn in public health: Sensemaking strategies to integrate genomics into state-level chronic disease prevention programs.

Science.gov (United States)

Senier, Laura; Smollin, Leandra; Lee, Rachael; Nicoll, Lauren; Shields, Michael; Tan, Catherine

2018-06-23

In the past decade, healthcare delivery has faced two major disruptions: the mapping of the human genome and the rise of evidence-based practice. Sociologists have documented the paradigmatic shift towards evidence-based practice in medicine, but have yet to examine its effect on other health professions or the broader healthcare arena. This article shows how evidence-based practice is transforming public health in the United States. We present an in-depth qualitative analysis of interview, ethnographic, and archival data to show how Michigan's state public health agency has navigated the turn to evidence-based practice, as they have integrated scientific advances in genomics into their chronic disease prevention programming. Drawing on organizational theory, we demonstrate how they managed ambiguity through a combination of sensegiving and sensemaking activities. Specifically, they linked novel developments in genomics to a long-accepted public health planning model, the Core Public Health Functions. This made cutting edge advances in genomics more familiar to their peers in the state health agency. They also marshaled state-specific surveillance data to illustrate the public health burden of hereditary cancers in Michigan, and to make expert panel recommendations for genetic screening more locally relevant. Finally, they mobilized expertise to help their internal colleagues and external partners modernize conventional public health activities in chronic disease prevention. Our findings show that tools and concepts from organizational sociology can help medical sociologists understand how evidence-based practice is shaping institutions and interprofessional relations in the healthcare arena. Copyright © 2018 Elsevier Ltd. All rights reserved.

Getting serious about the social determinants of health: new directions for public health workers.

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Raphael, Dennis

2008-09-01

International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that as compared to other wealthy nations Canada presents a mediocre population health profile and public policy environments increasingly less supportive of health, the Canadian public health gaze is firmly - and narrowly - focused on lifestyle issues of diet, physical activity and tobacco use. Much of this has to do with Canada being identified as being driven by a liberal political economy, a situation shared with a cluster of other developed nations. Reasons for Canada's neglect of structural and public policy issues are explored and ways by which public health workers in Canada and elsewhere can help to shift policymakers and the general public's understandings of the determinants of health are outlined.

System impact research – increasing public health and health care system performance

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Malmivaara, Antti

2016-01-01

Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

Getting the Word Out: New Approaches for Disseminating Public Health Science

Science.gov (United States)

Eyler, Amy A.; Harris, Jenine K.; Moore, Justin B.; Tabak, Rachel G.

2018-01-01

The gap between discovery of public health knowledge and application in practice settings and policy development is due in part to ineffective dissemination. This article describes (1) lessons related to dissemination from related disciplines (eg, communication, agriculture, social marketing, political science), (2) current practices among researchers, (3) key audience characteristics, (4) available tools for dissemination, and (5) measures of impact. Dissemination efforts need to take into account the message, source, audience, and channel. Practitioners and policy makers can be more effectively reached via news media, social media, issue or policy briefs, one-on-one meetings, and workshops and seminars. Numerous “upstream” and “midstream” indicators of impact include changes in public perception or awareness, greater use of evidence-based interventions, and changes in policy. By employing ideas outlined in this article, scientific discoveries are more likely to be applied in public health agencies and policy-making bodies. PMID:28885319

Just in Time: How Evidence-on-Demand Services Support Decision Making in Ontario's Child and Youth Mental Health Sector

Science.gov (United States)

Notarianni, Maryann; Sundar, Purnima; Carter, Charles

2016-01-01

Using the best available evidence to inform decision making is important for the design or delivery of effective health-related services and broader public policy. Several studies identify barriers and facilitators to evidence-informed decision making in Canadian health settings. This paper describes how the Ontario Centre of Excellence for Child…

Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework.

Science.gov (United States)

Gushulak, Bd; Weekers, J; Macpherson, Dw

2009-01-01

International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced

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

The State Public Health Laboratory System.

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Inhorn, Stanley L; Astles, J Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M; Wilcke, Burton W; White, Vanessa A

2010-01-01

This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the goal of which is to promote public-private collaboration to assure quality laboratory services and public health surveillance. To enhance the realization of the NLS, the Association of Public Health Laboratories (APHL) launched in 2004 a State Public Health Laboratory System Improvement Program. In the same year, APHL developed a Comprehensive Laboratory Services Survey, a tool to measure improvement through the decade to assure that essential PHL services are provided.

Use of Electronic Health Records and Administrative Data for Public Health Surveillance of Eye Health and Vision-Related Conditions

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Elliott, Amanda; Davidson, Arthur; Lum, Flora; Chiang, Michael; Saaddine, Jinan B; Zhang, Xinzhi; Crews, John E.; Chou, Chiu-Fang

2014-01-01

Purpose To discuss the current trend toward greater use of electronic health records and how these records could enhance public health surveillance of eye health and vision-related conditions. Methods We describe three currently available sources of electronic health data (Kaiser Permanente, the Veterans Health Administration, and the Centers for Medicare & Medicaid Services) and how these sources can contribute to a comprehensive vision and eye health surveillance system. Results Each of the three sources of electronic health data can contribute meaningfully to a comprehensive vision and eye health surveillance system, but none currently provide all the information required. The use of electronic health records for vision and eye health surveillance has both advantages and disadvantages. Conclusions Electronic health records may provide additional information needed to create a comprehensive vision and eye health surveillance system. Recommendations for incorporating electronic health records into such a system are presented. PMID:23158225

Smart health and innovation: facilitating health-related behaviour change.

