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Edwards RC, Kneale D, Stansfield C, Lester S. What are the mechanisms driving the early stages of embedded researcher interventions? A qualitative process evaluation in English local government. Soc Sci Med 2024; 340:116407. [PMID: 38016307 DOI: 10.1016/j.socscimed.2023.116407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/23/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023]
Abstract
Improved collaboration and communication between public health practitioners and academia could enhance the flow of research evidence into policy and practice. Embedded researchers present one type of intervention with the potential to bridge the research-implementation gap through their dual affiliations with decision makers and academia. Although embedded researcher posts are garnering increasing attention in public health, there remains a need to understand the mechanisms through which they may promote the translation of evidence into practice. To address this gap, we conducted a processes evaluation incorporating data from seventeen semi-structured interviews with embedded researchers in local government public health teams across England. We aimed to expand theoretical understandings of embedded researchers in public health through providing a detailed conceptualisation of the mechanisms shaping the early stages of their roles. Interviews with embedded researchers were conducted from late 2021 to spring 2022. Our results suggest that the initial months of embedded researcher roles are defined by a lengthy embedding phase centred on building trust and gathering contextual knowledge. This phase forms the foundation on which these interventions are built. We identified seven categories of outputs delivered by embedded researchers which primarily revolved around building research capacity and addressed many of the primary barriers limiting research activity in public health. Improvements in research awareness, interest, and involvement reflected early changes in local research cultures. However, our results align with previous work suggesting that changing an organisational research culture is a long-term process. Expectations for embedded researchers should thus be proportionate to the seniority and scale of the post and we add our voice to calls for sustained investment in these valuable interventions. Further examination of how embedded researcher roles evolve over time in public health is necessary to broaden understandings of the concept of embeddedness in these settings.
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Affiliation(s)
- Rachael C Edwards
- Evidence for Policy and Practice Information Centre, UCL Social Research Institute, Institute of Education, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
| | - Dylan Kneale
- Evidence for Policy and Practice Information Centre, UCL Social Research Institute, Institute of Education, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
| | - Claire Stansfield
- Evidence for Policy and Practice Information Centre, UCL Social Research Institute, Institute of Education, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
| | - Sarah Lester
- Evidence for Policy and Practice Information Centre, UCL Social Research Institute, Institute of Education, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
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Windle A, Javanparast S, Freeman T, Baum F. Factors that influence evidence-informed meso-level regional primary health care planning: a qualitative examination and conceptual framework. Health Res Policy Syst 2023; 21:99. [PMID: 37749644 PMCID: PMC10521552 DOI: 10.1186/s12961-023-01049-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/04/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Evidence-informed primary health care (PHC) planning in decentralised, meso-level regional organisations has received little research attention. In this paper we examine the factors that influence planning within this environment, and present a conceptual framework. METHODS We employed mixed methods: case studies of five Australian Primary Health Networks (PHNs), involving 29 primary interviews and secondary analysis of 38 prior interviews; and analysis of planning documents from all 31 PHNs. The analysis was informed by a WHO framework of evidence-informed policy-making, and institutional theory. RESULTS Influential actors included federal and state/territory governments, Local Health Networks, Aboriginal Community Controlled Health Organisations, local councils, public hospitals, community health services, and providers of allied health, mental health and aged care services. The federal government was most influential, constraining PHNs' planning scope, time and funding. Other external factors included: the health service landscape; local socio-demographic and geographic characteristics; (neoliberal) ideology; interests and politics; national policy settings and reforms; and system reorganisation. Internal factors included: organisational structure; culture, values and ideology; various capacity factors; planning processes; transition history; and experience. The additional regional layer of context adds to the complexity of planning. CONCLUSIONS Like national health policy-making, meso-level PHC planning occurs in a complex environment, but with additional regional factors and influences. We have developed a conceptual framework of the meso-level PHC planning environment, which can be employed by similar regional organisations to elucidate influential factors, and develop strategies and tools to promote transparent, evidence-informed PHC planning for better health outcomes.
