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Akintola A, Newbury-Birch D, Kilinc S. Bridging the gap between research evidence and its implementation in public health practice: case studies of embedded research model. BMC Public Health 2024; 24:1299. [PMID: 38741039 DOI: 10.1186/s12889-024-18727-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/28/2024] [Indexed: 05/16/2024] Open
Abstract
AIM To investigate the potential of embedded research in bridging the gap between research evidence and its implementation in public health practice. METHODS Using a case study methodology, semi-structured interviews were conducted with 4 embedded researchers, 9 public health practitioners, and 4 other stakeholders (2 teachers and 2 students) across four case study sites. Sites and individuals were purposively selected. Sites included two local authorities, one secondary school, and one sports organisation. Thematic data analysis was adopted to analyse the qualitative data. RESULTS Four themes were identified: (1) building and maintaining relationships, (2) working with stakeholders, (3) informing practice, and (4) critical reflection. CONCLUSIONS Embedded researchers build and maintain relationships with practitioners and other stakeholders to produce research. Evidence from the co-produced research informs future practice and research to improve service and delivery rendered to the public. Thus, embedded researchers use their role to bridge the research evidence - implementation gap in public health practice.
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Affiliation(s)
- Abisope Akintola
- School of Health and Life Science, Teesside University, Middlesbrough, UK.
- Manchester Institute of Innovation Research, Alliance Manchester Business School, University of Manchester, Manchester, UK.
| | - Dorothy Newbury-Birch
- School of School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
| | - Stephanie Kilinc
- School of School of Social Sciences, Humanities & Law, Teesside University, Middlesbrough, UK
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Clark EC, Burnett T, Blair R, Traynor RL, Hagerman L, Dobbins M. Strategies to implement evidence-informed decision making at the organizational level: a rapid systematic review. BMC Health Serv Res 2024; 24:405. [PMID: 38561796 PMCID: PMC10983660 DOI: 10.1186/s12913-024-10841-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Achievement of evidence-informed decision making (EIDM) requires the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice. This rapid systematic review synthesizes evidence for strategies for the implementation of EIDM across organizations, mapping facilitators and barriers to the COM-B (capability, opportunity, motivation, behaviour) model for behaviour change. The review was conducted to support leadership at organizations delivering public health services (health promotion, communicable disease prevention) to drive change toward evidence-informed public health. METHODS A systematic search was conducted in multiple databases and by reviewing publications of key authors. Articles that describe interventions to drive EIDM within teams, departments, or organizations were eligible for inclusion. For each included article, quality was assessed, and details of the intervention, setting, outcomes, facilitators and barriers were extracted. A convergent integrated approach was undertaken to analyze both quantitative and qualitative findings. RESULTS Thirty-seven articles are included. Studies were conducted in primary care, public health, social services, and occupational health settings. Strategies to implement EIDM included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Facilitators and barriers align with the COM-B model for behaviour change. Facilitators for capability include the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization, though staff turnover and subsequent knowledge loss was a barrier to capability. For opportunity, facilitators include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time, and barriers include competing priorities. Facilitators identified for motivation include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. Barriers include negative attitudes toward new practices, and lack of understanding and support from management. CONCLUSION This review provides a comprehensive analysis of facilitators and barriers for the implementation of EIDM in organizations for public health, mapped to the COM-B model for behaviour change. The existing literature for strategies to support EIDM in public health illustrates several facilitators and barriers linked to realizing EIDM. Knowledge of these factors will help senior leadership develop and implement EIDM strategies tailored to their organization, leading to increased likelihood of implementation success. REVIEW REGISTRATION PROSPERO CRD42022318994.
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Affiliation(s)
- Emily C Clark
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Trish Burnett
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Rebecca Blair
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Robyn L Traynor
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Leah Hagerman
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada.
- School of Nursing, McMaster University, Health Sciences Centre, 2J20, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Allen B, Urmanche A. NYC RxStat: Stakeholder perspectives on a national model public health and public safety partnership to reduce overdose deaths. Eval Program Plann 2023; 98:102275. [PMID: 36924570 DOI: 10.1016/j.evalprogplan.2023.102275] [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] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/14/2023] [Accepted: 03/08/2023] [Indexed: 05/17/2023]
Abstract
NYC RxStat, the United States' first public health and public safety partnership aiming to reduce overdose deaths, began in 2012 and established a national model for cross-sector partnerships. The partnership aimed to integrate data-driven policing with actionable public health interventions and surveillance to develop and implement cross-sector overdose responses. With federal support, jurisdictions nationally have implemented public health and public safety partnerships modeled on RxStat. To inform partnership replication efforts, we conducted a stakeholder evaluation of RxStat. We conducted in-depth, semi-structured interviews with 25 current and former RxStat stakeholders. Interviews probed stakeholder perceptions of RxStat's successes, challenges, and opportunities for growth. Interview data were iteratively coded and thematically analyzed. Stakeholders reported certainty about the need for cross-sector collaboration and described cross-disciplinary tensions, challenges to collaboration and implementation, and opportunities for partnership optimization and growth. Findings informed 12 strategies to improve RxStat and partnerships in its model, organized into three opportunity areas: (1) ensure stakeholder and agency accountability; (2) build secure and mutually beneficial data systems; and (3) structure partnerships to facilitate equitable collaboration. Cross-sector partnerships offer a promising strategy to integrate the public health and safety sectors, but disciplinary tensions in approach may hamper implementation. Findings can inform efforts to implement and scale cross-sector partnerships.
