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Pedersen JF, Overgaard C, Egilstrød B, Petersen KS. The added value and unintended negative consequences of public involvement processes in the planning, development and implementation of community health services: Results from a thematic synthesis. Int J Health Plann Manage 2022; 37:3250-3268. [PMID: 35983639 DOI: 10.1002/hpm.3553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Public involvement is widely considered a means to improve health and quality of health services. The research literature reveals ambiguities concerning added value and unintended negative consequences of public involvement processes. The aim of this study is to identify, synthesise and present an overview of added value and unintended negative consequences of public involvement processes in the planning, development and implementation of community health services. METHODS Data from 36 peer-reviewed articles retrieved from a systematic search in the CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, ProQuest, and Scopus databases in October 2019 and updated in April 2021 were extracted. A three-step thematic synthesis was conducted involving (1) line-by-line text coding, (2) developing descriptive themes and (3) generating analytical themes. RESULTS Two main themes along with their corresponding themes provided an overview of the added value of public involvement processes at the individual, service and political levels. Unintended negative consequences concerning individual resources, uncertainty about the effect of involvement and power differences were revealed. CONCLUSION Added value of public involvement processes is primarily reported on an individual and service level. The added value seems to be accompanied by unintended negative consequences. Training of professional facilitators and recruitment of participants that come from vulnerable groups could help promote equality in public involvement. Unintended negative consequences need to be further explored in future evaluations in order to achieve the desired goals of public involvement.
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Affiliation(s)
- Johanne Frøsig Pedersen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Charlotte Overgaard
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Barbara Egilstrød
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Kirsten Schultz Petersen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Baumann LA, Reinhold AK, Brütt AL. Public and patient involvement in health policy decision-making on the health system level – A scoping review. Health Policy 2022; 126:1023-1038. [DOI: 10.1016/j.healthpol.2022.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022]
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Song MS, Boo S. Effects of a nurse-led multicomponent intervention for frail older adults living alone in a community: a quasi-experimental study. BMC Nurs 2022; 21:20. [PMID: 35039037 PMCID: PMC8762939 DOI: 10.1186/s12912-021-00801-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given the rapid aging of the population in Korea, efforts to slow down or prevent frailty, to support the health of older adults, should be an important public health priority. This may allow them to continue living within the community by keeping their functional independence for as long as possible. This study aimed to evaluate the nurse-led multicomponent intervention for community-dwelling pre-frail or frail elderly on physical and psychosocial outcomes. METHOD A non-equivalent control pre-, post-, and follow-up test design was used with a sample of 126 prefrail or frail older adults (62 in the experimental and 64 in the control group). The 12-week multicomponent intervention for the experimental group comprised physical exercise, cognitive training, and nutrition and disease management education. Outcome variables (Timed Up and Go Test results and measures of frailty, handgrip strength, depression, social activity, and social support) were measured both pre- and post-intervention, and after the 12-week follow-up period. RESULTS For each group, we assessed the significant interaction of time with frailty, depression, social activity, and social support, as well as Timed Up and Go Test results. In the experimental group, levels of depression decreased while levels of social support and social activity increased from each measurement period to the next, within the 12-month study period; those in the control group were relatively stable over time. CONCLUSIONS The results indicate that nurse-led multicomponent intervention was effective for improving physical and psychosocial function of the (pre)frail older adults living alone in Korea, suggesting that older adults can take proactive roles in conducting their daily life and managing their health. A strategy for disseminating widely sustainable nurse-led multicomponent interventions should be developed for community-dwelling frail elderly who live alone.
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Affiliation(s)
- Mi Sook Song
- Research Institute of Nursing Science, College of Nursing, Ajou University, 206 Worldcup-ro, Yeongtong-gu, 16499, Suwon, South Korea
| | - Sunjoo Boo
- Research Institute of Nursing Science, College of Nursing, Ajou University, 206 Worldcup-ro, Yeongtong-gu, 16499, Suwon, South Korea.