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Affiliation(s)
- Alice Windle
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Sara Javanparast
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Toby Freeman
- Stretton Health Equity, Stretton Institute, The University of Adelaide, Adelaide, SA Australia
| | - Fran Baum
- Stretton Health Equity, Stretton Institute, The University of Adelaide, Adelaide, SA Australia
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Klepac B, Krahe M, Spaaij R, Craike M. Six Public Policy Recommendations to Increase the Translation and Utilization of Research Evidence in Public Health Practice. Public Health Rep 2023; 138:715-720. [PMID: 36239490 PMCID: PMC10467493 DOI: 10.1177/00333549221129355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Bojana Klepac
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Australia
| | | | - Ramon Spaaij
- Institute for Health and Sport, Victoria University, Melbourne, Australia
- School of Governance, Utrecht University, Utrecht, The Netherlands
| | - Melinda Craike
- Mitchell Institute for Education and Health Policy, Victoria University, Melbourne, Australia
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Dam JL, Nagorka-Smith P, Waddell A, Wright A, Bos JJ, Bragge P. Research evidence use in local government-led public health interventions: a systematic review. Health Res Policy Syst 2023; 21:67. [PMID: 37400905 DOI: 10.1186/s12961-023-01009-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Local governments play an important role in improving public health outcomes globally, critical to this work is applying the best-available research evidence. Despite considerable exploration of research use in knowledge translation literature, how research is practically applied by local governments remains poorly understood. This systematic review examined research evidence use in local government-led public health interventions. It focused on how research was used and the type of intervention being actioned. METHODS Quantitative and qualitative literature published between 2000 and 2020 was searched for studies that described research evidence use by local governments in public health interventions. Studies reporting interventions developed outside of local government, including knowledge translation interventions, were excluded. Studies were categorised by intervention type and their level of description of research evidence use (where 'level 1' was the highest and 'level 3' was the lowest level of detail). FINDINGS The search identified 5922 articles for screening. A final 34 studies across ten countries were included. Experiences of research use varied across different types of interventions. However, common themes emerged including the demand for localised research evidence, the legitimising role of research in framing public health issues, and the need for integration of different evidence sources. CONCLUSIONS Differences in how research was used were observed across different local government public health interventions. Knowledge translation interventions aiming to increase research use in local government settings should consider known barriers and facilitators and consider contextual factors associated with different localities and interventions.
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Affiliation(s)
- Jennifer L Dam
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia.
| | - Phoebe Nagorka-Smith
- School of Health and Social Development, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Alex Waddell
- Action Lab, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Annemarie Wright
- Victorian Department of Health and Human Services, 50 Lonsdale Street, Melbourne, VIC, 3000, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, VIC, 3053, Carlton, Australia
| | - Joannette J Bos
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Peter Bragge
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
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Woode Owusu M, Estupiñán Fdez de Mesa M, Mohammed H, Gerressu M, Hughes G, Mercer CH. Race to address sexual health inequalities among people of Black Caribbean heritage: could co-production lead to more culturally appropriate guidance and practice? Sex Transm Infect 2023:sextrans-2023-055798. [PMID: 37137709 DOI: 10.1136/sextrans-2023-055798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/18/2023] [Indexed: 05/05/2023] Open
Affiliation(s)
- Melvina Woode Owusu
- Centre for Population Research in Sexual Health and HIV, University College London, London, UK
| | | | - Hamish Mohammed
- Blood Safety, Hepatitis, STIs and HIV Division, UK Health Security Agency, London, UK
| | - Makeda Gerressu
- Centre for Population Research in Sexual Health and HIV, Department of Epidemiology and Public Health, University College London Research, London, UK
| | - Gwenda Hughes
- Department of Infectious Disease Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Catherine H Mercer
- Centre for Population Research in Sexual Health and HIV, University College London, London, UK
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Hamalaw SA, Bayati AH, Babakir-Mina M, Kiani MM, Takian A. The lessons of COVID-19 pandemic for communicable diseases surveillance system in Kurdistan Region of Iraq. HEALTH POLICY AND TECHNOLOGY 2023; 12:100717. [PMID: 36593886 PMCID: PMC9796971 DOI: 10.1016/j.hlpt.2022.100717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objectives This study aimed to determine the opportunities of and barriers to communicable diseases surveillance system (CDSS) during the COVID-19 pandemic and the extent to which the disease integrated into the CDSS in the Kurdistan region of Iraq. Study design A descriptive qualitative approach was applied. Methods We conducted seven semi-structured interviews and seven interviewee in a focus group discussion (FGD) with purposefully identified Key Informants (KI) from June to December 2020. All interviews were digitally recorded and transcribed verbatim. We adopted a mixed deductive-inductive approach for thematic data analysis, facilitated by using MAXQDA20 software for data management. Results Although the CDSS was considered appropriate and flexible, the COVID-19 was interpreted not to be integrated into the system due to political influence. The main concerns regarding core and support activities were the lack of epidemic preparedness, timeliness, and partial cessation of training and supervision during the pandemic. The existence of reasonable surveillance infrastructure, i.e., trained staff, was identified as an opportunity for improvement. The main challenges include staff deficiency, absence of motivation and financial support for present staff, scarce logistics, managerial and administrative issues, and lack of cooperation, particularly among stakeholders and surveillance staff. Conclusion Our findings revealed that the CDSS in the Kurdistan region requires substantial enhancement in epidemic preparedness, strengthening human resources, and logistics. the system can be developed by fostering meaningful intersectoral collaboration. We advocate that the health authorities and policy-makers prioritise the surveillance and effective management of communicable diseases.
