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Brubacher LJ, Lovato CY, Sriram V, Cheng M, Berman P. The use of evidence to guide decision-making during the COVID-19 pandemic: divergent perspectives from a qualitative case study in British Columbia, Canada. Health Res Policy Syst 2024; 22:66. [PMID: 38831457 PMCID: PMC11145826 DOI: 10.1186/s12961-024-01146-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/29/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The challenges of evidence-informed decision-making in a public health emergency have never been so notable as during the COVID-19 pandemic. Questions about the decision-making process, including what forms of evidence were used, and how evidence informed-or did not inform-policy have been debated. METHODS We examined decision-makers' observations on evidence-use in early COVID-19 policy-making in British Columbia (BC), Canada through a qualitative case study. From July 2021- January 2022, we conducted 18 semi-structured key informant interviews with BC elected officials, provincial and regional-level health officials, and civil society actors involved in the public health response. The questions focused on: (1) the use of evidence in policy-making; (2) the interface between researchers and policy-makers; and (3) key challenges perceived by respondents as barriers to applying evidence to COVID-19 policy decisions. Data were analyzed thematically, using a constant comparative method. Framework analysis was also employed to generate analytic insights across stakeholder perspectives. RESULTS Overall, while many actors' impressions were that BC's early COVID-19 policy response was evidence-informed, an overarching theme was a lack of clarity and uncertainty as to what evidence was used and how it flowed into decision-making processes. Perspectives diverged on the relationship between 'government' and public health expertise, and whether or not public health actors had an independent voice in articulating evidence to inform pandemic governance. Respondents perceived a lack of coordination and continuity across data sources, and a lack of explicit guidelines on evidence-use in the decision-making process, which resulted in a sense of fragmentation. The tension between the processes involved in research and the need for rapid decision-making was perceived as a barrier to using evidence to inform policy. CONCLUSIONS Areas to be considered in planning for future emergencies include: information flow between policy-makers and researchers, coordination of data collection and use, and transparency as to how decisions are made-all of which reflect a need to improve communication. Based on our findings, clear mechanisms and processes for channeling varied forms of evidence into decision-making need to be identified, and doing so will strengthen preparedness for future public health crises.
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Affiliation(s)
- Laura Jane Brubacher
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada.
| | - Chris Y Lovato
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Veena Sriram
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- School of Public Policy and Global Affairs, University of British Columbia, Vancouver, Canada
| | - Michael Cheng
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Peter Berman
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Koorts H, Ma J, Swain CTV, Rutter H, Salmon J, Bolton KA. Systems approaches to scaling up: a systematic review and narrative synthesis of evidence for physical activity and other behavioural non-communicable disease risk factors. Int J Behav Nutr Phys Act 2024; 21:32. [PMID: 38515118 PMCID: PMC10958859 DOI: 10.1186/s12966-024-01579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/24/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) are the leading causes of death worldwide. Systems approaches have potential for creating sustainable outcomes at scale but have rarely been used to support scale up in physical activity/nutrition promotion or NCD prevention more generally. This review aimed to: (i) synthesise evidence on the use of systems approaches in scaling up interventions targeting four behavioural risk factors for NCDs; and (ii) to explore how systems approaches have been conceptualised and used in intervention implementation and scale up. METHOD Seven electronic databases were searched for studies published 2016-2021. Eligible studies targeted at least one of four NCD behavioural risk factors (physical inactivity, tobacco use, alcohol consumption, diet), or described evaluation of an intervention planned for or scaled up. Studies were categorised as having a (i) high, (ii) moderate, or (iii) no use of a systems approach. A narrative synthesis of how systems approaches had been operationalised in scale up, following PRISMA guidelines. RESULTS Twenty-one intervention studies were included. Only 19% (n = 4) of interventions explicitly used systems thinking to inform intervention design, implementation and scale up (targeting all four risk factors n = 2, diet n = 1, tobacco use n = 1). Five studies ('high use') planned and implemented scale up with an explicit focus on relations between system elements and used system changes to drive impact at scale. Seven studies ('moderate use') considered systems elements impacting scale-up processes or outcomes but did not require achieving system-level changes from the outset. Nine studies ('no use') were designed to work at multiple levels among multiple agencies in an intervention setting, but the complexity of the system and relations between system elements was not articulated. We synthesised reported barriers and facilitators to scaling up, and how studies within each group conceptualised and used systems approaches, and methods, frameworks and principles for scaling up. CONCLUSION In physical activity research, and NCD prevention more broadly, the use of systems approaches in scale up remains in its infancy. For researchers, practitioners and policymakers wishing to adopt systems approaches to intervention implementation at scale, guidance is needed on how to communicate and operationalise systems approaches in research and in practice. TRIAL REGISTRATION PROSPERO (CRD42021287265).
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Affiliation(s)
- Harriet Koorts
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition (IPAN), 221 Burwood Highway, Burwood Geelong, VIC, 3125, Australia.
| | - Jiani Ma
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition (IPAN), 221 Burwood Highway, Burwood Geelong, VIC, 3125, Australia
| | - Christopher T V Swain
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Department of Physiotherapy, Faculty of Medicine Dentistry and Health Sciences, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Claverton Down, Bath, UK
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition (IPAN), 221 Burwood Highway, Burwood Geelong, VIC, 3125, Australia
| | - Kristy A Bolton
- School of Exercise and Nutrition Sciences, Deakin University, Institute for Physical Activity and Nutrition (IPAN), 221 Burwood Highway, Burwood Geelong, VIC, 3125, Australia
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Heerman WJ, Kenney E, Block JP, Fiechtner L, McMahon E, Kruse L, Sharifi M, Edmondson EK, Virudachalam S. A Narrative Review of Public Health Interventions for Childhood Obesity. Curr Obes Rep 2024; 13:87-97. [PMID: 38172483 DOI: 10.1007/s13679-023-00550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Public health interventions that intervene on macrolevel systems hold the promise of reducing childhood obesity at the population level through prevention. The purpose of this review is to highlight some of the recent and best scientific evidence related to public health interventions for the prevention of childhood obesity. We provide a narrative review of scientific evidence for six categories of public health interventions and their impact on childhood obesity: federal nutrition assistance programs, programs implemented in early care and education centers, interventions to support healthy nutrition and physical activity in schools, community-based programs and policies, labeling policies and marketing to children, and taxes on sugar sweetened beverages (SSB). RECENT FINDINGS Federal nutrition assistance programs have the strongest evidence to support reduction in childhood obesity and serve populations with the highest prevalence of childhood obesity. Other interventions including SSB taxes, community-wide interventions, and interventions at schools and early care and education centers also show significant improvements in child weight status. Overall public health interventions have strong evidence to support widespread implementation in service of reducing childhood obesity rates at the population level. To effectively address the recalcitrant childhood obesity epidemic, multi-pronged solutions are needed. The current evidence for public health obesity interventions is consistent with the paradigm that recognizes the importance of macrolevel systems influences on childhood obesity: interventions that are most effective intervene at macrolevels.
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Affiliation(s)
- William J Heerman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA.
| | - Erica Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jason P Block
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, USA
| | - Lauren Fiechtner
- Division of Pediatric Gastroenterology and Nutrition, Mass General for Children, The Greater Boston Food Bank, Boston, USA
| | - Ellen McMahon
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA
| | - Lauren Kruse
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, USA
| | - Mona Sharifi
- Department of Pediatrics, Yale School of Medicine, New Haven, USA
| | - Emma K Edmondson
- Department of Pediatrics and Leonard Davis Institute of Health Economics at University of Pennsylvania Perelman School of Medicine, Division of General Pediatrics, PolicyLab, and Clinical Futures at Children's Hospital of Philadelphia, Philadelphia, USA
| | - Senbagam Virudachalam
- Department of Pediatrics and Leonard Davis Institute of Health Economics at University of Pennsylvania Perelman School of Medicine, Division of General Pediatrics, PolicyLab, and Clinical Futures at Children's Hospital of Philadelphia, Philadelphia, USA
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Weber P, Birkholz L, Straub R, Kohler S, Helsper N, Dippon L, Pfeifer K, Rütten A, Semrau J. The Limitations and Potentials of Evaluating Economic Aspects of Community-Based Health Promotion: A Critical Review. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:165-179. [PMID: 38190019 PMCID: PMC10864521 DOI: 10.1007/s40258-023-00864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
Community-based health promotion (CBHP) interventions are promising approaches to address public health problems; however, their economic evaluation presents unique challenges. This review aims to explore the opportunities and limitations of evaluating economic aspects of CBHP, focusing on the assessment of intervention costs and outcomes, and the consideration of political-level changes and health equity. A systematic search of the PubMed, Web of Science and PsycInfo databases identified 24 CBHP interventions, the majority of which targeted disadvantaged communities. Only five interventions included a detailed cost/resource assessment. Outcomes at the operational level were mainly quantitative, related to sociodemographics and environment or health status, while outcomes at the political level were often qualitative, related to public policy, capacity building or networks/collaboration. The study highlights the limitations of traditional health economic evaluation methods in capturing the complexity of CBHP interventions. It proposes the use of cost-consequence analysis (CCA) as a more comprehensive approach, offering a flexible and multifaceted assessment of costs and outcomes. However, challenges remain in the measurement and valuation of outcomes, equity considerations, intersectoral costs and attribution of effects. While CCA is a promising starting point, further research and methodological advancements are needed to refine its application and improve decision making in CBHP.
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Affiliation(s)
- Philipp Weber
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany.
| | - Leonie Birkholz
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Riccarda Straub
- School of Business, Economics and Society, Chair of Health Management, Friedrich-Alexander-Universität Erlangen-Nürnberg, Lange Gasse 20, 90403, Nuremberg, Germany
| | - Simone Kohler
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Natalie Helsper
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Lea Dippon
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Alfred Rütten
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
| | - Jana Semrau
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Gebbertstr. 123b, 91058, Erlangen, Germany
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Longworth GR, Erikowa-Orighoye O, Anieto EM, Agnello DM, Zapata-Restrepo JR, Masquillier C, Giné-Garriga M. Conducting co-creation for public health in low and middle-income countries: a systematic review and key informant perspectives on implementation barriers and facilitators. Global Health 2024; 20:9. [PMID: 38233942 PMCID: PMC10795424 DOI: 10.1186/s12992-024-01014-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND There has been an increase in the use of co-creation for public health because of its claimed potential to increase an intervention's impact, spark change and co-create knowledge. Still, little is reported on its use in low-and-middle-income countries (LMICs). This study offers a comprehensive overview of co-creation used in public-health-related interventions, including the interventions' characteristics, and reported implementation barriers and facilitators. METHODS We conducted a systematic review within the Scopus and PubMed databases, a Google Scholar search, and a manual search in two grey literature databases related to participatory research. We further conducted eight interviews with first authors, randomly selected from included studies, to validate and enrich the systematic review findings. RESULTS Through our review, we identified a total of twenty-two studies conducted in twenty-four LMIC countries. Majority of the interventions were designed directly within the LMIC setting. Aside from one, all studies were published between 2019 and 2023. Most studies adopted a co-creation approach, while some reported on the use of co-production, co-design, and co-development, combined either with community-based participatory research, participatory action research or citizen science. Among the most reported implementation barriers, we found the challenge of understanding and accounting for systemic conditions, such as the individual's socioeconomic status and concerns related to funding constraints and length of the process. Several studies described the importance of creating a safe space, relying on local resources, and involving existing stakeholders in the process from the development stage throughout, including future and potential implementors. High relevance was also given to the performance of a contextual and/or needs assessment and careful tailoring of strategies and methods. CONCLUSION This study provides a systematic overview of previously conducted studies and of reported implementation barriers and facilitators. It identifies implementation barriers such as the setting's systemic conditions, the socioeconomic status and funding constrains along with facilitators such as the involvement of local stakeholders and future implementors throughout, the tailoring of the process to the population of interest and participants and contextual assessment. By incorporating review and interview findings, the study aims to provide practical insights and recommendations for guiding future research and policy.