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Baumann LA, Brütt AL. Public and patient involvement (PPI) in health policy decisionmaking on the health system-level: protocol for a systematic scoping review. BMJ Open 2021; 11:e043650. [PMID: 34011588 PMCID: PMC8137161 DOI: 10.1136/bmjopen-2020-043650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Public and patient involvement (PPI) in healthcare decisions at the health system-level (macro-level) has become increasingly important during recent years. Existing evidence indicates that PPI increase patient centredness and the democracy of healthcare decisions as well as patients' trust and acceptance of these decisions. However, different methods for PPI exist, and an overview of the outcomes and influential contextual factors has not yet been conducted. Therefore, this scoping review aims to provide an overview of the different methods used for PPI in health system decisionmaking and the reported outcomes and contextual factors for these methods. METHODS AND ANALYSIS The structure of this protocol is guided by the advanced scoping studies framework of Arksey and O' Malley, developed by Levac, Colquhoun and O'Brien, and the PRISMA-ScR Statement. We will systematically search electronic databases (MEDLINE, Cochrane Library, Scopus, CINAHL, PDQ-Evidence, Web of Science and PsycINFO) for peer-reviewed literature and screen the reference lists of included studies. Additionally, we will search for relevant grey literature and consult experts from the field to identify further information. Studies focusing on PPI in the context of health policy decision-making at the macro-level will be eligible for full-text screening. Studies focusing on decisions at the individual treatment-level (micro-level) and the organisational-level (mesolevel) as well as those dealing with PPI in health research will be excluded. A qualitative analysis will dissect how the included studies define PPI and its desirable outcomes, the achieved outcomes and reported contextual factors. ETHICS AND DISSEMINATION We will present the results at relevant conferences and in an open-access journal. Additionally, we will share them with the experts involved in the research process and consider ways in which to transfer the findings into practice. As only secondary and previously published information will be used, ethical approval is not necessary.
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Affiliation(s)
- Lisa Ann Baumann
- Department for Health Services Research, University of Oldenburg School of Medicine and Health Sciences, Oldenburg, Germany
| | - Anna Levke Brütt
- Department for Health Services Research, University of Oldenburg School of Medicine and Health Sciences, Oldenburg, Germany
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Milley K, Chima S, McIntosh JG, Ackland E, Emery JD. Long-term consumer involvement in cancer research: Working towards partnership. Health Expect 2021; 24:1263-1269. [PMID: 33949071 PMCID: PMC8369080 DOI: 10.1111/hex.13258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/03/2021] [Accepted: 03/27/2021] [Indexed: 01/02/2023] Open
Abstract
Background Meaningful consumer involvement in health research is important. There are limited data on how to maintain long‐term consumer involvement. Objective To identify barriers and facilitators to meaningful long‐term consumer involvement in research. Design Six semi‐structured interviews were conducted with members of the Primary Care Collaborative Cancer Clinical Trials Group (PC4) Community Advisory Group (CAG) and included the review of 40 supporting documents. Interviews and documents were analysed using inductive thematic analysis; the themes were mapped onto the domains of Cancer Australia's National Framework for Consumer Involvement in Cancer Control. Results Equality, respect and feeling valued were facilitators to long‐term involvement. These elements were part of an overarching theme of organizational commitment. Creating balance, managing competing deadlines and integrating a consumer role with a personal life were key barriers to involvement. These themes mapped strongly to the National Framework for Consumer Involvement in Cancer Control domains of committed organizations, capable consumers, inclusive groups and shared focus. Conclusion Research networks should reflect on several factors to maintain long‐term consumer involvement. Networks should aim to build a meaningful relationship, using clear communication and education, that reinforces the value and scope of a consumers contributions. We found that consumer education needs do not diminish over time and adequate skill development, support and feedback need to be on‐going. Creating regular opportunities for feedback and reflection are important to continue to meet best practice guidelines.
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Affiliation(s)
- Kristi Milley
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Primary Care Collaborative Cancer Clinical Trials Group, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
| | - Sophie Chima
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Primary Care Collaborative Cancer Clinical Trials Group, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
| | - Jennifer G McIntosh
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
| | - Elle Ackland
- Primary Care Collaborative Cancer Clinical Trials Group, Community Advisory Group, Melbourne, Vic., Australia
| | - Jon D Emery
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, Primary Care Collaborative Cancer Clinical Trials Group, Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia
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Ruiz-Eugenio L, Toledo del Cerro A, Gómez-Cuevas S, Villarejo-Carballido B. Qualitative Study on Dialogic Literary Gatherings as Co-creation Intervention and Its Impact on Psychological and Social Well-Being in Women During the COVID-19 Lockdown. Front Public Health 2021; 9:602964. [PMID: 33816414 PMCID: PMC8012801 DOI: 10.3389/fpubh.2021.602964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/22/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Dialogic Literary Gatherings (DLG) are evidence-based interventions implemented in very diverse educational and health settings. The main elements that make DLG a co-creation intervention and promote health during the COVID-19 crisis lockdown are presented. This study focuses on the case of a DLG that is being promoted by an adult school in the city of Barcelona. Methods: This qualitative study was conducted using a communicative approach. Seven in-depth interviews with participants in the online DLG have been conducted. Five of them are women without higher education ranging from 56 to 85 years old and two are educators of this school. Results: The main results are 2-fold. First, the factors that make DLG a co-creation intervention, such as egalitarian dialogue and dialogical creation of knowledge in the decision-making process, are found. Second, the results show how DLG is contributing to creating a supportive environment that breaks the social isolation of confinement and improving the participants' psychological and social well-being. Conclusions: The findings from this study contribute to generating knowledge about a co-creation process between adult education participants and educators in education and health promotion during the COVID-19 lockdown, which could be replicated in other contexts.
