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Boyko J, Riley B, Abramowicz A, Stockton L, Lambraki I, Garcia J, Savvaidis S, Neilson C. A mixed methods evaluation of capturing and sharing practitioner experience for improving local tobacco control strategies. Can J Public Health 2018; 110:103-113. [PMID: 30456744 PMCID: PMC6335370 DOI: 10.17269/s41997-018-0153-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 10/31/2018] [Indexed: 11/17/2022]
Abstract
Objective Practitioner experience is one type of evidence that is used in public health planning and action. Yet, methods for capturing and sharing experience are under-developed. We evaluated the reach, uptake and use of an example of capturing and sharing practitioner experience from tobacco control known as documentation of practice (DoP) reports. Methods The participatory, mixed methods approach included the following: a document review to capture data related to the extent and how DoP reports reached the target population; an online survey to assess awareness, use and perceptions about DoP reports; and semi-structured interviews to identify and explore examples of instrumental, conceptual and symbolic use of DoP reports. The samples for the survey and interviews included tobacco control practitioners from public health units in Ontario, Canada. Results Seventy-three individuals participated in the survey and 10 were interviewed. Awareness of at least one DoP report was high. The most common way of learning about DoP reports was email. DoP reports focused on policy issues had highest use; these reports were used in conceptual (helped raise awareness), instrumental (directly informed local policy development) and symbolic (confirmed a choice already made) ways. DoP reports may be improved with key messages, shorter development timelines, more relevant topic selection and dissemination to audiences beyond public health. Conclusion DoP reports are useful to public health practitioners working in tobacco control within Ontario; refinements to development and dissemination processes will enhance use. Future studies and adaptations of DoP reports could help improve use of practitioner experience as one source of evidence informing public health practice. Electronic supplementary material The online version of this article (10.17269/s41997-018-0153-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer Boyko
- Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, N2L3G1, Canada.
| | - Barbara Riley
- Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, N2L3G1, Canada
| | - Aneta Abramowicz
- Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, N2L3G1, Canada
| | - Lisa Stockton
- Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, N2L3G1, Canada
| | - Irene Lambraki
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Canada
| | - John Garcia
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Canada
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Tanuseputro P, Arnason T, Hennessy D, Smith B, Bennett C, Kopec J, Pinto AD, Perez R, Tuna M, Manuel D. Simulation modeling to enhance population health intervention research for chronic disease prevention. Can J Public Health 2018; 110:52-57. [PMID: 30039263 DOI: 10.17269/s41997-018-0109-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 06/27/2018] [Indexed: 11/17/2022]
Abstract
Population Health Intervention Research (PHIR) is an expanding field that explores the health effects of population-level interventions conducted within and outside of the health sector. Simulation modeling-the use of mathematical models to predict health outcomes in populations given a set of specified inputs-is a useful, yet underutilized tool for PHIR. It can be employed at several phases of the research process: (1) planning and designing PHIR studies; (2) implementation; and (3) knowledge translation of findings across settings and populations. Using the example of community-wide, built environment interventions for the prevention of type 2 diabetes, we demonstrate how simulation models can be a powerful technique for chronic disease prevention research within PHIR. With increasingly available data on chronic disease risk factors and outcomes, the use of simulation modeling in PHIR for chronic disease prevention is anticipated to grow. There is a continued need to ensure models are appropriately validated and researchers should be cautious in their interpretation of model outputs given the uncertainties that are inherent with simulation modeling approaches. However, given the complexity of disease pathways and methodological challenges of PHIR studies, simulation models can be a valuable tool for researchers studying population interventions that hold the potential to improve health and reduce health inequities.
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Affiliation(s)
- Peter Tanuseputro
- Bruyère Research Institute, 43 Bruyère Street, Ottawa, ON, K1N 5C8, Canada. .,Ottawa Hospital Research Institute, Ottawa Hospital - Civic Campus, 1053 Carling Ave Box 693, 2-005 Admin Services Building, Ottawa, ON, K1Y 4E9, Canada. .,Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada. .,Department of Medicine, Division of Palliative Care, University of Ottawa, Ottawa, Canada.