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Affiliation(s)
| | | | - Ebuka Miracle Anieto
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- School of Health and Sports Sciences, University of Suffolk, Ipswich, UK
| | | | - Jorge Raul Zapata-Restrepo
- Faculty of Psychology, Education and Sport Sciences, Universitat Ramon Llul, Blanquerna, Barcelona, Spain
| | - Caroline Masquillier
- Family Medicine and Population Health'- FAMPOP, Faculty of Medical and Health Sciences & 'Centre for Family, Population and Health, Faculty of Social sciences, University of Antwerp, Belgium, Belgium
| | - Maria Giné-Garriga
- Faculty of Psychology, Education and Sport Sciences, Universitat Ramon Llul, Blanquerna, Barcelona, Spain
- Faculty of Health Sciences, Universitat Ramon Llull, Blanquerna, Barcelona, Spain
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Rutten JJS, Smalbrugge M, van Buul LW, van Eijk J, Geerlings SE, Natsch S, Sloane PD, van der Wouden JC, Hertogh CMPM, Gerritsen DL. A Process Evaluation of an Antibiotic Stewardship Intervention for Urinary Tract Infections in Nursing Homes. J Am Med Dir Assoc 2024; 25:146-154.e9. [PMID: 38173264 DOI: 10.1016/j.jamda.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES To assess the internal and external validity of a cluster randomized controlled trial (cRCT) evaluating a decision tool with supportive interventions for the empirical treatment of urinary tract infections (UTIs) in nursing homes (NHs), and to identify facilitators and barriers in implementing this antibiotic stewardship intervention. DESIGN Mixed-methods process evaluation study. SETTING AND PARTICIPANTS Physicians, nursing staff, client council members, and residents of Dutch NHs. METHODS We used cRCT data of the ANNA study (Antibiotic Prescribing and Non-prescribing in Nursing Home Residents With Signs and Symptoms Ascribed to Urinary Tract Infection). In addition, we sent out an online evaluation questionnaire, conducted semistructured interviews with physicians and nursing staff, and consulted client council members. RESULTS Internal validity was lowered: control group physicians participated in several non-study-related activities regarding UTI. External validity was good: almost all intervention components had a high fidelity (52%-74%) and were perceived as relevant (physicians: 7.2-8.6 of 10, nursing staff: 6.5-8.5 of 10) and feasible (physicians: 7.5 of 10, nursing staff 6.4 of 10), with feasibility for residents with dementia and urine incontinence needing attention. The most common reason for deviating from the advice generated by the decision tool was an unclear illness presentation. Identified facilitators to implementation were confidence in the intervention, repeated intervention encounter, and having "champions" in the NH. Barriers were limited involvement of nursing staff, unstable nursing teams, residents' and representatives' belief that antibiotics should be prescribed, and a low antibiotic prescribing threshold within the NH culture. CONCLUSIONS AND IMPLICATIONS Lowered internal validity may have reduced the study effect. Attention should be paid to the feasibility of the intervention in residents with dementia and urinary incontinence. Improvement opportunities for implementation were higher nursing staff involvement and repeated intervention offering.
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Affiliation(s)
- Jeanine J S Rutten
- Department of Medicine for Older People, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Martin Smalbrugge
- Department of Medicine for Older People, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Laura W van Buul
- Department of Medicine for Older People, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Jorna van Eijk
- Department of Medicine for Older People, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Suzanne E Geerlings
- Division of Infectious Diseases, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Stephanie Natsch
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Philip D Sloane
- Department of Family Medicine, School of Medicine, and the Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA
| | - Johannes C van der Wouden
- Department of General Practice, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Cees M P M Hertogh
- Department of Medicine for Older People, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community care, Radboudumc Alzheimer Center, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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Agudelo-Hernández F, Rojas-Andrade R. Design and validation of a scale of core components of community interventions in mental health. Int J Health Plann Manage 2024; 39:36-47. [PMID: 37796724 DOI: 10.1002/hpm.3711] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/22/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023] Open
Abstract
AIMS To develop and validate an instrument to identify the core components of community strategies for mental health, especially mutual aid groups: The Mutual Aid Scale . METHODS 135 community strategies leaders participated in the study. The core components are active agency, coping strategies, recognition, and management of emotions, problem-solving strategies, supportive interaction, trust, self-identity construction, and strengthening of social networks. With these components a scale was designed. Content validity was carried out in addition to an exploratory factor analysis. RESULTS Two dimensions resulted, strengthening of agency capacity and Coping strategies, and the internal consistency of both factors was acceptable, with a Cronbach's alpha of 0.722 and 0.727, respectively. The Kaiser-Meyer-Olkin (KMO) statistic was used with a score of 0.831 and the Barlett Sphericity Test, with a significant value of 265.175. CONCLUSION This scale identifies the components of community interventions for mental health and can contribute to a better implementation of these strategies. It also articulates autonomous community processes with strategies developed in health services.
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Dieudonné J, Jantzen L, Sanwald M, Trompke M, Pieper D, Stegbauer C, Willms G, Buchberger B, Brian Büchter R, Bühn S, Fischer F, Klein K, Kuhn J, Messer M, Wegewitz U, Niederberger M. [What is a public health intervention? Results of a Delphi process in German-speaking countries]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023; 182-183:89-97. [PMID: 37625924 DOI: 10.1016/j.zefq.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/16/2023] [Accepted: 05/27/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Internationally, a variety of definitions for public health interventions (PHI) exist. In the German-speaking countries, however, a definition is still outstanding. Therefore, the aim of this study was to derive consensus criteria for the definition of PHI from the expert perspective of science and practice. METHODS A Delphi survey with two online rounds was conducted from December 2022 to February 2023. Six criteria were formulated by a working group and posed for consensus: 1) the intention of the intervention, 2) potential conflicts of interest of the initiators of the intervention, 3) primary vs. secondary/tertiary prevention, 4) costs, 5) targeting, and 6) the reach of the intervention. In both Delphi rounds, experts from academia and practice were recruited through relevant networks and associations throughout the German-speaking world. The judgments were asked about standardized rating scales with the possibility of open justification. RESULTS In the first Delphi round, n = 52 and in the second round n = 43 experts from research, care and administration/management in health care participated. Consensus was reached on four of the six criteria after the second Delphi round: the intention of the intervention, possible conflicts of interest of the initiators of the intervention, primary vs. secondary/tertiary prevention, and the scope of the intervention. From the perspective of the experts interviewed, these are the criteria that distinguish PHI. DISCUSSION AND CONCLUSION Based on the consensus criteria, PHI can be defined more concretely. Thus, the results contribute to a better inter- and transdisciplinary understanding. Ideally, the criteria will make it easier to assign interventions to the public health sector in the future, even if a precise examination will be necessary in individual cases, among other things because the experts disagreed on the criteria of costs and how to address the target group.
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Affiliation(s)
- Jessica Dieudonné
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Lisa Jantzen
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Michelle Sanwald
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Michaela Trompke
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Dawid Pieper
- IVGF - Institut für Versorgungs- und Gesundheitssystemforschung, Fakultät für Gesundheitswissenschaften, Medizinische Hochschule Brandenburg; Zentrum für Versorgungsforschung Brandenburg, Medizinische Hochschule Brandenburg, Neuruppin, Deutschland
| | - Constance Stegbauer
- aQua - Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Deutschland
| | - Gerald Willms
- aQua - Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Deutschland
| | | | - Roland Brian Büchter
- Institut für Forschung in der Operativen Medizin (IFOM), Fakultät für Gesundheit, Department für Humanmedizin, Universität Witten/Herdecke, Witten, Deutschland
| | - Stefanie Bühn
- Deutsche Allianz Klimawandel und Gesundheit e.V. (KLUG), Berlin, Deutschland
| | - Florian Fischer
- Bayerisches Zentrum Pflege Digital, Hochschule für angewandte Wissenschaften Kempten, Kempten, Deutschland
| | - Katharina Klein
- Charité-Universitätsmedizin Berlin, Geschlechterforschung in der Medizin; Deutsche Krebsgesellschaft e.V., Berlin, Deutschland
| | - Joseph Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Deutschland
| | - Melanie Messer
- Abteilung Pflegewissenschaft II, Universität Trier, Trier, Deutschland
| | - Uta Wegewitz
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Aalen, Deutschland
| | - Marlen Niederberger
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland.
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Fisher H, Audrey S, Chantler T, Dominey M, Evans K, Henden L, Hickman M, Letley L, Towson A, Thomas C. Towards successful implementation of public health research into practice: Experiences and lessons learned from EDUCATE. PUBLIC HEALTH IN PRACTICE 2023; 6:100447. [PMID: 38028256 PMCID: PMC10643450 DOI: 10.1016/j.puhip.2023.100447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background The English schools-based human papillomavirus (HPV) vaccination programme is routinely offered to all young people aged 12-13 years. The EDUCATE lesson was developed to overcome barriers to uptake related to unmet information needs by providing young people with information and answering questions they may have about the HPV vaccine. The resource comprises a PowerPoint presentation, interspersed with five short films and a guidance document for professionals delivering the lesson. Adopting public health research into practice is challenging and few papers describe the process. This paper reports the initial use of the EDUCATE resource in schools and the process involved in supporting wider implementation. Study design Implementation and knowledge mobilisation. Methods Five secondary schools supported implementation of the EDUCATE resource. Delivery took place during April and December 2022 and was observed in four schools, with feedback obtained from two school staff members and 15 young people. Alongside this, meetings were held with over 80 stakeholders with the aim of identifying possible policy levers to encourage use of the EDUCATE resource, and to enhance understanding of how wider scale and sustained impact can be achieved. Results Overall, the resource was positively received by school staff and young people engaged well during the lesson. As a result of the stakeholder networking activities, the research team worked with the Personal, Social, Health and Economic (PSHE) Association to adapt the materials to meet their Quality Assessment and incorporate elements, such as more interactive activities, requested during the implementation study. Conclusion The EDUCATE resource has the potential to change practice by enhancing information provision about the HPV vaccine in schools and supporting young people nationally to make informed decisions. Key learnings from the project include the importance of integrating input from target users at all stages of the research process, pragmatism in relation to evaluation research designs, and incentivising researchers to undertake translation activities through further funding and a greater focus on impact. Together, these can help facilitate the availability of public health resources and their adoption into 'real-world' practice.
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Affiliation(s)
- Harriet Fisher
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK
| | - Suzanne Audrey
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK
| | - Tracey Chantler
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Vaccinations and Immunisation, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | | | - Karen Evans
- School-aged Immunisation Team, Sirona Care & Health, Bristol, UK
| | - Lizzie Henden
- Communities and Public Health Team, Bristol City Council, Bristol, UK
| | - Matthew Hickman
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK
| | - Louise Letley
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK
| | - Alix Towson
- School-aged Immunisation Team, Sirona Care & Health, Bristol, UK
| | - Clare Thomas
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation (BSE), Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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10
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DiCasmirro J, Tranmer J, Davison C, Woo K, Ross-White A, Hubeny M, Goldie C. Public health interventions to prevent adolescent vaping: a scoping review protocol. JBI Evid Synth 2023; 21:2272-2278. [PMID: 37529974 DOI: 10.11124/jbies-23-00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
OBJECTIVE The objective of the review is to systematically examine the emerging literature related to public health interventions aimed at preventing adolescent vaping. INTRODUCTION The prevalence of vaping among adolescents is a rising concern worldwide. A thorough investigation of existing public health interventions to prevent vaping among adolescents is imperative to reduce serious and avoidable vaping-related health risks for this cohort. Many vaping-prevention interventions have been described in the literature, but their key components and outcomes have not been summarized. INCLUSION CRITERIA All English literature related to public health interventions preventing adolescent (aged 10 to 18 years) vaping from all countries will be included. METHODS This review will follow the JBI methodology for scoping reviews. A comprehensive search of academic and gray literature using MEDLINE (Ovid), CINAHL (EBSCOhost), Embase (Ovid), PubMed, PsycINFO (Ovid), ProQuest (Health and Medicine and Sociology Collections), and Web of Science Core Collection will be performed. Articles will be screened for inclusion by 2 independent reviewers. Results will be extracted using customized tools and summarized in a final report using narrative synthesis and presented in table format.
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Affiliation(s)
- Jamie DiCasmirro
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- School of Nursing, Faculty of Health and Behavioural Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Joan Tranmer
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- ICES, Queen's University, Kingston, ON, Canada
| | - Colleen Davison
- Department of Public Health Science, School of Medicine, Queen's University, Kingston, ON, Canada
- Department of Global Development Studies, School of Medicine, Queen's University, Kingston, ON, Canada
| | - Kevin Woo
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Amanda Ross-White
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- Bracken Heath Sciences Library, Queen's University, Kingston, ON, Canada
| | - Michael Hubeny
- School of Nursing, Faculty of Health and Behavioural Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Catherine Goldie
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- ICES, Queen's University, Kingston, ON, Canada
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11
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Sawras V, Deuffic-Burban S, Préau M, Spire B, Yazdanpanah Y, Champenois K. Assessing complex interventions: a systematic review of outcomes used in randomised controlled trials on STI partner notification in high-income countries. BMC Public Health 2023; 23:1838. [PMID: 37735382 PMCID: PMC10512513 DOI: 10.1186/s12889-023-16763-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Partner notification interventions are complex and assessing their effectiveness is challenging. By reviewing the literature on the effectiveness of partner notification interventions, our aim was to evaluate the choice, collection, and interpretation of outcomes and their impact on study findings. METHODS We conducted a systematic review of individual-level randomised controlled trials evaluating the effectiveness of partner notification interventions for bacterial STIs, HIV or sexually transmitted HCV in high-income countries since 2000. Partner notification interventions included assisted patient referral interventions and expedited treatment. The content analysis was carried out through a narrative review. RESULTS In the 9 studies that met the inclusion criteria, 16 different outcomes were found. In most studies, one or two outcomes assessing partner notification practices were associated with an outcome reflecting STI circulation through index case reinfections. These outcomes assessed the main expected effects of partner notification interventions. However, partner notification is composed of a succession of actions between the intervention on the index case and the testing and/or treatment of the notified partners. Intermediate outcomes were missing so as to better understand levers and barriers throughout the process. Potential changes in participants' sexual behaviour after partner notification, e.g. condom use, were outcomes reported in only two studies assessing interventions including counselling. Most outcomes were collected through interviews, some weeks after the intervention, which might lead to desirability and attrition biases, respectively. Assessment of the effectiveness of partner notification interventions on partner testing/treatment was limited by the collection of data from index cases. Few data describing index cases and their partners were provided in the studies. Additional data on the number and type of exposed partners and the proportion of partners already aware of their infection before being notified would help to interpret the results. CONCLUSIONS These insights would help to understand why and under what conditions the intervention is considered effective and therefore can be replicated or adapted to other populations and contexts.
