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Slesinski SC, Indvik K, Barrientos-Gutierrez T, Bolinaga A, Caiaffa WT, Diez-Canseco F, Miranda JJ, Rodriguez DA, Sarmiento OL, Siri JG, Vergara AV, Roux AVD. Research Translation to Promote Urban Health in Latin America: The SALURBAL Experience. J Urban Health 2024:10.1007/s11524-024-00877-5. [PMID: 38935205 DOI: 10.1007/s11524-024-00877-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
In highly urbanized and unequal Latin America, urban health and health equity research are essential to effective policymaking. To ensure the application of relevant and context-specific evidence to efforts to reduce urban health inequities, urban health research in Latin America must incorporate strategic research translation efforts. Beginning in 2017, the Urban Health in Latin America (SALURBAL) project implemented policy-relevant research and engaged policymakers and the public to support the translation of research findings. Over 6 years, more than 200 researchers across eight countries contributed to SALURBAL's interdisciplinary network. This network allowed SALURBAL to adapt research and engagement activities to local contexts and priorities, thereby maximizing the policy relevance of research findings and their application to promote policy action, inform urban interventions, and drive societal change. SALURBAL achieved significant visibility and credibility among academic and nonacademic urban health stakeholders, resulting in the development of evidence and tools to support urban policymakers, planners, and policy development processes across the region. These efforts and their outcomes reveal important lessons regarding maintaining flexibility and accounting for local context in research, ensuring that resources are dedicated to policy engagement and dissemination activities, and recognizing that assessing policy impact requires a nuanced understanding of complex policymaking processes. These reflections are relevant for promoting urban health and health equity research translation across the global south and worldwide. This paper presents SALURBAL's strategy for dissemination and policy translation, highlights innovative initiatives and their outcomes, discusses lessons learned, and shares recommendations for future efforts to promote effective translation of research findings.
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Affiliation(s)
- S Claire Slesinski
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Katherine Indvik
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | | | - Andrea Bolinaga
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Waleska Teixeira Caiaffa
- Belo Horizonte Observatory for Urban Health, Belo Horizonte, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Daniel A Rodriguez
- Institute of Transportation Studies, University of California, Berkeley, CA, USA
- Department of City and Regional Planning and Institute Transportation Studies, University of California, Berkeley, CA, USA
| | - Olga L Sarmiento
- Department of Epidemiology, University of Los Andes, Bogotá, Colombia
| | - José G Siri
- Independent Consultant, Urban Health, Philadelphia, PA, USA
| | - Alejandra Vives Vergara
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Desarrollo Urbano Sustentable, CEDEUS, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ana V Diez Roux
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
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de Bell S, Alejandre JC, Menzel C, Sousa-Silva R, Straka TM, Berzborn S, Bürck-Gemassmer M, Dallimer M, Dayson C, Fisher JC, Haywood A, Herrmann A, Immich G, Keßler CS, Köhler K, Lynch M, Marx V, Michalsen A, Mudu P, Napierala H, Nawrath M, Pfleger S, Quitmann C, Reeves JP, Rozario K, Straff W, Walter K, Wendelboe-Nelson C, Marselle MR, Oh RRY, Bonn A. Nature-based social prescribing programmes: opportunities, challenges, and facilitators for implementation. ENVIRONMENT INTERNATIONAL 2024; 190:108801. [PMID: 38909402 DOI: 10.1016/j.envint.2024.108801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/26/2024] [Accepted: 06/03/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Evidence on the health benefits of spending time in nature has highlighted the importance of provision of blue and green spaces where people live. The potential for health benefits offered by nature exposure, however, extends beyond health promotion to health treatment. Social prescribing links people with health or social care needs to community-based, non-clinical health and social care interventions to improve health and wellbeing. Nature-based social prescribing (NBSP) is a variant that uses the health-promoting benefits of activities carried out in natural environments, such as gardening and walking. Much current NBSP practice has been developed in the UK, and there is increasing global interest in its implementation. This requires interventions to be adapted for different contexts, considering the needs of populations and the structure of healthcare systems. METHODS This paper presents results from an expert group participatory workshop involving 29 practitioners, researchers, and policymakers from the UK and Germany's health and environmental sectors. Using the UK and Germany, two countries with different healthcare systems and in different developmental stages of NBSP practice, as case studies, we analysed opportunities, challenges, and facilitators for the development and implementation of NBSP. RESULTS We identified five overarching themes for developing, implementing, and evaluating NBSP: Capacity Building; Accessibility and Acceptability; Networks and Collaborations; Standardised Implementation and Evaluation; and Sustainability. We also discuss key strengths, weaknesses, opportunities, and threats for each overarching theme to understand how they could be developed to support NBSP implementation. CONCLUSIONS NBSP could offer significant public health benefits using available blue and green spaces. We offer guidance on how NBSP implementation, from wider policy support to the design and evaluation of individual programmes, could be adapted to different contexts. This research could help inform the development and evaluation of NBSP programmes to support planetary health from local and global scales.
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Affiliation(s)
- Siân de Bell
- Exeter HSDR Evidence Synthesis Centre, University of Exeter, 79 Heavitree Rd, Exeter EX2 4TH, United Kingdom.
| | | | - Claudia Menzel
- Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau, Landau, Germany
| | - Rita Sousa-Silva
- Young Academy for Sustainability Research, Freiburg Institute for Advanced Studies, University of Freiburg, Albertstraße 19, 79104 Freiburg im Breisgau, Germany; Institute of Environmental Sciences, Department of Environmental Biology, Leiden University, P.O. Box 9518, 2300 RA Leiden, the Netherlands
| | - Tanja M Straka
- Institute of Ecology, Technische Universität Berlin, 12165 Berlin, Germany
| | - Susanne Berzborn
- Black Forest National Park, Schwarzwaldhochstraße 2, 77889 Seebach, Germany
| | - Max Bürck-Gemassmer
- KLUG (German Alliance for Climate Change and Health), Hainbuchenstr. 10a, 13465, Berlin, Germany
| | | | - Chris Dayson
- Centre for Regional Economic and Social Research, Sheffield Hallam University, Sheffield S1 2LX, United Kingdom
| | - Jessica C Fisher
- Durrell Institute of Conservation and Ecology, University of Kent, Canterbury CT2 7NR, United Kingdom
| | - Annette Haywood
- Sheffield Centre for Health and Related Research (SCHARR), School of Medicine and Population Health, University of Sheffield, Sheffield S1 4DA, United Kingdom
| | - Alina Herrmann
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany; Institute for General Practice, University Hospital Cologne, Medical Faculty University of Cologne, Cologne, Germany
| | - Gisela Immich
- Chair of Public Health and Health Services Research, Faculty of Medicine, LMU Munich, Germany; Pettenkofer School of Public Health, Munich, Germany
| | - Christian S Keßler
- Institute of Social Medicine, Epidemiology and Health Economy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Department of Internal Medicine and Nature-based Therapies, Immanuel Hospital Berlin, Berlin, Germany
| | | | - Mary Lynch
- Faculty of Nursing & Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Viola Marx
- Dundee City Council, Dundee, United Kingdom
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Department of Internal Medicine and Nature-based Therapies, Immanuel Hospital Berlin, Berlin, Germany
| | - Pierpaolo Mudu
- WHO Regional Office for Europe, European Centre for Environment and Health, Bonn, Germany
| | - Hendrik Napierala
- Institute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Maximilian Nawrath
- Norwegian Institute for Water Research, Økernveien 94, 0579 Oslo, Norway
| | | | - Claudia Quitmann
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | | | - Kevin Rozario
- Friedrich Schiller University Jena, Institute of Biodiversity, Dornburger Straße 159, 07743 Jena, Germany; Helmholtz Centre for Environmental Research - UFZ, Department of Ecosystem Services, Permoserstr. 15, 04318 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany; Leipzig University, Wilhelm Wundt Institute for Psychology, Neumarkt 9, 04109 Leipzig, Germany
| | - Wolfgang Straff
- Umweltbundesamt (German Environment Agency), Wörlitzer Pl. 1, 0684 Dessau-Roßlau, Germany
| | - Katie Walter
- Ullapool Medical Practice, NHS Highland, Ullapool, United Kingdom
| | | | - Melissa R Marselle
- Environmental Psychology Research Group, School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Rachel Rui Ying Oh
- Helmholtz Centre for Environmental Research - UFZ, Department of Ecosystem Services, Permoserstr. 15, 04318 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany
| | - Aletta Bonn
- Friedrich Schiller University Jena, Institute of Biodiversity, Dornburger Straße 159, 07743 Jena, Germany; Helmholtz Centre for Environmental Research - UFZ, Department of Ecosystem Services, Permoserstr. 15, 04318 Leipzig, Germany; German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstraße 4, 04103 Leipzig, Germany
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Vílchez-Román C, Paucar-Caceres A, Quispe-Prieto S. The impact of research on health education/health literacy on policymaking in Latin America and the Caribbean Region. AIMS Public Health 2024; 11:330-348. [PMID: 39027398 PMCID: PMC11252583 DOI: 10.3934/publichealth.2024017] [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: 12/11/2023] [Revised: 02/19/2024] [Accepted: 01/28/2024] [Indexed: 07/20/2024] Open
Abstract
Background In this study, we addressed the gap between health research and policymaking in Latin America and the Caribbean (LAC), focusing on health education/health literacy. Despite growing research, translating findings into effective policies needs to be improved. We explored the factors that make research on health education and health literacy to be referenced and mentioned in policy documents in LAC (and in Peru). We proposed a model based on the hypothesis that the relationship between research and policymaking depends on the research strength of scientific evidence, timing, and social media activity. Methods A mixed-methods approach was employed, combining quantitative and qualitative data analysis. Quantitative data sources included multidisciplinary databases, altmetric data, and citations of policy documents. For data analysis, we obtained descriptive statistics to identify patterns and then verified the association between variables using χ2. The negative binomial regression was used to test the empirical model introduced above. Quantitative analysis was complemented by analysis of responses to a set of open questions from a sample of Peruvian health policymakers. Results We found that timing, strength of evidence, and social media activity were significant predictors of research cited in policy documents. Policy documents tended to rely more on qualitative evidence. A positive correlation between timing and cites in policy documents highlighted the importance of timely dissemination, whereas social media activity, while having an impact, had a relatively minor effect. Peruvian policymakers' responses emphasized the role of political context, the relevance of results, and policymakers' commitment to incorporating research into policies. Conclusion Strength of evidence, social media engagement, and publication timing are key predictors of citations for health education/literacy research in LAC policy documents. However, qualitative findings highlight challenges, including some distrust in research findings, together with limited access to relevant research. The findings offer opportunities to enhance evidence-informed health education/health literacy policy decisions. Implications To increase the influence on health policymakers, researchers should prioritize the timely dissemination of solid evidence, considering both traditional and digital platforms. Policymakers should focus on the quality and relevance of evidence when formulating policies.