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Affiliation(s)
- Soran Amin Hamalaw
- College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaimani, Iraq
| | - Ali Hattem Bayati
- College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaimani, Iraq
| | - Muhammed Babakir-Mina
- College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaimani, Iraq
| | - Mohammad Mehdi Kiani
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Takian
- Department of Global Health and Public Policy, Department of Health Management and Economics, School of Public Health, Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran
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Lilly K, Kean B, Hallett J, Robinson S, Selvey LA. Factors of the policy process influencing Health in All Policies in local government: A scoping review. Front Public Health 2023; 11:1010335. [PMID: 36844855 PMCID: PMC9949293 DOI: 10.3389/fpubh.2023.1010335] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Objectives This review aimed to identify factors in the policymaking environment that influence a Health in all Policies approach in local government, how these vary across different municipal contexts, and the extent that theories of the policy process are applied. Methods A scoping review was conducted to include sources published in English, between 2001 and 2021 in three databases, and assessed for inclusion by two blind reviewers. Results Sixty-four sources were included. Sixteen factors of the policy process were identified, expanding on previously reported literature to include understanding and framing of health, use of evidence, policy priority, and influence of political ideology. Eleven sources applied or referred to theories of the policy process and few reported findings based on different local government contexts. Conclusion There are a range of factors influencing a Health in All Policies approach in local government, although a limited understanding of how these differ across contexts. A theory-informed lens contributed to identifying a breadth of factors, although lack of explicit application of theories of the policy process in studies makes it difficult to ascertain meaningful synthesis of the interconnectedness of these factors.
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Affiliation(s)
- Kara Lilly
- School of Health, University of the Sunshine Coast, Maroochydore, QLD, Australia
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Bridie Kean
- School of Health, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Jonathan Hallett
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Suzanne Robinson
- School of Population Health, Curtin University, Perth, WA, Australia
- Deakin Health Economics, Faculty of Health Sciences, Deakin University, Burwood, VIC, Australia
| | - Linda A. Selvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Di Fabio JL, Delgado García B. [One hundred years of the Pan American Journal of Public Health: visualizing its contentCem anos da Revista Pan-Americana de Saúde Pública: visualização do seu conteúdo]. Rev Panam Salud Publica 2023; 47:e20. [PMID: 37114166 PMCID: PMC10128885 DOI: 10.26633/rpsp.2023.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/12/2022] [Indexed: 04/29/2023] Open
Abstract
Objectives Explore how the content of the articles published by the Pan American Journal of Public Health during its 100 years of existence has aligned with the key health issues of the Pan American Health Organization (PAHO). Methods A bibliometric analysis was carried out, with visualization of its results. Information on articles published in the Journal was retrieved from PAHO's Institutional Repository for Information Sharing (IRIS) for the first 75 years and Scopus for the last 25 years, until February 2022; References to Governing Bodies documents and statements by the directors were used to establish PAHO's key themes. Results Initially, 12 573 publications were obtained and 9 289 were considered for analysis for the period 1922 to 1996, and 3 208 for the period 1997 to 2022. For the bibliometric analysis of the Scopus information, indicators such as the authors and their origin, language of publication, and number and origin of citations were considered. For the visualizations, publications were divided into five periods so that they coincided with the periods established for the analysis of PAHO's priority themes. Keyword co-occurrence maps were made to observe the evolution of published topics and relate them to public health approaches in each period. Conclusion The topics published in the Pan American Journal of Public Health and its precursor bulletins reflect the history of regional public health and its evolution over time, as well as the key health issues of the Pan American Health Organization.