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Affiliation(s)
- Bennett Allen
- Center for Opioid Epidemiology and Policy, Department of Population Health, New York University Grossman School of Medicine, United States.
| | - Adelya Urmanche
- Department of Psychiatry, Mount Sinai Beth Israel, United States
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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] [What about the content of this article? (0)] [Affiliation(s)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Singaram M, Muraleedhran VR, Sivaprakasam M. Cross fertilisation of Public Health and Translational Research. J Indian Inst Sci 2022; 102:763-782. [PMID: 35968232 PMCID: PMC9364283 DOI: 10.1007/s41745-022-00317-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/21/2022] [Indexed: 01/05/2023]
Abstract
Public health is defined as the science of protecting the safety and improving the health of communities through education, policy-making and research for the prevention of disease (Gatseva and Argirova in J Public Health 19(3):205–6, 2011, 10.1007/s10389-011-0412-8; Winslow in Mod Med 2(1306):183–91, 1920. 10.1126/science.51.1306.23; What is public health. Centers for Disease Control Foundation. Centers for Disease Control, Atlanta, https://www.cdcfoundation.org/what-public-health; What is the WHO definition of health? from the Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, On 7 April 1948. The definition has not been amended since. 22 July 1946; signed by the representatives of 61 States (Official Records of WHO, no. 2, p. 100) and entered into force, 19 June;1948. https://web.archive.org/web/20190307113324/https:/www.who.int/about/who-we-are/frequently-asked-questions). Translational research in healthcare is not only useful and satisfying for the researchers to bring their work to market but it would also support public health by bringing affordable, attainable and scalable solutions to the community at large. This is of high significance because instead of increasing the GDP spent in public health, we should focus on the increasing the translational research spending, as this would lead to improved solutions. Hence, the public health offering would reach a larger community at an improved cost. The COVID-19 pandemic and the huge number of lives it claimed exposes challenges in the public health. The pandemic has caused economic and social disruption to millions of people around the world, with many falling into extreme poverty. In early 2021, it was estimated nearly 690 million people are undernourished and by end of 2021 to increase further by 132 million (Joint statement by ILO, FAO, IFAD and WHO. Impact of COVID-19 on people's livelihoods, their health and our food systems https://www.who.int/news/item/13-10-2020-impact-of-covid-19-on-people's-livelihoods-their-health-and-our-food-systems). The spending for public health has increased many folds during the pandemic and this is where translational research in healthcare can play a transformative role to reduce the burden on government healthcare budget (Covid-19 and its impact on Indian society. https://timesofindia.indiatimes.com/readersblog/covid-19-and-its-impact-on-india/covid-19-and-its-impact-on-indian-society-27565/). Over the past decade, public health research has started playing a major role in Indian academic settings. COVID-19 pandemic has further highlighted the role of public health. However, the potential of using technological advancement has not been fully utilised. This is where translational research and public health can play a role to tap the full potential of technology. This review paper explores the public health practices to understand the different practices to examine how both public health and translational research can cross-fertilise. It concludes with a short discussion on implications on policymakers.
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Affiliation(s)
- Muthu Singaram
- Healthcare Technology Innovation Centre (HTIC), Indian Institute of Technology Madras (IITM), Chennai, India
| | - V. R. Muraleedhran
- HSS Department and Centre for Technology and Policy, Indian Institute of Technology Madras (IITM), Chennai, India
| | - Mohanasankar Sivaprakasam
- Department of Electrical Engineering and Healthcare Technology Innovation Centre (HTIC), Indian Institute of Technology Madras (IITM), Chennai, India
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Clark EC, Dhaliwal B, Ciliska D, Neil-Sztramko SE, Steinberg M, Dobbins M. A pragmatic evaluation of a public health knowledge broker mentoring education program: a convergent mixed methods study. Implement Sci Commun 2022; 3:18. [PMID: 35168662 PMCID: PMC8845284 DOI: 10.1186/s43058-022-00267-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background Public health professionals are expected to use the best available research and contextual evidence to inform decision-making. The National Collaborating Centre for Methods and Tools developed, implemented, and evaluated a Knowledge Broker mentoring program aimed at facilitating organization-wide evidence-informed decision-making in ten public health units in Ontario, Canada. The purpose of this study was to pragmatically assess the impact of the program. Methods A convergent mixed methods design was used to interpret quantitative results in the context of the qualitative findings. A goal-setting exercise was conducted with senior leadership in each organization prior to implementing the program. Achievement of goals was quantified through deductive coding of post-program interviews with participants and management. Interviews analyzed inductively to qualitatively explain progress toward identified goals and identify key factors related to implementation of EIDM within the organization. Results Organizations met their goals for evidence use to varying degrees. The key themes identified that support an organizational shift to EIDM include definitive plans for participants to share knowledge during and after program completion, embedding evidence into decision-making processes, and supportive leadership with organizational investment of time and resources. The location, setting, or size of health units was not associated with attainment of EIDM goals; small, rural health units were not at a disadvantage compared to larger, urban health units. Conclusions The Knowledge Broker mentoring program allowed participants to share their learning and support change at their health units. When paired with organizational supports such as supportive leadership and resource investment, this program holds promise as an innovative knowledge translation strategy for organization wide EIDM among public health organizations. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-022-00267-5.
