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Wabnitz K, Rueb M, Rehfuess EA, Strahwald B, Pfadenhauer LM. Assessing the impact of an evidence- and consensus-based guideline for controlling SARS-CoV-2 transmission in German schools on decision-making processes: a multi-component qualitative analysis. Health Res Policy Syst 2023; 21:138. [PMID: 38115061 PMCID: PMC10729453 DOI: 10.1186/s12961-023-01072-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 11/10/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, decision-making on measures to reduce or prevent transmission of SARS-CoV-2 in schools was rendered difficult by a rapidly evolving and uncertain evidence base regarding their effectiveness and unintended consequences. To support decision-makers, an interdisciplinary panel of scientific experts, public health and school authorities as well as those directly affected by school measures, was convened in an unprecedented effort to develop an evidence- and consensus-based public health guideline for German schools. This study sought to assess whether and how this guideline impacted decision-making processes. METHODS This study comprised three components: (1) we sent inquiries according to the Freedom of Information Acts of each Federal State to ministries of education, family, and health. (2) We conducted semi-structured interviews with individuals involved in decision-making regarding school measures in two Federal States, and (3) we undertook semi-structured interviews with members of the guideline panel. The content of response letters in component 1 was analysed descriptively; data for components 2 and 3 were analysed using deductive-inductive thematic qualitative content analysis according to Kuckartz. RESULTS Responses to the Freedom of Information Act inquiries showed that the guideline was recognised as a relevant source of information by ministries of education in nine out of 16 Federal States and used as a reference to check existing directives for school measures in five Federal States. All participants (20 interviews) emphasised the value of the guideline given its evidence- and consensus-based development process but also noted limitations in its usability and usefulness, e.g., lack of context-specificity. It was consulted by participants who advised policy-makers (5 interviews) alongside other sources of evidence. Overall, perceptions regarding the guideline's impact were mixed. CONCLUSIONS Our findings suggest that the guideline was relatively well-known in Federal States' decision-making bodies and that it was considered alongside other forms of evidence in some of these. We suggest that further research to evaluate the impact of public health guidelines on (political) decision-making is warranted. Guideline development processes may need to be adapted to account for the realities of decision-making during public health emergencies and beyond.
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Affiliation(s)
- Katharina Wabnitz
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany.
- Pettenkofer School of Public Health, Munich, Germany.
| | - Mike Rueb
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Eva A Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Brigitte Strahwald
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Schaffler-Schaden D, Herfert J, O Brien J, Johansson T, Seymer A, Ludwig S, Stöggl T, Osterbrink J, Flamm M, van der Zee-Neuen A. Citizens, doctors, politicians - who´s an expert in times of COVID-19? A survey in Austria and Germany. ACTA ACUST UNITED AC 2021; 79:144. [PMID: 34399834 PMCID: PMC8365271 DOI: 10.1186/s13690-021-00666-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022]
Abstract
Background This study aimed to explore which measures and risk factors for a COVID − 19 infection are considered most important in the general population, health experts and policymakers and to assess the level of agreement across the groups from Austria and Germany. Methods A two-phased survey was conducted, participants were matched according to age and gender. Three different groups were asked which measures they considered most relevant in reducing a COVID-19 transmission, to determine which factors contribute most to the risk of disease, and to evaluate the level of agreement in the assessment of risk factor relevance for (a) the transmission of the disease and (b) the risk of a severe course of COVID-19. Results Risk factors for an infection that were selected from all three groups were immunosuppression/deficiency, cancer, chronic lung disease, smoking, age and working as a health care professional. Interrater agreement per population was only poor to slight and results were highly heterogeneous. Conclusions Our survey shows a broad spectrum of opinions and the associated general uncertainty about the risk factors for infection and a severe course of disease across the groups. Profound knowledge of politicians and experts is of high relevance to provide the public with valid information to ensure cooperation fighting the pandemic. Trial registration https://apps.who.int/trialsearch/ (ID: DRKS00022166). Registered 15 June 2020.