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Affiliation(s)
- José Luis Di Fabio
- Consultor independienteWashington D.C.Estados Unidos de AméricaConsultor independiente, Washington D.C., Estados Unidos de América
- José Luis Di Fabio,
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Moffat A, Cook EJ, Chater AM. Examining the influences on the use of behavioural science within UK local authority public health: Qualitative thematic analysis and deductive mapping to the COM-B model and Theoretical Domains Framework. Front Public Health 2022; 10:1016076. [PMID: 36339139 PMCID: PMC9632167 DOI: 10.3389/fpubh.2022.1016076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/22/2022] [Indexed: 01/28/2023] Open
Abstract
Background Behavioural science and its contribution towards improving public health is receiving increased recognition. Yet, the translation of these insights into public health practice is under-researched. This study explored the factors influencing the use of behavioural science within public health at a local authority level. Methods Fourteen local authority staff (n = 13 female) in the south of England participated in semi-structured interviews, which were analysed inductively to identify key themes. These were later mapped deductively to the COM-B model and Theoretical Domains Framework. Findings Nine themes were identified as factors that influence the use of behavioural science in local authority public health: (1) "Limited past experience," (2) "Narrow understanding," (3) "Perceived value of behavioural science," (4) "Translational gap from theory-to-practice," (5) "No protected time," (6) "Old ways of working," (7) "Political influence and organisational culture," (8) "Relationships with key stakeholders," (9) "Access to behavioural science resources". Deductive mapping of these themes revealed that five of the COM constructs (excluding Physical Capability) and eleven of the TDF domains influenced behavioural science use, with "Social influences" and "Knowledge" being the most prominent. Discussion Use of behavioural science within local authority public health practice is limited and inconsistent. For it to be successfully implemented, there must be an understanding of its role and value, alongside strategies to overcome a translational gap from theory to practice. Public health teams would benefit from protected time to enable application and strategies to break old habits of using a common-sense approach. System-wide buy-in, particularly related to senior leadership and system partners is needed, which would benefit from organisational and political culture change. Training opportunities, practical resources and expert in-house support should be considered a priority across public health teams.
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Affiliation(s)
- Abby Moffat
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom,*Correspondence: Abby Moffat
| | - Erica Jane Cook
- School of Psychology, University of Bedfordshire, Luton, United Kingdom
| | - Angel Marie Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom,Centre for Behaviour Change, University College London, London, United Kingdom
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McGee CE, Barlow-Pay M, Vassilev I, Baird J, Fenge LA, Chase D, Parkes J. Supporting and enabling health research in a local authority (SERLA): an exploratory study. BMC Public Health 2022; 22:1316. [PMID: 35810294 PMCID: PMC9270788 DOI: 10.1186/s12889-022-13396-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of research evidence to underpin public health practice and policy decisions in local government is strongly promoted but its implementation has not been straightforward. This study aimed to explore the factors, relationships and processes that contribute towards accessing, using, and generating research evidence that is relevant to local authority public health and social care and shapes its practice. METHODS Semi-structured individual interviews with elected councillors, officers directly involved with public health and social care and with community members from one urban unitary authority in South England were conducted. Interviews were audio recorded, transcribed verbatim and thematically analysed. RESULTS Fourteen participants took part in the semi-structured interviews. Local knowledge and evidence are prioritised, and anecdotal evidence is valued. The Director of Public Health was the principal source of information and support. Academics were rarely mentioned as information sources, and their involvement was ad hoc. The use of research evidence varied between individuals and departments, with wider engagement among public health specialists. Key barriers to the use of research evidence included access (not reported among public health professionals), research timeliness, local applicability, competence in finding and interpreting evidence and the role of research evidence within a political context. Public health and adult social care teams are not currently research active or research ready. Major barriers exist due to financial constraints and the socio-political context of local authorities. COVID-19 disrupted siloed ways of working, strengthening and opening potential collaborations within the local authority. This changed perspectives about the value of research but is likely time-limited unless underpinned by sustainable funding. CONCLUSION Creating strategic level roles within local government to work with the Director of Public Health to champion the research agenda and embedding researchers within and across teams would build capacity for local authorities to sustainably co-create, undertake, and use evidence to better inform future actions.
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Affiliation(s)
- Ciara E. McGee
- grid.451056.30000 0001 2116 3923National Institute for Health Research, Clinical Research Network Wessex, Southampton, UK ,grid.426418.d0000 0004 0394 7582Public Health, Southampton City Council, UK
| | - Megan Barlow-Pay
- grid.451056.30000 0001 2116 3923National Institute for Health Research, Research Design Service South Central, Southampton, UK
| | - Ivaylo Vassilev
- grid.5491.90000 0004 1936 9297Health Sciences, Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Janis Baird
- grid.5491.90000 0004 1936 9297MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK ,grid.430506.40000 0004 0465 4079Southampton Biomedical Research Centre, National Institute for Health Research, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK ,grid.451056.30000 0001 2116 3923Applied Research Collaboration Wessex, National Institute for Health Research, Southampton, UK
| | - Lee-Ann Fenge
- grid.17236.310000 0001 0728 4630Faculty of Health and Social Sciences, Bournemouth University, Poole, UK
| | - Debbie Chase
- grid.426418.d0000 0004 0394 7582Public Health, Southampton City Council, UK
| | - Julie Parkes
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK. .,Applied Research Collaboration Wessex, National Institute for Health Research, Southampton, UK.