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Santiago CPL, Cavalcante DDFB, Ambrosano GMB, Pereira AC, Lucena EHGD, Cavalcanti YW, Padilha WWN. [Resolvability of primary care in oral health in the State of Paraíba, Brazil]. Cien Saude Colet 2021; 26:3589-3597. [PMID: 34468654 DOI: 10.1590/1413-81232021269.2.23272019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 11/18/2019] [Indexed: 11/21/2022] Open
Abstract
Oral health resolvability in primary care of municipalities in the State of Paraíba, Brazil, was analyzed, and a cross-sectional study was conducted, using an inductive approach, comparative procedure and indirect documentation. The Resolvability Indicator (RI) consisted of the ratio between the number of Completed Treatments and First Programmatic Dental Consultations in municipalities in Paraíba (n = 223), between 2011 and 2014, by using data collected from the DATASUS/TABNET platform. The following explanatory variables were considered: Coverage of First Programmatic Dental Consultation (CFPDC), Coverage of Primary Care Teams (CPCT), Coverage of Oral Health Teams (COHT), Coverage of Family Health Teams (CFHT), Percentage of Tooth Extraction (PTE), Gross Domestic Product (GDP), Municipal Human Development Index (MHDI) and Gini Coefficient (GC). Descriptive statistics and negative binomial multiple regression were performed (α = 0.05). The median RI in 2011, 2012, 2013 and 2014 was, respectively, 20.4, 17.5, 15.2 and 15.7. There was a positive association between RI and CFPDC (PR = 1.14, CI = 1.02-1.28), CPCT (PR = 1.02, CI = 1.01-1.03), in addition to a negative association. between RI and year (PR = 0.83; IC = 0.74-0.94). The resolvability of oral health in primary care is influenced by coverage-related factors.
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Affiliation(s)
- Carmellyo Pires Leite Santiago
- Programa de Pós-Graduação em Odontologia. Departamento de Clínica de Odontologia Social. Centro de Ciências da Saúde. Universidade Federal da Paraíba. Campos I, Cidade Universitária. 58051-900. João Pessoa PB Brasil.
| | | | - Glaucia Maria Bovi Ambrosano
- Departamento de Odontologia Social. Faculdade de Odontologia de Piracicaba. Universidade Estadual de Campinas. Piracicaba SP Brasil
| | - Antônio Carlos Pereira
- Departamento de Odontologia Social. Faculdade de Odontologia de Piracicaba. Universidade Estadual de Campinas. Piracicaba SP Brasil
| | - Edson Hilan Gomes de Lucena
- Programa de Pós-Graduação em Odontologia. Departamento de Clínica de Odontologia Social. Centro de Ciências da Saúde. Universidade Federal da Paraíba. Campos I, Cidade Universitária. 58051-900. João Pessoa PB Brasil.
| | - Yuri Wanderley Cavalcanti
- Programa de Pós-Graduação em Odontologia. Departamento de Clínica de Odontologia Social. Centro de Ciências da Saúde. Universidade Federal da Paraíba. Campos I, Cidade Universitária. 58051-900. João Pessoa PB Brasil.
| | - Wilton Wilney Nascimento Padilha
- Programa de Pós-Graduação em Odontologia. Departamento de Clínica de Odontologia Social. Centro de Ciências da Saúde. Universidade Federal da Paraíba. Campos I, Cidade Universitária. 58051-900. João Pessoa PB Brasil.
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Le Gouais A, Foley L, Ogilvie D, Panter J, Guell C. Sharing believable stories: A qualitative study exploring the relevance of case studies for influencing the creation of healthy environments. Health Place 2021; 71:102615. [PMID: 34320460 PMCID: PMC8520914 DOI: 10.1016/j.healthplace.2021.102615] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/10/2021] [Accepted: 06/19/2021] [Indexed: 02/02/2023]
Abstract
Case study examples can inform policy recommendations and action to create healthy environments. This qualitative study, using semi-structured interviews with nine cross-sectoral stakeholders in England, explored the role of context in case study examples. We found that case studies can not only be a 'practical example' but also used as a 'believable story' with the power to influence decision-making. Case studies may be deemed believable if similar and locally relevant, but judgements can be inherently political and politicised. Metrics used to measure case study outcomes can differ in believability. Storytellers who understand different audiences can be used to build support.