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Affiliation(s)
- Victoire Sawras
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, F-75018, France
| | - Sylvie Deuffic-Burban
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, F-75018, France
| | - Marie Préau
- Institut de Psychologie, Université Lumière Lyon 2, Inserm, U1296, Lyon, France
| | - Bruno Spire
- Aix Marseille Univ, Inserm, IRD, SESSTIM, ISSPAM, Marseille, France
| | - Yazdan Yazdanpanah
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, F-75018, France
- Service de maladies infectieuses et tropicales, Hôpital Bichat Claude Bernard, Paris, F-75018, France
| | - Karen Champenois
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, IAME, Paris, F-75018, France.
- Inserm IAME - Faculté de Médecine Bichat, 16 rue Henri Huchard, Paris, 75018, France.
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12
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Araujo-Chaveron L, Sicsic J, Moffroid H, Díaz Luévano C, Blondel S, Langot F, Mueller JE. Impact of a COVID-19 certificate requirement on vaccine uptake pattern and intention for future vaccination. A cross-sectional study among French adults. Vaccine 2023; 41:5412-5423. [PMID: 37481404 DOI: 10.1016/j.vaccine.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/22/2023] [Accepted: 07/02/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND In August 2021, France enacted a COVID-19 certificate requirement (vaccination/recovery/test) to access specific services, with mandates for professional groups. We evaluated the impact of this incentive-coercive policy in terms of vaccine uptake equality, future vaccine intention and confidence in authorities' crisis management. METHODS In late August 2021, a representative sample of adults (18-75 years) completed an internet-based questionnaire. We classified vaccinated participants by stated reasons for vaccination and estimated adjusted prevalence ratios (aPR) using multivariable Poisson regression. Counterfactual vaccine status assumed non-vaccination of those vaccinated for the certificate. We analysed the association of free-text testimonial themes with level of confidence in authorities. RESULTS Among 972 participants, 85.7% were vaccinated or intended vaccination: 3.6% only for certificate/mandate, 17.7% mainly for certificate/mandate plus other reasons, and 64.4% mainly for other reasons. In the counterfactual situation, vaccine uptake would have been significantly more likely among older vs. younger participants (aPR = 1.35) and among those with moderate-high vs. low levels of confidence in authorities for COVID-19 crisis management (aPR = 2.04). In the observed situation, confidence was the only significant determinant of vaccine status (moderate-high vs. low, aPR = 1.39). Among those without genuine motivation for vaccination, professionally active persons were more likely to have ceded to the certificate requirement (aPR = 3.76). Those vaccinated only for the certificate were more likely to express future COVID-19 vaccine intention than unvaccinated persons (aPR = 6.41). Themes significantly associated with lower confidence were criticism of morality (aPR = 1.76) and poor communication by the authorities (aPR = 1.66). CONCLUSION The incentive-coercive policy has reduced the negative association of vaccine status with younger age and low confidence in authorities, but may have reinforced isolation of professionally inactive persons. The requirement did not negatively impact future COVID-19 vaccine intention. Future vaccine-incentive policies should pay special attention to populations with low levels of confidence in authorities.
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Affiliation(s)
- Lucia Araujo-Chaveron
- EHESP French School of Public Health, Rennes, France; Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France
| | | | - Hadrien Moffroid
- Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France; University of Melbourne, Australia
| | | | - Serge Blondel
- Université Paris Cité, LIRAES, F-75006 Paris, France; GRANEM - Groupe de Recherche Angevin en Economie et Management, Paris, France
| | - François Langot
- Le Mans Université (Gains-TEPP, IRA), Le Mans, France; IUF - Institut Universitaire de France, Paris, France; PSE - Paris School of Economics, Paris, France; CEPREMAP - Centre pour la recherche économique et ses applications, Paris, France; IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics, Bonn, Germany
| | - Judith E Mueller
- EHESP French School of Public Health, Rennes, France; Institut Pasteur, Université Paris Cité, Emerging Disease Epidemiology Unit, F-75015 Paris, France; Univ. Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, F-35000 Rennes, France.
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13
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Ram B, van Sluijs E, Chalkley A, Hargreaves D, Saxena S. Real-world application of a scalable school-based physical activity intervention: A cross-sectional survey of the implementation of The Daily Mile in Greater London primary schools. PLoS One 2023; 18:e0288500. [PMID: 37556408 PMCID: PMC10411754 DOI: 10.1371/journal.pone.0288500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/27/2023] [Indexed: 08/11/2023] Open
Abstract
School-based physical activity interventions are considered ideal given their potential to reach most children. They can help children achieve the recommended guidelines of 60 minutes of moderate-to-vigorous physical activity per day. The Daily Mile is a popular school-based active mile intervention with a global reach. It recommends ten core principles for successful implementation, three of which are key for effectiveness: that it is quick (15 minutes), the whole school participates, and that it takes place in the school day during lessons (excluding physical education lessons and scheduled breaks). Studies assessing the impacts of The Daily Mile do not often report implementation of the ten core principles which is crucial to identifying the potential impact and feasibility of scalable interventions in real-world settings. Our aim was to assess adherence to The Daily Mile's ten core principles in Greater London primary schools. We created and distributed a survey to 1717 primary schools during September 2020 and achieved a 21% (n = 369/1717) response rate by September 2021. Our sample was representative of Greater London primary schools with responses from every London borough. A total of 196/369 (53%) schools reported implementing The Daily Mile but none of them reported adherence to all ten core principles. Adherence to at least 6/10 principles in various combinations was reported by 54/196 (28%) schools. Only 19/196 (10%) schools that reported implementing The Daily Mile reported adherence to the three key principles recommended for effectiveness. Despite its popularity and global reach, our findings suggest that an implementation gap exists when The Daily Mile is adopted in real-world settings which is likely to challenge its intended purpose. Further research in school settings is needed to understand factors that can improve adherence to increase the potential public health impact of The Daily Mile and other similar interventions.
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Affiliation(s)
- Bina Ram
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Esther van Sluijs
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Anna Chalkley
- Centre for Physically Active Learning, Western Norway University of Applied Sciences, Bergen, Norway
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Dougal Hargreaves
- Mohn Centre for Children’s Health and Wellbeing, Imperial College London, United Kingdom
| | - Sonia Saxena
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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McCrabb S, Hall A, McKay H, Gonzalez S, Milat A, Bauman A, Sutherland R, Wolfenden L. From trials to communities: implementation and scale-up of health behaviour interventions. Health Res Policy Syst 2023; 21:79. [PMID: 37525165 PMCID: PMC10388470 DOI: 10.1186/s12961-023-01027-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 07/02/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND To maximise their potential benefits to communities, effective health behaviour interventions need to be implemented, ideally 'at scale', and are often adapted as part of this. To inform future implementation and scale-up efforts, this study broadly sought to understand (i) how often health behaviour interventions are implemented in communities, (ii) the adaptations that occur; (iii) how frequency it occurred 'at scale'; and (iv) factors associated with 'scale-up'. METHODS A cross-sectional survey was conducted of corresponding authors of trials (randomised or non-randomised) assessing the effects of preventive health behaviour interventions. Included studies of relevant Cochrane reviews served as a sampling frame. Participants were asked to report on the implementation and scale-up (defined as investment in large scale delivery by a (non)government organisation) of their intervention in the community following trial completion, adaptations made, and any research dissemination strategies employed. Information was extracted from published reports of the trial including assessments of effectiveness and risk of bias. RESULTS Authors of 104 trials completed the survey. Almost half of the interventions were implemented following trial completion (taking on average 19 months), and 54% of those were adapted prior to doing so. The most common adaptations were adding intervention components, and adapting the intervention to fit within the local service setting. Scale-up occurred in 33% of all interventions. There were no significant associations between research trial characteristics such as intervention effectiveness, risk of bias, setting, involvement of end-user, and incidence of scale-up. However the number of research dissemination strategies was positively associated to the odds of an intervention being scaled-up (OR = 1.50; 95% CI: 1.19, 1.88; p < 0.001). CONCLUSIONS Adaptation of implemented trials is often undertaken. Most health behaviour interventions are not implemented or scaled-up following trial completion. The use of a greater number of dissemination strategies may increase the likelihood of scaled up.
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Affiliation(s)
- Sam McCrabb
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia.
| | - Alix Hall
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia
| | - Heather McKay
- Department of Family Practice, Faculty of Medicine, University of British Colombia, Vancouver, Canada
| | - Sharleen Gonzalez
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Andrew Milat
- School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
- NSW Ministry of Health, St Leonards, NSW, Australia
| | - Adrian Bauman
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Rachel Sutherland
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, Wallsend, NSW, 2287, Australia
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15
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Dam JL, Nagorka-Smith P, Waddell A, Wright A, Bos JJ, Bragge P. Research evidence use in local government-led public health interventions: a systematic review. Health Res Policy Syst 2023; 21:67. [PMID: 37400905 DOI: 10.1186/s12961-023-01009-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/13/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Local governments play an important role in improving public health outcomes globally, critical to this work is applying the best-available research evidence. Despite considerable exploration of research use in knowledge translation literature, how research is practically applied by local governments remains poorly understood. This systematic review examined research evidence use in local government-led public health interventions. It focused on how research was used and the type of intervention being actioned. METHODS Quantitative and qualitative literature published between 2000 and 2020 was searched for studies that described research evidence use by local governments in public health interventions. Studies reporting interventions developed outside of local government, including knowledge translation interventions, were excluded. Studies were categorised by intervention type and their level of description of research evidence use (where 'level 1' was the highest and 'level 3' was the lowest level of detail). FINDINGS The search identified 5922 articles for screening. A final 34 studies across ten countries were included. Experiences of research use varied across different types of interventions. However, common themes emerged including the demand for localised research evidence, the legitimising role of research in framing public health issues, and the need for integration of different evidence sources. CONCLUSIONS Differences in how research was used were observed across different local government public health interventions. Knowledge translation interventions aiming to increase research use in local government settings should consider known barriers and facilitators and consider contextual factors associated with different localities and interventions.
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Affiliation(s)
- Jennifer L Dam
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia.
| | - Phoebe Nagorka-Smith
- School of Health and Social Development, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Alex Waddell
- Action Lab, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Annemarie Wright
- Victorian Department of Health and Human Services, 50 Lonsdale Street, Melbourne, VIC, 3000, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, VIC, 3053, Carlton, Australia
| | - Joannette J Bos
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
| | - Peter Bragge
- Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton Campus, Clayton, VIC, 3800, Australia
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16
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Ross I, Bick S, Ayieko P, Dreibelbis R, Wolf J, Freeman MC, Allen E, Brauer M, Cumming O. Effectiveness of handwashing with soap for preventing acute respiratory infections in low-income and middle-income countries: a systematic review and meta-analysis. Lancet 2023; 401:1681-1690. [PMID: 37121242 DOI: 10.1016/s0140-6736(23)00021-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/07/2022] [Accepted: 01/03/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Acute respiratory infection (ARI) is a leading cause of morbidity and mortality globally, with 83% of ARI mortality occurring in low-income and middle-income countries (LMICs) before the COVID-19 pandemic. We aimed to estimate the effect of interventions promoting handwashing with soap on ARI in LMICs. METHODS In our systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, Global Health, and Global Index Medicus for studies of handwashing with soap interventions in LMICs from inception to May 25, 2021. We included randomised and non-randomised controlled studies of interventions conducted in domestic, school, or childcare settings. Interventions promoting hand hygiene methods other than handwashing with soap were excluded, as were interventions in health-care facilities or the workplace. The primary outcome was ARI morbidity arising from any pathogen for participants of any age. Secondary outcomes were lower respiratory infection, upper respiratory infection, influenza confirmed by diagnostic test, COVID-19 confirmed by diagnostic test, and all-cause mortality. We extracted relative risks (RRs), using random-effects meta-analysis to analyse study results, and metaregression to evaluate heterogeneity. We assessed risk of bias in individual studies using an adapted Newcastle-Ottawa scale, and assessed the overall body of evidence using a Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The study is registered with PROSPERO, CRD42021231414. FINDINGS 26 studies with 161 659 participants met inclusion criteria, providing 27 comparisons (21 randomised). Interventions promoting handwashing with soap reduced any ARI compared with no handwashing intervention (RR 0·83 [95% CI 0·76-0·90], I2 88%; 27 comparisons). Interventions also reduced lower respiratory infections (0·78 [0·64-0·94], I2 64%; 12 comparisons) and upper respiratory infections (0·74 [0·59-0·93], I2 91%; seven comparisons), but not test-confirmed influenza (0·94 [0·42-2·11], I2 90%; three comparisons), test-confirmed COVID-19 (no comparisons), or all-cause mortality (prevalence ratio 0·95 [95% CI 0·71-1·27]; one comparison). For ARI, no heterogeneity covariates were significant at p<0·1 and the GRADE rating was moderate certainty evidence. INTERPRETATION Interventions promoting handwashing with soap can reduce ARI in LMICs, and could help to prevent the large burden of respiratory disease. FUNDING Bill & Melinda Gates Foundation, Reckitt Global Hygiene Institute, and UK FCDO.