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Affiliation(s)
- Dagmar Schaffler-Schaden
- Institute of General Practice, Family Medicine and Preventive Medicine, Centre for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.
| | - Juergen Herfert
- Red Bull Athlete Performance Centre, Brunnbachweg 71, 5303, Thalgau, Austria
| | - James O Brien
- Red Bull Athlete Performance Centre, Brunnbachweg 71, 5303, Thalgau, Austria.,The Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), 6027, Joondalup, WA, Australia
| | - Tim Johansson
- Institute of General Practice, Family Medicine and Preventive Medicine, Centre for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Alexander Seymer
- Department of Sociology, Paris Lodron University of Salzburg, Rudolfskai 42, 5020, Salzburg, Austria
| | - Stephan Ludwig
- Institute of Virology, University of Muenster, Von Esmarch-Strasse 56, 48149, Muenster, Germany
| | - Thomas Stöggl
- Red Bull Athlete Performance Centre, Brunnbachweg 71, 5303, Thalgau, Austria.,Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Schlossallee 49, 5400, Hallein/Rif, Austria
| | - Juergen Osterbrink
- Brooks College of Health, University of North Florida, Building 39, 1 UNF Drive, 32224, Jacksonville, FL, USA.,Institute of Nursing Science & Practice, Centre for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Maria Flamm
- Institute of General Practice, Family Medicine and Preventive Medicine, Centre for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
| | - Antje van der Zee-Neuen
- Institute of Nursing Science & Practice, Centre for Public Health and Healthcare Research, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria
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Bußkamp A, Vonstein C, Tillmann J, Roßmann C, De Bock F. [Promotion of physical activity among the elderly as an example of knowledge translation: How do scientific findings enter community practice?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:560-567. [PMID: 33837439 PMCID: PMC8087559 DOI: 10.1007/s00103-021-03311-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/12/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Scientific findings can be an important source of knowledge for public health stakeholders involved in promoting physical activity, but several barriers hinder their use. Knowledge translation can simplify this process, but it requires the understanding of the stakeholder's needs. OBJECTIVES This qualitative study aims to describe how public health stakeholders access information and scientific findings, identify possible barriers, and highlight the needs of stakeholders in terms of presentation and processing. MATERIALS AND METHODS Semi-structured interviews were conducted with twelve local- and state-level stakeholders from North Rhine-Westphalia, Saxony-Anhalt, and Thuringia working in the area of physical activity promotion. The interviewees were selected through purposive sampling. The interviews were evaluated using qualitative content analysis. RESULTS The benefits of scientific findings are emphasized by the interviewees, but a lack of resources in combination with a flood of information, high complexity, and technical jargon complicate their application. There is a need for tailored preparation in the form of summaries, filter functions, elaboration of practice-relevant elements, and ways of provision. CONCLUSIONS To achieve successful knowledge translation, collaboration and interactive exchange between researchers, policymakers, and practice as well as a demand-oriented processing of scientific findings are central. Networking and bundling of knowledge on a platform are important tasks for the future.
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Affiliation(s)
- Annalena Bußkamp
- Referat 2-22 "Zusammenarbeit mit Ländern, Krankenkassen und Verbänden, Gremien; Gesundes Alter; Frauengesundheit; Männergesundheit", Bundeszentrale für gesundheitliche Aufklärung, Maarweg 149-161, 50825, Köln, Deutschland.
| | - Claudia Vonstein
- Referat 2-22 "Zusammenarbeit mit Ländern, Krankenkassen und Verbänden, Gremien; Gesundes Alter; Frauengesundheit; Männergesundheit", Bundeszentrale für gesundheitliche Aufklärung, Maarweg 149-161, 50825, Köln, Deutschland
| | - Judith Tillmann
- Referat 2-22 "Zusammenarbeit mit Ländern, Krankenkassen und Verbänden, Gremien; Gesundes Alter; Frauengesundheit; Männergesundheit", Bundeszentrale für gesundheitliche Aufklärung, Maarweg 149-161, 50825, Köln, Deutschland
| | - Christin Roßmann
- Referat 2-22 "Zusammenarbeit mit Ländern, Krankenkassen und Verbänden, Gremien; Gesundes Alter; Frauengesundheit; Männergesundheit", Bundeszentrale für gesundheitliche Aufklärung, Maarweg 149-161, 50825, Köln, Deutschland
| | - Freia De Bock
- Abteilung 2, Bundeszentrale für gesundheitliche Aufklärung (BZgA), Köln, Deutschland
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Abstract
Michael Cook looks at the role of an embedded Public Health Information Specialist highlighting the ways the core evidence, information and knowledge skills are used to progress Public Health activity in local government settings. Acknowledging the current pandemic, he explores how COVID-19 has dominated all aspects of health and social care, and outlines how evidence services have work within these complex Public Health systems to lead the local response and recovery efforts.