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Affiliation(s)
- Laura Ruiz-Eugenio
- Department of Theory and History of Education, University of Barcelona, Barcelona, Spain
| | | | | | - Beatriz Villarejo-Carballido
- Department of Sociology, University of Barcelona, Barcelona, Spain
- Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
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Latulippe K, Hamel C, Giroux D. Co-Design to Support the Development of Inclusive eHealth Tools for Caregivers of Functionally Dependent Older Persons: Social Justice Design. J Med Internet Res 2020; 22:e18399. [PMID: 33164905 PMCID: PMC7683256 DOI: 10.2196/18399] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 09/04/2020] [Accepted: 09/13/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND eHealth can help reduce social health inequalities (SHIs) as much as it can exacerbate them. Taking a co-design approach to the development of eHealth tools has the potential to ensure that these tools are inclusive. Although the importance of involving future users in the development of eHealth tools to reduce SHIs is highlighted in the scientific literature, the challenges associated with their participation question the benefits of this involvement as co-designers in a real-world context. OBJECTIVE On the basis of Amartya Sen's theoretical framework of social justice, the aim of this study is to explore how co-design can support the development of an inclusive eHealth tool for caregivers of functionally dependent older persons. METHODS This study is based on a social justice design and participant observation as part of a large-scale research project funded by the Ministry of Families as part of the Age-Friendly Quebec Program (Québec Ami des Aînés). The analysis was based on the method developed by Miles and Huberman and on Paillé's analytical questioning method. RESULTS A total of 78 people participated in 11 co-design sessions in 11 Quebec regions. A total of 24 preparatory meetings and 11 debriefing sessions were required to complete this process. Co-designers participated in the creation of a prototype to support the search for formal services for caregivers. The majority of participants (except for 2) significantly contributed to the tool's designing. They also incorporated conversion factors to ensure the inclusiveness of the eHealth tool, such as an adequate level of digital literacy and respect for the caregiver's help-seeking process. In the course of the experiment, the research team's position regarding its role in co-design evolved from a neutral posture and promoting co-designer participation to one that was more pragmatic. CONCLUSIONS The use of co-design involving participants at risk of SHIs does not guarantee innovation, but it does guarantee that the tool developed will comply with their process of help-seeking and their literacy level. Time issues interfere with efforts to carry out a democratic process in its ideal form. It would be useful to single out some key issues to guide researchers on what should be addressed in co-design discussions and what can be left out to make optimal use of this approach in a real-world context.
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Affiliation(s)
- Karine Latulippe
- Department of Studies of Teaching and Learning, Laval University, Québec, QC, Canada
| | - Christine Hamel
- Department of Studies of Teaching and Learning, Laval University, Québec, QC, Canada
| | - Dominique Giroux
- Département de réadaptation, Faculté de médecine, Laval University, Québec, QC, Canada.,Centre d'Excellence du Vieillissement de Québec, Chu de Québec, Québec, QC, Canada
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South J, Connolly AM, Stansfield JA, Johnstone P, Henderson G, Fenton KA. Putting the public (back) into public health: leadership, evidence and action. J Public Health (Oxf) 2020; 41:10-17. [PMID: 29546426 DOI: 10.1093/pubmed/fdy041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 01/09/2018] [Indexed: 11/14/2022] Open
Abstract
There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities.
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Affiliation(s)
- J South
- Public Health England, London, UK
- Leeds Beckett University, Leeds, UK
| | | | - J A Stansfield
- Public Health England, London, UK
- Leeds Beckett University, Leeds, UK
| | - P Johnstone
- Public Health England, London, UK
- Leeds Beckett University, Leeds, UK
| | | | - K A Fenton
- Public Health England, London, UK
- Health and Wellbeing, Southwark Council, London, UK
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Ortiz K, Nash J, Shea L, Oetzel J, Garoutte J, Sanchez-Youngman S, Wallerstein N. Partnerships, Processes, and Outcomes: A Health Equity-Focused Scoping Meta-Review of Community-Engaged Scholarship. Annu Rev Public Health 2020; 41:177-199. [PMID: 31922931 PMCID: PMC8095013 DOI: 10.1146/annurev-publhealth-040119-094220] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In recent decades, there has been remarkable growth in scholarship examining the usefulness of community-engaged research (CEnR) and community-based participatory research (CBPR) for eliminating health inequities.This article seeks to synthesize the extant literature of systematic reviews, scoping reviews, and other related reviews regarding the context, processes, and research designs and interventions underlying CEnR that optimize its effectiveness. Through a scoping review, we have utilized an empirically derived framework of CBPR to map this literature and identify key findings and priorities for future research. Our study found 100 reviews of CEnR that largely support the CBPR conceptual framework.
