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Carlini BH, Garrett SB, Matos P, Nims LN, Kestens Y. Identifying policy options to regulate high potency cannabis: A multiple stakeholder concept mapping study in Washington State, USA. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104270. [PMID: 38043404 DOI: 10.1016/j.drugpo.2023.104270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Cannabis legalization in some U.S.A. states has catapulted the mass production of concentrates, with tetrahydrocannabinol (THC) concentrations ranging from 50-90%. A major public health concern is that these products will increase cannabis-related harms such as use disorders, psychotic symptoms, and accidental poisonings. This paper describes and contextualizes the results of a study requested by the WA State Legislature to understand perspectives of WA stakeholders on the topic. METHODS Concept Mapping (CM), a mixed-methods research approach that supports people-centered policy decisions was utilized. The goal of the study was to explore stakeholders' concern levels and support of policies to address the availability of high THC cannabis products. For analysis purposes, stakeholders were categorized into three groups: community, professionals, and cannabis advocates. RESULTS CM generated an inventory of policy ideas for regulating high-potency cannabis from a variety of stakeholders. Notably, stakeholders from community and professional groups supported environmental policy changes such as such as taxation, increasing minimum age for high concentration cannabis products, and advertising prohibition. Meanwhile, cannabis advocates (mostly industry actors) opposed taxation per THC content, proposed lowering taxes, and supported policies with low population impact such as educating parents, teachers, and youth. CONCLUSION Support for regulating high concentration THC products varied by stakeholder group. Consistent with how other health compromising industries have historically acted, cannabis industry stakeholders rejected regulation of their products. Future studies should explore non-cannabis industry stakeholders' willingness to work towards minimizing the influence of the cannabis industry in policy development processes to assure public health regulations prevail.
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Affiliation(s)
- Beatriz H Carlini
- Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences at the University of Washington, Seattle, WA, United States of America.
| | - Sharon B Garrett
- Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences at the University of Washington, Seattle, WA, United States of America
| | | | - Lexi N Nims
- Addictions, Drug & Alcohol Institute, Department of Psychiatry and Behavioral Sciences at the University of Washington, Seattle, WA, United States of America
| | - Yan Kestens
- École de santé publique de l'Université de Montréal, Montréal, Canada; Centre de Recherche en Santé Publique, Montréal, Canada
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Prado NMDBL, Aquino R, Hartz ZMDA, Santos HLPCD, Medina MG. Revisitando definições e naturezas da intersetorialidade: um ensaio teórico. CIENCIA & SAUDE COLETIVA 2022; 27:593-602. [DOI: 10.1590/1413-81232022272.47042020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/17/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Este ensaio teórico aborda definições e características centrais das ações intersetoriais para a saúde. Tem como objetivo, portanto, refletir sobre o conhecimento produzido a respeito das concepções e da natureza das ações intersetoriais para a saúde. Para a construção das análises, realizou-se uma revisão integrativa a partir de publicações referentes ao período de 2000 a 2019 identificadas nas bases de dados Lilacs, SciELO, Web of Science e Science Direct. O corpus contemplou 12 artigos, sendo analisados os aspectos relacionados com a finalidade, o propósito ou o método da ação intersetorial, sendo possível traçar similaridades e contrastes entre as definições. Diante da opacidade na construção de definições, coube situar que existe uma construção sócio-histórica dos conceitos, mas as definições provisórias expressam certo borramento ou apagamento que se encontram em disputa no interior do campo da saúde e que podem direcionar a distintos pontos de vista e constituir barreiras para incluir a implementação das ações intersetoriais relacionadas à promoção da saúde nas práticas cotidianas. De tais reflexões derivaram um conjunto de proposições acerca das naturezas das ações intersetoriais para a saúde, com vistas a contribuir para o debate sobre a temática.