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Affiliation(s)
- Michael Cook
- Bolton Council, Bolton, UK.,Public Health England, UK
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Mead R, Thurston M, Bloyce D. From public issues to personal troubles: individualising social inequalities in health within local public health partnerships. Critical Public Health 2020. [DOI: 10.1080/09581596.2020.1763916] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Rebecca Mead
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Miranda Thurston
- Department of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Daniel Bloyce
- Department of Sport and Exercise Sciences, University of Chester, Chester, UK
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Woodruff K, Roberts SCM. "Alcohol During Pregnancy? Nobody Does That Anymore": State Legislators' Use of Evidence in Making Policy on Alcohol Use in Pregnancy. J Stud Alcohol Drugs 2020. [PMID: 31250804 DOI: 10.15288/jsad.2019.80.380] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE In recent years, U.S. states have passed many laws addressing alcohol use in pregnancy, despite limited evidence on the impact of such policies. This study explores how state legislators use evidence when making policy on alcohol use in pregnancy. METHOD Study data are drawn from semistructured interviews with 29 state lawmakers and their aides in Maryland, North Carolina, and Virginia, conducted in March through July 2017. Interview transcripts were coded and analyzed by inductive and deductive methods. RESULTS Despite evidence on the harms of alcohol use in pregnancy, most lawmakers did not express concern about this topic. Instead, they expressed concern about opioid use in pregnancy. Personal experiences, anecdotes, and known contacts influenced legislators' views on substance use in pregnancy, whereas evidence, for the most part, did not. The intermediaries who typically bring evidence about problems and solutions to legislators did not appear to be raising the issue of alcohol use in pregnancy on legislators' agenda. CONCLUSIONS Basic evidence on the prevalence and harms of alcohol use in pregnancy did not appear to influence state lawmakers' policy priorities. Concern over opioid use in general may provide a window of opportunity to educate legislators on the relative scope and harms of alcohol and opioid use in pregnancy. It remains unclear why states are passing alcohol-in-pregnancy policies. More research is needed to explore how state lawmakers form their understanding of substance use in pregnancy and related policies.
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Affiliation(s)
- Katie Woodruff
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California
| | - Sarah C M Roberts
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California
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Kneale D, Rojas-García A, Thomas J. Obstacles and opportunities to using research evidence in local public health decision-making in England. Health Res Policy Syst 2019; 17:61. [PMID: 31248422 PMCID: PMC6598344 DOI: 10.1186/s12961-019-0446-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 03/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Local public health service delivery and policy-setting in England was overhauled in 2013, with local government now responsible for the complex tasks involved in protecting and improving population health and addressing health inequalities. Since 2013, public health funding per person has declined, adding to the challenge of public health decision-making. In a climate of austerity, research evidence could help to guide the more effective use of resources, although there are concerns that the reorganisation of public health decision-making structures has disrupted traditional evidence use patterns. This study aimed to explore local public health evidence use and needs in this new decision-making climate. METHODS Semi-structured interviews with Public Health Practitioners across three Local Authorities were conducted, with sites purposefully selected to represent urban, suburban and county Local Authorities, and to reflect a range of public health issues that might be encountered. A topic guide was developed that allowed participants to reflect on their experience and involvement in providing evidence for, or making a decision around, commissioning a public health service. Data were transcribed and template analysis was employed to understand the findings, which involved developing a coding template based on an initial transcript and applying this to subsequent transcripts. RESULTS Increased political involvement in local public health decision-making, while welcomed by some participants as a form of democratising public health, has influenced evidence preferences in a number of ways. Political and individual ideologies of locally elected officials meant that certain forms of evidence could be overlooked in favour of evidence that corresponded to decision-makers' preferences. Political involvement at the local level has increased the appetite for local knowledge and evidence. Research evidence needs to demonstrate its local salience if it is to contribute to decision-making alongside competing sources, particularly anecdotal information. CONCLUSION To better meet decision-making needs of politicians and practitioners, a shift in the scope of public health evidence is required. At a systematic review level, this could involve moving away from producing evidence that reflects broad global generalisations about narrow and simple questions, and instead towards producing forms of evidence that have local applicability and can support complex policy-focussed decisions.