| | - Trevor Arnason
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, B3H 1V7, Canada
| | - Deirdre Hennessy
- Ottawa Hospital Research Institute, Ottawa Hospital - Civic Campus, 1053 Carling Ave Box 693, 2-005 Admin Services Building, Ottawa, ON, K1Y 4E9, Canada
| | - Brendan Smith
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Public Health Ontario, 480 University Ave, Toronto, ON, M5G 1V2, Canada
| | - Carol Bennett
- Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada
| | - Jacek Kopec
- School of Population and Public Health, University of British Columbia, Milan Ilich Arthritis Research Centre, 5591 No. 3 Road, Richmond, BC, V6X 2C7, Canada
| | - Andrew D Pinto
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada.,Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Richard Perez
- Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada
| | - Meltem Tuna
- Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada
| | - Douglas Manuel
- Bruyère Research Institute, 43 Bruyère Street, Ottawa, ON, K1N 5C8, Canada.,Ottawa Hospital Research Institute, Ottawa Hospital - Civic Campus, 1053 Carling Ave Box 693, 2-005 Admin Services Building, Ottawa, ON, K1Y 4E9, Canada.,Institute for Clinical Evaluative Sciences, Civic Campus, Administrative Services Building, 1st Floor, 1053 Carling Avenue, Box 684, Ottawa, ON, K1Y 4E9, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, K1H 8M5, Canada
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Stockbridge EL, Miller TL, Carlson EK, Ho C. Predictors of latent tuberculosis infection treatment completion in the US private sector: an analysis of administrative claims data. BMC Public Health 2018; 18:662. [PMID: 29843664 PMCID: PMC5975486 DOI: 10.1186/s12889-018-5578-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 05/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Factors that affect latent tuberculosis infection (LTBI) treatment completion in the US have not been well studied beyond public health settings. This gap was highlighted by recent health insurance-related regulatory changes that are likely to increase LTBI treatment by private sector healthcare providers. We analyzed LTBI treatment completion in the private healthcare setting to facilitate planning around this important opportunity for tuberculosis (TB) control in the US. METHODS We analyzed a national sample of commercial insurance medical and pharmacy claims data for people ages 0 to 64 years who initiated daily dose isoniazid treatment between July 2011 and March 2014 and who had complete data. All individuals resided in the US. Factors associated with treatment completion were examined using multivariable generalized ordered logit models and bivariate Kruskal-Wallis tests or Spearman correlations. RESULTS We identified 1072 individuals with complete data who initiated isoniazid LTBI treatment. Treatment completion was significantly associated with less restrictive health insurance, age < 15 years, patient location, use of interferon-gamma release assays, non-poverty, HIV diagnosis, immunosuppressive drug therapy, and higher cumulative counts of clinical risk factors. CONCLUSIONS Private sector healthcare claims data provide insights into LTBI treatment completion patterns and patient/provider behaviors. Such information is critical to understanding the opportunities and limitations of private healthcare in the US to support treatment completion as this sector's role in protecting against and eliminating TB grows.
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Affiliation(s)
- Erica L. Stockbridge
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
- Department of Advanced Health Analytics and Solutions, Magellan Health, Inc., 4800 N Scottsdale Rd #4400, Scottsdale, AZ 85251 USA
- Institute for Patient Safety, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
| | - Thaddeus L. Miller
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center School of Public Health, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
| | - Erin K. Carlson
- College of Nursing and Health Innovation, University of Texas at Arlington, 411 S. Nedderman Drive, Arlington, TX 76019-0407 USA
| | - Christine Ho
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 USA
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Johnson RE, Oyebode O, Walker S, Knowles E, Robertson W. The difficult conversation: a qualitative evaluation of the 'Eat Well Move More' family weight management service. BMC Res Notes 2018; 11:325. [PMID: 29784021 DOI: 10.1186/s13104-018-3428-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 05/10/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The Eat Well Move More (EWMM) family and child weight management service is a 12-week intervention integrating healthy eating and physical activity education and activities for families and children aged 4-16. EWMM service providers identified low uptake 12 months prior to the evaluation. The aims of this study were to describe referral practices and pathways into the service to identify potential reasons for low referral and uptake rates. RESULTS We conducted interviews and focus groups with general practitioners (GPs) (n = 4), school nurses, and nursing assistants (n = 12). Data were analysed using thematic analysis. School nurses highlighted three main barriers to making a referral: parent engagement, child autonomy, and concerns over the National Child Measurement Programme letter. GPs highlighted that addressing obesity among children is a 'difficult conversation' with several complex issues related to and sustaining that difficulty. In conclusion, referral into weight management services in the community may persistently lag if a larger and more complex tangle of barriers lie at the point of school nurse and GP decision-making. The national prevalence of, and factors associated with this hesitation to discuss weight management issues with parents and children remains largely unknown.
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Carabali M, Austin N, King NB, Kaufman JS. The Zika epidemic and abortion in Latin America: a scoping review. Glob Health Res Policy 2018; 3:15. [PMID: 29750204 PMCID: PMC5932843 DOI: 10.1186/s41256-018-0069-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/28/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Latin America presently has the world's highest burden of Zika virus, but there are unexplained differences in national rates of congenital malformations collectively referred to as Congenital Zika Syndrome (CZS) in the region. While Zika virulence and case detection likely contribute to these differences, policy-related factors, including access to abortion, may play important roles. Our goal was to assess perspectives on, and access to, abortion in Latin America in the context of the Zika epidemic. METHODS We conducted a scoping review of peer-reviewed and gray literature published between January 2015 and December 2016, written in English, Spanish, Portuguese, or French. We searched PubMed, Scielo, and Google Scholar for literature on Zika and/or CZS and abortion, and used automated and manual review methods to synthesize the existing information. RESULTS 36 publications met our inclusion criteria, the majority of which were qualitative. Publications were generally in favor of increased access to safe abortion as a policy-level response for mitigating the impact of CZS, but issues with implementation were cited as the main challenge. Aside from the reform of abortion regulation in Colombia, we did not find evidence that the Zika epidemic had triggered shifts in abortion policy in other countries. CONCLUSION Abortion policy in the region remained largely unchanged following the Zika epidemic. Further empirical research on abortion access and differential rates of CZS across Latin American countries is required.