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Leal EMM, Barreto JOM, Silva FSD, Gurgel Júnior GD. [Cross-cultural adaptation of "Is research working for you? A self-assessment tool" in Brazil]. CIENCIA & SAUDE COLETIVA 2022; 27:2879-2894. [PMID: 35730854 DOI: 10.1590/1413-81232022277.20522021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 02/16/2022] [Indexed: 11/21/2022] Open
Abstract
The scope of this article is to translate and adapt the tool "Is research working for you? A self-assessment tool and discussion guide for health services management and policy organization," which self-assesses the institutional capacity of Health organizations to Acquire, Evaluate, Adapt and Apply scientific evidence in policy decision-making. It is a methodological, analytical study with a quantitative and qualitative approach. A sample of managers was used (n=99), representing 24 Brazilian health organizations, between October 2018 and November 2020. Proposed adaptations were made in a consensual way after adjustments of the disagreements of the expert committee - Kappa coefficient [0.41; 0.43 and 0.74]. Tool 4A, Brazilian version, had semantic, idiomatic, experimental, and conceptual equivalence with the original. The value of Cronbach's Alpha was 0.961; the value of the Intraclass Correlation Coefficient was 0.960. Tool 4A is valid and reliable in Brazil in terms of internal consistency and content. Its application is a catalyst for actions to structure institutional capacities to make the use of scientific evidence systematic in the decision-making processes of health organizations.
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Affiliation(s)
- Eliane Maria Medeiros Leal
- Programa de Pós-Graduação em Saúde Pública, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (Fiocruz). Av. Prof. Moraes Rego s/n, Cidade Universitária. 50670-420 Recife PE Brasil.
| | | | - Filipe Santana da Silva
- Departamento de Ciências Exatas e Sociais Aplicadas, Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre RS Brasil
| | - Garibaldi Dantas Gurgel Júnior
- Programa de Pós-Graduação em Saúde Pública, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (Fiocruz). Av. Prof. Moraes Rego s/n, Cidade Universitária. 50670-420 Recife PE Brasil.
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South J, Mapplethorpe T, Gledhill R, Marsh W, Stansfield J, Evans S, Mancini M, Outhwaite H. Learning from public health practice: the development of a library of community-centered practice examples. J Public Health (Oxf) 2022:6623459. [PMID: 35774035 DOI: 10.1093/pubmed/fdac065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/28/2022] [Accepted: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Valuable learning derived from public health practice can be captured through practice-based case studies, also known as practice examples. Practice examples of participatory interventions supplement the evidence base by providing information on the complexities of implementation in communities. This paper reports on a Public Health England project to build a bank of community-centered practice examples based on robust processes of collection and curation. METHODS The multidisciplinary project had three phases: (i) development and piloting a process to collect practice examples, (ii) refining review processes and gathering further examples via national and regional teams (iii) maintenance of an accessible collection on the library platform. RESULTS The project resulted in a searchable collection of 55 practice examples illustrating participatory approaches in public health practice. The collection shows diversity in terms of settings, population, focus and type of approach used to work with communities. A secondary outcome was the development of generic guidance and templates for further collections on public health topics. CONCLUSIONS This project illustrates how information on the implementation of community-centered approaches in real-life contexts can be gathered and disseminated through a transferable process. Having collections of practice examples supports knowledge exchange in public health as learning is shared.