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Affiliation(s)
- Ian Ross
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Sarah Bick
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Philip Ayieko
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Robert Dreibelbis
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jennyfer Wolf
- Department of Environmental, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Matthew C Freeman
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Elizabeth Allen
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael Brauer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Oliver Cumming
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Kokole D, Jané-Llopis E, Mercken L, Natera Rey G, Arroyo M, Pérez Gómez A, Mejía-Trujillo J, Piazza M, Bustamante I, O'Donnell A, Kaner E, Schulte B, de Vries H, Anderson P. Protocol for a process evaluation of SCALA study - Intervention targeting scaling up of primary health care-based prevention and management of heavy drinking and comorbid depression in Latin America. EVALUATION AND PROGRAM PLANNING 2023; 97:102217. [PMID: 36603348 DOI: 10.1016/j.evalprogplan.2022.102217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/18/2020] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
This paper describes the plan for a process evaluation of a quasi-experimental study testing the municipal level scale-up of primary health care-based measurement and brief advice programmes to reduce heavy drinking and comorbid depression in Colombia, Mexico, and Peru. The main aims of the evaluation are to assess the implementation of intervention components; mechanisms of impact that influenced the outcomes; and characteristics of the context that influenced implementation and outcomes. Based on this information, common drivers of successful outcomes will be identified. A range of data collection methods will be used: questionnaires; interviews; observations; logbooks; and document analysis. All participating providers will complete a pen-and-paper questionnaire at recruitment and two time points during the implementation period. Providers attending training will complete post-training questionnaires. Additionally, 1080 patients will be invited to self-complete a patient questionnaire. One-in-ten participating providers and fifteen other key stakeholders will participate in semi-structured interviews. Training sessions and community advisory board meetings will be observed by a neutral observer. Logbooks will be kept by local research teams to document events affecting the implementation. Project related documentation and other relevant reports describing the context will be examined.
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Affiliation(s)
- Daša Kokole
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD Maastricht, the Netherlands.
| | - Eva Jané-Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD Maastricht, the Netherlands; Univ. Ramon Llull, ESADE, Avenida de Pedralbes, 60, 62, 08034 Barcelona, Spain; Institute for Mental Health Policy Research, CAMH, 33 Russell Street, Toronto, ON M5S 2S1, Canada.
| | - Liesbeth Mercken
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD Maastricht, the Netherlands; Department of Health Psychology, Open University, Valkenburgerweg 1776419 AT Heerlen, the Netherlands.
| | - Guillermina Natera Rey
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz México-Xochimilco 101, Huipulco, 14370 Ciudad de México, CDMX, Mexico.
| | - Miriam Arroyo
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz México-Xochimilco 101, Huipulco, 14370 Ciudad de México, CDMX, Mexico.
| | | | | | - Marina Piazza
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Ave. Honorio Delgado 430, Urb. Ingeniería, S.M.P. Lima - Perú.
| | - Ines Bustamante
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Ave. Honorio Delgado 430, Urb. Ingeniería, S.M.P. Lima - Perú.
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
| | - Bernd Schulte
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD Maastricht, the Netherlands.
| | - Peter Anderson
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD Maastricht, the Netherlands; Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
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18
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Montano D, Kuchenbaur M, Peter R. Outcomes and process evaluation of a cluster-randomised participatory organisational intervention among German healthcare workers. BMC Health Serv Res 2023; 23:260. [PMID: 36927537 PMCID: PMC10018607 DOI: 10.1186/s12913-023-09240-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND In the present investigation the results of the outcome and process evaluation of a participatory workplace intervention are reported. The intervention aimed to increase the workers' self-assessed physical and mental work ability. METHODS The intervention was a two-arm, cluster-randomised trial with healthcare workers in 10 hospitals and one elderly care centre in Germany. Outcome data on workers were collected in questionnaires at baseline, and two follow-ups between 2019 and 2021. The intervention consisted of interviews and workshops, in which employees proposed measures for reducing the physical and psychosocial load and strengthening resources at work. Outcome data were analysed with linear-mixed regression models. The process evaluation was based on the thematic criteria proposed in previous literature and the collection of the type of intervention measures and their implementation status. RESULTS The regression analysis did not provide evidence of treatment differences or reductions of psychosocial load in the intervention wards. The process evaluation suggested that the measures did not address specifically the self-assessed work ability. In addition, there was no indication that the intervention measures were causally related to the intended goals. CONCLUSIONS The planning and implementation of organisational interventions require a careful consideration of the definition of intervention goals, the theoretical rationale of the intervention and a project-oriented action plan during the delivery phase.
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Affiliation(s)
- Diego Montano
- grid.10392.390000 0001 2190 1447Department of Population-Based Medicine, University of Tübingen, Hoppe-Seyler-Str. 9, Tübingen, 72076 Germany
- grid.6582.90000 0004 1936 9748Department of Medical Sociology, Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Parktstr. 11, Ulm, 89073 Germany
| | - Marco Kuchenbaur
- grid.6582.90000 0004 1936 9748Department of Medical Sociology, Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Parktstr. 11, Ulm, 89073 Germany
| | - Richard Peter
- grid.6582.90000 0004 1936 9748Department of Medical Sociology, Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Parktstr. 11, Ulm, 89073 Germany
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Effects of Return-to-Office, Public Schools Reopening, and Vaccination Mandates on COVID-19 Cases Among Municipal Employee Residents of New York City. J Occup Environ Med 2023; 65:193-202. [PMID: 36576876 PMCID: PMC9987646 DOI: 10.1097/jom.0000000000002776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE On September 13, 2021, teleworking ended for New York City municipal employees, and Department of Education employees returned to reopened schools. On October 29, COVID-19 vaccination was mandated. We assessed these mandates' short-term effects on disease transmission. METHODS Using difference-in-difference analyses, we calculated COVID-19 incidence rate ratios (IRRs) among residents 18 to 64 years old by employment status before and after policy implementation. RESULTS IRRs after (September 23-October 28) versus before (July 5-September 12) the return-to-office mandate were similar between office-based City employees and non-City employees. Among Department of Education employees, the IRR after schools reopened was elevated by 28.4% (95% confidence interval, 17.3%-40.3%). Among City employees, the IRR after (October 29-November 30) versus before (September 23-October 28) the vaccination mandate was lowered by 20.1% (95% confidence interval, 13.7%-26.0%). CONCLUSIONS Workforce mandates influenced disease transmission, among other societal effects.
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Kim LG, Bolton T, Sweeting MJ, Bell S, Fahle S, McMahon A, Walker M, Ferguson E, Miflin G, Roberts DJ, Di Angelantonio E, Wood AM. Impact of a post-donation hemoglobin testing strategy on efficiency and safety of whole blood donation in England: A modeling study. Transfusion 2023; 63:541-551. [PMID: 36794597 PMCID: PMC10952564 DOI: 10.1111/trf.17277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 02/17/2023]
Abstract
BACKGROUND Deferrals due to low hemoglobin are time-consuming and costly for blood donors and donation services. Furthermore, accepting donations from those with low hemoglobin could represent a significant safety issue. One approach to reduce them is to use hemoglobin concentration alongside donor characteristics to inform personalized inter-donation intervals. STUDY DESIGN AND METHODS We used data from 17,308 donors to inform a discrete event simulation model comparing personalized inter-donation intervals using "post-donation" testing (i.e., estimating current hemoglobin from that measured by a hematology analyzer at last donation) versus the current approach in England (i.e., pre-donation testing with fixed intervals of 12-weeks for men and 16-weeks for women). We reported the impact on total donations, low hemoglobin deferrals, inappropriate bleeds, and blood service costs. Personalized inter-donation intervals were defined using mixed-effects modeling to estimate hemoglobin trajectories and probability of crossing hemoglobin donation thresholds. RESULTS The model had generally good internal validation, with predicted events similar to those observed. Over 1 year, a personalized strategy requiring ≥90% probability of being over the hemoglobin threshold, minimized adverse events (low hemoglobin deferrals and inappropriate bleeds) in both sexes and costs in women. Donations per adverse event improved from 3.4 (95% uncertainty interval 2.8, 3.7) under the current strategy to 14.8 (11.6, 19.2) in women, and from 7.1 (6.1, 8.5) to 26.9 (20.8, 42.6) in men. In comparison, a strategy incorporating early returns for those with high certainty of being over the threshold maximized total donations in both men and women, but was less favorable in terms of adverse events, with 8.4 donations per adverse event in women (7.0, 10,1) and 14.8 (12.1, 21.0) in men. DISCUSSION Personalized inter-donation intervals using post-donation testing combined with modeling of hemoglobin trajectories can help reduce deferrals, inappropriate bleeds, and costs.
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Affiliation(s)
- Lois G. Kim
- Blood and Transplant Research Unit in Donor Health and BehaviourCambridgeUK
- Dept of Public Health & Primary CareUniversity of CambridgeCambridgeUK
| | - Thomas Bolton
- Dept of Public Health & Primary CareUniversity of CambridgeCambridgeUK
- BHF Data Science CentreHealth Data ResearchUK
| | | | - Steven Bell
- Dept of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
| | - Sarah Fahle
- Blood and Transplant Research Unit in Donor Health and BehaviourCambridgeUK
- Dept of Public Health & Primary CareUniversity of CambridgeCambridgeUK
| | - Amy McMahon
- Blood and Transplant Research Unit in Donor Health and BehaviourCambridgeUK
- Dept of Public Health & Primary CareUniversity of CambridgeCambridgeUK
| | - Matthew Walker
- Blood and Transplant Research Unit in Donor Health and BehaviourCambridgeUK
- Dept of Public Health & Primary CareUniversity of CambridgeCambridgeUK
| | - Eamonn Ferguson
- Blood and Transplant Research Unit in Donor Health and BehaviourCambridgeUK
- School of PsychologyUniversity of NottinghamNottinghamUK
| | | | - David J. Roberts
- Blood and Transplant Research Unit in Donor Health and BehaviourCambridgeUK
- NHS Blood & TransplantJohn Radcliffe HospitalOxfordUK
- Radcliffe Dept of MedicineUniversity of OxfordOxfordUK
| | - Emanuele Di Angelantonio
- Blood and Transplant Research Unit in Donor Health and BehaviourCambridgeUK
- Dept of Public Health & Primary CareUniversity of CambridgeCambridgeUK
- British Heart Foundation Centre of Research ExcellenceUniversity of CambridgeCambridgeUK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of CambridgeCambridgeUK
- Health Data Science Research CentreHuman TechnopoleMilanItaly
| | - Angela M. Wood
- Blood and Transplant Research Unit in Donor Health and BehaviourCambridgeUK
- Dept of Public Health & Primary CareUniversity of CambridgeCambridgeUK
- British Heart Foundation Centre of Research ExcellenceUniversity of CambridgeCambridgeUK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of CambridgeCambridgeUK
- Cambridge Centre of Artificial Intelligence in MedicineCambridgeUK
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Rajalu BM, Jayarajan D, Muliyala KP, Sharma P, Gandhi S, Chand PK. Development of a Personalized Tobacco Cessation Intervention Package (PTCIP) for Persons with Schizophrenia in India. Indian J Psychol Med 2023; 45:132-138. [PMID: 36925498 PMCID: PMC10011849 DOI: 10.1177/02537176221105581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Among persons with schizophrenia (PwS), tobacco use is higher in comparison to the general population, contributing to greater morbidity and mortality. Pharmacological interventions combined with psychosocial interventions are effective in tobacco cessation. While the effectiveness of extant psychosocial interventions-when used in isolation-seems limited, developing better combinations of interventions could help treatment providers deliver tobacco cessation services to PwS at different stages of motivation to quit. We aimed to develop a personalized tobacco cessation intervention package (PTCIP) for PwS. Methods The stage-based intervention package was developed through a systematic review of interventions for tobacco cessation, the authors' clinical experience, and expert validation. The components of the intervention package, developed for PwS visiting the outpatient psychiatric department, were retained, removed, or added based on the content validity ratio (CVR). Results The final components included brief advice, principles of motivational interviewing, psychoeducation, decisional balance matrix, positive reinforcement, offering various treatment options, personalized feedback using a smoking-risk calculator, and prediction of cardiovascular risk using the WHO package of essential noncommunicable disease (PEN). The delivery of the intervention package was refined based on pilot testing in eight participants. Conclusion The tailored package was designed to be delivered by a mental health professional as a single comprehensive 40 min to 45 min face-to-face session, integrated with routine follow-up visits, followed by two telephonic conversations in the second and third week of the initial session. The package needs to be tested in a randomized controlled trial for its effectiveness.
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Affiliation(s)
- Banu Manickam Rajalu
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Deepak Jayarajan
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Krishna Prasad Muliyala
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Priyamvada Sharma
- Dept. of Clinical Pharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Sailaxmi Gandhi
- Dept. of Nursing, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Prabhat Kumar Chand
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Stevens N, Alla F. [Population Health Intervention Research, Health Technology Assessment, Health Services Research and Intervention Implementation Research : Convergences and Singularities]. Rev Epidemiol Sante Publique 2023; 71:101424. [PMID: 36780726 DOI: 10.1016/j.respe.2023.101424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 12/16/2022] [Accepted: 12/30/2022] [Indexed: 02/13/2023] Open
Abstract
In public health, intervention is an object of research and evaluation which, over time, has given rise to numerous approaches. The first part of the article proposes to reposition intervention research in population health and intervention evaluation on a continuum. Although the former has a more cognitive objective and the latter a more pragmatic objective, they are not mutually exclusive. The distinction between these two practices is based on the predominance of the following characteristics: the objectives pursued, the scope of the investigations, the regulatory constraints, the financing obtained, the ethical approaches taken, and the deliverables established. The second part of the article offers a glance different fields and approaches within the continuum between these two poles: Health Technology Assessment, Health Services Research and Implementation Research. While all of them have the study of health interventions at their core, but each has developed through specialisation in one or the other type of intervention, in a particular scope or context, in certain evaluation questions, or in specific approaches. all as gateways to the study of public health intervention, these different approaches are by no means mutually exclusive.