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Affiliation(s)
- Mabel Carabali
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Avenue West, Purvis Hall Room 17A, Montreal, QC H3A 1A2 Canada
| | - Nichole Austin
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Avenue West, Purvis Hall Room 17A, Montreal, QC H3A 1A2 Canada
| | - Nicholas B. King
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Avenue West, Purvis Hall Room 17A, Montreal, QC H3A 1A2 Canada
- Biomedical Ethics Unit, McGill University, Montreal, QC Canada
| | - Jay S. Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1020 Pine Avenue West, Purvis Hall Room 17A, Montreal, QC H3A 1A2 Canada
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Londoño T, Trabado V, García-Rodríguez A, Balfagón P, Villalbí JR. [Improving the control of food allergy and intolerance risks in school settings: qualitative inputs from focus groups]. Gac Sanit 2018; 33:89-91. [PMID: 29691074 DOI: 10.1016/j.gaceta.2018.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/02/2018] [Accepted: 01/09/2018] [Indexed: 10/17/2022]
Abstract
This paper describes the use of focus groups as part of the evaluation of programmes to control food allergy and intolerance (FAI) in school settings in the city of Barcelona (Spain). After fostering their adoption and as a qualitative component of their evaluation, the public health services ran two focus groups, one with people from schools that manage their own kitchen, and another from companies that outsource this service. There were 28 participants from 46% of the centres invited. All the schools seem to have implemented a self-control programme on FAI. Although outsourcing companies already had a programme, the schools that managed their own service mostly adopted the programme promoted by the public health services. The number of schoolchildren with reported FAI reduced after the programme, as it required more rigorous documentation from families.
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Affiliation(s)
| | | | | | - Pere Balfagón
- Agència de Salut Pública de Barcelona, Barcelona, España
| | - Joan R Villalbí
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigacions Biomèdiques Sant Pau, Barcelona, España; Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, España.
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Russell K, Gilbert L, Hébert D, Ali A, Taylor RSL, Hendriks A. Ontario's Healthy Babies Healthy Children Screen tool: identifying postpartum families in need of home visiting services in Ottawa, Canada. Can J Public Health 2018; 109:386-394. [PMID: 29981082 DOI: 10.17269/s41997-018-0052-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 12/22/2017] [Indexed: 11/17/2022]
Abstract
INTERVENTION Across Ontario, the Healthy Babies Healthy Children (HBHC) postpartum screening tool is routinely used to identify families with potential risk of negative development outcomes for children. RESEARCH QUESTION To identify screening questions associated with subsequent high-risk in-depth assessment (IDA) in order to prioritize services. METHODS Ottawa families who gave birth (2013-2016) consented to the postpartum HBHC Screen (N = 29,162). Maternal socio-demographics, perinatal indicators, and 36 questions assessing pregnancy/birth, family, parenting, infant development, and health professional observations were analyzed for association with a high-risk IDA using regression analysis. RESULTS Upon first screen, 51% of families scored two or more risks. Most commonly, labour/delivery complications (27%), previous loss (26%), health professional concerns (22%), and mental illness (17%) were identified. Among IDA completions, 41% were assessed as high risk and this proportion increased when screened with 4+ risks. Characteristics associated with high-risk IDA among families scoring two or three included the following: maternal age ≤ 19 years (aRR = 2.0, 95% CI 1.50-2.80), 20-29 years (1.3, 1.12-1.53), ≥ 35 years (1.2, 1.04-1.45); combination breast and formula feeding on discharge (1.2, 1.03-1.37); < 18 years old at birth of first child (1.7, 1.13-2.43); single parent and no partner involved (1.6, 1.07-2.33); high school incomplete (1.8, 1.45-2.35); newcomer support needed (1.8, 1.43-2.17); financial concerns (1.6, 1.27-2.14); history of mental illness (1.2, 1.01-1.33); and parent disability (1.7, 1.09-2.78). CONCLUSION While offering the IDA when scoring 2+ risks is a provincial requirement, practices of increasing effort toward contacting families screened with 4+ risks are substantiated. An adapted approach to prioritize families screened with two or three risks is described.
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Affiliation(s)
- Katherine Russell
- Ottawa Public Health, 100 Constellation Crescent, Ottawa, Ontario, K2G 6J8, Canada.
| | - Louise Gilbert
- Healthy Babies Healthy Children, Ottawa Public Health, Ottawa, ON, Canada
| | - Denise Hébert
- Healthy Babies Healthy Children, Ottawa Public Health, Ottawa, ON, Canada
| | - Amira Ali
- Ottawa Public Health, 100 Constellation Crescent, Ottawa, Ontario, K2G 6J8, Canada
| | | | - Andrew Hendriks
- Ottawa Public Health, 100 Constellation Crescent, Ottawa, Ontario, K2G 6J8, Canada
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Tsui EK, Starecheski A. Uses of oral history and digital storytelling in public health research and practice. Public Health 2017; 154:24-30. [PMID: 29153972 DOI: 10.1016/j.puhe.2017.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/29/2017] [Accepted: 10/09/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Oral history (OH) and digital storytelling (DST) have been used in a range of ways in public health, including educating populations about health-protecting practices, advocating for improved clinical care and reflecting on public health efforts to combat infectious disease. Yet, these methods are rarely recognized for their potential to contribute to public health research and practice. The aim of this article is to assess how OH and DST have been used in the health fields and to provide examples of ways that these methods have contributed to work in several domains of public health. STUDY DESIGN Narrative review. METHODS We conducted a narrative review of articles gathered from PubMed using the search terms 'oral history' and 'digital storytelling', which resulted in 102 articles relevant to public health. We then conducted a thematic analysis to create a typology of article topics and to examine cross-cutting themes. RESULTS OH and DST have been used for both research and interventions in public health. Specifically, they have been used to 1) examine health risks and experiences; 2) engage and educate populations; 3) educate clinical professionals and organizations; and 4) inform public health practice. CONCLUSIONS Despite the time, resources, and training required to do OH and DST well, we argue that these methods have substantial potential for supplementing public health activities, allowing the field to glean additional lessons from its experiences, to educate its practitioners further, and to better learn from the experiences of communities affected by public health problems.