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Affiliation(s)
- Anna Le Gouais
- MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK,Corresponding author. Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK.
| | - Louise Foley
- MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - David Ogilvie
- MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Jenna Panter
- MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, TR1 3HD, UK
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Laustsen CE, Petersson P, Westergren A, Haak M. Involvement of professionals in research: knowledge integration, development of practice, and challenges: a group concept mapping study. Health Res Policy Syst 2021; 19:115. [PMID: 34380506 PMCID: PMC8408930 DOI: 10.1186/s12961-021-00763-5] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/20/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Research and practice are often considered as two different worlds with different values, which causes a gap between them. Involving professionals such as practitioners, managers, decision-makers, and policy-makers in research on ageing and health might address the gap between research and practice, strengthen the healthcare system, and increase older people's possibilities for healthy ageing. The aim of this study was to conceptualize professionals' involvement in research on ageing and health from the perspective of the professionals themselves. METHODS A mixed method called group concept mapping was used. Professionals with experience being involved in research on ageing and health participated in qualitative data collection through brainstorming sessions (n = 29) and by sorting statements (n = 29). Afterwards, they participated in a quantitative data collection by rating statements according to how much each statement strengthened practice (n = 30) and strengthened research (n = 28). Multidimensional scaling analysis and hierarchical cluster analysis were used to conduct quantitative analysis. Latent qualitative analysis was also conducted. RESULTS Analysis resulted in eight clusters which illustrated conceptual areas of professionals' involvement in research projects. The qualitative latent construct of the cluster map resulted in the themes: challenges for professionals; prerequisites and professionals' learning can contribute to development of practice; and integrated knowledge benefits older people. There was a strong correlation between what strengthens practice and research (r = 0.92). CONCLUSIONS This study illustrates conceptual areas of professionals' own perspectives on what their involvement in research can lead to. Their involvement may lead to knowledge being integrated, and the professionals may learn through their involvement, which can contribute to the development of practice. However, there can also be challenges that need to be handled when professionals are involved in research. The study can be useful for improving the understanding of and actual involvement of professionals in research, and for optimizing the involvement of professionals.
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Affiliation(s)
- Christine E. Laustsen
- Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Pia Petersson
- Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Albert Westergren
- Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Maria Haak
- Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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O'Flaherty M, Lloyd-Williams F, Capewell S, Boland A, Maden M, Collins B, Bandosz P, Hyseni L, Kypridemos C. Modelling tool to support decision-making in the NHS Health Check programme: workshops, systematic review and co-production with users. Health Technol Assess 2021; 25:1-234. [PMID: 34076574 DOI: 10.3310/hta25350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Local authorities in England commission the NHS Health Check programme to invite everyone aged 40-74 years without pre-existing conditions for risk assessment and eventual intervention, if needed. However, the programme's effectiveness, cost-effectiveness and equity impact remain uncertain. AIM To develop a validated open-access flexible web-based model that enables local commissioners to quantify the cost-effectiveness and potential for equitable population health gain of the NHS Health Check programme. OBJECTIVES The objectives were as follows: (1) co-produce with stakeholders the desirable features of the user-friendly model; (2) update the evidence base to support model and scenario development; (3) further develop our computational model to allow for developments and changes to the NHS Health Check programme and the diseases it addresses; (4) assess the effectiveness, cost-effectiveness and equity of alternative strategies for implementation to illustrate the use of the tool; and (5) propose a sustainability and implementation plan to deploy our user-friendly computational model at the local level. DESIGN Co-production workshops surveying the best-performing local authorities and a systematic literature review of strategies to increase uptake of screening programmes informed model use and development. We then co-produced the workHORSE (working Health Outcomes Research Simulation Environment) model to estimate the health, economic and equity impact of different NHS Health Check programme implementations, using illustrative-use cases. SETTING Local authorities in England. PARTICIPANTS Stakeholders from local authorities, Public Health England, the NHS, the British Heart Foundation, academia and other organisations participated in the workshops. For the local authorities survey, we invited 16 of the best-performing local authorities in England. INTERVENTIONS The user interface allows users to vary key parameters that represent programme activities (i.e. invitation, uptake, prescriptions and referrals). Scenarios can be compared with each other. MAIN OUTCOME MEASURES Disease cases and case-years prevented or postponed, incremental cost-effectiveness ratios, net monetary benefit and change in slope index of inequality. RESULTS The survey of best-performing local authorities revealed a diversity of effective approaches to maximise the coverage and uptake of NHS Health Check programme, with no distinct 'best buy'. The umbrella literature review identified a range of effective single interventions. However, these generally need to be combined to maximally improve uptake and health gains. A validated dynamic, stochastic microsimulation model, built on robust epidemiology, enabled service options analysis. Analyses of three contrasting illustrative cases estimated the health, economic and equity impact of optimising the Health Checks, and the added value of obtaining detailed local data. Optimising the programme in Liverpool can become cost-effective and equitable, but simply changing the invitation method will require other programme changes to improve its performance. Detailed data inputs can benefit local analysis. LIMITATIONS Although the approach is extremely flexible, it is complex and requires substantial amounts of data, alongside expertise to both maintain and run. CONCLUSIONS Our project showed that the workHORSE model could be used to estimate the health, economic and equity impact comprehensively at local authority level. It has the potential for further development as a commissioning tool and to stimulate broader discussions on the role of these tools in real-world decision-making. FUTURE WORK Future work should focus on improving user interactions with the model, modelling simulation standards, and adapting workHORSE for evaluation, design and implementation support. STUDY REGISTRATION This study is registered as PROSPERO CRD42019132087. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 35. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Martin O'Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | | | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Angela Boland