Science.gov (United States)

Redfern, J

2017-08-01

Non-communicable diseases (NCD) are the leading cause of death globally. Smart health technology and innovation is a potential strategy for increasing reach and for facilitating health behaviour change. Despite rapid growth in the availability and affordability of technology there remains a paucity of published and robust research in the area as it relates to health. The objective of the present paper is to review and provide a snapshot of a variety of contemporary examples of smart health strategies with a focus on evidence and research as it relates to prevention with a CVD management lens. In the present analysis, five examples will be discussed and they include a physician-directed strategy, consumer directed strategies, a public health approach and a screening strategy that utilises external hardware that connects to a smartphone. In conclusion, NCD have common risk factors and all have an association with nutrition and health. Smart health and innovation is evolving rapidly and may help with diagnosis, treatment and management. While on-going research, development and knowledge is needed, the growth of technology development and utilisation offers opportunities to reach more people and achieve better health outcomes at local, national and international levels.

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

Science.gov (United States)

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

How do public health professionals view and engage with research? A qualitative interview study and stakeholder workshop engaging public health professionals and researchers.

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van der Graaf, Peter; Forrest, Lynne F; Adams, Jean; Shucksmith, Janet; White, Martin

2017-11-22

With increasing financial pressures on public health in England, the need for evidence of high relevance to policy is now stronger than ever. However, the ways in which public health professionals (PHPs) and researchers relate to one another are not necessarily conducive to effective knowledge translation. This study explores the perspectives of PHPs and researchers when interacting, with a view to identifying barriers to and opportunities for developing practice that is effectively informed by research. This research focused on examples from two responsive research schemes, which provide university-based support for research-related enquiries from PHPs: the NIHR SPHR Public Health Practitioner Evaluation Scheme 1 and the responsive research service AskFuse 2 . We examined enquiries that were submitted to both between 2013 and 2015, and purposively selected eight enquiries for further investigation by interviewing the PHPs and researchers involved in these requests. We also identified individuals who were eligible to make requests to the schemes but chose not to do so. In-depth interviews were conducted with six people in relation to the PHPES scheme, and 12 in relation to AskFuse. The interviews were transcribed and analysed using thematic framework analysis. Verification and extension of the findings were sought in a stakeholder workshop. PHPs recognised the importance of research findings for informing their practice. However, they identified three main barriers when trying to engage with researchers: 1) differences in timescales; 2) limited budgets; and 3) difficulties in identifying appropriate researchers. The two responsive schemes addressed some of these barriers, particularly finding the right researchers to work with and securing funding for local evaluations. The schemes also supported the development of new types of evidence. However, other barriers remained, such as differences in timescales and the resources needed to scale-up research. An increased

Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government.

Science.gov (United States)

Martineau, F P; Graff, H; Mitchell, C; Lock, K

2014-09-01

The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives-for example, minimum unit pricing licensing conditions-can serve as test cases for wider national implementation. By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

Five Classic Articles in Public Health

OpenAIRE

Borak, Jonathan

2010-01-01

In this brief review, Dr. Jonathan Borak comments on five seminal papers that helped shape the fields of epidemiology and public health. These papers include Hill?s criteria for inferring causality; the first proof of the multistage theory of cancer; the first evidence that subclinical lead exposures can cause neurobehavioral impairment in children; a simple yet robust study that had a major influence on setting current air pollution policies; and a landmark review of the general public?s per...

Proposed declassification of disease categories related to sexual orientation in the International Statistical Classification of Diseases and Related Health Problems (ICD-11).

Science.gov (United States)

Cochran, Susan D; Drescher, Jack; Kismödi, Eszter; Giami, Alain; García-Moreno, Claudia; Atalla, Elham; Marais, Adele; Vieira, Elisabeth Meloni; Reed, Geoffrey M

2014-09-01

The World Health Organization is developing the 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), planned for publication in 2017. The Working Group on the Classification of Sexual Disorders and Sexual Health was charged with reviewing and making recommendations on disease categories related to sexuality in the chapter on mental and behavioural disorders in the 10th revision (ICD-10), published in 1990. This chapter includes categories for diagnoses based primarily on sexual orientation even though ICD-10 states that sexual orientation alone is not a disorder. This article reviews the scientific evidence and clinical rationale for continuing to include these categories in the ICD. A review of the evidence published since 1990 found little scientific interest in these categories. In addition, the Working Group found no evidence that they are clinically useful: they neither contribute to health service delivery or treatment selection nor provide essential information for public health surveillance. Moreover, use of these categories may create unnecessary harm by delaying accurate diagnosis and treatment. The Working Group recommends that these categories be deleted entirely from ICD-11. Health concerns related to sexual orientation can be better addressed using other ICD categories.

Gender issues in medical and public health education.

Science.gov (United States)

Wong, Y L

2000-01-01

There is no doubt that gender bias has been inherent in medical and public health education, research, and clinical practice. This paper discusses the central question for medical and public health educators viz. whether women's health concerns and needs could be best addressed by the conventional biomedical approach to medical and public health education, research, and practice. Gender inequalities in health and gender bias in medical and public health education are revealed. It is found that in most public health and prevention issues related to women's health, the core issue is male-female power relations, and not merely the lack of public health services, medical technology, or information. There is, thus, an urgent need to gender-sensitize public health and medical education. The paper proposes a gender analysis of health to distinguish between biological causes and social explanations for the health differentials between men and women. It also assessed some of the gender approaches to public health and medical education currently adopted in the Asia-Pacific region. It poses the pressing question of how medical and public health educators integrate the gender perspective into medical and public health education. The paper exhorts all medical and public health practitioners to explore new directions and identify innovative strategies to formulate a gender-sensitive curriculum towards the best practices in medicine and public health that will meet the health needs of women and men in the 21st century.

Public and private health-care financing with alternate public rationing rules.

Science.gov (United States)

Cuff, Katherine; Hurley, Jeremiah; Mestelman, Stuart; Muller, Andrew; Nuscheler, Robert

2012-02-01

We develop a model to analyze parallel public and private health-care financing under two alternative public sector rationing rules: needs-based rationing and random rationing. Individuals vary in income and severity of illness. There is a limited supply of health-care resources used to treat individuals, causing some individuals to go untreated. Insurers (both public and private) must bid to obtain the necessary health-care resources to treat their beneficiaries. Given individuals' willingnesses-to-pay for private insurance are increasing in income, the introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Further, the impact of introducing parallel private insurance depends on the rationing mechanism in the public sector. We show that the private health insurance market is smaller when the public sector rations according to need than when allocation is random. Copyright © 2010 John Wiley & Sons, Ltd.