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Affiliation(s)
- Carlos Vílchez-Román
- Research Department, CENTRUM Católica Graduate Business School (CCGBS), Pontificia Universidad Católica del Perú (PUCP), Lima 15023, Perú
| | - Alberto Paucar-Caceres
- Department for Operations, Technology, Events and Hospitality Management, Manchester Metropolitan University, Manchester, M15 6BH, United Kingdom
| | - Silvia Quispe-Prieto
- School of Nursing, Faculty of Health Sciences, Universidad Nacional Jorge Basadre Grohmann, Grohmann, Tacna 23000, Perú
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Semahegn A, Manyazewal T, Hanlon C, Getachew E, Fekadu B, Assefa E, Kassa M, Hopkins M, Woldehanna T, Davey G, Fekadu A. Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review. Health Res Policy Syst 2023; 21:131. [PMID: 38057873 PMCID: PMC10699029 DOI: 10.1186/s12961-023-01084-5] [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: 06/05/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND An estimated 85% of research resources are wasted worldwide, while there is growing demand for context-based evidence-informed health policymaking. In low- and middle-income countries (LMICs), research uptake for health policymaking and practice is even lower, while little is known about the barriers to the translation of health evidence to policy and local implementation. We aimed to compile the current evidence on barriers to uptake of research in health policy and practice in LMICs using scoping review. METHODS The scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses-extension for Scoping Reviews (PRISMA-ScR) and the Arksey and O'Malley framework. Both published evidence and grey literature on research uptake were systematically searched from major databases (PubMed, Cochrane Library, CINAHL (EBSCO), Global Health (Ovid)) and direct Google Scholar. Literature exploring barriers to uptake of research evidence in health policy and practice in LMICs were included and their key findings were synthesized using thematic areas to address the review question. RESULTS A total of 4291 publications were retrieved in the initial search, of which 142 were included meeting the eligibility criteria. Overall, research uptake for policymaking and practice in LMICs was very low. The challenges to research uptake were related to lack of understanding of the local contexts, low political priority, poor stakeholder engagement and partnership, resource and capacity constraints, low system response for accountability and lack of communication and dissemination platforms. CONCLUSION Important barriers to research uptake, mainly limited contextual understanding and low participation of key stakeholders and ownership, have been identified. Understanding the local research and policy context and participatory evidence production and dissemination may promote research uptake for policy and practice. Institutions that bridge the chasm between knowledge formation, evidence synthesis and translation may play critical role in the translation process.
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Affiliation(s)
- Agumasie Semahegn
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana.
| | - Tsegahun Manyazewal
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Services and Population Research Department, King's College London, London, UK
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eyerusalem Getachew
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bethelhem Fekadu
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Esubalew Assefa
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Department of Economics, Faculty of Arts and Social Sciences, The Open University, Milton Keynes, UK
| | | | - Michael Hopkins
- Science Policy Research Unit, University of Sussex, Brighton, UK
| | - Tassew Woldehanna
- College of Business and Economics, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gail Davey
- Global Health & Infection Department, Brighton and Sussex Medical School, Brighton, UK
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Global Health & Infection Department, Brighton and Sussex Medical School, Brighton, UK
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Mfutso-Bengo J, Nkungula N, Mnjowe E, Ng'ambi W, Jeremiah F, Kasende- Chinguwo F, Meckson Bickton F, Nkhoma D, Chinkhumba J, Mboma S, Ngwira L, Juma M, Kazanga-Chiumia I, Twea P, Manthalu G. Proposing the "Value- and Evidence-Based decision making and Practice" (VEDMAP) framework for Priority-Setting and knowledge translation in low and Middle-Income Countries: A novel framework for Decision-Making in Low-and middle income countries like Malawi. HEALTH POLICY OPEN 2023; 4:100094. [PMID: 37383887 PMCID: PMC10297823 DOI: 10.1016/j.hpopen.2023.100094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 10/21/2022] [Accepted: 03/26/2023] [Indexed: 06/30/2023] Open
Abstract
The existence and availability of evidence on its own does not guarantee that the evidence will be demanded and used by decision and policy makers. Decision and policy-makers, especially in low-income settings, often confront ethical dilemmas about determining the best available evidence and its utilization. This dilemma can be in the form of conflict of evidence, scientific and ethical equipoise and competing evidence or interests. Consequently, decisions are made based on convenience, personal preference, donor requirements, and political and social considerations which can result in wastage of resources and inefficiency. To mitigate these challenges, the use of "Value- and Evidence-Based Decision Making and Practice" (VEDMAP) framework is proposed. This framework was developed by Joseph Mfutso-Bengo in 2017 through a desk review. It was pretested through a scoping study under the Thanzi la Onse (TLO) Project which assessed the feasibility and acceptability of using the VEDMAP as a priority setting tool for Health Technology Assessment (HTA) in Malawi. The study used mixed methods whereby it conducted a desk review to map out and benchmark normative values of different countries in Africa and HTA; focus group discussion and key informant interviews to map out the actual (practised) values in Malawi. The results of this review confirmed that the use of VEDMAP framework was feasible and acceptable and can bring efficiency, traceability, transparency and integrity in decision- policy making process and implementation.
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Affiliation(s)
- Joseph Mfutso-Bengo
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
- Centre of Bioethics in Eastern and Southern Africa, Blantyre, Malawi
- Centre of Excellence in Ethics and Governance, Blantyre, Malawi
| | - Nthanda Nkungula
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
- Centre of Bioethics in Eastern and Southern Africa, Blantyre, Malawi
| | - Emmanuel Mnjowe
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Wingston Ng'ambi
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Faless Jeremiah
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Florence Kasende- Chinguwo
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Fanuel Meckson Bickton
- Malawi-Liverpool-Wellcome Trust Clinical Programme, Blantyre, Malawi
- UCL GOS Institute of Child Health, London, United Kingdom
| | - Dominic Nkhoma
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Jobiba Chinkhumba
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Sebastian Mboma
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Lucky Ngwira
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Mercy Juma
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Isabel Kazanga-Chiumia
- Health Economics and Policy Unit, Department of Health Systems and Policy, Kamuzu University of Health Sciences, Lilongwe, Malawi
| | - Pakwanja Twea
- Department of Planning and Policy Development, Ministry of Health, Malawi
| | - Gerald Manthalu
- Department of Planning and Policy Development, Ministry of Health, Malawi
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Malaeb D, Hallit S, Sakr F, Dabbous M, Saadeh W, Mansour S, Cherri S, Sarayeldyine SA, Salameh P, Hosseini H. The use of intravenous thrombolytics in acute ischemic stroke management: A scoping review from 2008 till 2021 in the Arab world in the Middle East and North Africa. J Stroke Cerebrovasc Dis 2023; 32:107201. [PMID: 37290154 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107201] [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: 03/28/2023] [Revised: 05/09/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVE The aim of this review was to assess and analyze the research output on intravenous thrombolysis in acute ischemic stroke in the Arab world in the Middle East and North Africa. METHODS Published literature on intravenous thrombolysis for acute ischemic stroke from 2008 to 2021 were retrieved from several electronic databases. Extracted records were analyzed in terms of year of publication, country, journal, research area, authors, and organizational affiliations. RESULTS A total of 37 studies were published between 2008 and 2021 from different Arab countries. Eight studies assessed the safety and efficacy of thrombolytic agents in AIS. Three studies were KAP studies addressing the knowledge, attitude and practice towards IVT. The majority of the selected studies (n=16) discussed the utilization rate of IVT among patients in different hospital settings across these countries. Ten studies reported the outcomes associated with the use of IVT for AIS. CONCLUSION This is the first scoping review to study the research activity related to the use of IVT in stroke in the Arab nations. In the last 15 years, stroke research productivity was very low in the Arab world compared to other regions of the world due to several impeding factors. Given the high burden of in-adherence to acute stroke treatment in the Arab nations, there is a serious need for an increased high-quality research activity to highlight the roadblocks associated with the limited use of IVT.
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Affiliation(s)
- Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates; School of Pharmacy, Lebanese International University, Beirut, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), P.O Box: 446, Jounieh lebanon; Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon; INSPECT-LB (Institut National de Sant e Publique, d'Épid emiologie Clinique et de Toxicologie-Liban); UMR U955 INSERM, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, 94010 Créteil, France; École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, 94010 Créteil, France
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Wadih Saadeh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Faculty of Public health, Lebanese University, Fanar, Lebanon
| | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sarah Cherri
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | | | - Pascale Salameh
- INSPECT-LB (Institut National de Sant e Publique, d'Épid emiologie Clinique et de Toxicologie-Liban); Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus; School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hassan Hosseini
- INSERM U955-E01, IMRB, Henri Mondor Hospital, Créteil, France; Department of Neurology, Henri Mondor Hospital, AP-HP, Créteil, France
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El-Jardali F, Fadlallah R, Bou Karroum L, Akl EA. Evidence synthesis to policy: development and implementation of an impact-oriented approach from the Eastern Mediterranean Region. Health Res Policy Syst 2023; 21:40. [PMID: 37264415 DOI: 10.1186/s12961-023-00989-5] [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: 12/22/2022] [Accepted: 05/04/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Despite the importance of evidence syntheses in informing policymaking, their production and use remain limited in the Eastern Mediterranean region (EMR). There is a lack of empirical research on approaches to promote and use policy-relevant evidence syntheses to inform policymaking processes in the EMR. OBJECTIVE This study sought to describe the development of an impact-oriented approach to link evidence synthesis to policy, and its implementation through selected case studies in Lebanon, a middle-income country in the EMR. METHODS This study followed a multifaceted and iterative process that included (i) a review of the literature, (ii) input from international experts in evidence synthesis and evidence-informed health policymaking, and (iii) application in a real-world setting (implementation). We describe four selected case studies of implementation. Surveys were used to assess policy briefs, deliberative dialogues, and post-dialogue activities. Additionally, Kingdon's stream theory was adopted to further explain how and why the selected policy issues rose to the decision agenda. RESULTS The approach incorporates three interrelated phases: (1) priority setting, (2) evidence synthesis, and (3) uptake. Policy-relevant priorities are generated through formal priority setting exercises, direct requests by policymakers and stakeholders, or a focusing event. Identified priorities are translated into focused questions that can be addressed via evidence synthesis (phase 1). Next, a scoping of the literature is conducted to identify existing evidence syntheses addressing the question of interest. Unless the team identifies relevant, up-to-date and high-quality evidence syntheses, it proceeds to conducting SRs addressing the priority questions of interest (phase 2). Next, the team prepares knowledge translation products (e.g., policy briefs) for undertaking knowledge uptake activities, followed by monitoring and evaluation (phase 3). There are two prerequisites to the application of the approach: enhancing contextual awareness and capacity strengthening. The four case studies illustrate how evidence produced from the suites of activities was used to inform health policies and practices. CONCLUSIONS To our knowledge, this is the first study to describe both the development and implementation of an approach to link evidence synthesis to policy in the EMR. We believe the approach will be useful for researchers, knowledge translation platforms, governments, and funders seeking to promote evidence-informed policymaking and practice.