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Affiliation(s)
- N Stevens
- Bordeaux Population Health Research Center. UMR 1219 CIC-EC 1401, Université de Bordeaux, 33 000 Bordeaux, France.
| | - F Alla
- Bordeaux Population Health Research Center. UMR 1219 CIC-EC 1401, Université de Bordeaux, 33 000 Bordeaux, France; Prevention department, CHU, 33 000 Bordeaux, France
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23
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von Meyenfeldt EM, van Nassau F. Implementing an enhanced recovery after thoracic surgery programme: just having a protocol is not enough. J Thorac Dis 2023; 15:1-4. [PMID: 36794130 PMCID: PMC9922613 DOI: 10.21037/jtd-2022-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Erik M. von Meyenfeldt
- Department of Thoracic Surgery, Lung Cancer Centre, Albert Schweitzer Hospital, Dordrecht, The Netherlands;,Department of Public and Occupational Health and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review. PHARMACY 2023; 11:pharmacy11010024. [PMID: 36827662 PMCID: PMC9960443 DOI: 10.3390/pharmacy11010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/03/2023] Open
Abstract
Pharmacists and their teams play an important role in providing public health services, however little is known about their level of contribution and the strength of evidence in Africa's Low- and Middle-Income Countries (LMICs). The purpose of this scoping review was to explore and map the available evidence on pharmacy professional-delivered public health interventions in Africa's LMICs. Six electronic databases (Medline, Embase, International Pharmaceutical Abstract, PsycInfo, Maternity and Infant Care, and Cochrane database), relevant grey literature sources, key journals focused on African health issues, and libraries of relevant organizations were searched between January 2010 and December 2020. Studies were included if they reported public health interventions delivered by pharmacy professionals (pharmacists or pharmacy technicians) or their teams. The quality of the individual studies was assessed using an adapted grading system. Thirty-nine studies were included in this review. Pharmacy professionals delivered a wide range of public health interventions, with the most common themes being noncommunicable diseases, infectious diseases, sexual and reproductive health, antimicrobial resistance, and other health conditions, e.g., dental health, unused drugs or waste, minor ailments. The majority of the studies were classified as low-quality evidence. They were predominantly feasibility and acceptability studies conducted in a narrow study area, in a small number of LMICs in Africa, resulting in little evidence of service effectiveness, issues of broad generalizability of the findings, and sustainability. The major constraints to service provision were identified as a lack of training, public recognition, and supporting policies. Pharmacy professionals and their teams across LMICs in Africa have attempted to expand their practice in public health. However, the pace of the expansion has been slow and lacks strong evidence for its generalizability and sustainability. Future research is needed to improve the quality of evidence, which will subsequently serve as a foundation for policy reform, allowing pharmacy professionals to make significant contributions to the public health initiatives in the region.
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Jago R, Salway R, House D, Beets M, Lubans DR, Woods C, de Vocht F. Rethinking children's physical activity interventions at school: A new context-specific approach. Front Public Health 2023; 11:1149883. [PMID: 37124783 PMCID: PMC10133698 DOI: 10.3389/fpubh.2023.1149883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Physical activity is important for children's health. However, evidence suggests that many children and adults do not meet international physical activity recommendations. Current school-based interventions have had limited effect on physical activity and alternative approaches are needed. Context, which includes school setting, ethos, staff, and sociodemographic factors, is a key and largely ignored contributing factor to school-based physical activity intervention effectiveness, impacting in several interacting ways. Conceptualization Current programs focus on tightly-constructed content that ignores the context in which the program will be delivered, thereby limiting effectiveness. We propose a move away from uniform interventions that maximize internal validity toward a flexible approach that enables schools to tailor content to their specific context. Evaluation designs Evaluation of context-specific interventions should explicitly consider context. This is challenging in cluster randomized controlled trial designs. Thus, alternative designs such as natural experiment and stepped-wedge designs warrant further consideration. Primary outcome A collective focus on average minutes of moderate-to-vigorous intensity physical activity may not always be the most appropriate choice. A wider range of outcomes may improve children's physical activity and health in the long-term. In this paper, we argue that greater consideration of school context is key in the design and analysis of school-based physical activity interventions and may help overcome existing limitations in the design of effective interventions and thus progress the field. While this focus on context-specific interventions and evaluation is untested, we hope to stimulate debate of the key issues to improve future physical activity intervention development and implementation.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, United Kingdom
- *Correspondence: Russell Jago,
| | - Ruth Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Danielle House
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Michael Beets
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - David Revalds Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Catherine Woods
- Physical Activity for Health Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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Bousmah MAQ, Diakhaté P, Toulao GÀD, Le Hesran JY, Lalou R. Effects of a free health insurance programme for the poor on health service utilisation and financial protection in Senegal. BMJ Glob Health 2022; 7:bmjgh-2022-009977. [PMID: 36526298 PMCID: PMC9764670 DOI: 10.1136/bmjgh-2022-009977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/04/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Implemented in 2013 in Senegal, the Programme National de Bourses de Sécurité Familiale (PNBSF) is a national cash transfer programme for poor households. Besides reducing household poverty and encouraging children's school attendance, an objective of the PNBSF is to expand health coverage by guaranteeing free enrolment in community-based health insurance (CBHI) schemes. In this paper, we provide the first assessment of the PNBSF free health insurance programme on health service utilisation and health-related financial protection. METHODS We collected household-level and individual-level cross-sectional data on health insurance in 2019-2020 within the Niakhar Population Observatory in rural Senegal. We conducted a series of descriptive analyses to fully describe the application of the PNBSF programme in terms of health coverage. We then used multivariate logistic and Poisson regression models within an inverse probability weighting framework to estimate the effect of being registered in a CBHI through the PNBSF-as compared with having no health insurance or having voluntarily enrolled in a CBHI scheme-on a series of outcomes. RESULTS With the exception of health facility deliveries, which were favoured by free health insurance, the PNBSF did not reduce the unmet need for healthcare or the health-related financial risk. It did not increase individuals' health service utilisation in case of health problems, did not increase the number of antenatal care visits and did not protect households against the risk of forgoing medical care and of catastrophic health expenditure. CONCLUSION We found limited effects of the PNBSF free health insurance on health service utilisation and health-related financial protection, although these failures were not necessarily due to the provision of free health insurance per se. Our results point to both implementation failures and limited programme outcomes. Greater commitment from the state is needed, particularly through strategies to reduce barriers to accessing covered healthcare.
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Affiliation(s)
- Marwân-al-Qays Bousmah
- Université Paris Cité, IRD, Inserm, Ceped, F-75006 Paris, France,Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | | | | | | | - Richard Lalou
- Université Paris Cité, MERIT, IRD, F-75006, Paris, France
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Broholm-Jørgensen M. The practice of hope in public health interventions: a qualitative single-case study. Health Promot Int 2022; 37:6749047. [DOI: 10.1093/heapro/daac144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Summary
This study examines hope practices in the context of participation in a public health intervention. Theoretically, the study builds upon Cheryl Mattingly’s notion of hope as a practice, which renders the possibility of examining participants actions, interactions and challenges with participating. This analytical lens contributes knowledge about how interventions are incorporated into participants’ hopes for a future life and the consequences of intervening in peoples’ everyday lives. The study builds on empirical material from a pilot study of the primary preventive intervention known as TOF (Tidlig Opsporing og Forebyggelse—a Danish acronym for ‘Early Detection and Prevention’) which aimed to identify high risk individuals and provide targeted preventive services. A by-product of a larger qualitative study, itself based on the TOF pilot study in 2019, this single-case study illustrates how participants’ life situation influence how they interpret and manage activities in a public health intervention. The study shows how the practice of hope in public health interventions is closely linked to participants’ own interpretations of how participation can lead to a life worth living. The findings, which show that participants’ needs, and life situation influence the ways in which they respond to an intervention, adds to the complexity in intervention research. Further, the study illustrates some of the ethical challenges that arise when researchers intervene in people’s everyday life. It reinforces the need for ongoing critical reflection and attention to be directed at how those being studied articulate and practice hope.
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Affiliation(s)
- Marie Broholm-Jørgensen
- National Institute of Public Health, Research Program on Health and Social Conditions, University of Southern Denmark , Copenhagen , Denmark
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Daneshi S, Ebadi Fard Azar F, Ahmadi Tabatabaei SV, Faryabi R, Kamali A, Sheikh Beig Goharrizi MA, Alian Samakkhah S, Hushmandi K, Rezabeigi Davarani E. Process and outcome evaluation of directly observed treatment short course (DOTs) in Kerman city, Southeast of Iran. Indian J Tuberc 2022; 69:620-625. [PMID: 36460399 DOI: 10.1016/j.ijtb.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/14/2021] [Accepted: 09/01/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Understanding tuberculosis (TB) treatment programs' process and the outcome is one of the critical strategies to prevent the disease's occurrence and accelerate achieving sustainable development goals to reduce TB cases. The present study aimed to evaluate directly observed treatment short-course (DOTs) for tuberculosis. METHODS The present cross-sectional, descriptive-analytical study extracted information from the tuberculosis surveillance system's recorded data by a researcher-made checklist with questions from patients and health system staff. We analyzed the data by SPSS version 20. RESULTS The outcome of patients' treatment was 85.39% improved, and the rest were death and failure of treatment and absence from treatment. The mean and standard deviation of the onset of the first symptom and diagnosis and detection of the disease was 117 and 126 days, respectively. The mean and standard deviation of the interval between diagnosis and treatment was 5.53 and 8.03 days, respectively. Regarding the treatment length, 95.5% of the cases followed the treatment length, and the rest were not observed. The history of hospitalization was 45.3% among patients, and the rest had no history of hospitalization, and the mean and standard deviation of the day of hospitalization were 6.68 ± 9.50 days. CONCLUSIONS The existence of an appropriate program for early diagnosis of tuberculosis, observing the length of treatment, training private and public centers to strengthen the care system, and strengthening the DOTs program to control tuberculosis seems to be necessary.
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Affiliation(s)
- Salman Daneshi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Farbod Ebadi Fard Azar
- Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Reza Faryabi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Ali Kamali
- Department of Internal Medicine, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
| | | | - Shohreh Alian Samakkhah
- Department of Food Hygiene, Faculty of Veterinary Medicine, Amol University of Special Modern Technology (AUSMT), Amol, Iran
| | - Kiavash Hushmandi
- Department of Food Hygiene and Quality Control, Division of Epidemiology & Zoonoses, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Esmat Rezabeigi Davarani
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Mitchell E, Ahern E, Saha S, McGettrick G, Trépel D. Value of Nonpharmacological Interventions for People With an Acquired Brain Injury: A Systematic Review of Economic Evaluations. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1778-1790. [PMID: 35525832 DOI: 10.1016/j.jval.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/10/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Acquired brain injury (ABI) has long-lasting effects, and patients and their families require continued care and support, often for the rest of their lives. For many individuals living with an ABI disorder, nonpharmacological rehabilitation treatment care has become increasingly important care component and relevant for informed healthcare decision making. Our study aimed to appraise economic evidence on the cost-effectiveness of nonpharmacological interventions for individuals living with an ABI. METHODS This systematic review was registered in PROSPERO (CRD42020187469), and a protocol article was subject to peer review. Searches were conducted across several databases for articles published from inception to 2021. Study quality was assessed according the Consolidated Health Economic Evaluation Reporting Standards checklist and Population, Intervention, Control, and Outcomes criteria. RESULTS Of the 3772 articles reviewed 41 publications met the inclusion criteria. There was a considerable heterogeneity in methodological approaches, target populations, study time frames, and perspectives and comparators used. Keeping these issues in mind, we find that 4 multidisciplinary interventions studies concluded that fast-track specialized services were cheaper and more cost-effective than usual care, with cost savings ranging from £253 to £6063. In 3 neuropsychological studies, findings suggested that meditated therapy was more effective and saved money than usual care. In 4 early supported discharge studies, interventions were dominant over usual care, with cost savings ranging from £142 to £1760. CONCLUSIONS The cost-effectiveness evidence of different nonpharmacological rehabilitation treatments is scant. More robust evidence is needed to determine the value of these and other interventions across the ABI care pathway.