Surgery, public health, and Pakistan.

Science.gov (United States)

Zafar, Syed Nabeel; McQueen, K A Kelly

2011-12-01

Surgical healthcare is rapidly gaining recognition as a major public health issue. Surgical disparities are large, with poorest populations receiving the least amount of emergency and essential surgical care. In light of recent evidence, developing countries, such as Pakistan, must acknowledge surgical disease as a major public health issue and prioritize research and intervention accordingly. We review information from various sources and describe the current situation of surgical health care in Pakistan and highlight areas of neglect. Pakistan suffers an annual deficit of 17 million surgeries. Surgical disease kills more people than infectious diseases inclusive of tuberculosis, HIV/AIDS, diarrheal disease, and childhood infections. The incidence of trauma and maternal mortality ratio are staggeringly high. There is a severe dearth of surgical and anesthesia-related epidemiological data. Important information that would help to drive policy and planning is not available. Corruption and neglect have led to a dilapidated health care infrastructure. Surgical care is largely inaccessible to the poor, especially those living in rural areas. The country faces a dearth of healthcare professionals, especially paramedics, anesthetists, and surgeons. Unsafe surgery and anesthesia poses a significant risk to patients. There is no national policy on surgical illness and the preventive aspects of surgery are nonexistent. Consistent with other underdeveloped countries, surgical care in Pakistan is dismal. Neglecting surgery and safe anesthesia has led to countless deaths and disability. Physicians, researchers, policy makers, and the government health care system must engage and commit to provide access to emergency, essential, and safe surgical care.

Training public health superheroes: five talents for public health leadership.

Science.gov (United States)

Day, Matthew; Shickle, Darren; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leaders have been criticized for their policy stances, relationships with governments and failure to train the next generation. New approaches to the identification and training of public health leaders may be required. To inform these, lessons can be drawn from public health 'superheroes'; public health leaders perceived to be the most admired and effective by their peers. Members and Fellows of the UK Faculty of Public Health were contacted via e-newsletter and magazine and asked to nominate their 'Public Health Superhero'. Twenty-six responses were received, nominating 40 different people. Twelve semi-structured interviews were conducted. Thematic analysis, based on 'grounded theory', was conducted. Five leadership 'talents' for public health were identified: mentoring-nurturing, shaping-organizing, networking-connecting, knowing-interpreting and advocating-impacting. Talent-based approaches have been effective for leadership development in other sectors. These talents are the first specific to the practice of public health and align with some aspects of existing frameworks. An increased focus on identifying and developing talents during public health training, as opposed to 'competency'-based approaches, may be effective in strengthening public health leadership. Further research to understand the combination and intensity of talents across a larger sample of public health leaders is required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Public health challenges in sun protection.

Science.gov (United States)

Eide, Melody J; Weinstock, Martin A

2006-01-01

Sunscreens are a popular choice for protection from ultraviolet radiation, and hence, important components in the public health campaign to reduce the burden of skin cancer. Public health messages in skin cancer prevention have been used effectively in educational campaigns. The benefits of sunscreen extend beyond skin cancer prevention into other aspects of health and disease prevention: sunscreen decreases the risk for sunburn during physical activity outdoors and seems not to increase the risk for osteoporosis. Public health efforts have laid a solid foundation on which to face the continuing challenge of promoting and developing effective public health campaigns and health policies that encourage sunscreen use, sun protection, and the primary prevention of skin cancer. In this article, the controversies, concerns, and challenges of sunscreen use as it relates to public health are discussed.

Trends in publications regarding evidence-practice gaps: a literature review.

Science.gov (United States)

Evensen, Ann E; Sanson-Fisher, Rob; D'Este, Catherine; Fitzgerald, Michael

2010-02-03

Well-designed trials of strategies to improve adherence to clinical practice guidelines are needed to close persistent evidence-practice gaps. We studied how the number of these trials is changing with time, and to what extent physicians are participating in such trials. This is a literature-based study of trends in evidence-practice gap publications over 10 years and participation of clinicians in intervention trials to narrow evidence-practice gaps. We chose nine evidence-based guidelines and identified relevant publications in the PubMed database from January 1998 to December 2007. We coded these publications by study type (intervention versus non-intervention studies). We further subdivided intervention studies into those for clinicians and those for patients. Data were analyzed to determine if observed trends were statistically significant. We identified 1,151 publications that discussed evidence-practice gaps in nine topic areas. There were 169 intervention studies that were designed to improve adherence to well-established clinical guidelines, averaging 1.9 studies per year per topic area. Twenty-eight publications (34%; 95% CI: 24% - 45%) reported interventions intended for clinicians or health systems that met Effective Practice and Organization of Care (EPOC) criteria for adequate design. The median consent rate of physicians asked to participate in these well-designed studies was 60% (95% CI, 25% to 69%). We evaluated research publications for nine evidence-practice gaps, and identified small numbers of well-designed intervention trials and low rates of physician participation in these trials.

Public health, academic medicine, and the alcohol industry's corporate social responsibility activities.

Science.gov (United States)

Babor, Thomas F; Robaina, Katherine

2013-02-01

We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry's economic interests.

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.

Merging public relations with health communication in the context of university alcohol prevention.

Science.gov (United States)

Brummette, John

2015-01-01

The scope of this study is to determine whether social norms marketing should be further evaluated according to its ability to serve as a public relations tactic for universities. Based on a framework of social norms theory and strategic issues management, this study uses a web-based survey with university parents (N = 173) to identify relationships among exaggerated parental misperceptions of student binge drinking, parental awareness of alcohol prevention programs, and parental perceptions of organizational legitimacy. Findings from this study are used to make the argument that health communication and public relations should be viewed as interrelated concepts in the context of university alcohol prevention.