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Affiliation(s)
- Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Center for Systematic Reviews On Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Racha Fadlallah
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Center for Systematic Reviews On Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Lama Bou Karroum
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Center for Systematic Reviews On Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Center for Systematic Reviews On Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada.
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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A Program Evaluation of a Dietary Sodium Reduction Research Consortium of Five Low- and Middle-Income Countries in Latin America. Nutrients 2022; 14:nu14204311. [PMID: 36296995 PMCID: PMC9606855 DOI: 10.3390/nu14204311] [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: 09/01/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 11/29/2022] Open
Abstract
Excess dietary sodium is a global public health priority, particularly in low- and middle-income countries where rates of hypertension and cardiovascular disease are high. The International Development Research Centre funded a research consortium of five Latin American countries (LAC) to inform public health policy for dietary sodium reduction (2016-2020). The objective of this study was to determine the outcomes of this funding on short-term (e.g., research, capacity building) and intermediary outcomes (e.g., policies). A summative program evaluation was conducted, using a logic model and multiple data sources including document review, surveys and interviews. Researchers from Argentina, Costa Rica, Brazil, Peru and Paraguay produced a significant amount of scientific evidence to guide decision making on sodium policy related to its content in foods, consumer behaviors (social marketing), and the health and economic benefits of dietary reduction. A substantive number of knowledge translation products were produced. The funding enabled training opportunities for researchers who developed skills that can be scaled-up to other critical nutrients and health issues. It was unexpected that intermediary policy changes would occur, however several countries demonstrated early policy improvements derived from this research. A funded research consortium of LAC is a practical approach to invoke policy innovations.
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Bawah AA, Biney AAE, Kyei P. “You Can’t Look at an Orange and Draw a Banana”: Using Research Evidence to Develop Relevant Health Policy in Ghana. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00693. [PMID: 36109053 PMCID: PMC9476488 DOI: 10.9745/ghsp-d-21-00693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 02/16/2022] [Indexed: 11/16/2022]
Abstract
We explored inhibitors and enablers of using health policy and systems research to inform the policy process in Ghana. The findings suggest a myriad of factors influencing evidence-based policy development, including the strength of the relationships between policy makers and research producers. We examined factors that either enabled or inhibited the process of evidence-based decision making regarding health policy in Ghana. We conducted qualitative interviews with 2 major groups of stakeholders: health policy and systems research producers (research producers [RPs]) and policy makers (PMs). In-depth interviews were conducted with 12 RPs, who were representatives from 11 health policy and systems research institutions; and 12 PMs working in various national health-related agencies, ministries, and departments. We analyzed the data using the thematic analysis approach. Interview results showed 5 recurring themes in their discussion of enablers and inhibitors of the evidence-to-policy process: (1) the quality, relevance, and quantity of available research evidence; (2) how findings are communicated to PMs; (3) the strength of relationships between RPs and PMs; (4) available structures that promote evidence-based policy making; and (5) the political context in which research and policy making occurs. These findings point to some specific areas for further collaboration and communication among Ghanaian stakeholders to ensure that appropriate health policies are developed from an evidence base.
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Ziebold C, Evans-Lacko S, Andrade MCR, Hoffmann MS, Fonseca L, Barbosa MG, Pan PM, Miguel E, Bressan RA, Rohde LA, Salum GA, de Jesus Mari J, Gadelha A. Childhood individual and family modifiable risk factors for criminal conviction: a 7-year cohort study from Brazil. Sci Rep 2022; 12:13381. [PMID: 35927553 PMCID: PMC9352677 DOI: 10.1038/s41598-022-13975-8] [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] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
Crime is a major public problem in low- and middle-income countries (LMICs) and its preventive measures could have great social impact. The extent to which multiple modifiable risk factors among children and families influence juvenile criminal conviction in an LMIC remains unexplored; however, it is necessary to identify prevention targets. This study examined the association between 22 modifiable individual and family exposures assessed in childhood (5-14 years, n = 2511) and criminal conviction at a 7-year follow-up (13-21 years, n = 1905, 76% retention rate) in a cohort of young people in Brazil. Population attributable risk fraction (PARF) was computed for significant risk factors. Criminal convictions were reported for 81 (4.3%) youths. Although most children living in poverty did not present criminal conviction (89%), poverty at baseline was the only modifiable risk factor significantly associated with crime (OR 4.14, 99.8% CI 1.38-12.46) with a PARF of 22.5% (95% CI 5.9-36.1%). It suggests that preventing children's exposure to poverty would reduce nearly a quarter of subsequent criminal convictions. These findings highlight the importance of poverty in criminal conviction, as it includes several deprivations and suggest that poverty eradication interventions during childhood may be crucial for reducing crime among Brazilian youth.
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Affiliation(s)
- Carolina Ziebold
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Major Maragliano, 241-Vila Mariana, São Paulo, 04017-030, Brazil.
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, WC2A 2AE, UK
| | | | - Maurício Scopel Hoffmann
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, WC2A 2AE, UK
- Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, 97105-900, Brazil
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil
| | - Lais Fonseca
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Major Maragliano, 241-Vila Mariana, São Paulo, 04017-030, Brazil
| | - Matheus Ghossain Barbosa
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Major Maragliano, 241-Vila Mariana, São Paulo, 04017-030, Brazil
| | - Pedro Mario Pan
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Major Maragliano, 241-Vila Mariana, São Paulo, 04017-030, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, 05403-010, Brazil
| | - Euripedes Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, 05403-010, Brazil
- Department of Psychiatry, Universidade de São Paulo, São Paulo, 05403-903, Brazil
| | - Rodrigo Affonseca Bressan
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Major Maragliano, 241-Vila Mariana, São Paulo, 04017-030, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, 05403-010, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, 05403-010, Brazil
- ADHD Outpatient and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, 90035-903, Brazil
| | - Giovanni Abrahão Salum
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Rio Grande do Sul, 90035-003, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, 05403-010, Brazil
| | - Jair de Jesus Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Major Maragliano, 241-Vila Mariana, São Paulo, 04017-030, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, 05403-010, Brazil
| | - Ary Gadelha
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Major Maragliano, 241-Vila Mariana, São Paulo, 04017-030, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, 05403-010, Brazil
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Verboom B, Baumann A. Mapping the Qualitative Evidence Base on the Use of Research Evidence in Health Policy-Making: A Systematic Review. Int J Health Policy Manag 2022; 11:883-898. [PMID: 33160295 PMCID: PMC9808178 DOI: 10.34172/ijhpm.2020.201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/06/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The use of research evidence in health policy-making is a popular line of inquiry for scholars of public health and policy studies, with qualitative methods constituting the dominant strategy in this area. Research on this subject has been criticized for, among other things, disproportionately focusing on high-income countries; overemphasizing 'barriers and facilitators' related to evidence use to the neglect of other, less descriptive concerns; relying on descriptive, rather than in-depth explanatory designs; and failing to draw on insights from political/policy studies theories and concepts. We aimed to comprehensively map the global, peer-reviewed qualitative literature on the use of research evidence in health policy-making and to provide a descriptive overview of the geographic, temporal, methodological, and theoretical characteristics of this body of literature. METHODS We conducted a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched nine electronic databases, hand-searched 11 health- and policy-related journals, and systematically scanned the reference lists of included studies and previous reviews. No language, date or geographic limitations were imposed. RESULTS The review identified 319 qualitative studies on a diverse array of topics related to the use of evidence in health policy-making, spanning 72 countries and published over a nearly 40 year period. A majority of these studies were conducted in high-income countries, but a growing proportion of the research output in this area is now coming from low- and middle-income countries, especially from sub-Saharan Africa. While over half of all studies did not use an identifiable theory or framework, and only one fifth of studies used a theory or conceptual framework drawn from policy studies or political science, we found some evidence that theory-driven and explanatory (eg, comparative case study) designs are becoming more common in this literature. Investigations of the barriers and facilitators related to evidence use constitute a large proportion but by no means a majority of the work in this area. CONCLUSION This review provides a bird's eye mapping of the peer reviewed qualitative research on evidence-to-policy processes, and has identified key features of - and gaps within - this body of literature that will hopefully inform, and improve, research in this area moving forward.
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Affiliation(s)
- Ben Verboom
- Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK
| | - Aron Baumann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Guleid FH, Njeru A, Kiptim J, Kamuya DM, Okiro E, Tsofa B, English M, Molyneux S, Kariuki D, Barasa E. Experience of Kenyan researchers and policy-makers with knowledge translation during COVID-19: a qualitative interview study. BMJ Open 2022; 12:e059501. [PMID: 35649617 PMCID: PMC9160583 DOI: 10.1136/bmjopen-2021-059501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/17/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Researchers at the KEMRI-Wellcome Trust Research Programme (KWTRP) carried out knowledge translation (KT) activities to support policy-makers as the Kenyan Government responded to the COVID-19 pandemic. We assessed the usefulness of these activities to identify the facilitators and barriers to KT and suggest actions that facilitate KT in similar settings. DESIGN The study adopted a qualitative interview study design. SETTING AND PARTICIPANTS Researchers at KWTRP in Kenya who were involved in KT activities during the COVID-19 pandemic (n=6) were selected to participate in key informant interviews to describe their experience. In addition, the policy-makers with whom these researchers engaged were invited to participate (n=11). Data were collected from March 2021 to August 2021. ANALYSIS A thematic analysis approach was adopted using a predetermined framework to develop a coding structure consisting of the core thematic areas. Any other theme that emerged in the coding process was included. RESULTS Both groups reported that the KT activities increased evidence availability and accessibility, enhanced policy-makers' motivation to use evidence, improved capacity to use research evidence and strengthened relationships. Policy-makers shared that a key facilitator of this was the knowledge products shared and the regular interaction with researchers. Both groups mentioned that a key barrier was the timeliness of generating evidence, which was exacerbated by the pandemic. They felt it was important to institutionalise KT to improve readiness to respond to public health emergencies. CONCLUSION This study provides a real-world example of the use of KT during a public health crisis. It further highlights the need to institutionalise KT in research and policy institutions in African countries to respond readily to public health emergencies.