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Affiliation(s)
- Eileen Mitchell
- Centre for Public Health, Queen's University, Belfast, Northern Ireland, UK; Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
| | - Elayne Ahern
- Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland; Department of Psychology, University of Limerick, Castletroy, Limerick, Ireland
| | - Sanjib Saha
- Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; School of Medicine, Dentistry and Biomedical Sciences, University of California, San Francisco, CA, USA; Health Economics Unit, Department of Clinical Science (Malmö), Lund University, Lund, Sweden
| | | | - Dominic Trépel
- Trinity College Institute for Neuroscience, Trinity College Dublin, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; School of Medicine, Dentistry and Biomedical Sciences, University of California, San Francisco, CA, USA; School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
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Capper TE, Brennan SF, Woodside JV, McKinley MC. What makes interventions aimed at improving dietary behaviours successful in the secondary school environment? A systematic review of systematic reviews. Public Health Nutr 2022; 25:2448-2464. [PMID: 35357283 PMCID: PMC9991643 DOI: 10.1017/s1368980022000829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To systematically review evidence from systematic reviews of interventions to improve dietary behaviours and reduce food wastage in secondary school pupils. DESIGN CINAHL, Cochrane Reviews, EMBASE, MEDLINE, PsychINFO and Web of Science were searched for systematic reviews of school-based dietary interventions from 2000 to 2020 published in a peer-reviewed journal in English. Articles were reviewed independently by two authors. AMSTAR-2 was used for quality assessment. SETTING Secondary school dietary interventions. PARTICIPANTS Adolescents (aged 11-18). RESULTS In total, thirteen systematic reviews of dietary interventions in secondary schools met the inclusion criteria. A number of key characteristics of interventions that contributed to improvements in food choices in secondary school pupils were identified. These included the combination of education and environmental restructuring, incorporation of computer-based feedback, media or messaging, peer and/or parent involvement, an increase in the availability of healthy foods and the use of behavioural theory as a basis to the intervention. Intervention components that contributed specifically to a reduction in sugar-sweetened beverage intake or an increase in fruit and vegetable consumption, which are particularly relevant to adolescents, could not be determined. Similarly, evidence for interventions that improve nutritional knowledge and attitudes was limited. CONCLUSIONS This systematic review of systematic reviews has identified a number of components of dietary interventions that can be explored to improve dietary behaviours in secondary school environments and, if demonstrated to be effective, be considered for inclusion in policies and strategies to improve the school food environment and promote dietary change.
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Affiliation(s)
- TE Capper
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Grosvenor Road, BelfastBT12 6BJ, UK
| | - SF Brennan
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Grosvenor Road, BelfastBT12 6BJ, UK
| | - JV Woodside
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Grosvenor Road, BelfastBT12 6BJ, UK
| | - MC McKinley
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Grosvenor Road, BelfastBT12 6BJ, UK
- Corresponding author: Email
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A Systematic Review of Evidence-Based Family Interventions for Trauma-Affected Refugees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159361. [PMID: 35954717 PMCID: PMC9367780 DOI: 10.3390/ijerph19159361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
Family connections are crucial for trauma-affected refugees from collectivistic cultures. Evidence-based family interventions are consistently promoted to support a host of mental and relational health needs of families exposed to traumatic stressors; however, there is still limited research focused on cultural adaptation and the testing of the effectiveness of these interventions on some of the most disenfranchised populations in the aftermath of forced displacement. This systematic review was conducted to examine the reach of existing evidence-based family interventions implemented with newly resettled refugees globally. Studies included in this review include those testing the effectiveness of a systemic treatment with pre and post intervention evaluation, studies with or without control groups, and studies that include at least one family member in addition to the target participants. Twelve studies met the inclusion criteria. Barriers to conducting randomized control trials with displaced refugee populations are discussed. Recommendations are made for future studies to include a focus on scientifically rigorous multi-method designs, specific cultural adaptation frameworks, and the integration of relational aspects rather than focusing only on individual adjustment. Global displacement continues to rise; therefore, it is imperative that the mental health and wellbeing of displaced populations be treated with a comprehensive, multi-level framework.
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Ridde V, Carillon S, Desgrées du Loû A, Sombié I. Analyzing implementation of public health interventions : a need for rigor, and the challenges of stakeholder involvement. Rev Epidemiol Sante Publique 2022; 71:101376. [PMID: 35835715 DOI: 10.1016/j.respe.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES This article shows how conceptual models can help to develop and evaluate public health interventions. It also reports on the challenges of getting stakeholders involved. METHOD The analysis is based on the reflexive approach applied by the authors during their participation in two public health intervention research (PHIR) projects, in France and in Burkina Faso. RESULTS In Paris, PHIR aimed to enable sub-Saharan immigrants to appropriate the existing means of prevention and sexual health care and to strengthen their empowerment in view of preserving their health. Evaluation was carried out using mixed methods. The intervention process theory is based on Ninacs' conceptual model of individual empowerment. The Consolidated Framework For Implementation Research (CFIR) was mobilized a posteriori to analyze the process. PHIR stemmed from collaboration between a research team and two associations. The different stakeholders were involved in the evaluation process, as were, at certain times, persons in highly precarious situations. In Ouagadougou, a community-based dengue vector control intervention was deployed to address an essential but neglected need. As regards evaluation, we opted for a holistic, mixed method approach (effectiveness and process). The contents of the intervention were determined based on tacit knowledge, a community preference survey and solid evidence. The theoretical framework of the intervention consisted in an eco-biological model of vector control. The implementation analysis combined an internal assessment of implementation fidelity with an external CFIR process analysis. All stakeholders were involved in the evaluation process. DISCUSSION Analysis confirmed not only the value of process evaluations in PHIR, but also the primordial importance of a rigorous approach. Stakeholder involvement is a major challenge to be addressed early in the planning of RISPs; with this in mind, effective and ethically sound assessment mechanisms need to be drawn up. Interdisciplinary evaluative approaches should be preferred, and the use of justified, relevant, and flexible frameworks is highly recommended. CONCLUSION Lessons learned for those wishing to engage in the process evaluation of a public health intervention are hereby presented.
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Affiliation(s)
- V Ridde
- Centre population et développement (Ceped), Institut de recherche pour le développement (IRD) et Université Paris Cité, Inserm ERL 1244, 45 rue des Saints-Pères, 75006 Paris, France.
| | - S Carillon
- Centre population et développement (Ceped), Institut de recherche pour le développement (IRD) et Université Paris Cité, Inserm ERL 1244, 45 rue des Saints-Pères, 75006 Paris, France
| | - A Desgrées du Loû
- Centre population et développement (Ceped), Institut de recherche pour le développement (IRD) et Université Paris Cité, Inserm ERL 1244, 45 rue des Saints-Pères, 75006 Paris, France
| | - I Sombié
- Institut des Sciences des Sociétés (INSS), Centre National de la Recherche Scientifique et Technologique (CNRST), 03 BP 7047, Avenue du Capitaine Thomas Sankara, Ouagadougou, Burkina Faso
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Golumbeanu M, Yang GJ, Camponovo F, Stuckey EM, Hamon N, Mondy M, Rees S, Chitnis N, Cameron E, Penny MA. Leveraging mathematical models of disease dynamics and machine learning to improve development of novel malaria interventions. Infect Dis Poverty 2022; 11:61. [PMID: 35659301 PMCID: PMC9167503 DOI: 10.1186/s40249-022-00981-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/04/2022] [Indexed: 01/04/2023] Open
Abstract
Background Substantial research is underway to develop next-generation interventions that address current malaria control challenges. As there is limited testing in their early development, it is difficult to predefine intervention properties such as efficacy that achieve target health goals, and therefore challenging to prioritize selection of novel candidate interventions. Here, we present a quantitative approach to guide intervention development using mathematical models of malaria dynamics coupled with machine learning. Our analysis identifies requirements of efficacy, coverage, and duration of effect for five novel malaria interventions to achieve targeted reductions in malaria prevalence. Methods A mathematical model of malaria transmission dynamics is used to simulate deployment and predict potential impact of new malaria interventions by considering operational, health-system, population, and disease characteristics. Our method relies on consultation with product development stakeholders to define the putative space of novel intervention specifications. We couple the disease model with machine learning to search this multi-dimensional space and efficiently identify optimal intervention properties that achieve specified health goals. Results We apply our approach to five malaria interventions under development. Aiming for malaria prevalence reduction, we identify and quantify key determinants of intervention impact along with their minimal properties required to achieve the desired health goals. While coverage is generally identified as the largest driver of impact, higher efficacy, longer protection duration or multiple deployments per year are needed to increase prevalence reduction. We show that interventions on multiple parasite or vector targets, as well as combinations the new interventions with drug treatment, lead to significant burden reductions and lower efficacy or duration requirements. Conclusions Our approach uses disease dynamic models and machine learning to support decision-making and resource investment, facilitating development of new malaria interventions. By evaluating the intervention capabilities in relation to the targeted health goal, our analysis allows prioritization of interventions and of their specifications from an early stage in development, and subsequent investments to be channeled cost-effectively towards impact maximization. This study highlights the role of mathematical models to support intervention development. Although we focus on five malaria interventions, the analysis is generalizable to other new malaria interventions. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00981-1.
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Affiliation(s)
- Monica Golumbeanu
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | - Guo-Jing Yang
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,Key Laboratory of Tropical Translational Medicine of Ministry of Education and School of Tropical Medicine and Laboratory Medicine, The First and Second Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, People's Republic of China.,University of Basel, Basel, Switzerland
| | - Flavia Camponovo
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland.,Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | | | | | | | - Sarah Rees
- Innovative Vector Control Consortium, Liverpool, UK
| | - Nakul Chitnis
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | - Ewan Cameron
- Malaria Atlas Project, Big Data Institute, University of Oxford, Oxford, UK.,Curtin University, Perth, Australia.,Telethon Kids Institute, Perth Children's Hospital, Perth, Australia
| | - Melissa A Penny
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland. .,University of Basel, Basel, Switzerland.
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Effectiveness of Integrated Diabetes Care Interventions Involving Diabetes Specialists Working in Primary and Community Care Settings: A Systematic Review and Meta-Analysis. Int J Integr Care 2022; 22:11. [PMID: 35634254 PMCID: PMC9104489 DOI: 10.5334/ijic.6025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 04/19/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction: Evidence that integrated diabetes care interventions can substantially improve clinical outcomes is mixed. However, previous systematic reviews have not focussed on clinical effectiveness where the endocrinologist was actively involved in guiding diabetes management. Methods: We searched EMBASE, COCHRANE, MEDLINE, SCOPUS, CINAHL, Google Scholar databases and grey literature published in English language up to 25 January 2021. Reviewed articles included Randomised Controlled Trials (RCTs) and pre-post studies testing the effectiveness on clinical outcomes after ≥6 months intervention in non-pregnant adults (age ≥ 18 years) with type 1 or type 2 diabetes mellitus. Two reviewers independently extracted data and completed a risk of bias assessment. Appropriate meta-analyses for each outcome from RCTs and pre-post studies were performed. Heterogeneity was assessed using the I2 statistic and Cochran’s Q and publication bias assessed using Doi plots. Studies were not pooled to estimate the cost-effectiveness as the cost outcomes were not comparable across trials/studies. Results: We reviewed 4 RCTs and 12 pre-post studies. The integrated care model of diabetes specialists working with primary care health professionals had a positive impact on HbA1c in both RCTs and pre-post studies and on systolic blood pressure, diastolic blood pressure, total cholesterol and weight in pre-post studies. In the RCTs, interventions reduced HbA1c (–0.10% [–0.15 to –0.05]) (–1.1 mmol/mol [–1.6 to –0.5]), versus control. Pre-post studies demonstrated improvements in HbA1c (–0.77% [–1.12 to –0.42]) (–8.4 mmol/mol [–12.2 to –4.6]), systolic blood pressure (–3.30 mmHg [–5.16 to –1.44]), diastolic blood pressure (–3.61 mmHg [–4.82 to –2.39]), total cholesterol (–0.33 mmol/L [–0.52 to –0.14]) and weight (–2.53 kg [–3.86 to –1.19]). In a pre-post study with no control group only 4% patients experienced hypoglycaemia after one year of intervention compared to baseline. Conclusions: Integrated interventions with an active endocrinologist involvement can result in modest improvements in HbA1c, blood pressure and weight management. Although the improvements per clinical outcome are modest, there is possible net improvements at a holistic level.
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Lee GY, Hickie IB, Occhipinti JA, Song YJC, Skinner A, Camacho S, Lawson K, Hilber AM, Freebairn L. Presenting a comprehensive multi-scale evaluation framework for participatory modelling programs: A scoping review. PLoS One 2022; 17:e0266125. [PMID: 35452462 PMCID: PMC9032404 DOI: 10.1371/journal.pone.0266125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 03/15/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Systems modelling and simulation can improve understanding of complex systems to support decision making, better managing system challenges. Advances in technology have facilitated accessibility of modelling by diverse stakeholders, allowing them to engage with and contribute to the development of systems models (participatory modelling). However, despite its increasing applications across a range of disciplines, there is a growing need to improve evaluation efforts to effectively report on the quality, importance, and value of participatory modelling. This paper aims to identify and assess evaluation frameworks, criteria, and/or processes, as well as to synthesize the findings into a comprehensive multi-scale framework for participatory modelling programs. MATERIALS AND METHODS A scoping review approach was utilized, which involved a systematic literature search via Scopus in consultation with experts to identify and appraise records that described an evaluation framework, criteria, and/or process in the context of participatory modelling. This scoping review is registered with the Open Science Framework. RESULTS The review identified 11 studies, which varied in evaluation purposes, terminologies, levels of examination, and time points. The review of studies highlighted areas of overlap and opportunities for further development, which prompted the development of a comprehensive multi-scale evaluation framework to assess participatory modelling programs across disciplines and systems modelling methods. The framework consists of four categories (Feasibility, Value, Change/Action, Sustainability) with 30 evaluation criteria, broken down across project-, individual-, group- and system-level impacts. DISCUSSION & CONCLUSION The presented novel framework brings together a significant knowledge base into a flexible, cross-sectoral evaluation effort that considers the whole participatory modelling process. Developed through the rigorous synthesis of multidisciplinary expertise from existing studies, the application of the framework can provide the opportunity to understand practical future implications such as which aspects are particularly important for policy decisions, community learning, and the ongoing improvement of participatory modelling methods.