[Public health services between "new public health" and "new public management"].

Science.gov (United States)

Oppen, M

1996-04-01

Today, a substantial reorientation of the Public Health services in the Federal Republic of Germany is broadly seen necessary. Patterns of functional and organisational restructuring of Public Health services on the regional and the communal level are closely linked with concepts of prevention and health promotion. Hence, a number of agencies have already adopted new tasks and functions like comprehensive and transorganizational planning, coordination and evaluation as well as the establishment of new reporting systems. Presently, the transformation process from the bureaucratic mode of administering matters of health to a new Public Health orientation receives new impacts from the international "New Public Management" movement. Comparatively late, with the beginning of the 1990s, a growing number of German municipalities has introduced new concepts of administration. Local government administrations, of which the Public Health services are a part, follow the model of modern service organizations producing services in a more efficient, professionalized and consumer-oriented way. Specific elements of economising modernisation programmes like re-distribution of tasks, de-centralisation, extension of managerial capacities, setting of stimulating working conditions that provide employees with greater independence of action as well as career opportunities, are at the same time prerequisites for innovative strategies of health protection and coordination policies of Public Health services.

[Social marketing and public health].

Science.gov (United States)

Arcaro, P; Mannocci, A; Saulle, R; Miccoli, S; Marzuillo, C; La Torre, G

2013-01-01

Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and public health communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as

Identifying evidence for public health guidance: a comparison of citation searching with Web of Science and Google Scholar.

Science.gov (United States)

Levay, Paul; Ainsworth, Nicola; Kettle, Rachel; Morgan, Antony

2016-03-01

To examine how effectively forwards citation searching with Web of Science (WOS) or Google Scholar (GS) identified evidence to support public health guidance published by the National Institute for Health and Care Excellence. Forwards citation searching was performed using GS on a base set of 46 publications and replicated using WOS. WOS and GS were compared in terms of recall; precision; number needed to read (NNR); administrative time and costs; and screening time and costs. Outcomes for all publications were compared with those for a subset of highly important publications. The searches identified 43 relevant publications. The WOS process had 86.05% recall and 1.58% precision. The GS process had 90.7% recall and 1.62% precision. The NNR to identify one relevant publication was 63.3 with WOS and 61.72 with GS. There were nine highly important publications. WOS had 100% recall, 0.38% precision and NNR of 260.22. GS had 88.89% recall, 0.33% precision and NNR of 300.88. Administering the WOS results took 4 h and cost £88-£136, compared with 75 h and £1650-£2550 with GS. WOS is recommended over GS, as citation searching was more effective, while the administrative and screening times and costs were lower. Copyright © 2015 John Wiley & Sons, Ltd.

Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program.

Science.gov (United States)

Meagher, Karen M; Lee, Lisa M

2016-01-01

Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation--deliberative public bioethics--into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice.

Managing Madness: Mental Health and Complexity in Public Policy

Directory of Open Access Journals (Sweden)

Ian Hickie

2013-09-01

Full Text Available This paper explores the concept of collaborative care, particularly in relation to a range of new models of organisation and service that are emerging in response to one of the most problematic areas of public policy – mental health. These emerging models of coordinated mental health care are testing the limits of the evidence supporting coordinated care, and require critical evaluation. Myriad concepts of collaborative or coordinated care in health, including mental health, have created multiple definitions. Once definitional issues have been surmounted, however, the evidence for coordination of health care is reasonably strong. There is considerable research about which treatments and programs are best for people with a mental illness. There are few areas seemingly as complex as mental health, given that responsibility for policy and service lies across all three tiers of Australian government and across multiple jurisdictions. It also engages public, private and non-government sectors. Co-morbidities are commonplace, particularly drug and alcohol problems among younger people. Governments in Australia have traditionally taken responsibility for policy, programs and services, either as direct service providers or through contracting outputs from others. Yet the evidence indicates that for people with a mental illness, the best solutions are often not found in government but in the community and in organisations outside of government. New organisations and new structures are attempting more holistic management approaches, combining clinical care, community support, housing, employment and other services. This paper considers some of these new models in the light of existing evidence. The key challenge facing continued reform in mental health is not uncertainty regarding programs or services, but rather how to drive coordinated care for consumers across departments, governments and providers. This review will highlight the key changes that

The University of Illinois at Chicago School of Public Health Doctor of Public Health program: an innovative approach to doctoral-level practice leadership development.

Science.gov (United States)

Lenihan, Patrick; Welter, Christina; Brandt-Rauf, Paul; Neuberger, Babette; Pinsker, Eve; Petros, Michael; Risley, Kristine

2015-03-01

The University of Illinois at Chicago, School of Public Health, Doctor of Public Health degree is designed to build leadership skills and an ability to contribute to the evidence base of practice. The competency-based, distance-format, doctoral-level program for midcareer professionals features an action learning approach in which students apply leadership principles from the virtual classroom to real-world problems at their work sites. Students demonstrate mastery of the competencies and readiness to advance to the dissertation stage through completing a portfolio by using a process of systematic reflection. The practice-oriented dissertation demonstrates the ability to contribute to the evidence base of public health practice in an area of emphasis. Preliminary evaluation data indicate that the program is meeting its intended purposes.

Epistemonikos: a free, relational, collaborative, multilingual database of health evidence.

Science.gov (United States)

Rada, Gabriel; Pérez, Daniel; Capurro, Daniel

2013-01-01

Epistemonikos (www.epistemonikos.org) is a free, multilingual database of the best available health evidence. This paper describes the design, development and implementation of the Epistemonikos project. Using several web technologies to store systematic reviews, their included articles, overviews of reviews and structured summaries, Epistemonikos is able to provide a simple and powerful search tool to access health evidence for sound decision making. Currently, Epistemonikos stores more than 115,000 unique documents and more than 100,000 relationships between documents. In addition, since its database is translated into 9 different languages, Epistemonikos ensures that non-English speaking decision-makers can access the best available evidence without language barriers.