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Askelson N, Ryan G, McRee AL, Farris PE, Shannon J, Hanson J, Kenyon DB, Daly E, Avdic L. Using concept mapping to identify opportunities for HPV vaccination efforts: Perspectives from the Midwest and West Coast. EVALUATION AND PROGRAM PLANNING 2021; 89:102010. [PMID: 34555736 PMCID: PMC8557125 DOI: 10.1016/j.evalprogplan.2021.102010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/11/2021] [Accepted: 09/02/2021] [Indexed: 05/07/2023]
Abstract
Human papillomavirus (HPV) infection significantly contributes to the burden of cancer in the United States, despite the existence of a highly effective vaccine. While numerous interventions to address vaccination uptake exist, vaccination rates remain low. We conducted a concept mapping exercise to solicit perspectives on barriers and facilitators to HPV vaccination from state-level stakeholders in five states in the Midwest and West Coast of the U.S. We identified 10 clusters of barriers and facilitators based on participants' statements. For rural areas specifically, clusters rated as most important included education and provider influence; those rated as most feasible were education and coordinated/consistent messaging. Our results suggest that a combination of important (but potentially more difficult to implement) strategies, combined with those rated as most feasible (but potentially less impactful) may be beneficial. Our findings highlight similarities across diverse states, suggesting that states can learn from each other and work together to improve HPV vaccination rates. Using concept mapping proved to be an efficient way to collect information from diverse, stakeholders in different locations, and is a methodology that could be used for program planning in areas beyond HPV vaccination.
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Affiliation(s)
- Natoshia Askelson
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Dr, Iowa City, IA 52245, USA
| | - Grace Ryan
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Dr, Iowa City, IA 52245, USA.
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, University of Minnesota Medical School, 717 Delaware St SE, Minneapolis, MN 55414, USA
| | - Paige E Farris
- Oregon Health & Science University/ Portland State University School of Public Health, Oregon Health & Science University, 250 NW Franklin Ave., Ste. 302, Bend, 97702, USA
| | - Jackilen Shannon
- Oregon Health & Science University/ Portland State University School of Public Health, Oregon Health & Science University, 250 NW Franklin Ave., Ste. 302, Bend, 97702, USA
| | - Jessica Hanson
- College of Education and Human Service Professions, University of Minnesota Duluth, 110 Sports & Health Center, 1216 Ordean Court, Duluth, MN 55812, USA
| | - DenYelle Baete Kenyon
- Sanford School of Medicine, School of Health Sciences, 414 E. Clark Street, Vermillion, SD 57069, USA
| | - Eliza Daly
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Dr, Iowa City, IA 52245, USA
| | - Lejla Avdic
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N. Riverside Dr, Iowa City, IA 52245, USA
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Leaders' Future Orientation and Public Health Investment Intention: A Moderated Mediation Model of Self-Efficacy and Perceived Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186922. [PMID: 32971881 PMCID: PMC7559104 DOI: 10.3390/ijerph17186922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022]
Abstract
Prior studies have investigated the issue of public health and health policy from economic, environmental, and healthcare perspectives. Research on public health from leaders’ perspective may also help to advance our knowledge about leaders’ perceptions, attitudes, and behavioral intentions toward public health management. Therefore, this study is based on social ideal theory, social cognitive theory, and social trust theory to investigate the influence of leaders’ future orientation on public health investment intention with the mediating role of leaders’ self-efficacy and the moderating role of perceived social support. Using a structural equation modeling with a sample data of 381 leaders of government agencies in Vietnam, empirical results indicate that leaders’ future orientation has a positive influence on public health investment intention. Furthermore, self-efficacy is found to have a positive mediating effect in the relationship between leaders’ future orientation and public health investment intention. In addition, perceived social support positively moderates the link between leaders’ future orientation and self-efficacy. Perceived social support also moderates the indirect effect of leaders’ future orientation on public health investment intention through self-efficacy. On one hand, this study contributes to theoretical research by clarifying the effects of leaders’ perceptions, and cognitive and behavioral intentions toward public health investment. Findings of this study may have implications for researchers who may have interest in studying the issue of public health management from leaders’ viewpoints. On the other hand, this study contributes to practitioners since understanding how leaders’ characteristics affect public health investment will enhance the quality of policy makers’ decision-making in improving public health for citizens and society.