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Affiliation(s)
- Jane South
- School of Health, Leeds Beckett University, Leeds LS1 3HE, UK.,Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Tom Mapplethorpe
- Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Rachel Gledhill
- UK Health Security Agency Knowledge and Library Services, UK Health Security Agency, London SW1H 0EU, UK
| | - Wendy Marsh
- UK Health Security Agency Knowledge and Library Services, UK Health Security Agency, London SW1H 0EU, UK
| | - Jude Stansfield
- School of Health, Leeds Beckett University, Leeds LS1 3HE, UK.,Office for Health Improvement and Disparities, Department of Health and Social Care, London SW1H 0EU, UK
| | - Sian Evans
- Local Knowledge and Intelligence Service (LKIS) East, Office for Health Improvement and Disparities, Department of Health and Social Care, Cambridge CB21 5XA, UK
| | - Michelle Mancini
- Office for Health Improvement and Disparities, North East and Yorkshire, Department of Health and Social Care, Newcastle NE15 8NY, UK
| | - Helen Outhwaite
- Improvement Directorate, NHS England and NHS Improvement, Leeds LS2 7UE, UK
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Kovai V, Mahjabeen Z, Jalaludin B, Fox F. Towards an effective collaboration between the South Western Sydney Local Health District and local councils: insights from a qualitative study. Health Res Policy Syst 2022; 20:47. [PMID: 35484602 PMCID: PMC9052566 DOI: 10.1186/s12961-022-00850-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partnership between local government and local health districts is imperative, given their overlapping goals. However, the need for further evidence-informed actions to address health inequities remains. The effectiveness of such partnerships requires better insight into how local governments perceive partnerships with local health districts, and how well equipped and prepared they are to deal with the health equity opportunities and challenges. It was precisely for these reasons that a qualitative study was conducted by South Western Sydney Local Health District (SWSLHD) in 2016. OBJECTIVE This study aims to better understand how to improve the effectiveness of collaboration between local governments and the public health sector. METHODS Qualitative data were collected from 14 in-depth interviews with staff representing five of the local councils comprising SWSLHD. These data were then thematically analysed using inductive and deductive reasoning through the application of NVivo software. RESULTS While councils recognize the potential value of consulting SWSLHD, limited communication and the absence of a clearly defined process for collaboration needs to be addressed. Moreover, councils perceive knowledge gaps in relation to basic issues, such as who provides what services to whom, and how to access local-government-level data from health experts. CONCLUSIONS The study confirms the importance of providing locally relevant public health data to help address issues of mutual concern that arise during the consultation process. Moreover, it suggests that proactive and ongoing consultation between SWSLHD and councils is critical if there is to be effective engagement, and coordinated and sustained action. The concerns raised in this study echo findings from studies from other local government settings of Victoria, South Australia and New South Wales. Thus, the study findings may be applied to other councils beyond the SWSLHD.
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Affiliation(s)
- Vilas Kovai
- Population Health-Health Promotion Service, South Western Sydney Local Health District, Waranara Building, Eastern Campus, Liverpool Hospital, Liverpool BC, NSW, 1871, Australia.
| | - Zeenat Mahjabeen
- School of Social Sciences, Faculty of Arts, Architecture and Design, The University of New South Wales, Kensington, NSW, 2052, Australia
| | - Bin Jalaludin
- Population Health Intelligence, Health People and Places Unit, South Western Sydney Local Health District Locked, Bag 7279, Liverpool, NSW, 1871, Australia
| | - Francis Fox
- Population Health-Health Promotion Service, South Western Sydney Local Health District, Waranara Building, Eastern Campus, Liverpool Hospital, Liverpool BC, NSW, 1871, Australia
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Maniatopoulos G, Hunter DJ, Gray J. The art and science of priority-setting: assessing the value of Public Health England's Prioritization Framework. J Public Health (Oxf) 2021; 43:625-631. [PMID: 32030421 PMCID: PMC8458020 DOI: 10.1093/pubmed/fdaa016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 11/14/2019] [Accepted: 01/14/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Findings are presented from the evaluation of Public Health England's (PHE) Prioritization Framework (PF) aimed to assist local authority commissioners with their public health investment and disinvestment decisions. The study explored the take up of the PF in three early adopter local authority settings. METHODS Semi-structured interviews (n = 30) across three local authorities supplemented by participant observation of workshops. RESULTS Participants acknowledged that the PF provided a systematic means of guiding priority-setting and one that encouraged transparency over investment and disinvestment decisions. The role performed by PHE and its regional teams in facilitating the process was especially welcomed and considered critical to the adoption process. However, uptake of the PF required a significant investment of time and commitment from public health teams at a time when resources were stretched. The impact of the political environment in the local government was a major factor determining the likely uptake of the PF. Ensuring committed leadership and engagement from senior politicians and officers was regarded as critical to success. CONCLUSIONS The study assessed the value and impact of PHE's PF tool in three early adopter local authorities. Further research could explore the value of the tool in aiding investment and disinvestment decisions and its impact on spending.