Cancer registration, public health and the reform of the European data protection framework: Abandoning or improving European public health research?

Science.gov (United States)

Andersen, Mette Rye; Storm, Hans H

2015-06-01

The importance of cancer- and other disease registries for planning, management and evaluation of healthcare systems has been shown repeatedly during the last 50 years. Complete and unbiased population-level analyses on routinely collected, individual data concerning health and personal characteristics can address significant concerns about risk factors for cancer and provide sound evidence about public health and the effectiveness of healthcare systems. The existence of quality controlled and comprehensive data in registries, allowed to be used for quality control, research and public health purposes are taken as granted by most health professionals and researchers. However, the current revision of the European Union (EU) data protection framework suggests a harmonisation of requirements for confidentiality and individual consent to data processing, likely at the expense of proper use of registry data in the health sector. Consequences of excessive confidentiality rules that may lead to missed data linkages have been simulated. The simulations provide one possible explanation for observed heterogeneity among some cancer incidence data. Further, public health, quality control and epidemiological research on large populations can no longer provide evidence for health interventions, if requirements for consent renders research impossible or where attempts to obtain consent from each data subject generates biased results. Health professionals should engage in the on-going debate on the Commission's proposal for a General Data Protection Regulation. The nature and use of registry data in public health research must be explained and known to policy-makers and the public. Use of cancer registry data and other epidemiological activity will terminate abruptly if an unnecessarily strict EU data protection regulation is adopted. Research based interventions, as well as the international recognised standing of cancer registries and register-based research institutions in

Leprosy: International Public Health Policies and Public Health Eras

Directory of Open Access Journals (Sweden)

Niyi Awofeso

2011-09-01

Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.

Public acceptance and public relations. Communication approach to related pre-public relation problems

Energy Technology Data Exchange (ETDEWEB)

Tanaka, Y [Gakushuin Univ., Tokyo (Japan)

1977-07-01

A set of problems are discussed, which must be studied before the public relations are dealt with. Firstly, the trade-off between energy and health must be considered. Although the probability of death caused by atomic accidents is very small (one three hundred millionth a year), many peoples hate atomic power and oppose to the construction of nuclear power plants. Four reasons for this are considered: (1) social diffusion of innovation, (2) nuclear allergy, (3) shortage of the conception of risk-benefit, and (4) heterogeneity of the public. According to the investigation of the relationship between electric power and livelihood, carried out by the policyand science research institute in Tokyo, the highly subjective decision for the acceptance of atomic power is independent of the objective knowledge on atomic power.

The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

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Lee, K

2000-09-01

There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

Soil and public health: invisible bridges

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Pachepsky, Yakov

2017-04-01

Public health institutions, as ancient as civilizations itself, are intrinsically connected with soils. The massive body of the empirical knowledge about this connection has been accumulated. Recently unraveling the underlying mechanisms of this link has begun, and many of them appear to have the microbiological origin. The impressive progress in understanding the nexus between soil and health has been achieved by experimentation with preserved soil microbial systems functioning along with the metagenomic characterization. The objective of this work is to present an overview of some recent onsets. In the food safety arena, survival of human pathogens in soils has been related to the degree of soil eutrophication and/or related structure of soil microbial communities. Soil microbial systems affect the affinity of plants to internalizing pathogenic organisms. Pharmaceutical arsenals benefit from using field soil environment for developing antibiotics. Enzyme production by soil bacteria is used as the signal source for drug activation. Sanitary functions of sols are dependent on soil microbial system workings. The healthy living can be enhanced by the human immune system training received from direct contact with soils. The hygiene hypothesis considers the microbial input due to exposure to soil as the essential ecosystem service. The invisible links between soil and public health result in large-scale consequences. Examples of concurrent degradation of soil and public health are worth scrutinizing. Public health records can provide valuable sources of 'soil-public health' interactions. It may be worthwhile to examine current assessments of soil health from the public health standpoint. Soil management can be an efficient instrument of public health control.

Maternal Mortality in Nigerian and Public Health Interventions ...

African Journals Online (AJOL)

Health related goals are majorly driven by public health interventions, and some good progress has been noticed in issues relating to maternal mortality and morbidity i.e. Improve Maternal Health (MDG 5). 1The public health interventions utilized include, but are not limited to: surveillance, outreach, referral and follow up, ...

[Health and gender relations: a reflection on the challenges for the implementation of public policies for health care for indigenous women].

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Ferreira, Luciane Ouriques

2013-04-01

This article presents some contrasts that exist between the discourses of public policies concerning women's health care, especially with respect to indigenous women, and the ethnological discourse which emphasizes the specificity of gender relations within indigenous societies. We worked on the assumption that the development of these public policies as well as the organization of health care services offered, which in fact are necessary, have a transforming effect on prevailing gender relations within Amerindian Societies. On the one hand, gender relations between indigenous people are associated with the domains of kinship and corporeality. On the other hand, the process of creating public policies, by means of biomedical intervention and the medicalization of the female body, constitutes a powerful tool for body modeling and the construction of subjectivities contributing to making women worthy of citizenship. The female gender is under discussion and its content is being negotiated.

Evidence of Pilates practice on mental health of healthy people

Directory of Open Access Journals (Sweden)

Salvador Boix Vilella

2017-08-01

Full Text Available Introduction: The Pilates method was designed to create a connection between mind and body through a combined work of strength and flexibility, without submitting the body to excessive stress. Objective: To expose the most relevant research results from an analytical-interpretative perspective, in relation to the mental health of healthy people who habitually practice Pilates. Materials and methods: An analysis of the main benefits of the Pilates method on mental health was carried out, by using the results of finished research. To do this, the databases ScienceDirect, PubMed and Dialnet were accessed to identify publications that relate Pilates to mental variables. Results: The 19 revised studies show scientific evidence on the levels of humor, self-efficacy, self-esteem, mood, stress, quality of sleep, depression and identification with physical exercise. However, studies focused on attention, anxiety-state, positive or negative affect and quality of life proved that the evidence is still very limited. Conclusions: New longitudinal cutting researches using sufficiently wide samples are necessary to clear the unknowns still existing in relation to Pilates. This will determine whether the high popularity of the method is associated with the important health benefits reported.