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Allen P, Pilar M, Walsh-Bailey C, Hooley C, Mazzucca S, Lewis CC, Mettert KD, Dorsey CN, Purtle J, Kepper MM, Baumann AA, Brownson RC. Quantitative measures of health policy implementation determinants and outcomes: a systematic review. Implement Sci 2020; 15:47. [PMID: 32560661 PMCID: PMC7304175 DOI: 10.1186/s13012-020-01007-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/05/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Public policy has tremendous impacts on population health. While policy development has been extensively studied, policy implementation research is newer and relies largely on qualitative methods. Quantitative measures are needed to disentangle differential impacts of policy implementation determinants (i.e., barriers and facilitators) and outcomes to ensure intended benefits are realized. Implementation outcomes include acceptability, adoption, appropriateness, compliance/fidelity, feasibility, penetration, sustainability, and costs. This systematic review identified quantitative measures that are used to assess health policy implementation determinants and outcomes and evaluated the quality of these measures. METHODS Three frameworks guided the review: Implementation Outcomes Framework (Proctor et al.), Consolidated Framework for Implementation Research (Damschroder et al.), and Policy Implementation Determinants Framework (Bullock et al.). Six databases were searched: Medline, CINAHL Plus, PsycInfo, PAIS, ERIC, and Worldwide Political. Searches were limited to English language, peer-reviewed journal articles published January 1995 to April 2019. Search terms addressed four levels: health, public policy, implementation, and measurement. Empirical studies of public policies addressing physical or behavioral health with quantitative self-report or archival measures of policy implementation with at least two items assessing implementation outcomes or determinants were included. Consensus scoring of the Psychometric and Pragmatic Evidence Rating Scale assessed the quality of measures. RESULTS Database searches yielded 8417 non-duplicate studies, with 870 (10.3%) undergoing full-text screening, yielding 66 studies. From the included studies, 70 unique measures were identified to quantitatively assess implementation outcomes and/or determinants. Acceptability, feasibility, appropriateness, and compliance were the most commonly measured implementation outcomes. Common determinants in the identified measures were organizational culture, implementation climate, and readiness for implementation, each aspects of the internal setting. Pragmatic quality ranged from adequate to good, with most measures freely available, brief, and at high school reading level. Few psychometric properties were reported. CONCLUSIONS Well-tested quantitative measures of implementation internal settings were under-utilized in policy studies. Further development and testing of external context measures are warranted. This review is intended to stimulate measure development and high-quality assessment of health policy implementation outcomes and determinants to help practitioners and researchers spread evidence-informed policies to improve population health. REGISTRATION Not registered.
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Affiliation(s)
- Peg Allen
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA.