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Brendan Collins
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Piotr Bandosz
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Lirije Hyseni
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Chris Kypridemos
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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13
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van der Graaf P, Blank L, Holding E, Goyder E. What makes a 'successful' collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme. Health Res Policy Syst 2021; 19:9. [PMID: 33472643 PMCID: PMC7816377 DOI: 10.1186/s12961-020-00671-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/27/2020] [Accepted: 12/13/2020] [Indexed: 11/24/2022] Open
Abstract
Background The national Public Health Practice Evaluation Scheme (PHPES) is a response-mode funded evaluation programme operated by the National Institute for Health Research School for Public Health Research (NIHR SPHR). The scheme enables public health professionals to work in partnership with SPHR researchers to conduct rigorous evaluations of their interventions. Our evaluation reviewed the learning from the first five years of PHPES (2013–2017) and how this was used to implement a revised scheme within the School. Methods We conducted a rapid review of applications and reports from 81 PHPES projects and sampled eight projects (including unfunded) to interview one researcher and one practitioner involved in each sampled project (n = 16) in order to identify factors that influence success of applications and effective delivery and dissemination of evaluations. Findings from the review and interviews were tested in an online survey with practitioners (applicants), researchers (principal investigators [PIs]) and PHPES panel members (n = 19) to explore the relative importance of these factors. Findings from the survey were synthesised and discussed for implications at a national workshop with wider stakeholders, including public members (n = 20). Results Strengths: PHPES provides much needed resources for evaluation which often are not available locally, and produces useful evidence to understand where a programme is not delivering, which can be used to formatively develop interventions. Weaknesses: Objectives of PHPES were too narrowly focused on (cost-)effectiveness of interventions, while practitioners also valued implementation studies and process evaluations. Opportunities: PHPES provided opportunities for novel/promising but less developed ideas. More funded time to develop a protocol and ensure feasibility of the intervention prior to application could increase intervention delivery success rates. Threats: There can be tensions between researchers and practitioners, for example, on the need to show the 'success’ of the intervention, on the use of existing research evidence, and the importance of generalisability of findings and of generating peer-reviewed publications. Conclusions The success of collaborative research projects between public health practitioners (PHP) and researchers can be improved by funders being mindful of tensions related to (1) the scope of collaborations, (2) local versus national impact, and (3) increasing inequalities in access to funding. Our study and comparisons with related funding schemes demonstrate how these tensions can be successfully resolved.
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Affiliation(s)
- Peter van der Graaf
- School of Health and Life Sciences, Teesside University, Centuria Building, Middlesbrough, TS1 3BA, United Kingdom.
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14
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P Rigby B, van der Graaf P, B Azevedo L, Hayes L, Gardner B, J Dodd-Reynolds C. Challenges, opportunities and solutions for local physical activity stakeholders: an implementation case study from a cross-sectoral physical activity network in Northeast England. BMC Public Health 2020; 20:1760. [PMID: 33228613 PMCID: PMC7686773 DOI: 10.1186/s12889-020-09847-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/21/2020] [Accepted: 11/05/2020] [Indexed: 11/17/2022] Open
Abstract
Background Increasingly, national policy initiatives and programmes have been developed to increase physical activity (PA). However, challenges in implementing and translating these policies into effective local-level programmes have persisted, and change in population PA levels has been small. This may be due to insufficient attention given to the implementation context, and the limited interactions between local policy-makers, practitioners and researchers. In this paper we use a case study of a cross-sectoral network in Northeast England, to identify the local-level challenges and opportunities for implementing PA policies and programmes, particularly the updated 2019 UK PA guidelines. Methods Five focus groups (n = 59) were conducted with practice partners, local policy-makers and researchers during an initial workshop in April 2018. Through facilitated discussion, participants considered regional priorities for research and practice, along with barriers to implementing this agenda and how these may be overcome. During a second workshop in December 2018, overarching findings from workshop one were fedback to a similar group of stakeholders, along with national policy-makers, to stimulate feedback from delegates on experiences that may support the implementation of the UK PA guidelines locally, focusing on specific considerations for research, evidence and knowledge exchange. Results In workshop one, three overarching themes were developed to capture local challenges and needs: (i) understanding complexity and context; (ii) addressing the knowledge and skills gap; and (iii) mismatched timescales and practices. In workshop two, participants’ implementation plans encompassed: (i) exploring a systems approach to implementation; (ii) adapting policy to context; and (iii) local prioritising. Conclusions Our findings suggest that academics, practitioners and policy-makers understand the complexities of implementing PA strategies, and the challenges of knowledge exchange. The updated UK PA guidelines policy presented an opportunity for multiple agencies to consider context-specific implementation and address enduring tensions between stakeholders. An organically derived implementation plan that prioritises PA, maps links to relevant local policies and supports a context-appropriate communication strategy, within local policy, practice and research networks, will help address these. We present 10 guiding principles to support transferable knowledge exchange activities within networks to facilitate implementation of national PA policy in local contexts. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09847-3.