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

[Position of health at international relations. Part I. Structural dimensions of health].

Science.gov (United States)

Cianciara, Dorota; Wysocki, Mirosław J

2011-01-01

In the article, the health is perceived as complex, multidimensional concept and not as absence of disease. This is consistent with public health perspective, where public health is regarded as public as well as political activity. It aims to solve health and social problems, depends on analysis of phenomena, needs the negotiations and relies on making decision on feasible directions of changes--what, why, how, where, when and by whom should be done. Public health policy developed as a result of international relations, and UN family fora especially, is regarded as significant for creating of health position. The aim of this article was: (1) the analysis of selected concepts and definitions related to structural dimensions of health, used in UN international arrangements; (2) an attempt to explain the evolution of health structure notions at worldwide agenda. The UN main bodies, programmes and funds working on the health field are mentioned and voting rules in UN General Assembly and World Health Assembly are reminded. The following structural dimensions were considered: (a) well-being, (b) human rights, (c) everyday resource, health potential, (4) equity. All were explored in WHO Constitution, Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights, Ottawa Charter for Health Promotion and numerous WHA and UN GA resolutions, decisions as well as other documents. Some remarkable differences in English and Polish language versions and meanings were pointed out. It was argued that present perception of structural dimension of health is strongly derived from the preamble of the WHO Constitution adopted and signed on 22 July 1946 by the representatives of 61 States. It is an evidence of the strength of this document and wisdom of its authors. The greater progress is associated. with concepts and notion of organizational dimensions of health perceived as action and processes leading to health. Long-term efforts to strengthen

Health Reporting in Print Media in Lebanon: Evidence, Quality and Role in Informing Policymaking

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El-Jardali, Fadi; Bou Karroum, Lama; Bawab, Lamya; Kdouh, Ola; El-Sayed, Farah; Rachidi, Hala; Makki, Malak

2015-01-01

Background Media plays a vital role in shaping public policies and opinions through disseminating health-related information. This study aims at exploring the role of media in informing health policies in Lebanon, identifying the factors influencing health reporting and investigating the role of evidence in health journalism and the quality of health reporting. It also identifies strategies to enhance the use of evidence in health journalism and improve the quality of health reporting. Methods Media analysis was conducted to assess the way media reports on health-related issues and the quality of reporting using a quality assessment tool. Semi-structured interviews were also conducted with 27 journalists, researchers and policymakers to explore their perception on the role of media in health policymaking and the factors influencing health reporting. In addition, a validation workshop was conducted. Results Out of 1,279 health-related news articles identified, 318 articles used certain type of evidence to report health issues 39.8% of which relied on experts’ opinions as their source of evidence while only 5.9% referenced peer-reviewed research studies. The quality of health reporting was judged to be low based on a quality assessment tool consisting of a set of ten criteria. Journalists raised concerns about issues impeding them from referring to evidence. Journalists also reported difficulties with the investigative health journalism. Policymakers and researchers viewed media as an important tool for evidence-informed health policies, however, serious concerns were voiced in terms of the current practice and capacities. Conclusion Our study provides a structured reflection on the role of media and the factors that influence health reporting including context-specific strategies that would enhance the quality and promote the use of evidence in health reporting. In the light of the political changes in many Middle Eastern countries, findings from this study can

Health Effects and Public Health Concerns of Energy Drink Consumption in the United States: A Mini-Review.

Science.gov (United States)

Al-Shaar, Laila; Vercammen, Kelsey; Lu, Chang; Richardson, Scott; Tamez, Martha; Mattei, Josiemer

2017-01-01

As energy drink consumption continues to grow worldwide and within the United States, it is important to critically examine the nutritional content and effects on population health of these beverages. This mini-review summarizes the current scientific evidence on health consequences from energy drink consumption, presents relevant public health challenges, and proposes recommendations to mitigate these issues. Emerging evidence has linked energy drink consumption with a number of negative health consequences such as risk-seeking behaviors, poor mental health, adverse cardiovascular effects, and metabolic, renal, or dental conditions. Despite the consistency in evidence, most studies are of cross-sectional design or focus almost exclusively on the effect of caffeine and sugar, failing to address potentially harmful effects of other ingredients. The negative health effects associated with energy drinks (ED) are compounded by a lack of regulatory oversight and aggressive marketing by the industry toward adolescents. Moreover, the rising trend of mixing ED with alcohol presents a new challenge that researchers and public health practitioners must address further. To curb this growing public health issue, policy makers should consider creating a separate regulatory category for ED, setting an evidence-based upper limit on caffeine, restricting sales of ED, and regulating existing ED marketing strategies, especially among children and adolescents.

Health Effects and Public Health Concerns of Energy Drink Consumption in the United States: A Mini-Review

Directory of Open Access Journals (Sweden)

Laila Al-Shaar

2017-08-01

Full Text Available As energy drink consumption continues to grow worldwide and within the United States, it is important to critically examine the nutritional content and effects on population health of these beverages. This mini-review summarizes the current scientific evidence on health consequences from energy drink consumption, presents relevant public health challenges, and proposes recommendations to mitigate these issues. Emerging evidence has linked energy drink consumption with a number of negative health consequences such as risk-seeking behaviors, poor mental health, adverse cardiovascular effects, and metabolic, renal, or dental conditions. Despite the consistency in evidence, most studies are of cross-sectional design or focus almost exclusively on the effect of caffeine and sugar, failing to address potentially harmful effects of other ingredients. The negative health effects associated with energy drinks (ED are compounded by a lack of regulatory oversight and aggressive marketing by the industry toward adolescents. Moreover, the rising trend of mixing ED with alcohol presents a new challenge that researchers and public health practitioners must address further. To curb this growing public health issue, policy makers should consider creating a separate regulatory category for ED, setting an evidence-based upper limit on caffeine, restricting sales of ED, and regulating existing ED marketing strategies, especially among children and adolescents.