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Affiliation(s)
- E K Tsui
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health & Health Policy, USA.
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Nunes Pereira T, Alves Monteiro R, Pacheco Santos LM. [Food and nutrition in primary care in Brazil]. Gac Sanit 2017; 32:297-303. [PMID: 29126658 DOI: 10.1016/j.gaceta.2017.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/15/2017] [Accepted: 08/21/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To describe food and nutrition actions in primary health care in Brazil. METHODS Exploratory review of articles published between 2007 and 2016. Lilacs, PubMed, Scopus and Web of Science databases were consulted. RESULTS 103 articles were included, mostly published between 2012 and 2016 and developed mainly in the Southeast region of Brazil. The most prevalent research topics were food behaviour or consumption, nutritional status and non-communicable diseases. Most research was led by universities and was focused on diagnosis. Few actions on health promotion, healthy eating, assistance, treatment, integral health care and prevention of diseases related to food and nutrition were found in the review. CONCLUSION National interest in food and nutrition has increased, however academic production is still far from the actual needs for providing evidence that impacts health status. More research is needed to describe, propose and evaluate programmes and actions. Therefore, it is essential for closer relationships to be forged between universities, managers and health services in order to identify common interests and to develop research that meets the needs of the area and contribute to planning and improving programmes and actions.
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Affiliation(s)
- Tatiane Nunes Pereira
- Departamento de Salud Colectiva, Facultad de Ciencias de la Salud, Universidad de Brasilia, Brasilia, Distrito Federal, Brasil.
| | - Renata Alves Monteiro
- Departamento de Nutrición, Facultad de Ciencias de la Salud, Universidad de Brasilia, Brasilia, Distrito Federal, Brasil
| | - Leonor Maria Pacheco Santos
- Departamento de Salud Colectiva, Facultad de Ciencias de la Salud, Universidad de Brasilia, Brasilia, Distrito Federal, Brasil
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Rutkow L, Smith KC, Lai AY, Vernick JS, Davis CS, Alexander GC. Prescription drug monitoring program design and function: A qualitative analysis. Drug Alcohol Depend 2017; 180:395-400. [PMID: 28978492 DOI: 10.1016/j.drugalcdep.2017.08.040] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Opioid-related overdose deaths are a major public health challenge. Forty-nine states have implemented Prescription Drug Monitoring Programs (PDMPs) that collect information about individuals' prescription medications. Little is known about state governments' implementation of PDMPs. We conducted semi-structured interviews with PDMP staff, law enforcement officials, and administrative agency employees to learn about their attitudes and experiences with PDMPs. METHODS From May 2015 to June 2016, we conducted 37 semi-structured interviews with state actors in four states. Questions focused on interviewees' perceptions about PDMP goals, home agency characteristics, and future PDMP initiatives. States were selected purposively. Interviewees were identified through purposive and snowball sampling. RESULTS Interviewees identified key PDMP goals as: improve patient treatment decisions; influence prescribing practices; assist in the identification of "doctor shoppers"; and serve as a tool for law enforcement. Interviewees identified the following characteristics as key for a PDMP's home agency: regulatory and enforcement authority; intra- and inter-agency collaboration; and commitment to data quality and protection. Interviewees identified three promising areas for future PDMP efforts: data sharing and analysis; integration of PDMP data with electronic medical records; and training for current and potential PDMP users. CONCLUSIONS Our findings reveal areas that states may want to prioritize, including improving prescribers' knowledge and use of the PDMP as well as fostering inter-agency collaborations that include PDMP staff. By capitalizing on these opportunities, state governments may improve the effectiveness of their PDMPs, potentially making them more useful tools to curb the morbidity and mortality associated with opioid use disorders.
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Vitória PD, Nunes C, Precioso J. Parents' educational level and second-hand tobacco smoke exposure at home in a sample of Portuguese children. Rev Port Pneumol (2006) 2017; 23:221-224. [PMID: 28347749 DOI: 10.1016/j.rppnen.2017.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/11/2017] [Accepted: 02/13/2017] [Indexed: 10/19/2022] Open
Abstract
Second-hand tobacco smoke (SHS) exposure is a major and entirely avoidable health risk for children's health, well-being and development. The main objective of the current study was to investigate the association between parents' educational level and children's SHS home exposure. A self-administered questionnaire was conducted within a sample of 949 students in 4th grade (mean age 9.56±0.75, 53.4% male). The sample was randomly selected from all schools located at Lisbon District, Portugal. The current study confirmed that Portuguese children are exposed to unacceptable high levels of SHS at home, mainly by their parents' smoke. Prevalence of smokers was higher amongst parents with low educational level. Children of parents with low educational level were more likely to suffer SHS exposure at home. These results confirmed the social inequalities associated with smoking, support the relevance of more research on this subject and stress the need for more interventions to control this problem. Some interventions should be specifically aimed at less educated parents, particularly at less educated mothers.