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Affiliation(s)
- Fatuma Hassan Guleid
- Policy Engagement & Knowledge Translation Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Alex Njeru
- Policy Engagement & Knowledge Translation Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Joy Kiptim
- Policy Engagement & Knowledge Translation Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Dorcas Mwikali Kamuya
- Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - Emelda Okiro
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Population Health, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Benjamin Tsofa
- Health Policy and Systems Research, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Mike English
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Health Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | - Sassy Molyneux
- Health Systems and Research Ethics, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - David Kariuki
- Department of Health Policy and Research, Ministry of Health, Nairobi, Kenya
| | - Edwine Barasa
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
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Hosseinnejad A, Rassouli M, Jahani S, Elahi N, Molavynejad S. Requirements for Creating a Position for Community Health Nursing Within the Iranian Primary Health Care System: A SWOT Analysis. Front Public Health 2022; 9:793973. [PMID: 35096746 PMCID: PMC8793020 DOI: 10.3389/fpubh.2021.793973] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/09/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Accepting community health nursing in the primary care system of each country and focusing on creating a position for community health nurses is of significant importance. The aim of this study was to examine the stakeholders' perception of the requirements for establishing a position for community health nursing in the Iranian primary health care system. Methods: This qualitative study was done using 24 semi-structured interviews conducted from May 2020 to February 2021 in Iran. The participants were selected through purposive sampling and consisted of nursing policy makers, the policy makers of the Health Deputy of Ministry of Health, the managers and the authorities of universities of medical sciences all across the country, community health nursing faculty members, and community health nurses working in health care centers. After recording and transcribing the data, data analysis was performed in MAXQDA10 software, using Elo and Kyngas's directed content analysis approach and based on WHO's community health nursing role enhancement model. The statements for each main category were summarized in SWOT classification. To examine the trustworthiness of the data, Lincoln & Guba's criteria were used. Results: By analyzing the interviews 6 main categories identified consist of creating a transparent framework for community health nursing practice, enhancing community health nursing education and training for practice in the primary health care system and community settings, seeking support, strengthening the cooperation and engagement among the key stakeholders of the primary health care system, changing the policies and the structure of the health system, and focusing on the deficiencies of the health system. Each main categories including the subcategories strengths, weaknesses, opportunities and threats (SWOT). Conclusions: Based on the participants' opinions, focusing on the aforementioned dimensions is one of the requirements of developing a position for community health nursing within the Iranian PHC system. It seems that correct and proper implementation of these strategies in regard with the cultural context of society can help policymakers manage challenges that prevent the performance of community health nursing in the health system.
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Affiliation(s)
- Aazam Hosseinnejad
- Student Research Committee, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Simin Jahani
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasrin Elahi
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Paing PY, Kyaw ZL, Schojan M, Traill T, Thura S, Tin N, Sein TT, Myint HHT, Bolton P, Lee C. Development of a knowledge broker group to support evidence-informed policy: lessons learned from Myanmar. Health Res Policy Syst 2021; 19:153. [PMID: 34963496 PMCID: PMC8713039 DOI: 10.1186/s12961-021-00806-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally, policy-makers face challenges to using evidence in health decision-making, particularly lack of interaction between research and policy. Knowledge-brokering mechanisms can fill research–policy gaps and facilitate evidence-informed policy-making. In Myanmar, the need to promote evidence-informed policy is significant, and thus a mechanism was set up for this purpose. This paper discusses lessons learned from the development of the Knowledge Broker Group–Myanmar (KBG-M), supported by the Johns Hopkins Bloomberg School of Public Health’s Applied Mental Health Research Group (JHU) and Community Partners International (CPI). Methods Sixteen stakeholders were interviewed to explore challenges in formulating evidence-informed policy. Two workshops were held: the first to further understand the needs of policy-makers and discuss knowledge-brokering approaches, and the second to co-create the KBG-M structure and process. The KBG-M was then envisioned as an independent body, with former officials of the Ministry of Health and Sports (MoHS) and representatives from the nongovernmental sector actively engaging in the health sector, with an official collaboration with the MoHS. Results A development task force that served as an advisory committee was established. Then, steps were taken to establish the KBG-M and obtain official recognition from the MoHS. Finally, when the technical agreement with the MoHS was nearly complete, the process stopped because of the military coup on 1 February 2021, and is now on hold indefinitely. Conclusions Learning from this process may be helpful for future or current knowledge-brokering efforts, particularly in fragile, conflict-affected settings. Experienced and committed advisory committee members enhanced stakeholder relationships. Responsive coordination mechanisms allowed for adjustments to a changing bureaucratic landscape. Coordination with similar initiatives avoided overlap and identified areas needing technical support. Recommendations to continue the work of the KBG-M itself or similar platforms include the following: increase resilience to contextual changes by ensuring diverse partnerships, maintain advisory committee members experienced and influential in the policy-making process, ensure strong organizational and funding support for effective functioning and sustainability, have budget and timeline flexibility to allow sufficient time and resources for establishment, organize ongoing needs assessments to identify areas needing technical support and to develop responsive corrective approaches, and conduct information sharing and collaboration between stakeholders to ensure alignment.
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Affiliation(s)
- Pyone Yadanar Paing
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar.
| | - Zarni Lynn Kyaw
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar
| | - Matthew Schojan
- Department of Mental Health, Global Mental Health Research Group, Johns Hopkins School of Public Health, 624 N. Broadway, Baltimore, MD, United States of America
| | - Tom Traill
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar
| | - Si Thura
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar
| | - Nilar Tin
- Public Health Professional, Yangon, Myanmar
| | - Than-Tun Sein
- Anthropology Department, Ramanya Hall, Yangon University, Yangon University PO, Yangon, Myanmar
| | - Hnin Hnin Tha Myint
- Community Partners International, 81 University Avenue Road, Shwe Taung Gyar Ward (1), Bahan Township, Yangon, Myanmar
| | - Paul Bolton
- Department of Mental Health, Global Mental Health Research Group, Johns Hopkins School of Public Health, 624 N. Broadway, Baltimore, MD, United States of America
| | - Catherine Lee
- Department of Mental Health, Global Mental Health Research Group, Johns Hopkins School of Public Health, 624 N. Broadway, Baltimore, MD, United States of America
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Tiwari BB, Ban A, Gurung S, Karki KB. Translating evidence into policy: opinions and insights of Health Researchers and Policymakers in Nepal. BMC Health Serv Res 2021; 21:1066. [PMID: 34625071 PMCID: PMC8501615 DOI: 10.1186/s12913-021-07102-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 09/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Evidence-Based Policymaking (EBP) process in Nepal is rife with poor practices where often policymakers are portrayed as perpetrators for such practices. However, we need to think of the EBP as a two-sided coin where both research pull and research push play equally significant roles. This study aimed to assess the perception of Nepalese health policymakers and researchers on EBP and identify appropriate mechanisms to integrate evidence into policies. METHODS Following the constructivist philosophical paradigm, qualitative research design was used in the study with the grounded theory approach. Purposive sampling was performed, and the 12 in-depth interviews were conducted, where number of interviews was finalized using saturation theory. All interviews were audio-recorded, transcribed, translated to English, coded line by line, and then developed into themes. Thematic analysis technique was used to manually analyze the data. RESULTS Study participants highlighted that evidence is being utilized during policy formulation but not in the amount it should be, with a preference for anecdotal evidence further reducing the chance. Apart from these barriers, poor credibility of information obtained, poorly targeted dissemination, inadequate policy-based researches, and policymakers and researchers operating within the spheres of their own with a feeble link to channel the flow of information between them were identified by participants. On the other hand, the publication of one-pager research brief, conduction of nationally representative surveys especially quantitative studies, the practice of cost-effectiveness study, and policymaker's involvement during the research were some facilitators identified. CONCLUSIONS Moreover, the study accentuates that better communication strategies such as the establishment of formal forums with policymakers and researchers, better-targeted dissemination, and identification of priority areas have wide potential to promote a unified front of health policymakers and researchers for EBP.
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Affiliation(s)
- Biplav Babu Tiwari
- Maharajgunj Medical Campus (MMC), Institute of Medicine (IOM), Tribhuvan University (TU), Kathmandu, Nepal. .,College of Public Health, University of Georgia, Athens, Georgia.
| | - Anusha Ban
- Maharajgunj Medical Campus (MMC), Institute of Medicine (IOM), Tribhuvan University (TU), Kathmandu, Nepal.,College for Public Health and Social Justice, Saint Louis University, Saint Louis, USA
| | - Sony Gurung
- Maharajgunj Medical Campus (MMC), Institute of Medicine (IOM), Tribhuvan University (TU), Kathmandu, Nepal.,College of Public Health, University of Georgia, Athens, Georgia
| | - Khem Bahadur Karki
- Maharajgunj Medical Campus (MMC), Institute of Medicine (IOM), Tribhuvan University (TU), Kathmandu, Nepal
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Aligning Best Practices: A Guiding Framework as a Valuable Tool for Public Health Workforce Development with the Example of Ukraine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179246. [PMID: 34501834 PMCID: PMC8431433 DOI: 10.3390/ijerph18179246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022]
Abstract
Background: At present, in Ukraine, there is an insufficient capacity for up-to-date surveillance of the health status of the general population; public health (PH) promotion and disease prevention activities are scarce. Additionally, there is an urgent need to ensure, develop and support an efficient public health workforce (PHW) and appropriately address existing health issues. Ukraine currently introduces PH system reforms in line with its current burden of disease, the epidemiological profile and the Essential Public Health Services (EPHOs). This analysis aims to propose a pragmatic framework to provide guidance and recommendations related to the development, support and planning of the PHW in Ukraine. Methods: We constructed a framework based on a previously published scoping review and analyzed various policy analysis approaches. In line with the recommendations found in the literature and the best practices used elsewhere, this method enabled the construction of a framework for facilitating successful PHW development. In addition, an expert workshop was held, serving as a reality check for identifying crucial areas of the PH system in Ukraine. Results: The proposed framework includes a country’s background, the evidence and available policy options, such as the health system (including core functions, organizational resources, regulations and norms), health system capacities (including human resources; PH capacity assessment; datasets and databases; forecasting strategies; licensing, accreditation and quality assurance) and capacity building (including PH education, training, core competencies and ethical and professional codes of conduct). To facilitate and support effective implementation of the framework, we propose (1) implementing strategies to facilitate changes in attitude, behavior and practices among the citizens; (2) implementing strategies to facilitate the necessary behavioral changes in the PHW; (3) implementing strategies to facilitate the necessary organizational and institutional changes; (4) implementing strategies to facilitate system changes and (5) identification of potential barriers and obstacles for the implementation of these strategies. Conclusion: The report highlights the practical tactics and best practices for providing suggestions for PHW support and planning. The employment of prominent analytical tools and procedures in policymaking processes suggests an effective strategy for PHW development in Ukraine.