Use of 'eradication' in HIV cure-related research: a public health debate.

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Dubé, Karine; Luter, Stuart; Lesnar, Breanne; Newton, Luke; Galea, Jerome; Brown, Brandon; Gianella, Sara

2018-02-13

The landscape of Human Immunodeficiency Virus (HIV) research has changed drastically over the past three decades. With the remarkable success of antiretroviral treatment (ART) in decreasing AIDS-related mortality, some researchers have shifted their HIV research focus from treatment to cure research. The HIV cure research community often uses the term eradication to describe the science, and talks about eradicating the virus from the body. In public discourse, the term eradication could be conflated with disease eradication at the population level. In this paper, we call for a reframing of HIV cure research as control, as it is a more accurate descriptor and achievable goal in the foreseeable future. The properties of HIV are discordant with eradicability standards at both the individual level (as a clinical concept), and at the population level (as a public health concept). At the individual level, true eradication would necessitate absolute elimination of all latent HIV reservoirs from the body. Current HIV cure-related research strategies have proven unsuccessful at accurately quantifying, let alone eliminating these reservoirs. At the population level, eradication implies the permanent global reduction of HIV to zero new cases and to zero risk for future cases. Given the absence of an efficacious HIV vaccine and the impracticality and unethicality of eliminating animal reservoirs, global eradication of HIV is highly implausible. From a public health perspective, HIV eradication remains an elusive goal. The term 'eradication' is a misleading description of current HIV cure-related research. Instead, we call for the use of more realistic expressions such as 'sustained virologic HIV suppression (or control)' or 'management of HIV persistence' to describe HIV cure-related research. Using these terms reorients what HIV cure science can potentially achieve in the near future and avoids creating unrealistic expectations, particularly among the millions of people

The American Public Health Association's 2017 Year of Climate Change and Health: Time for Action.

Science.gov (United States)

DeJarnett, Natasha; Robb, Katherine; Castellanos, Ivana; Dettman, Louise; Patel, Surili S

2017-10-26

Climate change is today's greatest public health threat. 1 As the nation's leading voice in public health, the American Public Health Association (APHA) has demonstrated an enduring commitment to climate change as a health issue. As far back as the mid-1920s, AJPH reported on the health impacts of climate change. 2-4 Shaping the development of future organizational efforts, APHA members created the organization's first policy statement on climate change in 1995 (updated in 2007 and 2015). APHA continued to bring attention to climate change and public health, making it the theme of National Public Health Week 2008. Since then, evidence of climate change's causes and effects has mounted, but politicization of the issue and low prioritization by the public has made progress toward mitigation and adaptation slow. (Am J Public Health. Published online ahead of print October 26, 2017: e1-e2. doi:10.2105/AJPH.2017.304168).

Linking research to practice: the rise of evidence-based health sciences librarianship.

Science.gov (United States)

Marshall, Joanne Gard

2014-01-01

The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services.

Linking research to practice: the rise of evidence-based health sciences librarianship*

Science.gov (United States)

Marshall, Joanne Gard

2014-01-01

Purpose: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. Methods: Four sources of evidence are used to examine the rise of EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. Results: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired by evidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. Implications: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services. PMID:24415915

[Field epidemiological study on news reports that related to public health emergencies].

Science.gov (United States)

Zhang, Shun-xiang; Li, Xue-mei; Luo, Nian-ci; Mei, Shu-jiang; Jiang, Li-juan

2013-12-01

All news reports (NR) that were related to public health emergency (PHE) were collected from the Southern Metropolis Daily (SMD) to explore the characteristics of epidemiology in the fields. Based on the theory of communication that including both case and text analysis, qualitative analysis on all the NR regarding PHE published in SMD from the years of 2008 to 2012, was carried out and input to database using the EpiData. Numbers of articles as indicators were compared to show the yearly change of different types of events. Various features of the NR including coverage, source of information, location of the incident, style and size of news, with or without editorials etc. were statistically analyzed by SPSS version 18.0. Among all the 998 reports related to PHE, higher proportion was found in the events of Infectious diseases (35.3%) and food safety (34.1%)respectively. Events on vaccines and drugs used for disease prevention and control (8.9%), environmental pollution caused incidents (8.0%)appeared to be less frequent. Events related to occupational disease, poisoning, bioterrorism and biochemical events were rare. Looking at the monthly distribution of reports, we noticed that the peaks occurred in 2008 and in 2009, which were caused by the Melamine-contamination events and the 2009 H1N1 pandemic. Between 2010 and 2012, figures of monthly reports were smooth, including some critical events from the interests of the media. Most events took place in Guangdong province (34.3%) and other provinces (50.9%), with some were from Hong Kong, Macao and Taiwan regions (9.5%). However, international events (5.2%)were less seen. Extensive coverage accounted for 17.6% of all of reports, and 11.5% allotted the editorials or other forms of in-depth reports. Most of the source of reports on infectious diseases and food safety were from the official release, however. The main sources of occupational diseases and poisoning, vaccines and drug incidents, environmental pollution

Evidence-based patient choice and consumer health informatics in the Internet age.

Science.gov (United States)

Eysenbach, G; Jadad, A R

2001-01-01

In this paper we explore current access to and barriers to health information for consumers. We discuss how computers and other developments in information technology are ushering in the era of consumer health informatics, and the potential that lies ahead. It is clear that we witness a period in which the public will have unprecedented ability to access information and to participate actively in evidence-based health care. We propose that consumer health informatics be regarded as a whole new academic discipline, one that should be devoted to the exploration of the new possibilities that informatics is creating for consumers in relation to health and health care issues.

Surfing the net for public health resources.