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Affiliation(s)
- Grace Yeeun Lee
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | | | - Jo-An Occhipinti
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW, Australia
| | | | - Adam Skinner
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Salvador Camacho
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kenny Lawson
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Adriane Martin Hilber
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Louise Freebairn
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
- Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW, Australia
- Research School of Population Health, The Australian National University, Canberra, ACT, Australia
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Dugdale Z, Eiter B, Chaumont Menéndez C, Wong I, Bauerle T. Findings from a systematic review of fatigue interventions: What's (not) being tested in mining and other industrial environments. Am J Ind Med 2022; 65:248-261. [PMID: 35184307 DOI: 10.1002/ajim.23334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/10/2022] [Accepted: 01/31/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Fatigue negatively impacts mineworker health and safety. In this paper, we identify fatigue interventions tested on industrial shiftworkers and explore their effects and the factors that may influence application in an industrial setting such as a mine site. METHODS This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A structured, systematic search of the literature was conducted to identify relevant studies published between 1980 and 2020. Researchers independently conducted article screening and study quality appraisals against pre-established criteria, and then extracted data and conducted a narrative synthesis of the included studies. RESULTS Seven intervention studies, out of 1651 articles initially screened, were retained for narrative synthesis. Four studies tested the alerting effects of bright-light treatment, one evaluated the effectiveness of blue-light blocking glasses at improving daytime sleep quality and nighttime vigilance, and two examined whether sleep hygiene and alertness management trainings improved sleep quality or alertness. There was substantial evidence for the use of bright-light treatments to improve night shiftworker alertness, but insufficient evidence to draw conclusions about the effectiveness of blue-light blocking glasses and sleep hygiene and alertness management trainings due to the small number of studies included. Shiftworkers were mostly male and employed in industrial subsectors such as production and manufacturing, oil and gas, and transportation. No mining-specific intervention studies were identified. CONCLUSIONS Future research is needed to identify effective fatigue risk management interventions for the mining industry as well as best practices for implementing these interventions with mineworkers.
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Affiliation(s)
- Zoë Dugdale
- Spokane Mining Research Division National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Spokane Washington USA
| | - Brianna Eiter
- Spokane Mining Research Division National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Spokane Washington USA
| | - Cammie Chaumont Menéndez
- Division of Safety Research National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Morgantown West Virginia USA
| | - Imelda Wong
- Division of Science Integration National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Cincinnati Ohio USA
| | - Tim Bauerle
- Spokane Mining Research Division National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Spokane Washington USA
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So B, Kwon KH. The impact of physical activity on well-being, lifestyle and health promotion in an era of COVID-19 and SARS-CoV-2 variant. Postgrad Med 2022; 134:349-358. [DOI: 10.1080/00325481.2022.2052467] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Bohee So
- Division of Beauty Arts Care, Department of Practical Arts, Graduate School of Culture and Arts, Dongguk University, Seoul 04620, Republic of Korea
| | - Ki Han Kwon
- College of General Education, Kookmin University, Seoul 02707, Republic of Korea
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Fostering participation in digital contact tracing. INFORMATION ECONOMICS AND POLICY 2022; 58:100938. [PMCID: PMC8214816 DOI: 10.1016/j.infoecopol.2021.100938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 04/17/2021] [Accepted: 06/16/2021] [Indexed: 06/29/2023]
Abstract
Digital contact tracing is a promising digital public health intervention to manage epidemics. However, in order to reach its full potential, the technology has to be widely adopted and used. During the SARS-CoV-2 pandemic, this has not necessarily been the case. We review the literature with a focus on how participation in digital contact tracing could be fostered and provide policy recommendations on how to increase its adoption and usage as well as recommendations for further research.
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Burgemeister FC, Crawford SB, Hackworth NJ, Hokke S, Nicholson JM. Place-based approaches to improve health and development outcomes in young children: A scoping review. PLoS One 2021; 16:e0261643. [PMID: 34941941 PMCID: PMC8700019 DOI: 10.1371/journal.pone.0261643] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/08/2021] [Indexed: 11/24/2022] Open
Abstract
This scoping review examines the strength of evidence for the effectiveness of public policy-led place-based initiatives designed to improve outcomes for disadvantaged children, their families and the communities in which they live. Study designs and methods for evaluating such place-based initiatives were assessed, along with the contexts in which initiatives were implemented and evaluated. Thirty-two reports relating to 12 initiatives were included. Eleven initiatives used a quasi-experimental evaluation to assess impact, although there were considerable design variations within this. The remaining initiative used a pre- and post- evaluation design. Place-based initiatives by definition aim to improve multiple and interrelated outcomes. We examined initiatives to determine what outcomes were measured and coded them within the five domains of pregnancy and birth, child, parent, family and community. Across the 83 outcomes reported in the 11 studies with a comparison group, 30 (36.4%) demonstrated a positive outcome, and all but one initiative demonstrated a positive outcome in at least one outcome measure. Of the six studies that examined outcomes more than once post baseline, 10 from 38 outcomes (26.3%) demonstrated positive sustained results. Many initiatives were affected by external factors such as policy and funding changes, with unknown impact on their effectiveness. Despite the growth of place-based initiatives to improve outcomes for disadvantaged children, the evidence for their effectiveness remains inconclusive.
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Affiliation(s)
| | | | - Naomi J. Hackworth
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
- Parenting Research Centre, East Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Stacey Hokke
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Jan M. Nicholson
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Queensland University of Technology, Brisbane, Queensland, Australia
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Wikström M, Kouvonen A, Joensuu M. Intrarater reliability of the Abilitator-a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position: a test-retest study. BMJ Open 2021; 11:e057295. [PMID: 34880030 PMCID: PMC8655543 DOI: 10.1136/bmjopen-2021-057295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The Abilitator is a patient-reported outcome measure (PROM) of work ability and functioning of those in a weak labour market position. It covers items for work ability and self-rated health, for example, and summary scales for social, psychological, cognitive and physical functioning, as well as everyday skills. The aim of this study was to evaluate the intrarater test-retest reliability, internal consistency and basic psychometric properties of the Finnish version of the Abilitator. DESIGN, SETTING AND OUTCOME The test-retest study was conducted in European Social Fund projects in 2018-2019. The participants completed two Abilitator questionnaires over 7-14 days. The internal consistency analysis was based on data collected in 2017-2019 in services for the long-term unemployed. The reliability was assessed using correlations (r, rs , intraclass correlation coefficient (ICC)), agreement with Bland-Altman analysis and internal consistency with Cronbach's alpha. PARTICIPANTS The test-retest study had 67 participants (52% men, mean age 43.9 years) and the internal consistency study 10 923 (48% men, mean age 38.58 years), respectively. Of all the participants, 80% had been unemployed for over a year. RESULTS The test-retest r or rs ranged from 0.71 to 0.93 and ICC from 0.74 to 0.93 for the items and summary scales. An exception was the life satisfaction item, with an rs of 0.60 and ICC of 0.45. A statistically significant difference was observed in the summary scale for social functioning (t=-2.01, p=0.049). Agreement was observed for all variables except social functioning. Alphas for summary scales ranged from 0.74 to 0.91. CONCLUSIONS The Finnish version of the Abilitator is a reliable PROM for the target group and has acceptable to excellent intrarater test-retest reliability and internal consistency, apart from the life satisfaction item. Further testing is needed for the social functioning summary scale.
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Affiliation(s)
- Miia Wikström
- Finnish Institute of Occupational Health, Helsinki, Finland
- Faculty of Social Sciences, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Uusimaa, Finland
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matti Joensuu
- Finnish Institute of Occupational Health, Helsinki, Finland
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Gormley MA, Pericot-Valverde I, Diaz L, Coleman A, Lancaster J, Ortiz E, Moschella P, Heo M, Litwin AH. Effectiveness of peer recovery support services on stages of the opioid use disorder treatment cascade: A systematic review. Drug Alcohol Depend 2021; 229:109123. [PMID: 34700201 DOI: 10.1016/j.drugalcdep.2021.109123] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/22/2021] [Accepted: 10/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Peer recovery support services (PRSS) have been increasingly incorporated during the recovery process for opioid use disorder (OUD), yet little is known about the effects of PRSS on clinical outcomes of individuals who misuse opioids. This study systematically synthesized existing literature reporting the effectiveness of PRSS interventions on stages of the OUD treatment cascade. METHODS A search conducted on five databases identified studies from database inception to January 26th 2021 that evaluated the effects of PRSS on PRSS engagement, medication for OUD (MOUD) initiation, MOUD retention, opioid and non-opioid misuse, and remission. Characteristics of PRSS interventions, study design, and clinical outcomes were extracted. Methodological quality was assessed with the quality assessment tool for quantitative studies by the Effective Public Health Practice Project. RESULTS Of 123 titles, 22 were subjected to full-text review and 12 ultimately met inclusion criteria. Only two studies were randomized control trials, half compared the outcomes of PRSS participants to those of a counterfactual group. Most PRSS were unstandardized and broadly described, involving linkage to treatment (91.7%) or follow-up support (91.7%). MOUD initiation was reported the most often (66.7%), followed by PRSS engagement (33.3%) and opioid use (25.0%). No studies reported findings for MOUD retention or remission. Findings for available outcomes were inconsistent and difficult to compare due to the heterogeneity of PRSS interventions and methodological limitations. CONCLUSION Effectiveness of PRSS interventions on stages of the OUD treatment cascade remain inconclusive. Additional research is necessary before supporting the implementation of PRSS on a broad scale.
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Affiliation(s)
- Mirinda Ann Gormley
- Clemson University College of Behavioral, Social, and Health Science, Department of Public Health Sciences, 503 Edwards Hall, Clemson SC, 29631, USA; Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA.
| | - Irene Pericot-Valverde
- Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA; Clemson University School of Health Research, 605 Grove Road Suite 301, Clemson, SC, 29605, USA
| | - Liam Diaz
- Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA; Greenville County Behavioral Health AmeriCorps VISTA Program, 130 Industrial Dr. Suite B, Greenville, SC, 29607, USA
| | - Ashley Coleman
- Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA
| | - Jonathan Lancaster
- Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA; Clemson University College of Behavioral, Social, and Health Science, Department of Psychology, 418 Brackett Hall, Clemson SC, 29634, USA
| | - Erik Ortiz
- Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA
| | - Phillip Moschella
- Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA; Prisma Health Department of Emergency Medicine, 701 Grove Rd., Greenville, SC, 29605, USA; University of South Carolina School of Medicine Greenville, Department of Medicine, 701 Grove road, Greenville, SC, 29605, USA
| | - Moonseong Heo
- Clemson University College of Behavioral, Social, and Health Science, Department of Public Health Sciences, 503 Edwards Hall, Clemson SC, 29631, USA; Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA
| | - Alain H Litwin
- Prisma Health Addiction Research Center, 605 Grove Rd. Suite 205, Greenville, SC, 29605, USA; University of South Carolina School of Medicine Greenville, Department of Medicine, 701 Grove road, Greenville, SC, 29605, USA; Clemson University School of Health Research, 605 Grove Road Suite 301, Clemson, SC, 29605, USA; Prisma Health Department of Internal Medicine, 876 W Faris Rd., Greenville, SC, 29605, USA
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McTiernan K, Gullon-Scott F, Dudley R. Do Positive Psychology Interventions Impact on the Subjective Wellbeing and Depression of Clients? A Systematic Methodological Review. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2021. [DOI: 10.1007/s10879-021-09522-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractMental health services are placing a greater emphasis on wellbeing and recovery. The current research investigated if positive psychology interventions (PPIs) increase peoples’ subjective wellbeing and reduce clinical depression. A systematic methodological review was conducted on randomized-control-trials with people attending clinical services. Five databases were searched. A hand search was then completed on the reference lists of the identified articles and the associated journals. Eleven research interventions were reviewed. PPIs were found to significantly increase wellbeing, relative to controls and there were fewer studies indicating a difference in decreasing depression. However, subsequent analysis revealed that the interventions were heterogeneous which limits the drawing of definitive systematic conclusions. A methodological evaluation also found that there were recurring issues: in delivering the interventions, measuring subjective wellbeing, and applying the design. Thus, the methodological quality of the research interventions, as measured by the current review was low. There is emerging evidence that PPIs improve peoples’ mental health. However, there is scope to standardize and to improve the quality of the research interventions.
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Nichols J, Cox SM, Cook C, Lea GW, Belliveau G. Research-based Theatre about veterans transitioning home: A mixed-methods evaluation of audience impacts. Soc Sci Med 2021; 292:114578. [PMID: 34864601 DOI: 10.1016/j.socscimed.2021.114578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 10/25/2021] [Accepted: 11/15/2021] [Indexed: 12/01/2022]
Abstract
RATIONALE Contact!Unload, a research-based theatre production, portrays veterans experiencing mental health challenges and overcoming them through therapeutic enactment. It was performed eight times by veteran performers in 2017 for audiences in two Canadian cities comprised of civilians and military-connected personnel and their families (n = 525). METHODS Drawing upon qualitative and quantitative data sources, this paper evaluates the immediate and longer-term impacts of Contact!Unload as a knowledge translation intervention for audience members. RESULTS Our findings suggest that the performance: 1) improved knowledge of mental health concerns and symptoms that some veterans experience when transitioning to civilian life, 2) increased knowledge of the need for mental health supports and care for veterans, 3) sustained impacts on awareness and knowledge six months after the play and 4) sparked dialogue and actions after the show for some audience members. Moreover, theatre was seen as a powerful medium to engage audience members both cognitively and affectively in the topic. CONCLUSIONS Research-based theatre has significant potential as a knowledge translation intervention for mental health topics. The work also points to the untapped potential of using RbT to engage audience members in a mental health literacy intervention. Future work is needed to study how to effectively combine research-based theatre with intervention design frameworks and other mental health literacy interventions.