| | - Meagan Pilar
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Callie Walsh-Bailey
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Cole Hooley
- School of Social Work, Brigham Young University, 2190 FJSB, Provo, UT, 84602, USA
| | - Stephanie Mazzucca
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Cara C Lewis
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA
| | - Kayne D Mettert
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA
| | - Caitlin N Dorsey
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA
| | - Jonathan Purtle
- Department of Health Management & Policy, Drexel University Dornsife School of Public Health, Nesbitt Hall, 3215 Market St, Philadelphia, PA, 19104, USA
| | - Maura M Kepper
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Ana A Baumann
- Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, 4921 Parkview Place, Saint Louis, MO, 63110, USA
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Mulderij LS, Wolters F, Verkooijen KT, Koelen MA, Groenewoud S, Wagemakers A. Effective elements of care-physical activity initiatives for adults with a low socioeconomic status: A concept mapping study with health promotion experts. EVALUATION AND PROGRAM PLANNING 2020; 80:101813. [PMID: 32179253 DOI: 10.1016/j.evalprogplan.2020.101813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/11/2020] [Accepted: 02/24/2020] [Indexed: 06/10/2023]
Abstract
In care-physical activity (care-PA) initiatives, primary care and sports are combined to stimulate PA among adults at risk of lifestyle related diseases. Preliminary results from Dutch care-PA initiatives for adults with a low socioeconomic status (SES) indicate a decrease in participants' body weight and an improved quality of life, however, the elements that make these initiatives successful are yet to be identified. In total, 19 Dutch health promotion experts participated in our concept mapping (CM) of the effective elements of care-PA initiatives for adults with a low SES. The experts identified 111 effective elements of these initiatives, which were grouped into 11 clusters, focusing on: 1) approaching participants within the care-PA initiative, 2) barriers experienced throughout the initiative, 3) long-term implementation, 4) customizing the care-PA initiative to the target population, 5) social support, 6) structure and guidance, 7) the professionals within the care-PA initiative, 8) the accessibility of the care-PA initiative, 9) targeted behaviour and progression, 10) recruitment and administration, and 11) intersectoral collaboration. CM was useful for creating a valuable overview of these effective elements. Our results could be used to improve the development and implementation of future care-PA initiatives for adults with a low SES.
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Affiliation(s)
- Lisanne S Mulderij
- Health & Society, Wageningen University & Research, P.O. Box 8130, 6700 EW Wageningen, the Netherlands.
| | - Fieke Wolters
- Health & Society, Wageningen University & Research, P.O. Box 8130, 6700 EW Wageningen, the Netherlands
| | - Kirsten T Verkooijen
- Health & Society, Wageningen University & Research, P.O. Box 8130, 6700 EW Wageningen, the Netherlands
| | - Maria A Koelen
- Health & Society, Wageningen University & Research, P.O. Box 8130, 6700 EW Wageningen, the Netherlands
| | - Stef Groenewoud
- Scientific Centre for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Sciences, P.O. Box 9101, 114, 6500 HB Nijmegen, the Netherlands
| | - Annemarie Wagemakers
- Health & Society, Wageningen University & Research, P.O. Box 8130, 6700 EW Wageningen, the Netherlands
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Dantas MK, Oliveira LRD, Ferolla LM, Paschoalotto MAC, Lopes JEF, Passador JL, Passador CS. Cross-sectoral assessment of public policies in health and the environment: Scenario of the municipalities in the state of Sao Paulo. EVALUATION AND PROGRAM PLANNING 2017; 65:30-39. [PMID: 28689027 DOI: 10.1016/j.evalprogplan.2017.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 04/27/2017] [Accepted: 06/01/2017] [Indexed: 06/07/2023]
Abstract
From the identification of the current and rising demand for integrated solutions by government players, especially at the stage of evaluation of public policies, this paper carried out an cross-sectoral outcome assessment of local government cost-effectiveness in the fields of health and environment. The analysis is based on the amount of resources allocated by each of the 645 municipalities in the state of São Paulo, to each field, involving consolidated evaluation indicators (IDSUS and IAA, respectively). This study required the prior distribution of municipalities in clusters within homogeneous groups previously proposed in IDSUS calculation methodology. The results suggest that the addressed areas are intimately connected, indicating that larger (and better) environmental investments can produce promising outcomes toward health performance. Therefore, there is a demand for integrated public policies in the context of environmental health. Also, there is the indication that the resource management and the proper allocation thereof may be more relevant than the total amount spent; and that lower cost-effectiveness values do not necessarily demonstrate high scores in the assessed performance indicators.