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Affiliation(s)
- Kasim Ortiz
- Department of Sociology and Criminology, University of New Mexico, Albuquerque, New Mexico 87131, USA;
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Institute for the Study of "Race" and Social Justice, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Jacob Nash
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Logan Shea
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - John Oetzel
- Waikato Management School, University of Waikato, 3240 Hamilton, New Zealand
| | - Justin Garoutte
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Behavioral Health Research Center of the Southwest (BHRCS), Pacific Institute for Research and Evaluation (PIRE), Albuquerque, New Mexico 87106, USA
| | - Shannon Sanchez-Youngman
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
- Center for Social Policy, University of New Mexico, Albuquerque, New Mexico 87131, USA
- School of Public Administration, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Nina Wallerstein
- College of Population Health, Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico 87131, USA
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Haldane V, Chuah FLH, Srivastava A, Singh SR, Koh GCH, Seng CK, Legido-Quigley H. Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PLoS One 2019; 14:e0216112. [PMID: 31075120 PMCID: PMC6510456 DOI: 10.1371/journal.pone.0216112] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/15/2019] [Indexed: 11/23/2022] Open
Abstract
Background Community participation is widely believed to be beneficial to the development, implementation and evaluation of health services. However, many challenges to successful and sustainable community involvement remain. Importantly, there is little evidence on the effect of community participation in terms of outcomes at both the community and individual level. Our systematic review seeks to examine the evidence on outcomes of community participation in high and upper-middle income countries. Methods and findings This review was developed according to PRISMA guidelines. Eligible studies included those that involved the community, service users, consumers, households, patients, public and their representatives in the development, implementation, and evaluation of health services, policy or interventions. We searched the following databases from January 2000 to September 2016: Medline, Embase, Global Health, Scopus, and LILACs. We independently screened articles for inclusion, conducted data extraction, and assessed studies for risk of bias. No language restrictions were made. 27,232 records were identified, with 23,468 after removal of duplicates. Following titles and abstracts screening, 49 met the inclusion criteria for this review. A narrative synthesis of the findings was conducted. Outcomes were categorised as process outcomes, community outcomes, health outcomes, empowerment and stakeholder perspectives. Our review reports a breadth of evidence that community involvement has a positive impact on health, particularly when substantiated by strong organisational and community processes. This is in line with the notion that participatory approaches and positive outcomes including community empowerment and health improvements do not occur in a linear progression, but instead consists of complex processes influenced by an array of social and cultural factors. Conclusion This review adds to the evidence base supporting the effectiveness of community participation in yielding positive outcomes at the organizational, community and individual level. Trial registration Prospero record number:CRD42016048244.
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Affiliation(s)
- Victoria Haldane
- Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Fiona L. H. Chuah
- Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Aastha Srivastava
- Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Shweta R. Singh
- Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Gerald C. H. Koh
- Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Chia Kee Seng
- Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Helena Legido-Quigley
- Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
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Jenkins EK, Kothari A, Bungay V, Johnson JL, Oliffe JL. Strengthening population health interventions: developing the CollaboraKTion Framework for Community-Based Knowledge Translation. Health Res Policy Syst 2016; 14:65. [PMID: 27578195 PMCID: PMC5006543 DOI: 10.1186/s12961-016-0138-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/09/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Much of the research and theorising in the knowledge translation (KT) field has focused on clinical settings, providing little guidance to those working in community settings. In this study, we build on previous research in community-based KT by detailing the theory driven and empirically-informed CollaboraKTion framework. METHODS A case study design and ethnographic methods were utilised to gain an in-depth understanding of the processes for conducting a community-based KT study as a means to distilling the CollaboraKTion framework. Drawing on extensive field notes describing fieldwork observations and interactions as well as evidence from the participatory research and KT literature, we detail the processes and steps undertaken in this community-based KT study as well as their rationale and the challenges encountered. In an effort to build upon existing knowledge, Kitson and colleagues' co-KT framework, which provides guidance for conducting KT aimed at addressing population-level health, was applied as a coding structure to inform the current analysis. This approach was selected because it (1) supported the application of an existing community-based KT framework to empirical data and (2) provided an opportunity to contribute to the theory and practice gaps in the community-based KT literature through an inductively derived empirical example. RESULTS Analysis revealed that community-based KT is an iterative process that can be viewed as comprising five overarching processes: (1) contacting and connecting; (2) deepening understandings; (3) adapting and applying the knowledge base; (4) supporting and evaluating continued action; and (5) transitioning and embedding as well as several key elements within each of these processes (e.g. building on existing knowledge, establishing partnerships). These empirically informed theory advancements in KT and participatory research traditions are summarised in the CollaboraKTion framework. We suggest that community-based KT researchers place less emphasis on enhancing uptake of specific interventions and focus on collaboratively identifying and creating changes to the contextual factors that influence health outcomes. CONCLUSIONS The CollaboraKTion framework can be used to guide the development, implementation and evaluation of contextually relevant, evidence-informed initiatives aimed at improving population health, amid providing a foundation to leverage future research and practice in this emergent KT area.