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Yazdizadeh B, Sajadi HS, Mohtasham F, Mohseni M, Majdzadeh R. Systematic review and policy dialogue to determine challenges in evidence-informed health policy-making: findings of the SASHA study. Health Res Policy Syst 2021; 19:73. [PMID: 33947402 PMCID: PMC8097912 DOI: 10.1186/s12961-021-00717-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 04/03/2021] [Indexed: 11/19/2022] Open
Abstract
Background Various interventions have been undertaken in Iran to promote evidence-informed health policy-making (EIHP). Identifying the challenges in EIHP is the first step toward strengthening EIHP in each country through the design of tailored interventions. Therefore, the current study was conducted to synthesize the results of earlier studies and to finalize the list of barriers to EIHP in Iran. Methods To identify the barriers to EIHP in Iran, two steps were taken: a systematic review and policy dialogue. To conduct the systematic review, three Iranian databases and PubMed, Health Systems Evidence (HSE), Embase, and Scopus were searched. The reference lists of included papers and documentation from some local organizations were hand-searched. Upon conducting the systematic review, given the significance of stakeholders in clarifying the problem of EIHP, policy dialogue was used to complete the list previously extracted and to do advocacy. Selection criteria for the stakeholders included influential and informed individuals from knowledge-producing, knowledge-utilizing, and knowledge-brokering organizations. Semi-structured interviews were held with three important absent stakeholders. Results Challenges specific to Iran that were identified included the lack of integration of the health ministry and the medical universities, lack of ties between health knowledge utilization organizations, failure to establish long-term research plans, neglect of national research needs at the time of recruiting human resources in knowledge-producing organizations, and duplication and lack of coordination in routine data obtained from surveillance systems, disease registration systems, and censuses. It seems that some challenges are common across countries, including neglecting the importance of inter- and intra-disciplinary studies, the capacity of policy-makers and managers to utilize evidence, the criteria for evaluating the performance of policy-makers, managers, and academic members, the absence of long-term programmes in knowledge-utilizing organizations, the rapid replacement of policy-makers and managers, and lack of use of evaluation studies. Conclusions In this study, we tried to identify the challenges regarding EIHP in Iran using a systematic review and policy dialogue approach. This is the first step toward determining the best interventions to improve evidence-informed policy-making in each country, because these challenges are contextual and need to be investigated contextually. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00717-x.
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Affiliation(s)
- Bahareh Yazdizadeh
- Knowledge Utilization Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Haniye Sadat Sajadi
- Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Mohtasham
- Knowledge Utilization Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Mohseni
- Knowledge Utilization Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community Based Participatory Research Center, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Garritty C, Hamel C, Hersi M, Butler C, Monfaredi Z, Stevens A, Nussbaumer-Streit B, Cheng W, Moher D. Assessing how information is packaged in rapid reviews for policy-makers and other stakeholders: a cross-sectional study. Health Res Policy Syst 2020; 18:112. [PMID: 32993657 PMCID: PMC7523380 DOI: 10.1186/s12961-020-00624-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 08/30/2020] [Indexed: 01/08/2023] Open
Abstract
Background Rapid reviews (RRs) are useful products to healthcare policy-makers and other stakeholders, who require timely evidence. Therefore, it is important to assess how well RRs convey useful information in a format that is easy to understand so that decision-makers can make best use of evidence to inform policy and practice. Methods We assessed a diverse sample of 103 RRs against the BRIDGE criteria, originally developed for communicating clearly to support healthcare policy-making. We modified the criteria to increase assessability and to align with RRs. We identified RRs from key database searches and through searching organisations known to produce RRs. We assessed each RR on 26 factors (e.g. organisation of information, lay language use). Results were descriptively analysed. Further, we explored differences between RRs published in journals and those published elsewhere. Results Certain criteria were well covered across the RRs (e.g. all aimed to synthesise research evidence and all provided references of included studies). Further, most RRs provided detail on the problem or issue (96%; n = 99) and described methods to conduct the RR (91%; n = 94), while several addressed political or health systems contexts (61%; n = 63). Many RRs targeted policy-makers and key stakeholders as the intended audience (66%; n = 68), yet only 32% (n = 33) involved their tacit knowledge, while fewer (27%; n = 28) directly involved them reviewing the content of the RR. Only six RRs involved patient partners in the process. Only 23% (n = 24) of RRs were prepared in a format considered to make information easy to absorb (i.e. graded entry) and 25% (n = 26) provided specific key messages. Readability assessment indicated that the text of key RR sections would be hard to understand for an average reader (i.e. would require post-secondary education) and would take 42 (± 36) minutes to read. Conclusions Overall, conformity of the RRs with the modified BRIDGE criteria was modest. By assessing RRs against these criteria, we now understand possible ways in which they could be improved to better meet the information needs of healthcare decision-makers and their potential for innovation as an information-packaging mechanism. The utility and validity of these items should be further explored. Protocol availability The protocol, published on the Open Science Framework, is available at: osf.io/68tj7
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Affiliation(s)
- Chantelle Garritty
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, CPCR Building, 501 Smyth Rd, Box 201B, Ottawa, ON, K1H 8L6, Canada. .,TRIBE Graduate Program, University of Split School of Medicine, Split, Croatia.
| | - Candyce Hamel
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, CPCR Building, 501 Smyth Rd, Box 201B, Ottawa, ON, K1H 8L6, Canada.,TRIBE Graduate Program, University of Split School of Medicine, Split, Croatia
| | - Mona Hersi
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, CPCR Building, 501 Smyth Rd, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - Claire Butler
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, CPCR Building, 501 Smyth Rd, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - Zarah Monfaredi
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, CPCR Building, 501 Smyth Rd, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - Adrienne Stevens
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, CPCR Building, 501 Smyth Rd, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | | | - Wei Cheng
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, CPCR Building, 501 Smyth Rd, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - David Moher
- Knowledge Synthesis Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, CPCR Building, 501 Smyth Rd, Box 201B, Ottawa, ON, K1H 8L6, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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19
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Kimiaeimehr F, Hosseini SM, Alimohammadzadeh K, Bahadori M, Maher A. Confirmatory factor analysis model of factors affecting the implementation of clinical guidelines in Iran. Med J Islam Repub Iran 2020; 34:122. [PMID: 33437718 PMCID: PMC7787019 DOI: 10.34171/mjiri.34.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Clinical guidelines refer to a developed scientific statement to help physicians and patients for decision-making about the best care for special clinical conditions, which can be an important document to shape evidence-based medicine. This study aimed to identify factors affecting the implementation of clinical guidelines in Iran to enhance the quality of services. Methods: This descriptive analytical study was performed with combined quantitative-qualitative method in the first half of 2019. The statistical population consisted of 400 health managers and experts who were selected through multistage sampling method in 5 regions of Iran (north, south, center, east, and west). Overall, 20 academic experts were selected from each university. For data collection, a researcher-made questionnaire (n = 400) was used. To measure face and content validity, content validity ratio (CVR) and content validity index (CVI) were used. Also, to determine reliability, test-retest method, with Cronbach's alpha coefficient of 0.934 was used. For data analysis, Lisrel 8.8 and SPSS 24 were used. Finally, fitness indices were used to determine the fitness of the model. Results: Six factors, including organizational (9 components), organizational culture (8 components), the clinical guidelines feature (8 components), insurance (7 components), and trusteeship of the health care system (8 components) were identified as the main dimensions. The economic dimension had the maximum effect on implementing clinical guidelines (0.90), while the clinical guidelines feature (0.63) and organizational culture (0.63) showed the minimum extent of effect on implementing clinical guidelines. Conclusion: Evidently, imposing the mentioned interventions with the ultimate goal of sustainable behavior change in providing health care services requires contribution of all practitioners, presentation of suitable facilities for implementing clinical guidelines based on evidence, time and personnel management, training methodology and planning, developing the necessary infrastructure, supervision, and developing professional and legal motivation.
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Affiliation(s)
- Farzaneh Kimiaeimehr
- Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Seyed Mojtaba Hosseini
- Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Khalil Alimohammadzadeh
- Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
- Health Economics Policy Research Center, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Mohammadkarim Bahadori
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Maher
- Department of Health Services Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
- Department of Health Policy, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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TOWARD ORGANIZATIONAL EVIDENCE-BASED MANAGEMENT IN HEALTHCARE ORGANIZATIONS. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2020. [DOI: 10.33457/ijhsrp.688181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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21
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Garritty C, Hersi M, Hamel C, Stevens A, Monfaredi Z, Butler C, Tricco AC, Hartling L, Stewart LA, Welch V, Thavorn K, Cheng W, Moher D. Assessing the format and content of journal published and non-journal published rapid review reports: A comparative study. PLoS One 2020; 15:e0238025. [PMID: 32845906 PMCID: PMC7449464 DOI: 10.1371/journal.pone.0238025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 08/08/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND As production of rapid reviews (RRs) increases in healthcare, knowing how to efficiently convey RR evidence to various end-users is important given they are often intended to directly inform decision-making. Little is known about how often RRs are produced in the published or unpublished domains, and what and how information is structured. OBJECTIVES To compare and contrast report format and content features of journal-published (JP) and non-journal published (NJP) RRs. METHODS JP RRs were identified from key databases, and NJP RRs were identified from a grey literature search of 148 RR producing organizations and were sampled proportionate to cluster size by organization and product type to match the JP RR group. We extracted and formally compared 'how' (i.e., visual arrangement) and 'what' information was presented. RESULTS We identified 103 RRs (52 JP and 51 NJP) from 2016. A higher percentage of certain features were observed in JP RRs compared to NJP RRs (e.g., reporting authors; use of a traditional journal article structure; section headers including abstract, methods, discussion, conclusions, acknowledgments, conflict of interests, and author contributions; and use of figures (e.g., Study Flow Diagram) in the main document). For NJP RRs, a higher percentage of features were observed (e.g., use non-traditional report structures; bannering of executive summary sections and appendices; use of typographic cues; and including outcome tables). NJP RRs were more than double in length versus JP RRs. Including key messages was uncommon in both groups. CONCLUSIONS This comparative study highlights differences between JP and NJP RRs. Both groups may benefit from better use of plain language, and more clear and concise design. Alternative innovative formats and end-user preferences for content and layout should be studied further with thought given to other considerations to ensure better packaging of RR results to facilitate uptake into policy and practice. STUDY REGISTRATION The full protocol is available at: https://osf.io/29xvk/.