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Affiliation(s)
- G Maniatopoulos
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - D J Hunter
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - J Gray
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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15
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de Oliveira SMDVL, Bento ADL, Valdes G, de Oliveira STP, de Souza AS, Barreto JOM. [Institutionalizing evidence-based policies in BrazilInstitucionalización de las políticas informadas por evidencia]. Rev Panam Salud Publica 2020; 44:e165. [PMID: 33346235 PMCID: PMC7746000 DOI: 10.26633/rpsp.2020.165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 10/02/2020] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate capacities, organizational arrangements, and barriers to the implementation of Evidence Centers (NEvs) as part of Brazil's Evidence-Informed Policy Network (EVIPNet). Method A mixed methods descriptive-analytical, multiple-case exploratory study was performed. Coordinators of active NEvs answered a questionnaire in three parts: participant characteristics, assessment of the capacity to "acquire, assess, adapt, and apply" evidence (4A), and open questions addressing organizational arrangements and barriers to the implementation of NEvs. Results The study included 15 NEvs, mostly from the Midwest; 73.3% were based in universities, while 20% were installed in state/city health departments or in the Ministry of Health. All coordinators had completed graduate training and 80% reported 1 to 5 years' experience with evidence-based policies as well as proficiency in English. None of the participants worked exclusively as NEv coordinator. NEv teams included health care professionals, students (undergraduate/graduate), professors, and civil servants from health departments. The data revealed high capacity to "acquire" and "assess" evidence, and low capacity to "adapt" and "apply" evidence. On average, three activities or products were developed yearly by each NEv, especially knowledge translation initiatives (systematic reviews and deliberative dialogues) and training for health care professionals, managers and undergraduate/graduate students. Five barrier categories were described: 1) financing, 2) network integration, 3) institutionalization of demands, 4) adaptive capacity, and 5) research communication skills to recommend actions at the local level. Conclusions Trained human resources associated with academic and research institutions are available to support evidence-informed policies. However, the sustainability of NEvs depends on coordinated action to ensure the capacity to adapt and apply evidence.
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Affiliation(s)
| | - Andressa de Lucca Bento
- Secretaria Municipal de Saúde (SESAU) Campo Grande (MS) Brasil Secretaria Municipal de Saúde (SESAU), Campo Grande (MS), Brasil
| | - Gabriel Valdes
- Secretaria Municipal de Saúde (SESAU) Campo Grande (MS) Brasil Secretaria Municipal de Saúde (SESAU), Campo Grande (MS), Brasil
| | - Saú Tavares Pereira de Oliveira
- Secretaria Municipal de Saúde (SESAU) Campo Grande (MS) Brasil Secretaria Municipal de Saúde (SESAU), Campo Grande (MS), Brasil
| | - Albert Schiaveto de Souza
- Universidade Federal de Mato Grosso do Sul (UFMS) Campo Grande (MS) Brasil Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande (MS), Brasil
| | - Jorge Otávio Maia Barreto
- Fundação Oswaldo Cruz (Fiocruz) Brasília (DF) Brasil Fundação Oswaldo Cruz (Fiocruz), Brasília (DF), Brasil
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16
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Bonell C, Prost A, Melendez-Torres GJ, Davey C, Hargreaves JR. Will it work here? A realist approach to local decisions about implementing interventions evaluated as effective elsewhere. J Epidemiol Community Health 2020; 75:46-50. [PMID: 32907917 DOI: 10.1136/jech-2020-214287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/02/2020] [Accepted: 08/24/2020] [Indexed: 11/04/2022]
Abstract
There is increasing interest in what evidence is needed to inform decisions about transporting interventions evaluated as effective to new settings. There has been less attention to how local decision-makers decide whether to implement such interventions immediately or subject to further evaluation. Using the example of school-based social and emotional learning, we consider this drawing on realist methods. We suggest decisions need to assess existing evaluations not merely in terms of whether the intervention was effective but also: how the intervention was implemented and what contextual factors affected this (drawing on process evaluation); and for whom the intervention was effective and through what mechanisms (drawing on mediation, moderation and qualitative comparative analyses from primary studies and/or systematic reviews). We contribute new insights to local needs assessments, suggesting that these should assess: the potential, capability, contribution and capacity present in the new setting for implementation; and whether similar 'aetiological mechanisms' underlie adverse outcomes locally as in previous evaluations. We recommend that where there is uncertainty concerning whether an intervention can feasibly be implemented this indicates the need for piloting of implementation. Where there is uncertainty concerning whether implementation of the intervention will trigger intended mechanisms, this suggests the need for a new effectiveness trial. Where there is uncertainty concerning whether intervention mechanisms, even if triggered, will generate the intended outcomes, this suggests that decision-makers may need to look to other types of intervention as being needed for their setting instead.
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Affiliation(s)
- Chris Bonell
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Calum Davey
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - James R Hargreaves
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
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17
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Ng B, Colimon-Ardila NC. Challenges Implementing Preventive Measures at a Nursing-Skilled Facility in Mexico. Am J Geriatr Psychiatry 2020; 28:1012-1013. [PMID: 32631749 PMCID: PMC7832932 DOI: 10.1016/j.jagp.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Bernardo Ng
- Sun Valley Behavioral Med Ctr, Imperial, CA.