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Affiliation(s)
- Emily K. Jenkins
- University of British Columbia, School of Nursing, T201-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Anita Kothari
- Western University, School of Health Studies, Arthur and Sonia Labatt Health Sciences Building, Rm. 222, London, Ontario N6A 5B9 Canada
| | - Vicky Bungay
- University of British Columbia, School of Nursing, T201-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Joy L. Johnson
- Simon Fraser University, Office of the Vice-President, Research, 8888 University Drive, Burnaby, British Columbia V5A 1S6 Canada
| | - John L. Oliffe
- University of British Columbia, School of Nursing, T201-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
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Community Engagement in Family Planning in the U.S.: A Systematic Review. Am J Prev Med 2015; 49:S116-23. [PMID: 26190842 PMCID: PMC4581852 DOI: 10.1016/j.amepre.2015.03.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 11/20/2022]
Abstract
CONTEXT Community engagement may include activities that involve community members in the design, implementation, and evaluation of services. The objective of this systematic review was to evaluate the evidence on this kind of community engagement in U.S. family planning programs, including its effects on various health outcomes, its perceived value, and the barriers and facilitators to implementation. EVIDENCE ACQUISITION Using an analytic approach drawn from U.S. Preventive Services Task Force, multiple databases were searched for articles published from 1985 through February 2011 that described studies about community engagement related to family planning. In 2011, relevant articles were reviewed, summarized, and assessed for potential bias using a standardized abstraction process. An updated, targeted review for the 2011-2014 period was conducted in early 2015. EVIDENCE SYNTHESIS Eleven papers related to family planning were included. All were qualitative, descriptive, and at high risk for bias. Engagement strategies involved various methods for developing educational materials, program development, or program evaluation. All studies reported benefits to community engagement, such as more-appropriate educational materials or more community support for programs. Barriers to engagement included the substantial time and resources required. Four more articles were identified in the targeted, additional search. CONCLUSIONS Community engagement is described as beneficial across the included studies, but the body of evidence for community engagement in family planning is relatively small. Given the high value ascribed to community engagement, more research and documentation of the various approaches taken and their relative strengths and weaknesses are needed.
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Quality of reporting on patient and public involvement within surgical research: a systematic review. Ann Surg 2015; 261:243-50. [PMID: 24950279 DOI: 10.1097/sla.0000000000000768] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recruitment difficulties are a well-reported concern in surgical literature, which may be improved by patient and public involvement (PPI). PPI within research has been defined as being conducted "with" or "by" patients or members of the public rather than being "about" or "for" them. However, the extent to which PPI is used within surgical research is unknown. METHODS Surgical literature was systematically reviewed using EMBASE, MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, and PubMed. Search terms related to (i) patients, (ii) involvement, (iii) perioperative care, and (iv) impact. Quality of PPI reporting was evaluated using the GRIPP (Guidance for Reporting Involvement of Patients and Public checklist and the guidelines developed by Wright and Foster. A patient representative advised on the purpose and analysis of this systematic review. RESULTS Eight articles described PPI in surgical trials to improve the identification of research topics, study design, recruitment, retention, and data collection. Quality of PPI reporting was suboptimal, as none of the articles provided a clear account of how PPI was conceptualized. Training and support for patients, their involvement in dissemination, and a critique of the limitations of PPI were not reported. However, it was not clear whether this represents an underutilization of PPI or purely suboptimal reporting in surgery. CONCLUSIONS There is a paucity of surgical research reporting upon PPI, and the quality of reporting is low. Further research to define appropriate standards for reporting on PPI activities may facilitate broadening the utilization and impact of PPI in surgical research.
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Sarrami-Foroushani P, Travaglia J, Debono D, Braithwaite J. Implementing strategies in consumer and community engagement in health care: results of a large-scale, scoping meta-review. BMC Health Serv Res 2014; 14:402. [PMID: 25230846 PMCID: PMC4177168 DOI: 10.1186/1472-6963-14-402] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 09/11/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There is growing recognition of the importance of the active involvement of consumers and community members in health care. Despite the long history of consumer and community engagement (CCE) research and practice, there is no consensus on the best strategies for CCE. In this paper, we identify various dimensions of CCE-related strategies and offer a practical model to assist policy-makers, practitioners and researchers. METHODS We undertook a large-scale, scoping meta-review and searched six databases using a list of nine medical subject headings (MeSH) and a comprehensive list of 47 phrases. We identified and examined a total of 90 relevant systematic reviews. RESULTS Identified reviews show that although there is a significant body of research on CCE, the development of the field is hindered by a lack of evidence relating to specific elements of CCE. They also indicate a diverse and growing enterprise, drawing on a wide range of disciplinary, political and philosophical perspectives and a mix of definitions, targets, approaches, strategies and mechanisms. CCE interventions and strategies aim to involve consumers, community members and the public in general, as well as specific sub-groups, including children and people from culturally and linguistically diverse backgrounds. Strategies for CCE vary in terms of their aim and type of proposed activity, as do the methods and tools which have been developed to support them. Methods and tools include shared decision making, use of decision aids, consumer representation, application of electronic and internet-based facilities, and peer support. The success of CCE is dependent on both the approach taken and contextual factors, including structural facilitators such as governmental support, as well as barriers such as costs, organisational culture and population-specific limitations. CONCLUSIONS The diversity of the field indicates the need to measure each component of CCE. This meta-review provides the basis for development of a new eight stage model of consumer and community engagement. This model emphasises the importance of clarity and focus, as well as an extensive evaluation of contextual factors within specific settings, before the implementation of CCE strategies, enabling those involved in CCE to determine potential facilitators and barriers to the process.
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Affiliation(s)
- Pooria Sarrami-Foroushani
- />Australian Institute for Health Innovation (AIHI), University of New South Wales (UNSW), Sydney, NSW 2052 Australia
| | - Joanne Travaglia
- />Australian Institute for Health Innovation (AIHI), University of New South Wales (UNSW), Sydney, NSW 2052 Australia
- />School of Public Health and Community Medicine (SPHCM), University of New South Wales (UNSW), Sydney, NSW 2052 Australia
| | - Deborah Debono
- />Australian Institute for Health Innovation (AIHI), University of New South Wales (UNSW), Sydney, NSW 2052 Australia
| | - Jeffrey Braithwaite
- />Australian Institute for Health Innovation (AIHI), University of New South Wales (UNSW), Sydney, NSW 2052 Australia
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Rifkin SB. Examining the links between community participation and health outcomes: a review of the literature. Health Policy Plan 2014; 29 Suppl 2:ii98-106. [PMID: 25274645 PMCID: PMC4202913 DOI: 10.1093/heapol/czu076] [Citation(s) in RCA: 185] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2014] [Indexed: 11/30/2022] Open
Abstract
As a key principle of Primary Health Care (PHC) and Health Systems Reform, community participation has a prominent place in the current global dialogue. Participation is not only promoted in the context of provision and utilization of health services. Advocates also highlight participation as a key factor in the wider context of the importance of social determinants of health and health as a human right. However, the evidence that directly links community participation to improved health status is not strong. Its absence continues to be a barrier for governments, funding agencies and health professionals to promote community participation. The purpose of this article is to review research seeking to link community participation with improved health status outcomes programmes. It updates a review undertaken by the author in 2009. The search includes published articles in the English language and examines the evidence of in the context of health care delivery including services and promotion where health professionals have defined the community's role. The results show that in most studies community participation is defined as the intervention seeking to identify a direct causal link between participation and improved health status modeled on Randomized Control studies (RCT). The majority of studies show it is not possible to examine the link because there is no standard definition of 'community' and 'participation'. Where links are found, they are situation-specific and are unpredictable and not generalizable. In the discussion, an alternative research framework is proposed arguing that community participation is better understood as a process. Once concrete interventions are identified (i.e. improved birth outcomes) then the processes producing improved health status outcomes can be examined. These processes may include and can lead to community uptake, ownership and sustainability for health improvements. However, more research is needed to ensure their validity.