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Affiliation(s)
- Paulo D Vitória
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal; CIS-IUL, Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal.
| | - Célia Nunes
- Departamento de Matemática e Centro de Matemática e Aplicações, Faculdade de Ciências, Universidade da Beira Interior, Covilhã, Portugal
| | - José Precioso
- Instituto de Educação, Universidade do Minho, Campus de Gualtar, Braga, Portugal
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van Bon-Martens MJH, van de Goor IAM, van Oers HAM. Concept mapping as a method to enhance evidence-based public health. Eval Program Plann 2017; 60:213-228. [PMID: 27614363 DOI: 10.1016/j.evalprogplan.2016.08.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 08/22/2016] [Indexed: 06/06/2023]
Abstract
In this paper we explore the suitability of concept mapping as a method for integrating knowledge from science, practice, and policy. In earlier research we described and analysed five cases of concept mapping procedures in the Netherlands, serving different purposes and fields in public health. In the current paper, seven new concept mapping studies of co-produced work are added to extend this analysis. For each of these twelve studies we analysed: (1) how the method was able to integrate knowledge from practice with scientific knowledge by facilitating dialogue and collaboration between different stakeholders in the field of public health, such as academic researchers, practitioners, policy-makers and the public; (2) how the method was able to bring theory development a step further (scientific relevance); and (3) how the method was able to act as a sound basis for practical decision-making (practical relevance). Based on the answers to these research questions, all but one study was considered useful for building more evidence-based public health, even though the extent to which they underpinned actual decision-making varied. The chance of actually being implemented in practice seems strongly related to the extent to which the responsible decision-makers are involved in the way the concept map is prepared and executed.
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Affiliation(s)
- Marja J H van Bon-Martens
- Trimbos Institute, the Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands; Academic Collaborative Centre for Public Health Brabant, Tranzo, Tilburg School of Social and Behavioural Sciences, University of Tilburg, P.O. Box 90153, 5000 LE Tilburg, The Netherlands.
| | - Ien A M van de Goor
- Academic Collaborative Centre for Public Health Brabant, Tranzo, Tilburg School of Social and Behavioural Sciences, University of Tilburg, P.O. Box 90153, 5000 LE Tilburg, The Netherlands.
| | - Hans A M van Oers
- Academic Collaborative Centre for Public Health Brabant, Tranzo, Tilburg School of Social and Behavioural Sciences, University of Tilburg, P.O. Box 90153, 5000 LE Tilburg, The Netherlands; National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
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Ab Rahman N, Teng CL, Sivasampu S. Antibiotic prescribing in public and private practice: a cross-sectional study in primary care clinics in Malaysia. BMC Infect Dis 2016; 16:208. [PMID: 27188538 PMCID: PMC4869350 DOI: 10.1186/s12879-016-1530-2] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 04/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antibiotic overuse is driving the emergence of antibiotic resistance worldwide. Good data on prescribing behaviours of healthcare providers are needed to support antimicrobial stewardship initiatives. This study examined the differences in antibiotic prescribing rates of public and private primary care clinics in Malaysia. METHODS We used data from the National Medical Care Survey (NMCS), a nationwide cluster sample of Malaysian public and private primary care clinics in 2014. NMCS contained demographic, diagnoses and prescribing from 129 public clinics and 416 private clinics. We identified all encounters who were prescribed antibiotic and analyse the prescribing rate, types of antibiotics, and diagnoses that resulted in antibiotic. RESULTS Five thousand eight hundred ten encounters were prescribed antibiotics; antibiotic prescribing rate was 21.1 % (public clinics 6.8 %, private clinics 30.8 %). Antibiotic prescribing was higher in private clinics where they contributed almost 87 % of antibiotics prescribed in primary care. Upper respiratory tract infection (URTI) was the most frequent diagnosis in patients receiving antibiotic therapy and accounted for 49.2 % of prescriptions. Of the patients diagnosed with URTI, 46.2 % received antibiotic treatment (public 16.8 %, private 57.7 %). Penicillins, cephalosporins and macrolides were the most commonly prescribed antibiotics and accounted for 30.7, 23.6 and 16.0 % of all antibiotics, respectively. More recently available broad-spectrum antibiotics such as azithromycin and quinolones were more frequently prescribed in private clinics. CONCLUSIONS Antibiotic prescribing rates are high in both public and private primary care settings in Malaysia, especially in the latter. This study provides evidence of excessive and inappropriate antibiotic prescribing for self-limiting conditions. These data highlights the needs for more concerted interventions targeting both prescribers and public. Improvement strategies should focus on reducing inappropriate prescribing.