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Affiliation(s)
- Jennica Nichols
- W. Maurice Young Centre for Applied Ethics, School of Population and Public Health, The University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z, Canada
| | - Susan M Cox
- W. Maurice Young Centre for Applied Ethics, School of Population and Public Health, The University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z, Canada.
| | - Christina Cook
- Language & Literacy Education, Faculty of Education, The University of British Columbia, 6445 University Boulevard, Vancouver, BC, V6T 1Z2,, Canada
| | - Graham W Lea
- Faculty of Education, The University of Manitoba, 71 Curry Place, Winnipeg, Manitoba, R3T2N2, Canada
| | - George Belliveau
- Language & Literacy Education, Faculty of Education, The University of British Columbia, 6445 University Boulevard, Vancouver, BC, V6T 1Z2,, Canada
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Yun HJ, Seo K, Han D. [The Effects of Programs on Body-Image Improvement in Adolescents: A Systematic Review and Meta-Analysis]. J Korean Acad Nurs 2021; 51:597-616. [PMID: 34737252 DOI: 10.4040/jkan.21104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/31/2021] [Accepted: 09/08/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE This study's objective was to investigate the effects of programs that improve adolescents' body image, using a systematic review and meta-analysis. METHODS A literature search was performed in eleven electronic databases, using preferred reporting items for systematic reviews and meta-analysis guidelines. Population characteristics, contents of the programs, and measured outcomes were systematically reviewed from 21 selected studies. To estimate the size of the effects, meta-analysis was conducted using Comprehensive Meta-Analysis software. RESULTS The contents of the programs that aimed to improve body image included physical, psychological, interpersonal, and sociocultural interventions. Sixteen studies were meta-analyzed to estimate the effect size of body-image improvement programs. Results showed that the program for body-image improvement had significant effects on body satisfaction (effect size [ES] = 0.56, 95% confidence interval [CI] = 0.23 to 0.89), and body dissatisfaction (ES = - 0.15, 95% CI = - 0.23 to - 0.08). CONCLUSION The program for body image improvement in adolescents includes a combination of physical, psychological, interpersonal relationship, and socio-cultural dimensions. The program that seeks to improve body image appears to be effective at increasing body satisfaction, and at reducing body dissatisfaction in adolescents. Thus, it is necessary to develop and apply multidimensional programs for adolescents to have a positive body image.
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Affiliation(s)
- Hyun Jung Yun
- Department of Nursing, Cheongju University, Cheongju, Korea
| | - Kyoungsan Seo
- College of Nursing, Chungnam National University, Daejeon, Korea.
| | - Dallong Han
- Department of Nursing, Cheongju University, Cheongju, Korea
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Theoretical approaches to process evaluations of complex interventions in health care: a systematic scoping review protocol. Syst Rev 2021; 10:268. [PMID: 34625119 PMCID: PMC8499466 DOI: 10.1186/s13643-021-01825-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Complex interventions in health care are characterized by multiple interacting components as well as by numerous nonlinear interactions with the social systems within which they are being implemented. The process of developing, evaluating and implementing complex interventions is therefore challenging. Established guidance such as the MRC (Medical Research Council) framework for developing and evaluating complex interventions refers to process evaluations as an integral part of the development of complex evidence-based interventions. Even though the need for process evaluations is recognized, the realization of such approaches is challenging because methodological instruction is sparse, and the phenomenon of interest is complex. A number of theoretical approaches indicating how to conduct process evaluations of complex interventions in health care exist, but a systematic and comprehensive overview of these is missing. Thus, the objective of the systematic scoping review described herein is to provide an overview and analysis of theoretical approaches suitable for the planning and conducting of process evaluations. METHODS The design and conduct of this review will follow the procedures of a systematic scoping review. The search strategy will be developed following the BeHEMoTh (Behaviour of interest; Health context; Exclusions; Models or Theories) template which has been conceptualized for structured reviews of theory. The systematic search of the MEDLINE (via PubMed), CINAHL (via EBSCO) and PsycInfo (via EBSCO) electronic databases will be complemented by "hand searching" techniques. Study selection, data extraction, and data analysis will be performed by tandems of two researchers independently of each other. Divergent decisions and judgements between the two researchers will be discussed by the whole review team. DISCUSSION The findings from this scoping review will provide an overview and comparison of theoretical approaches suitable for process evaluations of complex interventions in health care. The review results will support researchers in choosing the theoretical approach that best fits the respective focus of their process evaluation study. SYSTEMATIC REVIEW REGISTRATION This study has been registered with PROSPERO (International Prospective Register of Systematic Reviews) under registration number CRD42020211732 .
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Active Lives South Australia health economic analysis: an evidence base for the potential of health promotion strategies supporting physical activity guidelines to reduce public health costs while improving wellbeing. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 30:1791-1807. [PMID: 34567951 PMCID: PMC8449747 DOI: 10.1007/s10389-021-01649-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/25/2021] [Indexed: 11/22/2022]
Abstract
Aim The COVID-19 pandemic has threatened individual and population wellbeing and strategies to jointly address these challenges within budget constraints are required. The aim of our research is to analyse evidence from the Active Lives South Australia study to consider the potential of physical activity (PA) health promotion strategies to be health-system cost saving while addressing wellbeing challenges. Methods The Active Lives South Australia study compares adult populations who meet and do not meet physical activity (PA) guidelines (150+ minutes of weekly physical activity) with respect to their subjective wellbeing and health care utilisation. Subject and results Adults who met PA guidelines had better wellbeing across all aspects with and without adjustment for age, sex and income covariates. Analysis showed significant associations between meeting guidelines and lower probabilities of visiting and utilisation of GPs, specialist doctors, other health professionals, hospital inpatient admissions, outpatient clinic and emergency department visits, and an overall A$1760 lower cost per person annually. Controlling for age, sex and income, health expenditure for adults who met PA guidelines was significantly lower by A$1393 per person annually. That translated to A$804 million potential annual SA health system cost saving by shifting all adults to meeting PA guidelines. Conclusion There is significant potential for effective health promotion strategies to be net cost saving while addressing wellbeing challenges of COVID-19 recovery where they can shift target populations from not meeting to meeting PA guidelines.
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Baker T, Rock M, Bondo K, van der Meer F, Kutz S. 11 years of regular access to subsidized veterinary services is associated with improved dog health and welfare in remote northern communities. Prev Vet Med 2021; 196:105471. [PMID: 34509773 DOI: 10.1016/j.prevetmed.2021.105471] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022]
Abstract
Access to veterinary services can have positive impacts on animal health and welfare, and on human mental and physical health and well-being; however, many communities worldwide lack access to such services. At their request, the 5 communities of the Sahtu Settlement Area, Northwest Territories, Canada, have received annual access to preventive veterinary services through the University of Calgary's Northern Community Health Rotation since 2008. To determine the reach of the program, we conducted a dog census in 2017. We then conducted a chart review of 11 years of dog medical records from 2008 to 2018 to evaluate how the reach of the program, the uptake of veterinary services, and dog population demographics, health and welfare measures changed over the duration of the program. In the chart review, we used either multi-level logistic regression or generalized linear models, to determine how seven variables, including age, sex, breed, body condition, deworming, vaccination, and sterilization status upon clinic entry, changed over the course of program delivery. Our results suggest that program reach, veterinary service uptake, and dog demographic, health and welfare measures improved over time. We observed high rabies vaccination coverage in some communities (48 %-83 % of the dog population) and moderate overall sterilization status (25 %-56 % of the dog population) with female dog sterilization more common than male (75 % of dogs leaving the 2017 clinics, compared to 43 %). Several dog demographic, health, and welfare measures, including age, body condition, and vaccination, deworming, and sterilization status, were significantly better in later years of the program (all p < 0.001). Differences among communities, both in dog population numbers from the 2017 census (40-89 dogs) and in the uptake of veterinary services in 2017 (48 %-83 % of the dog population), were notable. Vaccination uptake was directly related to clinic attendance, but sterilization was impacted by additional factors, including community members' acceptance of the procedure. Some unintended consequences were noted, however, including the potential effect of sterilization on the availability of traditional dog breeds in the communities. Overall, our study findings demonstrate that subsidized veterinary services provided over a regular and extended period of time benefit animal population demographics, health and welfare, and could have positive impacts on human well-being. The framework of community collaboration and long-term commitment developed through this program serves as a model for achieving common health goals among communities in need and veterinary service providers.
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Affiliation(s)
- Tessa Baker
- Department of Ecosystem and Public Health, University of Calgary Faculty of Veterinary Medicine, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada
| | - Melanie Rock
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Kristin Bondo
- Department of Ecosystem and Public Health, University of Calgary Faculty of Veterinary Medicine, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Frank van der Meer
- Department of Ecosystem and Public Health, University of Calgary Faculty of Veterinary Medicine, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Susan Kutz
- Department of Ecosystem and Public Health, University of Calgary Faculty of Veterinary Medicine, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
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Challinor A, Ogundalu A, McIntyre JC, Bramwell V, Nathan R. The empirical evidence base for the use of the HCR-20: A narrative review of study designs and transferability of results to clinical practice. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2021; 78:101729. [PMID: 34425379 DOI: 10.1016/j.ijlp.2021.101729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/30/2021] [Accepted: 07/24/2021] [Indexed: 06/13/2023]
Abstract
The HCR-20, a widely used method of assessing and managing risk, relies on the structured professional judgement approach. This paper reports a narrative literature review of the HCR-20 studies to explore the applicability of the study results to the use of the HCR-20 in clinical practice. From a literature search using terms "HCR-20" and "HCR 20", 206 papers were included. Of studies using the HCR-20 version 2 (n = 191), 92% (n = 176) relied on variables based on scores derived by adding item scores, and 50% (n = 95) tested the HCR-20 using predictive validity methodology. Of the HCR-20 version 3 studies (n = 21), the "presence of risk factors" step was the most commonly examined (n = 18, 86%), but 2 of the 7 steps ("scenario planning" and "management") were not examined at all. Amongst those studies whose primary focus was on the HCR-20, 67% (n = 64/95) did so by assessing the predictive validity of the tool. Only one employed a design to test whether the use of the HCR-20 affected violence rates. The predominant study design provides support for the use of the HCR-20 as an actuarial tool, and there is limited empirical evidence in support of its effectiveness as a structured professional judgement approach to the assessment and management of the risk of violence.
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Affiliation(s)
- Alexander Challinor
- University of Liverpool, UK; Health Education England North West, Liverpool, UK; Mersey Care NHS Foundation Trust, UK.
| | | | | | | | - Rajan Nathan
- Cheshire and Wirral Partnership NHS Trust, UK; University of Liverpool, UK; University of Chester, UK; John Moores University Liverpool, UK
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Venugopal V, Lennqvist R, Latha PK, S R, Suraya A, Jakobsson K, Kjellstrom T. Challenges in conducting epidemiological field studies evaluating associations between heat stress and renal health among workers in informal sectors: experiences from India. ENVIRONMENTAL RESEARCH 2021; 200:111343. [PMID: 34015298 DOI: 10.1016/j.envres.2021.111343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/28/2021] [Accepted: 05/13/2021] [Indexed: 06/12/2023]
Abstract
Well-designed Environmental Epidemiological Studies (EES) play a crucial role in quantifying the influence of environmental exposures and their associated risks on health in the wider population. They provide critical research evidence for identifying and developing interventions to avert adverse health consequences from those exposures. However, uncertainty and variability inherent to any field based EES could hinder the nature and magnitude of association between an exposure and health outcome. This is particularly pronounced in resource limited settings and resource-tight research projects. The present study evaluated the association between occupational heat stress and renal health among informal work sectors in India which had some significant challenges. Informal workers exposed to chronic occupational heat stress had significantly higher adverse renal health outcomes than the unexposed workers. Our field challenges included gaining access and permissions to conduct the study, participant recalls bias and attrition, accurately estimating exposures, confounding from causes of both exposure and disease, and to a large extent tight-funding. Though opportunities are abundant, we must ensure field conditions are optimized to attain study objectives. A keen understanding and sensitivity towards the cultural and work settings is essential for successful project completion. Based on our experiences, we provide strategies to adopt to improve fieldwork and provide recommendations to help overcome the field challenges and achieve better results for future EES studies in developing country settings.
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Affiliation(s)
- Vidhya Venugopal
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India.
| | - Robin Lennqvist
- Occupational and Environmental Medicine, Gothenburg University, Sweden
| | - P K Latha
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Rekha S
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Anna Suraya
- CIHLMU Center for International Health, University Hospital, LMU Munich, Germany
| | | | - Tord Kjellstrom
- National Center for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia; HEAT-SHIELD Project, Center for Technology Research and Innovation Ltd, (CETRI), Limassol, Cyprus; Health and Environment International Trust, Mapua, New Zealand
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