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Affiliation(s)
- Dylan Kneale
- Evidence for Policy and Practice Information and Coordinating Centre, UCL Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL, United Kingdom.
| | - Antonio Rojas-García
- NIHR CLAHRC North Thames, Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom.
| | - James Thomas
- Evidence for Policy and Practice Information and Coordinating Centre, UCL Institute of Education, University College London, 20 Bedford Way, London, WC1H 0AL, United Kingdom
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Ford JA, Jones AP, Wong G, Barton G, Clark A, Sims E, Swart AM, Steel N. Improving primary care Access in Context and Theory (I-ACT trial): a theory-informed randomised cluster feasibility trial using a realist perspective. Trials 2019; 20:193. [PMID: 30947737 PMCID: PMC6449944 DOI: 10.1186/s13063-019-3299-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/18/2019] [Indexed: 11/30/2022] Open
Abstract
Background Primary care access can be challenging for older, rural, socio-economically disadvantaged populations. Here we report the I-ACT cluster feasibility trial which aims to assess the feasibility of trial design and context-sensitive intervention to improve primary care access for this group and so expand existing theory. Methods Four general practices were recruited; three randomised to intervention and one to usual care. Intervention practices received £1500, a support manual and four meetings to develop local, innovative solutions to improve the booking system and transport. Patients aged over 64 years old and without household car access were recruited to complete questionnaires when booking an appointment or attending the surgery. Outcome measures at 6 months included: self-reported ease of booking an appointment and transport; health care use; patient activation; capability; and quality of life. A process evaluation involved observations and interviews with staff and participants. Results Thirty-four patients were recruited (26 female, eight male, mean age 81.6 years for the intervention group and 79.4 for usual care) of 1143 invited (3% response rate). Most were ineligible because of car access. Twenty-nine participants belonged to intervention practices and five to usual care. Practice-level data was available for all participants, but participant self-reported data was unavailable for three. Fifty-six appointment questionnaires were received based on 150 appointments (37.3%). Practices successfully designed and implemented the following context-sensitive interventions: Practice A: a stacked telephone system and promoting community transport; Practice B: signposting to community transport, appointment flexibility, mobility scooter charging point and promoting the role of receptionists; and Practice C: local taxi firm partnership and training receptionists. Practices found the process acceptable because it gave freedom, time and resource to be innovative or provided an opportunity to implement existing ideas. Data collection methods were acceptable to participants, but some found it difficult remembering to complete booking and appointment questionnaires. Expanded theory highlighted important mechanisms, such as reassurance, confidence, trust and flexibility. Conclusions Recruiting older participants without access to a car proved challenging. Retention of participants and practices was good but only about a third of appointment questionnaires were returned. This study design may facilitate a shift from one-size-fits-all interventions to more context-sensitive interventions. Trial registration ISRCTN18321951, Registered on 6 March 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3299-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- John A Ford
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Chancellors Drive, Norwich, NR4 7TJ, UK.
| | - Andy P Jones
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Chancellors Drive, Norwich, NR4 7TJ, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Garry Barton
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Chancellors Drive, Norwich, NR4 7TJ, UK.,Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Allan Clark
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Chancellors Drive, Norwich, NR4 7TJ, UK.,Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Erika Sims
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Ann Marie Swart
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Nick Steel
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Chancellors Drive, Norwich, NR4 7TJ, UK
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Anderson WJ, Cheeseman H, Butterworth G. Political priorities and public health services in English local authorities: the case of tobacco control and smoking cessation services. J Public Health (Oxf) 2018; 40:e269-e274. [PMID: 29059319 DOI: 10.1093/pubmed/fdx143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/04/2017] [Indexed: 11/13/2022] Open
Abstract
Background Since 2013, local authorities in England have been responsible for public health including smoking cessation services. Methods Online surveys of tobacco control leads in English local authorities were conducted in 2014 (76% response rate, n = 116), 2015 (82% response rate, n = 124) and 2016 (85% response rate, n = 129). Results A high priority for tobacco control was reported in 17% of local authorities in 2014, rising to 27% in 2016. A low priority for tobacco control was reported in 4% of local authorities in 2014, rising to 11% in 2016. Budgets for smoking cessation services were cut in 16% of local authorities in 2014, 39% in 2015 and 59% in 2016. In 2016, budgets were cut in all local authorities where the priority given to tobacco control was perceived to be low and in 40% of the local authorities where it was perceived to be high. Cuts in smoking cessation budgets were principally due to cuts to the public health grant and wider cuts to local authority budgets. Conclusions At a time of significant cost pressure, political support for tobacco control in English local authorities mitigates but does not remove the risk of cuts to budgets for smoking cessation services.
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Milne E. Just William. J Public Health (Oxf) 2017; 39:651-652. [PMID: 29301053 DOI: 10.1093/pubmed/fdx165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Indexed: 11/13/2022] Open
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