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Affiliation(s)
- Norazida Ab Rahman
- Healthcare Statistics Unit, Clinical Research Centre, 3rd Floor MMA Building, 124 Pahang Road, 53000, Kuala Lumpur, Malaysia.
| | - Cheong Lieng Teng
- Department of Family Medicine, International Medical University, Seremban, Malaysia
| | - Sheamini Sivasampu
- Healthcare Statistics Unit, Clinical Research Centre, 3rd Floor MMA Building, 124 Pahang Road, 53000, Kuala Lumpur, Malaysia
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Akinboro O, Ottenbacher A, Martin M, Harrison R, James T, Martin E, Murdoch J, Linnear K, Cardarelli K. Racial and Ethnic Disparities in Health and Health Care: an Assessment and Analysis of the Awareness and Perceptions of Public Health Workers Implementing a Statewide Community Transformation Grant in Texas. J Racial Ethn Health Disparities 2016; 3:46-54. [PMID: 26896104 DOI: 10.1007/s40615-015-0111-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/31/2015] [Accepted: 04/06/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Little is known about the awareness of public health professionals regarding racial and ethnic disparities in health in the United States of America (USA). Our study objective was to assess the awareness and perceptions of a group of public health workers in Texas regarding racial health disparities and their chief contributing causes. METHODS We surveyed public health professionals working on a statewide grant in Texas, who were participants at health disparities' training workshops. Multivariable logistic regression was employed in examining the association between the participants' characteristics and their perceptions of the social determinants of health as principal causes of health disparities. RESULTS There were 106 respondents, of whom 38 and 35 % worked in health departments and non-profit organizations, respectively. The racial/ethnic groups with the highest incidence of HIV/AIDS and hypertension were correctly identified by 63 and 50 % of respondents, respectively, but only 17, and 32 % were knowledgeable regarding diabetes and cancer, respectively. Seventy-one percent of respondents perceived that health disparities are driven by the major axes of the social determinants of health. Exposure to information about racial/ethnic health disparities within the prior year was associated with a higher odds of perceiving that social determinants of health were causes of health disparities (OR 9.62; 95 % CI 2.77, 33.41). CONCLUSION Among public health workers, recent exposure to information regarding health disparities may be associated with their perceptions of health disparities. Further research is needed to investigate the impact of such exposure on their long-term perception of disparities, as well as the equity of services and programs they administer.
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Affiliation(s)
- Oladimeji Akinboro
- Department of Medicine, Montefiore New Rochelle Hospital, 16 Guion Place, New Rochelle, NY, 10801, USA. .,Formerly at the Center for Community Health, Texas Prevention Institute, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Allison Ottenbacher
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA.,Formerly at the Center for Community Health, Texas Prevention Institute, University of North Texas Health Science Center, Fort Worth, TX, USA
| | | | | | - Thomas James
- 2M Research Services, Cedar Hill, TX, USA.,University of Oklahoma, Norman, OK, USA
| | | | - James Murdoch
- 2M Research Services, Cedar Hill, TX, USA.,University of Texas at Dallas, Dallas, TX, USA
| | - Kim Linnear
- University of North Texas Health Sciences Center, Fort Worth, TX, USA
| | - Kathryn Cardarelli
- University of Kentucky College of Public Health, Lexington, KY, USA.,Formerly at the Center for Community Health, Texas Prevention Institute, University of North Texas Health Science Center, Fort Worth, TX, USA
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Knight GM, Dharan NJ, Fox GJ, Stennis N, Zwerling A, Khurana R, Dowdy DW. Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making. Int J Infect Dis 2015; 42:17-23. [PMID: 26546234 PMCID: PMC4996966 DOI: 10.1016/j.ijid.2015.10.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 01/07/2023] Open
Abstract
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 reevaluated 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.
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Affiliation(s)
- Gwenan M Knight
- National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, 8(th) floor Commonwealth Building, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK; TB Modelling Group, TB Centre, Centre for Mathematical Modelling, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
| | - Nila J Dharan
- New Jersey Medical School - Rutgers, the State University of New Jersey, Newark, New Jersey, USA
| | - Gregory J Fox
- Respiratory Epidemiology Clinical Research Unit, McGill University, Montreal, Quebec, Canada
| | - Natalie Stennis
- New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control, New York, New York, USA
| | - Alice Zwerling
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Renuka Khurana
- Maricopa County Department of Public Health, Clinical Services, Phoenix, Arizona, USA
| | - David W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Affiliation(s)
- Meredith L Shoemaker
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341 USA
| | - Dawn M Holman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341 USA
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341 USA
| | - Mary C White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341 USA
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Linmans JJ, van Rossem C, Knottnerus JA, Spigt M. Exploring the process when developing a lifestyle intervention in primary care for type 2 diabetes: a longitudinal process evaluation. Public Health 2014; 129:52-9. [PMID: 25542747 DOI: 10.1016/j.puhe.2014.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 08/04/2014] [Accepted: 11/05/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVES A thorough understanding of the processes involved in lifestyle interventions is needed in order to close the gap between research and daily practice. This study explored the processes involved in the provision of a lifestyle intervention to patients with type 2 diabetes mellitus (T2DM) by health care professionals in primary care. STUDY DESIGN Mixed methods. METHODS Health care professionals were asked to intensify lifestyle interventions for patients with T2DM in a routine care setting. Data were collected by serial interviews with health care professionals and patients, recorded consultations, an activity questionnaire and biomedical information. Qualitative data were analysed using a framework analysis with a phenomenological approach. RESULTS The lifestyle intervention developed by the health care professionals included motivational interviewing, a nutrition and physical activity diary, and a multidisciplinary approach [physiotherapist, dietician, general practitioner and diabetes practice nurse (DPN)]. Participants and health care professionals were positive about the intervention, and patients were more active (P = 0.027), lost weight (P = 0.031) and had lower levels of glycated haemoglobin (P = 0.012). However, qualitative data showed that patients were passive during the consultation, and did not ask questions about ways to improve their lifestyle. DPNs did not use motivational interviewing optimally; provided patients with information that was difficult to understand; and were easily satisfied with the efforts of the patients. CONCLUSIONS Lifestyle intervention for patients with T2DM is difficult in routine primary care. DPNs should adapt to the knowledge level of the patients, and patients must be stimulated to take an active role in their treatment. Patients and health care professionals should become equal partners in determining mutually agreeable treatment plans and goals.