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Affiliation(s)
- Chantelle Garritty
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- TRIBE Graduate Program, University of Split School of Medicine, Split, Croatia
| | - Mona Hersi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Candyce Hamel
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- TRIBE Graduate Program, University of Split School of Medicine, Split, Croatia
| | - Adrienne Stevens
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Zarah Monfaredi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Claire Butler
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Andrea C. Tricco
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Lisa Hartling
- Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Lesley A. Stewart
- Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Vivian Welch
- Methods Centre, Bruyère Research Institute, Ottawa, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Wei Cheng
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - David Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
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22
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Abstract
Coastal areas worldwide represent an aggregation of population and assets of growing economic, geopolitical, and sociocultural significance, yet their functions are increasingly challenged by worsening coastal hazards. Vulnerability assessments have been recognized as one way we can better understand which geographic areas and segments of society are more susceptible to adverse impacts from different stressors or hazards. The aims of this paper are to evaluate the state of coastal vulnerability assessment mapping efforts and to identify opportunities for advancement and refinement that will lead to more cohesive, impactful, and policy-relevant coastal vulnerability studies. We conducted a systematic review of the literature that addresses physical and social vulnerability to coastal hazards and contains corresponding mapping products. The content was analyzed for the scale of analysis, location, disciplinary focus, conceptual framework, metrics used, methodological approach, data sources, mapping output, and policy relevance. Results showed that most Coastal Vulnerability Mapping Assessments (CVMAs) are conducted at the local level using a range of methodologies, often with limited inclusion of social considerations and limited discussion of policy relevance. Based on our analysis, we provide seven recommendations for the advancement of this field that would improve CVMAs’ methodological rigor, policy relevance, and alignment with other vulnerability assessment paradigms.
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23
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Khalid AF, Lavis JN, El-Jardali F, Vanstone M. Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis. Health Res Policy Syst 2020; 18:21. [PMID: 32070370 PMCID: PMC7027202 DOI: 10.1186/s12961-020-0530-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/21/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature about how best to support the use of research evidence in such situations, we conducted a critical interpretive synthesis approach to develop a conceptual framework that outlines the strategies that leverage the facilitators and address the barriers to evidence use in crisis zones. METHODS We systematically reviewed both empirical and non-empirical literature and used an interpretive analytic approach to synthesise the results and develop the conceptual framework. We used a 'compass' question to create a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, MEDLINE, SSCI and Web of Science. A second reviewer was assigned to a representative sample of articles. We purposively sampled additional papers to fill in conceptual gaps. RESULTS We identified 21 eligible papers to be analysed and purposively sampled an additional 6 to fill conceptual gaps. The synthesis resulted in a conceptual framework that focuses on evidence use in crisis zones examined through the lens of four systems - political, health, international humanitarian aid and health research. Within each of the four systems, the framework identifies the most actionable strategies that leverage the facilitators and address the barriers to evidence use. CONCLUSIONS This study presents a new conceptual framework that outlines strategies that leverage the facilitators and address the barriers to evidence use in crisis zones within different systems. This study expands on the literature pertaining to evidence-informed decision-making.
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Affiliation(s)
- Ahmad Firas Khalid
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
| | - John N Lavis
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
- Department of Political Science, McMaster University, Hamilton, ON, Canada
| | - Fadi El-Jardali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Health Management & Policy, American University of Beirut, Beirut, Lebanon
- enter for Systematic Review in Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Meredith Vanstone
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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24
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Chen R, Wong E, Wu L, Zhu Y. Toward universal human papillomavirus vaccination for adolescent girls in Hong Kong: a policy analysis. J Public Health Policy 2020; 41:170-184. [PMID: 32054980 PMCID: PMC7228912 DOI: 10.1057/s41271-020-00220-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Studies have assessed early population-level impact of human papillomavirus (HPV) vaccination programs for preventing cervical cancer. Through a case study in Hong Kong we examined stakeholder engagement and interactions to promote a universal HPV vaccination program using the Health Policy Triangle framework for structured health policy analysis. Using data from a document review and semi-structured in-depth interviews, we used thematic and stakeholder analyses to describe the process of policy formation. Given Hong Kong’s political and health system, and a mix of Chinese and Western values, stakeholders judged legitimacy of the process differently. We discuss their varied ethical stances and the role of research evidence for informing policy-making. For effective HPV vaccination policy and promotion of universal free HPV vaccination among adolescent girls, new strategies are needed to broaden acceptance of the process, to frame policies in terms of facts and values, and to connect research to policy-making and improve coalition-building.
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Affiliation(s)
- Ruirui Chen
- Jinan University-affiliated Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China.
| | - Eliza Wong
- Division of Health System, Policy & Management, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lijuan Wu
- Jinan University-affiliated Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China
| | - Yuanfang Zhu
- Jinan University-affiliated Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China
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Jessani NS, Valmeekanathan A, Babcock C, Ling B, Davey-Rothwell MA, Holtgrave DR. Exploring the evolution of engagement between academic public health researchers and decision-makers: from initiation to dissolution. Health Res Policy Syst 2020; 18:15. [PMID: 32039731 PMCID: PMC7011533 DOI: 10.1186/s12961-019-0516-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 12/10/2019] [Indexed: 11/10/2022] Open
Abstract
CONTEXT Relationships between researchers and decision-makers have demonstrated positive potential to influence research, policy and practice. Over time, interest in better understanding the relationships between the two parties has grown as demonstrated by a plethora of studies globally. However, what remains elusive is the evolution of these vital relationships and what can be learned from them with respect to advancing evidence-informed decision-making. We therefore explored the nuances around the initiation, maintenance and dissolution of academic-government relationships. METHODS We conducted in-depth interviews with 52 faculty at one school of public health and 24 government decision-makers at city, state, federal and global levels. Interviews were transcribed and coded deductively and inductively using Atlas.Ti. Responses across codes and respondents were extracted into an Excel matrix and compared in order to identify key themes. FINDINGS Eight key drivers to engagement were identified, namely (1) decision-maker research needs, (2) learning, (3) access to resources, (4) student opportunities, (5) capacity strengthening, (6) strategic positioning, (7) institutional conditionalities, and (8) funder conditionalities. There were several elements that enabled initiation of relationships, including the role of faculty members in the decision-making process, individual attributes and reputation, institutional reputation, social capital, and the role of funders. Maintenance of partnerships was dependent on factors such as synergistic collaboration (i.e. both benefit), mutual trust, contractual issues and funding. Dissolution of relationships resulted from champions changing/leaving positions, engagement in transactional relationships, or limited mutual trust and respect. CONCLUSIONS As universities and government agencies establish relationships and utilise opportunities to share ideas, envision change together, and leverage their collaborations to use evidence to inform decision-making, a new modus operandi becomes possible. Embracing the individual, institutional, networked and systems dynamics of relationships can lead to new practices, alternate approaches and transformative change. Government agencies, schools of public health and higher education institutions more broadly, should pay deliberate attention to identifying and managing the various drivers, enablers and disablers for relationship initiation and resilience in order to promote more evidence-informed decision-making.
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Affiliation(s)
- Nasreen S Jessani
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America.
- Center for Evidence Based Health Care, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
- Africa Centre for Evidence, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa.
| | - Akshara Valmeekanathan
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
| | - Carly Babcock
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
| | - Brenton Ling
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
| | - Melissa A Davey-Rothwell
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
| | - David R Holtgrave
- School of Public Health, University at Albany, State University of New York, Rensselaer, NY, USA
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Ezenwaka U, Mbachu C, Etiaba E, Uzochukwu B, Onwujekwe O. Integrating evidence from research into decision-making for controlling endemic tropical diseases in South East Nigeria: perceptions of producers and users of evidence on barriers and solutions. Health Res Policy Syst 2020; 18:4. [PMID: 31931821 PMCID: PMC6958705 DOI: 10.1186/s12961-019-0518-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023] Open
Abstract
Background Endemic tropical diseases (ETDs) constitute a significant health burden in resource-poor countries. Weak integration of research evidence into policy and practice poses a major challenge to the control of ETDs. This study was undertaken to explore barriers to the use of research evidence in decision-making for controlling ETDs. It also highlights potential strategies for addressing these barriers, including the gaps in research generation and utilisation in the context of endemic disease control. Methods Information on barriers and solutions to integrating research evidence into decision-making for controlling ETDs in Anambra State, Nigeria, was collected from 68 participants (producers and users of evidence) during structured discussions in a workshop. Participants were purposively selected and allocated to groups based on their current involvement in endemic disease control and expertise. Discussions were facilitated with a topic guide and detailed notes were taken by an appointed recorder. Outputs from the discussions were synthesised and analysed manually. Results Cross-cutting barriers include a weak research linkage between producers and users of evidence and weak capacity to undertake health policy and systems research (HPSR). Producers of evidence were purported to conceptualise and frame their research questions based on their academic interests and funders’ focus without recourse to the decision-makers. Conversely, poor demand for research evidence was reported among users of evidence. Another user barrier identified was moribund research units of the Department of Planning Research and Statistics within the State Ministry of Health. Potential solutions for addressing these barriers include creation of knowledge networks and partnerships between producers and users of evidence, institutionalisation of sustainable capacity-building of both parties in HPSR and revival of State research units. Conclusions Evidence-informed decision-making for controlling ETDs is limited by constraints in the interactions of some factors between the users (supply side) and producers (demand side) of evidence. These constraints could be solved through stronger research collaborations, institutionalisation of HPSR, and frameworks for getting research into policy and practice.