Science.gov (United States)

Angell, C; Hemingway, A; Hartwell, H

2011-08-01

To identify public health open educational resources (OER) available online, map the identified OER to The Public Health Skills and Career Framework (PHSCF), and triangulate these findings with public health practitioners. Systematic online search for public health OER. An online search was undertaken using a pre-defined set of search terms and inclusion/exclusion criteria. Public health OER were then mapped against the UK PHSCF. The findings of the search were discussed with public health specialists to determine whether or not they used these resources. A number of public health OER were identified, located on 42 websites from around the world. Mapping against the UK PHSCF demonstrated a lack of coverage in some areas of public health education. It was noted that many of the OER websites identified were not those generally used in practice, and those sites preferred by public health specialists were not identified by the online search. Public health OER are available from a number of providers, frequently universities and government organizations. However, these reflect a relatively small pool of original OER providers. Tagging of websites does not always identify their public health content. In addition, users of public health OER may not use search engines to identify resources but locate them using other means. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

What makes public health studies ethical? Dissolving the boundary between research and practice

Science.gov (United States)

2014-01-01

Background The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary – whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants – have been unsatisfactory. Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle – from initial planning through to knowledge exchange. Discussion The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives. The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services

What makes public health studies ethical? Dissolving the boundary between research and practice.

Science.gov (United States)

Willison, Donald J; Ondrusek, Nancy; Dawson, Angus; Emerson, Claudia; Ferris, Lorraine E; Saginur, Raphael; Sampson, Heather; Upshur, Ross

2014-08-08

The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary - whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants - have been unsatisfactory.Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle - from initial planning through to knowledge exchange. The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives.The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services organizations, and beyond. Public

Public health nursing, ethics and human rights.

Science.gov (United States)

Ivanov, Luba L; Oden, Tami L

2013-05-01

Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations. © 2013 Wiley Periodicals, Inc.

A multistate examination of partnership activity among local public health systems using the National Public Health Performance Standards.

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Barnes, Priscilla A; Curtis, Amy B; Hall-Downey, Laura; Moonesinghe, Ramal

2012-01-01

This study examines whether partnership-related measures in the second version of the National Public Health Performance Standards (NPHPS) are useful in evaluating level of activity as well as identifying latent constructs that exist among local public health systems (LPHSs). In a sample of 110 LPHSs, descriptive analysis was conducted to determine frequency and percentage of 18 partnership-related NPHPS measures. Principal components factor analysis was conducted to identify unobserved characteristics that promote effective partnerships among LPHSs. Results revealed that 13 of the 18 measures were most frequently reported at the minimal-moderate level (conducted 1%-49% of the time). Coordination of personal health and social services to optimize access (74.6%) was the most frequently reported measure at minimal-moderate levels. Optimal levels (conducted >75% of the time) were reported most frequently in 2 activities: participation in emergency preparedness coalitions and local health departments ensuring service provision by working with state health departments (67% and 61% of respondents, respectively) and the least optimally reported activity was review partnership effectiveness (4% of respondents). Factor analysis revealed categories of partnership-related measures in 4 domains: resources and activities contributing to relationship building, evaluating community leadership activities, research, and state and local linkages to support public health activities. System-oriented public health assessments may have questions that serve as proxy measures to examine levels of interorganizational partnerships. Several measures from the NPHPS were useful in establishing a national baseline of minimal and optimal activity levels as well as identifying factors to enhance the delivery of the 10 essential public health services among organizations and individuals in public health systems.

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

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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.

The Impact of IMC on Advertising and Public Relations Education.

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Griffin, W. Glenn; Pasadeos, Yorgo

1998-01-01

Surveys advertising and public relations faculty members with regard to IMC (Integrated Marketing Communications) and its impact on current curricula. Finds (1) areas of discontent with current course curricula; (2) evidence of "separate agendas" between advertising and public relations educators on this issue; and (3) evidence of a generation gap…

Social capital: theory, evidence, and implications for oral health.

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Rouxel, Patrick L; Heilmann, Anja; Aida, Jun; Tsakos, Georgios; Watt, Richard G

2015-04-01

In the last two decades, there has been increasing application of the concept of social capital in various fields of public health, including oral health. However, social capital is a contested concept with debates on its definition, measurement, and application. This study provides an overview of the concept of social capital, highlights the various pathways linking social capital to health, and discusses the potential implication of this concept for health policy. An extensive and diverse international literature has examined the relationship between social capital and a range of general health outcomes across the life course. A more limited but expanding literature has also demonstrated the potential influence of social capital on oral health. Much of the evidence in relation to oral health is limited by methodological shortcomings mainly related to the measurement of social capital, cross-sectional study designs, and inadequate controls for confounding factors. Further research using stronger methodological designs should explore the role of social capital in oral health and assess its potential application in the development of oral health improvement interventions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Beyond the usual suspects: using political science to enhance public health policy making.

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Fafard, Patrick

2015-11-01

That public health policy and practice should be evidence based is a seemingly uncontroversial claim. Yet governments and citizens routinely reject the best available evidence and prefer policies that reflect other considerations and concerns. The most common explanations of this paradox emphasise scientific disagreement, the power of 'politics', or the belief that scientists and policymakers live in two separate communities that do not communicate. However, another explanation may lie in the limits of the very notion of evidence-based policy making. In fact, the social science discipline of political science offers a rich body of theory and empirical evidence to explain the apparent gap between evidence and policy. This essay introduces this literature with a particular emphasis on a recent book by Katherine Smith, Beyond evidence-based policy in public health: the interplay of ideas. As the title suggests, Smith argues that what matters for public health policy is less scientific evidence and much more a more complex set of ideas. Based on detailed case studies of UK tobacco and health inequality policy, Smith offers a richly textured alternative account of what matters for policy making. This excellent book is part of a small but growing body of political science research on public health policy that draws on contemporary theories of policy change and governance more generally. This essay provides a window on this research, describes some examples, but emphasises that public health scholars and practitioners too often retain a narrow if not naive view of the policy-making process. 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.