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Affiliation(s)
- Benjamin P Rigby
- Department of Sociology, Faculty of Social Sciences and Health, Durham University, 32 Old Elvet, Durham, DH1 3HN, UK. .,NINE Doctoral Training Partnership, C/O Faculty of Social Sciences and Health, Durham University, Arthur Holmes Building, Durham, DH1 3LE, UK. .,Wolfson Research Institute for Health and Wellbeing Physical Activity Special Interest Group, Durham University Queen's Campus, University Boulevard, Thornaby, Stockton-on-Tees, TS17 6BH, UK. .,Fuse: The Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon Tyne, NE1 7RY, UK.
| | - Peter van der Graaf
- Fuse: The Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon Tyne, NE1 7RY, UK.,Centre for Public Health Research, School of Health and Life Sciences, Teesside University, Southfield Road, Middlesbrough, TS1 3BX, UK
| | - Liane B Azevedo
- Department of Allied Health Professions, Sport and Exercise, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Louise Hayes
- Fuse: The Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon Tyne, NE1 7RY, UK.,Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson, Newcastle, NE2 4AX, UK
| | - Benjamin Gardner
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, London, SE5 8AF, UK
| | - Caroline J Dodd-Reynolds
- Wolfson Research Institute for Health and Wellbeing Physical Activity Special Interest Group, Durham University Queen's Campus, University Boulevard, Thornaby, Stockton-on-Tees, TS17 6BH, UK.,Fuse: The Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon Tyne, NE1 7RY, UK.,Department of Sport and Exercise Sciences, Durham University, 42 Old Elvet, Durham, DH1 3HN, UK
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15
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Lloyd-Williams F, Hyseni L, Guzman-Castillo M, Kypridemos C, Collins B, Capewell S, Schwaller E, O'Flaherty M. Evaluating stakeholder involvement in building a decision support tool for NHS health checks: co-producing the WorkHORSE study. BMC Med Inform Decis Mak 2020; 20:182. [PMID: 32778087 PMCID: PMC7418313 DOI: 10.1186/s12911-020-01205-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/03/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022] Open
Abstract
Background Stakeholder engagement is being increasingly recognised as an important way to achieving impact in public health. The WorkHORSE (Working Health Outcomes Research Simulation Environment) project was designed to continuously engage with stakeholders to inform the development of an open access modelling tool to enable commissioners to quantify the potential cost-effectiveness and equity of the NHS Health Check Programme. An objective of the project was to evaluate the involvement of stakeholders in co-producing the WorkHORSE computer modelling tool and examine how they perceived their involvement in the model building process and ultimately contributed to the strengthening and relevance of the modelling tool. Methods We identified stakeholders using our extensive networks and snowballing techniques. Iterative development of the decision support modelling tool was informed through engaging with stakeholders during four workshops. We used detailed scripts facilitating open discussion and opportunities for stakeholders to provide additional feedback subsequently. At the end of each workshop, stakeholders and the research team completed questionnaires to explore their views and experiences throughout the process. Results 30 stakeholders participated, of which 15 attended two or more workshops. They spanned local (NHS commissioners, GPs, local authorities and academics), third sector and national organisations including Public Health England. Stakeholders felt valued, and commended the involvement of practitioners in the iterative process. Major reasons for attending included: being able to influence development, and having insight and understanding of what the tool could include, and how it would work in practice. Researchers saw the process as an opportunity for developing a common language and trust in the end product, and ensuring the support tool was transparent. The workshops acted as a reality check ensuring model scenarios and outputs were relevant and fit for purpose. Conclusions Computational modellers rarely consult with end users when developing tools to inform decision-making. The added value of co-production (continuing collaboration and iteration with stakeholders) enabled modellers to produce a “real-world” operational tool. Likewise, stakeholders had increased confidence in the decision support tool’s development and applicability in practice.
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Affiliation(s)
- Ffion Lloyd-Williams
- Department of Public Health and Policy. Institute of Population Health Science, University of Liverpool, The Quadrangle, University of Liverpool, Liverpool, L69 3GB, UK
| | - Lirije Hyseni
- Department of Public Health and Policy. Institute of Population Health Science, University of Liverpool, The Quadrangle, University of Liverpool, Liverpool, L69 3GB, UK
| | - Maria Guzman-Castillo
- Department of Public Health and Policy. Institute of Population Health Science, University of Liverpool, The Quadrangle, University of Liverpool, Liverpool, L69 3GB, UK.,Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Chris Kypridemos
- Department of Public Health and Policy. Institute of Population Health Science, University of Liverpool, The Quadrangle, University of Liverpool, Liverpool, L69 3GB, UK
| | - Brendan Collins
- Department of Public Health and Policy. Institute of Population Health Science, University of Liverpool, The Quadrangle, University of Liverpool, Liverpool, L69 3GB, UK
| | - Simon Capewell
- Department of Public Health and Policy. Institute of Population Health Science, University of Liverpool, The Quadrangle, University of Liverpool, Liverpool, L69 3GB, UK
| | - Ellen Schwaller
- Department of Public Health and Policy. Institute of Population Health Science, University of Liverpool, The Quadrangle, University of Liverpool, Liverpool, L69 3GB, UK
| | - Martin O'Flaherty
- Department of Public Health and Policy. Institute of Population Health Science, University of Liverpool, The Quadrangle, University of Liverpool, Liverpool, L69 3GB, UK.