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Affiliation(s)
- Uchenna Ezenwaka
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria. .,Department of Health Administration and Management, Faculty of Health Science and Technology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.
| | - Chinyere Mbachu
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.,Department of Community Medicine, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Enyi Etiaba
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.,Department of Health Administration and Management, Faculty of Health Science and Technology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Benjamin Uzochukwu
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.,Department of Community Medicine, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.,Department of Health Administration and Management, Faculty of Health Science and Technology, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria
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Engaging Policymakers to Disseminate Research. Health Serv Res 2020. [DOI: 10.1007/978-3-030-28357-5_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Scalway T, Otmani Del Barrio M, Ramirez B. Research on vector-borne diseases: implementation of research communication strategies. Infect Dis Poverty 2019; 8:101. [PMID: 31806008 PMCID: PMC6896314 DOI: 10.1186/s40249-019-0610-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background Effective communication of research findings on vector-borne diseases in Africa is challenging for a number of reasons. Following the experiences of a number of researchers over the life of a project, this article looks for lessons that can be shared with the wider research community. Main body Between 2014 and 2017, a set of five inter-disciplinary teams from seven African countries collaborated on a project focusing on vector-borne diseases in the context of climate change. A central objective of this work was to influence policy and programming with relevant research findings. This article examines how principles of research communication, derived from the literature and current guidelines, can be applied in practice. Several challenges and lessons are highlighted, showing that research communication takes place within difficult constraints and in complex, fluid institutional and political environments. The processes of communication between policymakers and researchers including stakeholder mapping, defining research communication plans and tailoring communication products are discussed. Conclusions The article concludes that while guidelines and frameworks for research communication are helpful, they should not detract from the ability of local teams to adapt to circumstances. Of key importance are the relationships and networks of local research teams.
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Affiliation(s)
| | - Mariam Otmani Del Barrio
- Unit on Vectors, Environment and Society, The UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Bernadette Ramirez
- Unit on Vectors, Environment and Society, The UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland
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Craveiro I, Hortale V, Oliveira APCD, Dal Poz M, Portela G, Dussault G. The utilization of research evidence in Health Workforce Policies: the perspectives of Portuguese and Brazilian National Policy-Makers. J Public Health (Oxf) 2019. [PMID: 29538723 DOI: 10.1093/pubmed/fdx148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The production of knowledge on Human Resources for Health (HRH) issues has increased exponentially since 2000 but integration of the research in the policy-making process is often lagging. We looked at how research on HRH contributes or not to inform policy decisions and interventions affecting the health workforce in Portugal and Brazil. Methods We designed a comparative case study of semi-structured interviews with present and past national decision-makers, policy advisors and researchers. Issues explored included the existence of a national HRH policy and the use, or non-use, of research evidence by policy makers and reasons to do so. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Results Policy-makers in Brazil recognize a greater use of evidence in the process of defining HRH policy when compared to Portugal's. But the existence of formal instruments to support policy development is not sufficient to ensure that policies are informed by evidence. Conclusions In both countries the importance of the use of evidence in the formulation of policies was recognized by policy-makers. However, the influence of other factors, such as political pressures from various lobby groups and from the media and the policy short timeframe which requires rapid responses, is predominant.
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Affiliation(s)
- Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal
| | - Virginia Hortale
- Escola Nacional de Saúde Pública da Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ana Paula Cavalcante de Oliveira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal
| | - Mario Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Brazil
| | - Gustavo Portela
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Brazil
| | - Gilles Dussault
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal
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Son Y, Kang HS. [A Text Mining Analysis of HPV Vaccination Research Trends]. CHILD HEALTH NURSING RESEARCH 2019; 25:458-467. [PMID: 35004437 PMCID: PMC8650979 DOI: 10.4094/chnr.2019.25.4.458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/03/2019] [Accepted: 06/07/2019] [Indexed: 11/29/2022] Open
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Ma S, Li J, Liu L, Le TD. Discovering context specific causal relationships. INTELL DATA ANAL 2019. [DOI: 10.3233/ida-184010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Edwards A, Zweigenthal V, Olivier J. Evidence map of knowledge translation strategies, outcomes, facilitators and barriers in African health systems. Health Res Policy Syst 2019; 17:16. [PMID: 30732634 PMCID: PMC6367796 DOI: 10.1186/s12961-019-0419-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 01/20/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The need for research-based knowledge to inform health policy formulation and implementation is a chronic global concern impacting health systems functioning and impeding the provision of quality healthcare for all. This paper provides a systematic overview of the literature on knowledge translation (KT) strategies employed by health system researchers and policy-makers in African countries. METHODS Evidence mapping methodology was adapted from the social and health sciences literature and used to generate a schema of KT strategies, outcomes, facilitators and barriers. Four reference databases were searched using defined criteria. Studies were screened and a searchable database containing 62 eligible studies was compiled using Microsoft Access. Frequency and thematic analysis were used to report study characteristics and to establish the final evidence map. Focus was placed on KT in policy formulation processes in order to better manage the diversity of available literature. RESULTS The KT literature in African countries is widely distributed, problematically diverse and growing. Significant disparities exist between reports on KT in different countries, and there are many settings without published evidence of local KT characteristics. Commonly reported KT strategies include policy briefs, capacity-building workshops and policy dialogues. Barriers affecting researchers and policy-makers include insufficient skills and capacity to conduct KT activities, time constraints and a lack of resources. Availability of quality locally relevant research was the most reported facilitator. Limited KT outcomes reflect persisting difficulties in outcome identification and reporting. CONCLUSION This study has identified substantial geographical gaps in knowledge and evidenced the need to boost local research capacities on KT practices in low- and middle-income countries. Evidence mapping is also shown to be a useful approach that can assist local decision-making to enhance KT in policy and practice.
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Affiliation(s)
- Amanda Edwards
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
| | - Virginia Zweigenthal
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
- Western Cape Government Health, Cape Town, South Africa
| | - Jill Olivier
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925 South Africa
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Akhras KS, Alsheikh-Ali AA, Kabbani S. Use of real-world evidence for healthcare decision-making in the Middle East: practical considerations and future directions. Expert Rev Pharmacoecon Outcomes Res 2019; 19:245-250. [PMID: 30626231 DOI: 10.1080/14737167.2019.1568243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Real-world evidence (RWE) is increasingly being used in coverage, reimbursement and formulary decisions for medicines globally. Areas covered: The Middle East (ME) region is significantly behind in generating and using RWE in health policy decisions due to several factors that shaped the health sector over the past few decades. The trend, however, is changing due to several factors that are shaping the future of the healthcare industry in the region. Among other factors, rising healthcare cost, changing population and disease demographics, increased focus on the quality of healthcare, digitization of medical data, increased demand for local clinical and economic data, and overall greater influence of global trends in the healthcare industry. For the region to realize the benefit of RWE in healthcare decisions, it needs to overcome several challenges including embracing the value that RWE brings to healthcare decisions, building trust between stakeholders, establishing reliability and validity of databases used to generate RWE, enhancing technical capabilities, investing in local data generation, and conducting high-quality RWE studies while maintaining patients' confidentiality. Expert commentary: We believe that the next decade will witness significant increase in RWE generation in the region, and will play a key role in driving efficiency in healthcare delivery.
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Affiliation(s)
- Kasem S Akhras
- a Director, Government Affairs and Market Access , Middle East and Africa Region, AstraZeneca , 2nd Floor Block D Building 27, Dubai Healthcare City, P.O. Box 505070, Dubai , UAE
| | - Alawi A Alsheikh-Ali
- b Dean - College of Medicine and Professor of Cardiovascular Medicine , Mohammed Bin Rashid University of Medicine and Health Sciences , Dubai , UAE
| | - Samer Kabbani
- c Associate Professor of Medicine, College of Medicine , Lebanese American University Medical Center , Beirut , Lebanon
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Salhab HA, Salameh P, Hajj H, Hosseini H. Stroke in the Arab World: A bibliometric analysis of research activity (2002-2016). eNeurologicalSci 2018; 13:40-45. [PMID: 30547100 PMCID: PMC6276280 DOI: 10.1016/j.ensci.2018.11.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 11/17/2018] [Indexed: 01/24/2023] Open
Abstract
Background The Arab world has an increasing prevalence of strokes, a leading cause of death in this part of the world. Aims The aim of this article is to quantify the stroke research activity in the Arab countries over the past 15 years taking into consideration the population, GDP, and DALY of each country. Methods A PubMed search was conducted to find stroke research articles published from the Arab countries between 2002 and 2016 (inclusive). Medical subject headings related to strokes and author origin/affiliation were used for this purpose. Results The Arab world only produced 0.51% of all the stroke-related publications on PubMed even though the stroke-related DALY percentage in this region was greater than 2.88% during the period we studied. In general, the number of publications increased in the last few years. Somalia came first regarding the percentage of stroke to non-stroke publications released. Lebanon had the highest number of publications per GDP (in US Billion Dollars), Qatar had the highest number of publications per million persons (PPMP), while Saudi Arabia had the highest number of publications per 1% of stroke DALY. In addition, a strong positive correlation was found between the number of stroke publications and GDP; however, the correlation between the number of stroke publication and either population size or DALY was a weak positive one. Conclusions A general increase in publications is noticed, but stroke research activity in the Arab world is still poor compared to other parts of the world. The Arab world only contributed to 0.51% of all the stroke-related publications on PubMed even though the stroke-related DALY percentage in this region was greater than 2.88% between 2002 and 2016. The number of stroke-related publications produced by the Arab world increased in the last few years. Lebanon had the highest number of publications per GDP (in US Billion Dollars), Qatar had the highest number of publications per million persons (PPMP). A strong positive correlation was found between the number of stroke publications and GDP.
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Affiliation(s)
- Hamza A. Salhab
- Faculty of Medicine, American University of Beirut, Lebanon
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Hind Hajj
- Algorithm SAL, Zouk Mosbeh, P.O. Box 11 962, Beirut, Lebanon
| | - Hassan Hosseini
- Department of Neurology, Henri-Mondor Hospital, UPEC, Assistance Publique-Hopitaux de Paris, Creteil, France
- Corresponding author at: Department of Neurology, Henri-Mondor Hospital, UPEC, Assistance Publique-Hôpitaux de Paris, Créteil, France.