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Affiliation(s)
- J J Linmans
- CAPHRI School for Public Health and Primary Care, Department of General Practice, Maastricht University, Maastricht, The Netherlands.
| | - C van Rossem
- CAPHRI School for Public Health and Primary Care, Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | - J A Knottnerus
- CAPHRI School for Public Health and Primary Care, Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | - M Spigt
- CAPHRI School for Public Health and Primary Care, Department of General Practice, Maastricht University, Maastricht, The Netherlands
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Turner AM, Brownstein MK, Cole K, Karasz H, Kirchhoff K. Modeling workflow to design machine translation applications for public health practice. J Biomed Inform 2014; 53:136-46. [PMID: 25445922 DOI: 10.1016/j.jbi.2014.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 09/24/2014] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Provide a detailed understanding of the information workflow processes related to translating health promotion materials for limited English proficiency individuals in order to inform the design of context-driven machine translation (MT) tools for public health (PH). MATERIALS AND METHODS We applied a cognitive work analysis framework to investigate the translation information workflow processes of two large health departments in Washington State. Researchers conducted interviews, performed a task analysis, and validated results with PH professionals to model translation workflow and identify functional requirements for a translation system for PH. RESULTS The study resulted in a detailed description of work related to translation of PH materials, an information workflow diagram, and a description of attitudes towards MT technology. We identified a number of themes that hold design implications for incorporating MT in PH translation practice. A PH translation tool prototype was designed based on these findings. DISCUSSION This study underscores the importance of understanding the work context and information workflow for which systems will be designed. Based on themes and translation information workflow processes, we identified key design guidelines for incorporating MT into PH translation work. Primary amongst these is that MT should be followed by human review for translations to be of high quality and for the technology to be adopted into practice. CONCLUSION The time and costs of creating multilingual health promotion materials are barriers to translation. PH personnel were interested in MT's potential to improve access to low-cost translated PH materials, but expressed concerns about ensuring quality. We outline design considerations and a potential machine translation tool to best fit MT systems into PH practice.
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Affiliation(s)
- Anne M Turner
- University of Washington Northwest Center for Public Health Practice, 1107 NE 45th Street, Suite 400, Box 354809, Seattle, WA 98105, USA; Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA; Department of Health Services, University of Washington, Seattle, WA, USA.
| | - Megumu K Brownstein
- University of Washington Northwest Center for Public Health Practice, 1107 NE 45th Street, Suite 400, Box 354809, Seattle, WA 98105, USA
| | - Kate Cole
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Hilary Karasz
- Public Health - Seattle & King County, Seattle, WA, USA
| | - Katrin Kirchhoff
- Department of Electrical Engineering, University of Washington, Seattle, WA, USA
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Abstract
In this commentary, we review definition frameworks for community health and examine factors having core relevance to shaping the meaning of this term and growing field. We conclude by suggesting a potential framework for conceptualizing and advancing this field of public health practice through improved understanding of the meaning, scope, and science of community health.
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Affiliation(s)
- Richard A Goodman
- Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, USA; Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, USA.
| | - Rebecca Bunnell
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, USA
| | - Samuel F Posner
- Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, USA
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van Bon-Martens MJH, van de Goor LAM, Holsappel JC, Kuunders TJM, Jacobs-van der Bruggen MAM, te Brake JHM, van Oers JAM. Concept mapping as a promising method to bring practice into science. Public Health 2014; 128:504-14. [PMID: 24923995 DOI: 10.1016/j.puhe.2014.04.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 02/16/2014] [Accepted: 04/03/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Concept mapping is a method for developing a conceptual framework of a complex topic for use as a guide to evaluation or planning. In concept mapping, thoughts and ideas are represented in the form of a picture or map, the content of which is determined by a group of stakeholders. This study aimed to explore the suitability of this method as a tool to integrate practical knowledge with scientific knowledge in order to improve theory development as a sound basis for practical decision-making. METHOD Following a short introduction to the method of concept mapping, five Dutch studies, serving different purposes and fields in public health, will be described. The aim of these studies was: to construct a theoretical framework for good regional public health reporting; to design an implementation strategy for a guideline for integral local health policy; to guide the evaluation of a local integral approach of overweight and obesity in youth; to guide the construction of a questionnaire to measure the quality of postdisaster psychosocial care; and to conceptualize an integral base for formulation of ambitions and targets for the new youth healthcare programme of a regional health service. RESULTS The studies showed that concept mapping is a way to integrate practical and scientific knowledge with careful selection of participants that represent the different perspectives. Theory development can be improved through concept mapping; not by formulating new theories, but by highlighting the key issues and defining perceived relationships between topics. In four of the five studies, the resulting concept map was received as a sound basis for practical decision-making. CONCLUSIONS Concept mapping is a valuable method for evidence-based public health policy, and a powerful instrument for facilitating dialogue, coherence and collaboration between researchers, practitioners, policy makers and the public. Development of public health theory was realized by a step-by-step approach, considering both scientific and practical knowledge. However, the external validity of the concept maps in place and time is of importance.