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16
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Fusco F, Marsilio M, Guglielmetti C. Co-production in health policy and management: a comprehensive bibliometric review. BMC Health Serv Res 2020; 20:504. [PMID: 32503522 PMCID: PMC7275357 DOI: 10.1186/s12913-020-05241-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 07/04/2019] [Accepted: 04/19/2020] [Indexed: 12/25/2022] Open
Abstract
Background Due to an increasingly elderly population, a higher incidence of chronic diseases and higher expectations regarding public service provision, healthcare services are under increasing strain to cut costs while maintaining quality. The importance of promoting systems of co-produced health between stakeholders has gained considerable traction both in the literature and in public sector policy debates. This study provides a comprehensive map of the extant literature and identifies the main themes and future research needs. Methods A quantitative bibliometric analysis was carried out consisting of a performance analysis, science mapping, and a scientific collaboration analysis. Web of Science (WoS) was chosen to extract the dataset; the search was refined by language, i.e. English, and type of publication, i.e. journal academic articles and reviews. No time limitation was selected. Results The dataset is made up of 295 papers ranging from 1994 to May 2019. The analysis highlighted an annual percentage growth rate in the topic of co-production of about 25%. The articles retrieved are split between 1225 authors and 148 sources. This fragmentation was confirmed by the collaboration analysis, which revealed very few long-lasting collaborations. The scientific production is geographically polarised within the EU and Anglo-Saxon countries, with the United Kingdom playing a central role. The intellectual structure consists of three main areas: public administration and management, service management and knowledge translation literature. The co-word analysis confirms the relatively low scientific maturity of co-production applied to health services. It shows few well-developed and central terms, which refer to traditional areas of co-production (e.g. public health, social care), and some emerging themes related to social and health phenomena (e.g. the elderly and chronic diseases), the use of technologies, and the recent patient-centred approach to care (patient involvement/engagement). Conclusions The field is still far from being mature. Empirical practices, especially regarding co-delivery and co-management as well as the evaluation of their real impacts on providers and on patients are lacking and should be more widely investigated.
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Affiliation(s)
- Floriana Fusco
- Department of Economics, Management and Quantitative Methods (DEMM), Università degli Studi di Milano, via Conservatorio, 7, 20122, Milan, Italy
| | - Marta Marsilio
- Department of Economics, Management and Quantitative Methods (DEMM), Università degli Studi di Milano, via Conservatorio, 7, 20122, Milan, Italy.
| | - Chiara Guglielmetti
- Department of Economics, Management and Quantitative Methods (DEMM), Università degli Studi di Milano, via Conservatorio, 7, 20122, Milan, Italy
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Alvidrez J, Nápoles AM, Bernal G, Lloyd J, Cargill V, Godette D, Cooper L, Horse Brave Heart MY, Das R, Farhat T. Building the Evidence Base to Inform Planned Intervention Adaptations by Practitioners Serving Health Disparity Populations. Am J Public Health 2020; 109:S94-S101. [PMID: 30699023 DOI: 10.2105/ajph.2018.304915] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Many evidence-based interventions (EBIs) have been developed to prevent or treat major health conditions. However, many EBIs have exhibited limited adoption, reach, and sustainability when implemented in diverse community settings. This limitation is especially pronounced in low-resource settings that serve health disparity populations. Often, practitioners identify problems with existing EBIs originally developed and tested with populations different from their target population and introduce needed adaptations to make the intervention more suitable. Although some EBIs have been extensively adapted for diverse populations and evaluated, most local adaptations to improve fit for health disparity populations are not well documented or evaluated. As a result, empirical evidence is often lacking regarding the potential effectiveness of specific adaptations practitioners may be considering. We advocate an expansion in the emphasis of adaptation research from researcher-led interventions to research that informs practitioner-led adaptations. By presenting a research vision and strategies needed to build this area of science, we aim to inform research that facilitates successful adaptation and equitable implementation and delivery of EBIs that reduce health disparities.
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Affiliation(s)
- Jennifer Alvidrez
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Anna María Nápoles
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Guillermo Bernal
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Jacqueline Lloyd
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Victoria Cargill
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Dionne Godette
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Lisa Cooper
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Maria Yellow Horse Brave Heart
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Rina Das
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
| | - Tilda Farhat
- Jennifer Alvidrez, Anna María Nápoles, Rina Das, and Tilda Farhat are with the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD. Guillermo Bernal was with the Office of the President, Carlos Albizu University, San Juan, PR, during the time of essay preparation. Jacqueline Lloyd is with the National Institute on Drug Abuse, NIH. Victoria Cargill is with the Office of Research on Women's Health, NIH. Dionne Godette is with the Office of Disease Prevention, NIH. Lisa Cooper is with the Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD. Maria Yellow Horse Brave Heart is with the Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque. Rina Das and Tilda Farhat are also Guest Editors for this supplement issue
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Keeble M, Burgoine T, White M, Summerbell C, Cummins S, Adams J. Planning and Public Health professionals' experiences of using the planning system to regulate hot food takeaway outlets in England: A qualitative study. Health Place 2021; 67:102305. [PMID: 33526206 DOI: 10.1016/j.healthplace.2020.102305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/23/2020] [Accepted: 02/10/2020] [Indexed: 12/12/2022]
Abstract
Takeaway food outlets offer limited seating and sell hot food to be consumed away from their premises. They typically serve energy-dense, nutrient-poor food. National planning guidelines in England offer the potential for local planning policies to promote healthier food environments through regulation of takeaway food outlets. Around half of English local government areas use this approach, but little is known about the process of adoption. We aimed to explore experiences and perceived success of planning policy adoption. In 2018 we recruited Planning and Public Health professionals from 16 local government areas in England and completed 26 telephone interviews. We analysed data with a thematic analysis approach. Participants felt that planning policy adoption was appropriate and can successfully regulate takeaway food outlets with the intention to improve health. They identified several facilitators and barriers towards adoption. Facilitators included internal co-operation between Planning and Public Health departments, and precedent for planning policy adoption set elsewhere. Barriers included "nanny-state" criticism, and difficulty demonstrating planning policy effectiveness. These could be considered in future guidelines to support widespread planning policy adoption.
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Boulding H, Kamenetzky A, Ghiga I, Ioppolo B, Herrera F, Parks S, Manville C, Guthrie S, Hinrichs-Krapels S. Mechanisms and pathways to impact in public health research: a preliminary analysis of research funded by the National Institute for Health Research (NIHR). BMC Med Res Methodol 2020; 20:34. [PMID: 32075580 PMCID: PMC7031933 DOI: 10.1186/s12874-020-0905-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 11/19/2018] [Accepted: 01/20/2020] [Indexed: 11/23/2022] Open
Abstract
Background The mechanisms and pathways to impacts from public health research in the UK have not been widely studied. Through the lens of one funder (NIHR), our aims are to map the diversity of public health research, in terms of funding mechanisms, disciplinary contributions, and public health impacts, identify examples of impacts, and pathways to impact that existing reporting mechanisms may not otherwise have captured, and provide illustrations of how public health researchers perceive the generation of non-academic impact from their work. Methods A total of 1386 projects were identified as ‘public health research’ by the NIHR and listed in the NIHR Public Health Overview database (2000–2016). From these, a subset of 857 projects were matched as potentially having begun reporting impacts via an external data-gathering platform (Researchfish). Data on the 857 projects were analyzed quantitatively, and nine projects were selected to investigate further through semi-structured interviews with principal investigators. Two workshops took place to validate emerging and final findings and facilitate analysis. Results In addition to the NIHR School for Public Health Research and the NIHR Public Health Research Programme, 89% of projects contained in the NIHR Public Health Overview portfolio as ‘public health research’ are funded via other NIHR research programmes, suggesting significant diversity in disciplines contributing to public health research and outcomes. The pathways to impact observed in our in-depth case studies include contributing to debates on what constitutes appropriate evidence for national policy change, acknowledging local ‘unintended’ impacts, building trusted relationships with stakeholders across health and non-health sectors and actors, collaborating with local authorities, and using non-academic dissemination channels. Conclusions Public health as a discipline contributes substantially to impact beyond academia. To support the diversity of these impacts, we need to recognise localized smaller-scale impacts, and the difference in types of evidence required for community and local authority-based impacts. This will also require building capacity and resources to enable impact to take place from public health research. Finally, support is required for engagement with local authorities and working with non-health sectors that contribute to health outcomes.
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Affiliation(s)
- Harriet Boulding
- The Policy Institute, King's College London, 22 Kingsway, London, WC2B 6LE, UK
| | - Adam Kamenetzky
- The Policy Institute, King's College London, 22 Kingsway, London, WC2B 6LE, UK
| | - Ioana Ghiga
- RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK
| | - Becky Ioppolo
- RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK
| | | | - Sarah Parks
- RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK
| | | | - Susan Guthrie
- RAND Europe, Westbrook Centre, Cambridge, CB4 1YG, UK
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Taylor B, Henshall C, Kenyon S, Litchfield I, Greenfield S. Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis. BMJ Open 2018; 8:e019993. [PMID: 30297341 PMCID: PMC6194404 DOI: 10.1136/bmjopen-2017-019993] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study compares rapid and traditional analyses of a UK health service evaluation dataset to explore differences in researcher time and consistency of outputs. DESIGN Mixed methods study, quantitatively and qualitatively comparing qualitative methods. SETTING Data from a home birth service evaluation study in a hospital in the English National Health Service, which took place between October and December 2014. Two research teams independently analysed focus group and interview transcript data: one team used a thematic analysis approach using the framework method, and the second used rapid analysis. PARTICIPANTS Home birth midwives (6), midwifery support workers (4), commissioners (4), managers (6), and community midwives (12) and a patient representative (1) participated in the original study. PRIMARY OUTCOME MEASURES Time taken to complete analysis in person hours; analysis findings and recommendations matched, partially matched or not matched across the two teams. RESULTS Rapid analysis data management took less time than thematic analysis (43 hours vs 116.5 hours). Rapid analysis took 100 hours, and thematic analysis took 126.5 hours in total, with interpretation and write up taking much longer in the rapid analysis (52 hours vs 8 hours). Rapid analysis findings overlapped with 79% of thematic analysis findings, and thematic analysis overlapped with 63% of the rapid analysis findings. Rapid analysis recommendations overlapped with 55% of those from the thematic analysis, and thematic analysis overlapped with 59% of the rapid analysis recommendations. CONCLUSIONS Rapid analysis delivered a modest time saving. Excessive time to interpret data in rapid analysis in this study may be due to differences between research teams. There was overlap in outputs between approaches, more in findings than recommendations. Rapid analysis may have the potential to deliver valid, timely findings while taking less time. We recommend further comparisons using additional data sets with more similar research teams.
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Affiliation(s)
- Beck Taylor
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Catherine Henshall
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Sara Kenyon
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Ian Litchfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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