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Alla K, Oprescu F, Hall WD, Whiteford HA, Head BW, Meurk CS. Can automated content analysis be used to assess and improve the use of evidence in mental health policy? A systematic review. Syst Rev 2018; 7:194. [PMID: 30442191 PMCID: PMC6238396 DOI: 10.1186/s13643-018-0853-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 10/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This review assesses the utility of applying an automated content analysis method to the field of mental health policy development. We considered the possibility of using the Wordscores algorithm to assess research and policy texts in ways that facilitate the uptake of research into mental health policy. METHODS The PRISMA framework and the McMaster appraisal tools were used to systematically review and report on the strengths and limitations of the Wordscores algorithm. Nine electronic databases were searched for peer-reviewed journal articles published between 2003 and 2016. Inclusion criteria were (1) articles had to be published in public health, political science, social science or health services disciplines; (2) articles had to be research articles or opinion pieces that used Wordscores; and (3) articles had to discuss both strengths and limitations of using Wordscores for content analysis. RESULTS The literature search returned 118 results. Twelve articles met the inclusion criteria. These articles explored a range of policy questions and appraised different aspects of the Wordscores method. DISCUSSION Following synthesis of the material, we identified the following as potential strengths of Wordscores: (1) the Wordscores algorithm can be used at all stages of policy development; (2) it is valid and reliable; (3) it can be used to determine the alignment of health policy drafts with research evidence; (4) it enables existing policies to be revised in the light of research; and (5) it can determine whether changes in policy over time were supported by the evidence. Potential limitations identified were (1) decreased accuracy with short documents, (2) words constitute the unit of analysis and (3) expertise is needed to choose 'reference texts'. CONCLUSIONS Automated content analysis may be useful in assessing and improving the use of evidence in mental health policies. Wordscores is an automated content analysis option for comparing policy and research texts that could be used by both researchers and policymakers.
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Affiliation(s)
- Kristel Alla
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, 4006, Australia. .,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Archerfield, QLD, 4108, Australia.
| | - Florin Oprescu
- School of Health and Sport Sciences, The University of the Sunshine Coast, Maroochydore DC, QLD, 4558, Australia
| | - Wayne D Hall
- Centre for Youth Substance Abuse Research, CYSAR K Floor, Mental Health Centre, Royal Brisbane and Women's Hospital Campus, The University of Queensland, Herston, QLD, 4029, Australia
| | - Harvey A Whiteford
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, 4006, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Archerfield, QLD, 4108, Australia
| | - Brian W Head
- School of Political Science, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Carla S Meurk
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, 4006, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Archerfield, QLD, 4108, Australia
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Malla C, Aylward P, Ward P. Knowledge translation for public health in low- and middle- income countries: a critical interpretive synthesis. Glob Health Res Policy 2018; 3:29. [PMID: 30377666 PMCID: PMC6196454 DOI: 10.1186/s41256-018-0084-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/27/2018] [Indexed: 11/10/2022] Open
Abstract
Background Effective knowledge translation allows the optimisation of access to and utilisation of research knowledge in order to inform and enhance public health policy and practice. In low- and middle- income countries, there are substantial complexities that affect the way in which research can be utilised for public health action. This review attempts to draw out concepts in the literature that contribute to defining some of the complexities and contextual factors that influence knowledge translation for public health in low- and middle- income countries. Methods A Critical Interpretive Synthesis was undertaken, a method of analysis which allows a critical review of a wide range of heterogeneous evidence, through incorporating systematic review methods with qualitative enquiry techniques. A search for peer-reviewed articles published between 2000 and 2016 on the topic of knowledge translation for public health in low- and middle – income countries was carried out, and 85 articles were reviewed and analysed using this method. Results Four main concepts were identified: 1) tension between ‘global’ and ‘local’ health research, 2) complexities in creating and accessing evidence, 3) contextualising knowledge translation strategies for low- and middle- income countries, and 4) the unique role of non-government organisations in the knowledge translation process. Conclusion This method of review has enabled the identification of key concepts that may inform practice or further research in the field of knowledge translation in low- and middle- income countries. Electronic supplementary material The online version of this article (10.1186/s41256-018-0084-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Catherine Malla
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide, South Australia 5042 Australia
| | - Paul Aylward
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide, South Australia 5042 Australia
| | - Paul Ward
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide, South Australia 5042 Australia
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Yazdizadeh B, Mohtasham F. Assessment of research systems in universal health coverage-related organizations. Med J Islam Repub Iran 2018; 32:15. [PMID: 30159266 PMCID: PMC6108238 DOI: 10.18869/mjiri.32.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Indexed: 11/28/2022] Open
Abstract
Background: Universal health coverage (UHC) is the desired goal of achieving universal access to health services without having to endure pain and financial difficulties. Multiple factors can help steer countries toward UHC. One of the most important factors is the production of valid quality evidence that can be achieved through research. The present study aimed at outlining the status of research systems in UHC–related organizations and identifying the barriers faced by research.
Methods: The key individuals and organizations that could provide rich, relevant, and diverse data in response to the research question were purposively selected for the interviews. Thematic analysis was used to analyze the interviews. Categories and subcategories were deductively extracted from the text based on research system performance as follows: resource provision, production and utilization of knowledge, existing resources, and stewardship. Then, the themes were inductively extracted from the interviews.
Results: Many barriers existed for performing research in UHC–related organizations. The stewardship barrier seemed to play a key role such that structural changes in organizations affected the production & utilization of evidence. Limited financial and human resources were evident in most of the organizations. Research questions were not comprehensively identified. The conducted studies either were not designed to answer the relevant questions and/or were not appropriately reported to policy makers. As a result, their implementation in decision- making did not reach the ideal status.
Conclusion: Research utilization aimed at achieving UHC will come to realize only when and if research is conducted to produce evidence required for decision–making and implementation. Therefore, in addition to the interventions recommended by the World Health Organization, we should design and implement interventions tailored to the local barriers and needs of UHC–related organizations.
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Affiliation(s)
- Bahareh Yazdizadeh
- Knowledge Utilization Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Mohtasham
- Knowledge Utilization Research Centre, Tehran University of Medical Sciences, Tehran, Iran
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Jessani NS, Siddiqi SM, Babcock C, Davey-Rothwell M, Ho S, Holtgrave DR. Factors affecting engagement between academic faculty and decision-makers: learnings and priorities for a school of public health. Health Res Policy Syst 2018; 16:65. [PMID: 30045730 PMCID: PMC6060478 DOI: 10.1186/s12961-018-0342-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/22/2018] [Indexed: 12/02/2022] Open
Abstract
Background Schools of public health (SPHs) are increasingly being recognised as important contributors of human, social and intellectual capital relevant to health policy and decision-making. Few studies within the implementation science literature have systematically examined knowledge exchange experiences within this specific organisational context. The purpose of this study was therefore to elicit whether documented facilitators and barriers to engaging with government decision-makers resonates within an academic SPH context. We sought to understand the variations in such experiences at four different levels of government decision-making. Furthermore, we sought to elicit intervention priorities as identified by faculty. Methods Between May and December 2016, 211 (34%) of 627 eligible full-time faculty across one SPH in the United States of America participated in a survey on engagement with decision-makers at the city, state, federal and global government levels. Surveys were administered face-to-face or via Skype. Descriptive data as well as tests of association and logistic regression analyses were conducted using STATA. Results Over three-quarters of respondents identified colleagues with ties to decision-makers, institutional affiliation and conducting policy-relevant research as the highest facilitators. Several identified time constraints, academic incentives and financial support as important contributors to engagement. Faculty characteristics, such as research areas of expertise, career track and faculty rank, were found to be statistically significantly associated with facilitators. The top three intervention priorities that emerged were (1) creating incentives for engagement, (2) providing funding for engagement and (3) inculcating an institutional culture around engagement. Conclusions The data suggest that five principal categories of factors – individual characteristics, institutional environment, relational dynamics, research focus and funder policies – affect the willingness and ability of academic faculty to engage with government decision-makers. This study suggests that SPHs could enhance the relevance of their role in health policy decision-making by (1) periodically measuring engagement with decision-makers; (2) enhancing individual capacity in knowledge translation and communication, taking faculty characteristics into account; (3) institutionalising a culture that supports policies and practices for engagement in decision-making processes; and (4) creating a strategy to expand and nurture trusted, relevant networks and relationships with decision-makers.
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Affiliation(s)
- Nasreen S Jessani
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America.
| | - Sameer M Siddiqi
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
| | - Carly Babcock
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
| | - Melissa Davey-Rothwell
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
| | - Shirley Ho
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
| | - David R Holtgrave
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD, 21205, United States of America
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Harries AD, Khogali M, Kumar AMV, Satyanarayana S, Takarinda KC, Karpati A, Olliaro P, Zachariah R. Building the capacity of public health programmes to become data rich, information rich and action rich. Public Health Action 2018; 8:34-36. [PMID: 29946518 DOI: 10.5588/pha.18.0001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/02/2018] [Indexed: 11/10/2022] Open
Abstract
Good quality, timely data are the cornerstone of health systems, but in many countries these data are not used for evidence-informed decision making and/or for improving public health. The SORT IT (Structured Operational Research and Training Initiative) model has, over 8 years, trained health workers in low- and middle-income countries to use data to answer important public health questions by taking research projects through to completion and publication in national or international journals. The D2P (data to policy) training initiative is relatively new, and it teaches health workers how to apply 'decision analysis' and develop policy briefs for policy makers: this includes description of a problem and the available evidence, quantitative comparisons of policy options that take into account predicted health and economic impacts, and political and feasibility assessments. Policies adopted from evidence-based information generated through the SORT IT and D2P approaches can be evaluated to assess their impact, and the cycle repeated to identify and resolve new public health problems. Ministries of Health could benefit from this twin-training approach to make themselves 'data rich, information rich and action rich', and thereby use routinely collected data in a synergistic manner to improve public health policy making and health care delivery.
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Affiliation(s)
- A D Harries
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,London School of Hygiene & Tropical Medicine, London, UK
| | - M Khogali
- Vital Strategies, New York, New York, USA
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia Office, New Delhi, India
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia Office, New Delhi, India
| | - K C Takarinda
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,AIDS & TB Department, Ministry of Health and Child Care, Harare, Zimbabwe
| | - A Karpati
- Vital Strategies, New York, New York, USA
| | - P Olliaro
- Special Programme for Research and Training in Tropical Disease, World Health Organization, Geneva, Switzerland
| | - R Zachariah
- Special Programme for Research and Training in Tropical Disease, World Health Organization, