Knowledge management tools and mechanisms for evidence-informed decision-making in the WHO European Region: a scoping review

BACKGROUND

Knowledge management (KM) emerged as a strategy to promote evidence-informed decision-making. This scoping review aims to map existing KM tools and mechanisms used to promote evidence-informed health decision-making in the WHO European Region and identify knowledge gaps.

METHODS

Following the Joanna Briggs Institute (JBI) guidance for conducting scoping reviews, we searched Medline, PubMed, EMBASE, the Cochrane library, and Open Grey. We conducted a descriptive analysis of the general characteristics of the included papers and conducted narrative analysis of the included studies and categorized studies according to KM type and phase.

RESULTS

Out of 9541 citations identified, we included 141 studies. The KM tools mostly assessed are evidence networks, surveillance tools, observatories, data platforms and registries, with most examining KM tools in high-income countries of the WHO European region. Findings suggest that KM tools can identify health problems, inform health planning and resource allocation, increase the use of evidence by policymakers and stimulate policy discussion.

CONCLUSION

Policymakers and funding agencies are called to support capacity-building activities, and future studies to strengthen KM in the WHO European region particularly in Eastern Europe and Central Asia. An updated over-arching strategy to coordinate KM activities in the WHO European region will be useful in these efforts.

The elephant in the room? Why spatial stigma does not receive the public health attention it deserves

In the context of health inequalities, spatial stigma refers to the ways that areas experiencing socioeconomic inequalities become negatively portrayed and labelled in public, official and policy discourses. With respect to the body of research on social determinants of health and health inequalities, and attention accorded to this issue in policy or practice, spatial stigma remains significantly under-represented compared with other possible causal factors. We suggest three explanations contributing to this neglect. First, the lack of research into spatial stigma originates from a more limited public health focus on the symbolic meanings of places for health, compared to their physical and social dimensions. Second, lay involvement and evidence of lived experiences of health inequalities continues to be under-represented in public health decision-making. Finally, it is the case that public health organizations may also be contributing to negative area portrayals in their communications of health inequalities. There are growing examples of social action being taken by groups of residents to resist this stigma through the promotion of more positive portrayals of areas and communities. Greater public health attention to this issue as well is likely to result in health gains and aid the development of more effective health inequalities strategies.

What are the elements of a whole system approach to community-centred public health? A qualitative study with public health leaders in England's local authority areas

OBJECTIVES

The aim of the study was to identify key elements of whole system approaches to building healthy communities and putting communities at the heart of public health with a focus on public health practice to reduce health inequalities.

DESIGN

A mixed-method qualitative study was undertaken. The primary method was semi-structured interviews with 17 public health leaders from 12 local areas. This was supplemented by a rapid review of literature, a survey of 342 members of the public via Public Health England's (PHE) People's Panel and a round-table discussion with 23 stakeholders.

SETTING

Local government in England.

RESULTS

Eleven elements of community-centred public health practice that constitute taking a whole system approach were identified. These were grouped into the headings of involving, strengthening, scaling and sustaining. The elements were underpinned by a set of values and principles.

CONCLUSION

Local public health leaders are in a strong position to develop a whole system approach to reducing health inequalities that puts communities at its heart. The elements, values and principles summarise what a supportive infrastructure looks like and this could be further tested with other localities and communities as a framework for scaling community-centred public health.