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Affiliation(s)
- Marina Kolland Dantas
- School of Economics, Business Administration and Accounting at Ribeirão Preto, University of São Paulo, Brazil; Faculdade de Economia, Administração e Contabilidade, Bloco B2, Sala 74, Brazil.
| | - Lilian Ribeiro de Oliveira
- School of Economics, Business Administration and Accounting at Ribeirão Preto, University of São Paulo, Brazil.
| | - Luna Marquez Ferolla
- School of Economics, Business Administration and Accounting at Ribeirão Preto, University of São Paulo, Brazil.
| | | | - José Eduardo Ferreira Lopes
- Federal University of Uberlândia, School of Business and Management - FAGEN, Uberlândia, Minas Gerais, Brazil.
| | - João Luiz Passador
- School of Economics, Business Administration and Accounting at Ribeirão Preto, University of São Paulo, Brazil.
| | - Claudia Souza Passador
- School of Economics, Business Administration and Accounting at Ribeirão Preto, University of São Paulo, Brazil.
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Harting J, Peters D, Grêaux K, van Assema P, Verweij S, Stronks K, Klijn EH. Implementing multiple intervention strategies in Dutch public health-related policy networks. Health Promot Int 2017; 34:193-203. [DOI: 10.1093/heapro/dax067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Janneke Harting
- Department of Public Health, AMC University of Amsterdam, Amsterdam, The Netherlands
| | - Dorothee Peters
- Department of Public Health, AMC University of Amsterdam, Amsterdam, The Netherlands
| | - Kimberly Grêaux
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Patricia van Assema
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Stefan Verweij
- Department of Spatial Planning and Environment, University of Groningen, The Netherlands
| | - Karien Stronks
- Department of Public Health, AMC University of Amsterdam, Amsterdam, The Netherlands
| | - Erik-Hans Klijn
- Department of Public Administration, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Peters DTJM, Raab J, Grêaux KM, Stronks K, Harting J. Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases. Health Policy 2017; 121:1296-1302. [PMID: 29033059 DOI: 10.1016/j.healthpol.2017.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 08/25/2017] [Accepted: 10/02/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Inter-sectoral policy networks may be effective in addressing environmental determinants of health with interventions. However, contradictory results are reported on relations between structural network characteristics (i.e., composition and integration) and network performance, such as addressing environmental determinants of health. This study examines these relations in different phases of the policy process. METHODS A multiple-case study was performed on four public health-related policy networks. Using a snowball method among network actors, overall and sub-networks per policy phase were identified and the policy sector of each actor was assigned. To operationalise the outcome variable, interventions were classified by the proportion of environmental determinants they addressed. RESULTS In the overall networks, no relation was found between structural network characteristics and network performance. In most effective cases, the policy development sub-networks were characterised by integration with less interrelations between actors (low cohesion), more equally distributed distances between the actors (low closeness centralisation), and horizontal integration in inter-sectoral cliques. The most effective case had non-public health central actors with less connections in all sub-networks. CONCLUSION The results suggest that, to address environmental determinants of health, sub-networks should be inter-sectorally composed in the policy development rather than in the intervention development and implementation phases, and that policy development actors should have the opportunity to connect with other actors, without strong direction from a central actor.
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Affiliation(s)
- D T J M Peters
- Academic Medical Center - University of Amsterdam, Department of Public Health, the Netherlands
| | - J Raab
- University of Tilburg, Department of Organization Studies, the Netherlands
| | - K M Grêaux
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands
| | - K Stronks
- Academic Medical Center - University of Amsterdam, Department of Public Health, the Netherlands
| | - J Harting
- Academic Medical Center - University of Amsterdam, Department of Public Health, the Netherlands.