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18
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Schoemaker CG, van Loon J, Achterberg PW, den Hertog FRJ, Hilderink H, Melse J, Vonk RAA, van Oers H. Four normative perspectives on public health policy-making and their preferences for bodies of evidence. Health Res Policy Syst 2020; 18:94. [PMID: 32831080 PMCID: PMC7446163 DOI: 10.1186/s12961-020-00614-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 08/03/2020] [Indexed: 01/03/2023] Open
Abstract
Calls for evidence-informed public health policy-making often ignore that there are multiple, and often competing, bodies of potentially relevant evidence to which policy-makers have recourse in identifying policy priorities and taking decisions. In this paper, we illustrate how policy frames may favour the use of specific bodies of evidence. For the sixth Dutch Public Health Status and Foresight report (2014), possible future trends in population health and healthcare expenditure were used as a starting point for a deliberative dialogue with stakeholders to identify and formulate the most important societal challenges for the Dutch health system. Working with these stakeholders, we expanded these societal challenges into four normative perspectives on public health. These perspectives can be regarded as policy frames. In each of the perspectives, a specific body of evidence is favoured and other types of evidence are neglected. Crucial outcomes in one body may be regarded as irrelevant from other perspectives. Consequently, the results of research from a single body of evidence may not be helpful in the policy-making processes because policy-makers need to account for trade-offs between all competing interests and values. To support these policy processes, researchers need to combine qualitative and quantitative methodologies to address different outcomes from the start of their studies. We feel it is time for the research community to re-politicise the idea of evidence use and for policy-makers to demand research that helps them to account for all health-related policy goals. This is a prerequisite for real evidence-informed policy-making.
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Affiliation(s)
- Casper G Schoemaker
- National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720, BA, Bilthoven, The Netherlands.
| | - Jeanne van Loon
- Ministry of Education, Culture and Science, Rijnstraat 50, 2515 XP, Den Haag, The Netherlands
| | - Peter W Achterberg
- National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720, BA, Bilthoven, The Netherlands
| | - Frank R J den Hertog
- National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720, BA, Bilthoven, The Netherlands
| | - Henk Hilderink
- National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720, BA, Bilthoven, The Netherlands
| | - Johan Melse
- National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720, BA, Bilthoven, The Netherlands
| | - Robert A A Vonk
- The Council for Health and Society, Parnassusplein 5, 2511 VX, Den Haag, The Netherlands
| | - Hans van Oers
- Ministry of Health, Welfare and Sport, Parnassusplein 5, 2511 VX, Den Haag, The Netherlands
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South E, Lorenc T. Use and value of systematic reviews in English local authority public health: a qualitative study. BMC Public Health 2020; 20:1100. [PMID: 32660533 PMCID: PMC7359488 DOI: 10.1186/s12889-020-09223-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Responsibility for public health in England transferred from the National Health Service to local authorities in 2013, representing a different decision-making environment. Systematic reviews are considered the gold standard of evidence for clinical decision-making but little is known about their use in local government public health. This study aimed to explore the extent to which public health decision-makers in local authorities engage with systematic reviews and how they do so. Methods Semi-structured interviews were conducted with senior public health practitioners (n = 14) in Yorkshire and the Humber local authorities. Sampling was purposive and involved contacting Directors of Public Health directly and snowballing through key contacts. Face-to-face or telephone interviews were digitally recorded, transcribed verbatim and analysed using the Framework Method. Results Public health practitioners described using systematic reviews directly in decision-making and engaging with them more widely in a range of ways, often through a personal commitment to professional development. They saw themselves as having a role to advocate for the use of rigorous evidence, including systematic reviews, in the wider local authority. Systematic reviews were highly valued in principle and public health practitioners had relevant skills to find and appraise them. However, the extent of use varied by individual and local authority and was limited by the complexity of decision-making and various barriers. Barriers included that there were a limited number of systematic reviews available on certain public health topics, such as the wider determinants of health, and that the narrow focus of reviews was not reflective of complex public health decisions facing local authorities. Reviews were used alongside a range of other evidence types, including grey literature. The source of evidence was often considered an indicator of quality, with specific organisations, such as Public Health England, NICE and Cochrane, particularly trusted. Conclusions Research use varies and should be considered within the specific decision-making and political context. There is a need for systematic reviews to be more reflective of the decisions facing local authority public health teams.
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Affiliation(s)
- Emily South
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK.
| | - Theo Lorenc
- Centre for Reviews and Dissemination, University of York, York, YO10 5DD, UK
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