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Sarrami-Foroushani P, Travaglia J, Debono D, Braithwaite J. Key concepts in consumer and community engagement: a scoping meta-review. BMC Health Serv Res 2014; 14:250. [PMID: 24923771 PMCID: PMC4074380 DOI: 10.1186/1472-6963-14-250] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 06/10/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although consumer and community engagement (CCE) in health care is receiving increasing attention, research and practice in this area are hampered by the variability of concepts and terminology commonly employed. This scoping meta-review aims to identify key CCE concepts and examine terminology used to describe them. METHODS In a scoping meta-review, an extensive list of 47 phrases and 11 Medical Subject Headings (MeSH) was used to undertake a comprehensive and systematic search in PubMed Central, Embase, EBM reviews, CINAHL, APAPsycNET, and Scopus. RESULTS 59 systematic reviews met the selection criteria and were included in the final analysis. The analysis identified nine different concepts related to CCE: shared decision making, self-management, CCE in health care systems, community-based health promotion, providing access to health care, rehabilitation, participation in research, collaboration in research design and conduct, and peer support. The identified concepts differ from each other in many aspects including the aim of the activity, the role of consumers and the type of professionals' involvement. Each concept was described by a range of terms, with some terms shared by different concepts. In addition, two overlapping concepts of patient-centeredness and patient empowerment were recognised. CONCLUSIONS This study describes CCE-related key concepts and provides new insight into their relationship with different CCE-related terms. Identification of key CCE-related concepts and terms will be useful to focus future studies and initiatives and enhance production of CCE-related evidence.
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Affiliation(s)
- Pooria Sarrami-Foroushani
- Centre for Clinical Governance Research, Australian Institute of Health Innovation (AIHI), University of New South Wales (UNSW), Sydney, NSW 2052, Australia
| | - Joanne Travaglia
- Centre for Clinical Governance Research, Australian Institute of Health Innovation (AIHI), University of New South Wales (UNSW), Sydney, NSW 2052, Australia
- School of Public Health and Community Medicine (SPHCM), University of New South Wales (UNSW), Sydney, NSW 2052, Australia
| | - Deborah Debono
- Centre for Clinical Governance Research, Australian Institute of Health Innovation (AIHI), University of New South Wales (UNSW), Sydney, NSW 2052, Australia
| | - Jeffrey Braithwaite
- Centre for Clinical Governance Research, Australian Institute of Health Innovation (AIHI), University of New South Wales (UNSW), Sydney, NSW 2052, Australia
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Piškur B, Daniëls R, Jongmans MJ, Ketelaar M, Smeets RJEM, Norton M, Beurskens AJHM. Participation and social participation: are they distinct concepts? Clin Rehabil 2013; 28:211-20. [PMID: 23988324 DOI: 10.1177/0269215513499029] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The concept of participation has been extensively used in health and social care literature since the World Health Organization introduced its description in the International Classification of Functioning, Disability and Health (ICF) in 2001. More recently, the concept of social participation is frequently used in research articles and policy reports. However, in the ICF, no specific definition exists for social participation, and an explanation of differences between the concepts is not available. AIM The central question in this discussion article is whether participation, as defined by the ICF, and social participation are distinct concepts. This article illustrates the concepts of participation and social participation, presents a critical discussion of their definitions, followed by implications for rehabilitation and possible future directions. DISCUSSION A clear definition for participation or social participation does not yet exist. Definitions for social participation differ from each other and are not sufficiently distinct from the ICF definition of participation. Although the ICF is regarded an important conceptual framework, it is criticised for not being comprehensive. The relevance of societal involvement of clients is evident for rehabilitation, but the current ICF definition of participation does not sufficiently capture societal involvement. CONCLUSION Changing the ICF's definition of participation towards social roles would overcome a number of its shortcomings. Societal involvement would then be understood in the light of social roles. Consequently, there would be no need to make a distinction between social participation and participation.
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Affiliation(s)
- Barbara Piškur
- 1Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University, Heerlen, The Netherlands
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Kothari A, Wathen CN. A critical second look at integrated knowledge translation. Health Policy 2012; 109:187-91. [PMID: 23228520 DOI: 10.1016/j.healthpol.2012.11.004] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 09/10/2012] [Accepted: 11/08/2012] [Indexed: 11/29/2022]
Abstract
Integrated knowledge translation (IKT) requires active collaboration between researchers and the ultimate users of knowledge throughout a research process, and is being aggressively positioned as an essential strategy to address the problem of underutilization of research-derived knowledge. The purpose of this commentary is to assist potential "knowledge users", particularly those working in policy or service settings, by highlighting some of the more nuanced benefits of the IKT model, as well as some of its potential costs. Actionable outcomes may not be immediately (or ever) forthcoming, but the process of collaboration can result in group-level identity transformation that permits access to different professional perspectives as well as, we suggest, added organizational and social value. As well, the IKT approach provides space for the re-balancing of what is considered "expertise". We offer this paper to help practitioners, administrators and policymakers more realistically assess the potential benefits and costs of engaging in IKT-oriented research.
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Affiliation(s)
- Anita Kothari
- School of Health Sciences, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.
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Brownson RC, Allen P, Duggan K, Stamatakis KA, Erwin PC. Fostering more-effective public health by identifying administrative evidence-based practices: a review of the literature. Am J Prev Med 2012; 43:309-19. [PMID: 22898125 PMCID: PMC3990249 DOI: 10.1016/j.amepre.2012.06.006] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CONTEXT The aim of evidence-based decision-making in public health involves the integration of science-based interventions with community preferences to improve population health. Although considerable literature is available on the development and adoption of evidence-based guidelines and barriers to their implementation, the evidence base specific to public health administration is less developed. This article reviews the literature from public health and related disciplines to identify administrative evidence-based practices (A-EBPs; i.e., agency-level structures and activities that are positively associated with performance measures). EVIDENCE ACQUISITION A "review of reviews" was carried out to assess the evidence for the effectiveness of A-EBPs covering the time frame January 2000 through March 2012. The following steps were used: (1) select databases; (2) determine search parameters and conduct the search; (3) screen titles and abstracts; (4) obtain selected documents; (5) perform initial synthesis; (6) abstract data; and (7) synthesize evidence. EVIDENCE SYNTHESIS In both the reviews and original empiric studies, the most common outcome reported was performance of the local health department or local public health system. On the basis of a synthesis of data from 20 reviews, a total of 11 high-priority A-EBPs were identified (i.e., practices that local public health systems potentially can modify within a few years). The A-EBPs covered five major domains of workforce development, leadership, organizational climate and culture, relationships and partnerships, and financial processes. CONCLUSIONS As the body of practice-based research continues to grow and the ability to measure administrative evidence-based practices improves, this initial list can be further developed and improved.
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Affiliation(s)
- Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri 63110, USA.
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Falisse JB, Meessen B, Ndayishimiye J, Bossuyt M. Community participation and voice mechanisms under performance-based financing schemes in Burundi. Trop Med Int Health 2012; 17:674-82. [PMID: 22487362 DOI: 10.1111/j.1365-3156.2012.02973.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Community participation is often described as a key for primary health care in low-income countries. Recent performance-based financing (PBF) initiatives have renewed the interest in this strategy by questioning the accountability of those in charge at the health centre (HC) level. We analyse the place of two downward accountability mechanisms in a PBF scheme: health committees elected among the communities and community-based organizations (CBOs) contracted as verifiers of health facilities' performance. METHOD We evaluated 100 health committees and 79 CBOs using original data collected in six Burundi provinces (2009-2010) and a framework based on the literature on community participation in health and New Institutional Economics. RESULTS Health committees appear to be rather ineffective, focusing on supporting the medical staff and not on representing the population. CBOs do convey information about the concerns of the population to the health authorities; yet, they represent only a few users and lack the ability to force changes. PBF does not automatically imply more 'voice' from the population, but introduces an interesting complement to health committees with CBOs. However, important efforts remain necessary to make both mechanisms work. More experiments and analysis are needed to develop truly efficient 'downward' mechanisms of accountability at the HC level.
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Rofail D, Colligs A, Abetz L, Lindemann M, Maguire L. Factors contributing to the success of folic acid public health campaigns. J Public Health (Oxf) 2012; 34:90-9. [PMID: 21727078 PMCID: PMC3285116 DOI: 10.1093/pubmed/fdr048] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Studies in the 1990s have found that periconceptional dietary folate, supplementation of folic acid or supplemental multivitamins containing folic acid, help prevent neural tube defect (NTDs) if taken at the right time. This literature review assesses the extant folic acid public health campaigns literature and identifies some common variables used in folic acid consumption campaign evaluations. METHODS This review was part of a larger study that searched PUBMED, PsycINFO and Embase from 1976 to 2010 to identify articles related to the psychosocial and economic impact of NTDs (especially spina bifida) on patients and caregivers. RESULTS Awareness of folic acid levels prior to conception improved post-campaign from 6 to 41%. Knowledge about consumption and correct periconceptional use of folic acid also improved. However, in most studies more than 50% of women did not take folic acid as prescribed. Many factors were associated with or without taking folic acid post-campaign, including incomplete outreach, prior awareness and knowledge, closeness to pregnancy, demographics and other personal characteristics. CONCLUSIONS Sustained campaigning to maintain awareness about and promote periconceptional consumption of folic acid in order to reduce the incidence of NTDs is clearly needed. Additional initiatives could complement existing public health strategies.
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Affiliation(s)
- D Rofail
- Mapi Values, Adelphi Mill, Macclesfield, Bollington, Cheshire SK10 5JB, UK.
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Leung GM, Gray S. A time for growth, maturation and harvest. J Public Health (Oxf) 2010; 32:295. [DOI: 10.1093/pubmed/fdq064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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