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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. EVALUATION AND PROGRAM PLANNING 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] [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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Using concept mapping in the development of the EU-PAD framework (EUropean-Physical Activity Determinants across the life course): a DEDIPAC-study. BMC Public Health 2016; 16:1145. [PMID: 27825370 PMCID: PMC5101801 DOI: 10.1186/s12889-016-3800-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/01/2016] [Indexed: 11/13/2022] Open
Abstract
Background A large proportion of European children, adults and older adults do not engage in sufficient physical activity (PA). Understanding individual and contextual factors associated with PA behaviours is essential for the identification and implementation of effective preventative environments, policies, and programmes that can promote an active lifestyle across life course and can potentially improve health. The current paper intends to provide 1) a multi-disciplinary, Pan-European and life course view of key determinants of PA behaviours and 2) a proposal of how these factors may cluster. Methods After gathering a list of 183 potential PA behaviours-associated factors and a consensus meeting to unify/consolidate terminology, a concept mapping software was used to collate European experts’ views of 106 identified factors for youth (<19 years), adults (19–64 years), and older adults (≥65 years). The analysis evaluated common trends in the clustering of factors and the ratings of the distinct factors’ expected modifiability and population-level impact on PA behaviours across the life course. Priority for research was also assessed for each cluster. Results The concept mapping resulted in six distinct clusters, broadly merged in two themes: 1) the ‘Person’, which included clusters ‘Intra-Personal Context and Wellbeing’ and ‘Family and Social Economic Status’ (42 % of all factors) and 2) the ‘Society’, which included the remaining four clusters ‘Policy and Provision’, ‘Cultural Context and Media’, ‘Social Support and Modelling’, and ‘Supportive Environment’ (58 % of all factors). Overall, 25 factors were rated as the most impactful on PA behaviours across the life course and being the most modifiable. They were mostly situated in the ‘Intra-Personal Context and Wellbeing’ cluster. Furthermore, 16 of them were rated as top priority for research. Conclusions The current framework provides a preliminary overview of factors which may account for PA behaviour across the life course and are most relevant to the European community. These insights could potentially be a foundation for future Pan-European research on how these factors might interact with each other, and assist policy makers to identify appropriate interventions to maximize PA behaviours and thus the health of European citizens.
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Carey G, Malbon E, Carey N, Joyce A, Crammond B, Carey A. Systems science and systems thinking for public health: a systematic review of the field. BMJ Open 2015; 5:e009002. [PMID: 26719314 PMCID: PMC4710830 DOI: 10.1136/bmjopen-2015-009002] [Citation(s) in RCA: 181] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 10/23/2015] [Accepted: 11/11/2015] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This paper reports on findings from a systematic review designed to investigate the state of systems science research in public health. The objectives were to: (1) explore how systems methodologies are being applied within public health and (2) identify fruitful areas of activity. DESIGN A systematic review was conducted from existing literature that draws on or uses systems science (in its various forms) and relates to key public health areas of action and concern, including tobacco, alcohol, obesity and the social determinants of health. DATA ANALYSIS 117 articles were included in the review. An inductive qualitative content analysis was used for data extraction. The following were systematically extracted from the articles: approach, methodology, transparency, strengths and weaknesses. These were then organised according to theme (ie, commonalities between studies within each category), in order to provide an overview of the state of the field as a whole. The assessment of data quality was intrinsic to the goals of the review itself, and therefore, was carried out as part of the analysis. RESULTS 4 categories of research were identified from the review, ranging from editorial and commentary pieces to complex system dynamic modelling. Our analysis of each of these categories of research highlighted areas of potential for systems science to strengthen public health efforts, while also revealing a number of limitations in the dynamic systems modelling being carried out in public health. CONCLUSIONS There is a great deal of interest in how the application of systems concepts and approach might aid public health. Our analysis suggests that soft systems modelling techniques are likely to be the most useful addition to public health, and align well with current debate around knowledge transfer and policy. However, the full range of systems methodologies is yet to be engaged with by public health researchers.
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Affiliation(s)
- Gemma Carey
- Regulatory Institutions Network Australian National University, Canberra, Australia
| | - Eleanor Malbon
- The Australian Prevention Partnership Centre, Sax Institute, Sydney, Australia
| | - Nicole Carey
- Self-organizing Systems Research Group School of engineering and applied sciences Harvard University
| | - Andrew Joyce
- Centre for Social Impact, Swinburne University, Melbourne, Victoria, Australia
| | - Brad Crammond
- Centre for Epidemiology and Preventive Health. Monash University, Melbourne, Australia
| | - Alan Carey
- Maths Science Institute Australian National University
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