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Affiliation(s)
- M J H van Bon-Martens
- Academic Collaborative Centre for Public Health Brabant, Tranzo, Tilburg School of Social and Behavioural Sciences, University of Tilburg, Tilburg, The Netherlands; Regional Health Service (GGD) Hart voor Brabant, 's-Hertogenbosch, The Netherlands; Trimbos Institute, the Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
| | - L A M van de Goor
- Academic Collaborative Centre for Public Health Brabant, Tranzo, Tilburg School of Social and Behavioural Sciences, University of Tilburg, Tilburg, The Netherlands
| | - J C Holsappel
- Regional Health Service (GGD) Amsterdam, Amsterdam, The Netherlands; Impact, National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Diemen, The Netherlands; Centre for Public Health Status and Forecasting (cVTV), Bilthoven, National Institute for Public Health and the Environment (RIVM), The Netherlands
| | - T J M Kuunders
- Academic Collaborative Centre for Public Health Brabant, Tranzo, Tilburg School of Social and Behavioural Sciences, University of Tilburg, Tilburg, The Netherlands; Regional Health Service (GGD) Hart voor Brabant, 's-Hertogenbosch, The Netherlands
| | - M A M Jacobs-van der Bruggen
- Academic Collaborative Centre for Public Health Brabant, Tranzo, Tilburg School of Social and Behavioural Sciences, University of Tilburg, Tilburg, The Netherlands; Regional Health Service (GGD) Hart voor Brabant, 's-Hertogenbosch, The Netherlands
| | - J H M te Brake
- Impact, National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Diemen, The Netherlands
| | - J A M van Oers
- Academic Collaborative Centre for Public Health Brabant, Tranzo, Tilburg School of Social and Behavioural Sciences, University of Tilburg, Tilburg, The Netherlands; Centre for Public Health Status and Forecasting (cVTV), Bilthoven, National Institute for Public Health and the Environment (RIVM), The Netherlands
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Cohen BE, Schultz A, McGibbon E, VanderPlaat M, Bassett R, GermAnn K, Beanlands H, Fuga LA. A Conceptual Framework of Organizational Capacity for Public Health Equity Action (OC-PHEA). Can J Public Health 2013; 104:e262-6. [PMID: 23823893 PMCID: PMC6973720 DOI: 10.17269/cjph.104.3735] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 03/11/2013] [Accepted: 02/24/2013] [Indexed: 11/17/2022]
Abstract
The Canadian public health sector's foundational values of social justice and equity, and its mandate to promote population health, make it ideally situated to take a strong lead in addressing persistent and unacceptable inequities in health between socially disadvantaged, marginalized or excluded groups and the general population. There is currently much attention paid to improving understanding of pathways to health equity and development of effective population health interventions to reduce health inequities. Strengthening the capacity of the public health sector to develop, implement and sustain equity-focused population health initiatives - including readiness to engage in a social justice-based equity framework for public health - is an equally essential area that has received less attention. Unfortunately, there is evidence that current capacity of the Canadian public health sector to address inequities is highly variable. The first step in developing a sustained approach to improving capacity for health equity action is the identification of what this type of capacity entails. This paper outlines a Conceptual Framework of Organizational Capacity for Public Health Equity Action (OC-PHEA), grounded in the experience of Canadian public health equity champions, that can guide research, dialogue, reflection and action on public health capacity development to achieve health equity goals.
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Affiliation(s)
- Benita E Cohen
- Faculty of Nursing, University of Manitoba, Winnipeg, MB, Canada.
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Abstract
It was against a background of no formal career path for public health officers that, in 1915, the seminal Welch-Rose Report1 outlined a system of public health education for the United States. The first schools of public health soon followed, but growth was slow, with only 12 schools by 1960. With organization and growing numbers, accreditation became an expectation. As the mission of public health has grown and achieved new urgency, schools have grown in number, depth and breadth. By mid-2011, there were 46 accredited schools of public health, with more in the pipeline. While each has a unique character, they also must possess certain core characteristics to be accredited. Over time, as schools developed, and concepts of public health expanded, so too did curricula and missions as well as types of people who were trained. In this review, we provide a brief summary of US public health education, with primary emphasis on professional public health schools. We also examine public health workforce needs and evaluate how education is evolving in the context of a growing maturity of the public health profession. We have not focused on programs (not schools) that offer public health degrees or on preventive medicine programs in schools of medicine, since schools of public health confer the majority of master's and doctoral degrees. In the future, there likely will be even more inter-professional education, new disciplinary perspectives and changes in teaching and learning to meet the needs of millennial students.
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Affiliation(s)
- Linda Rosenstock
- University of California, Los Angeles School of Public Health, Los Angeles, CA USA
| | - Karen Helsing
- Institute of Medicine of the National Academies, Washington, DC, USA
| | - Barbara K. Rimer
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC USA
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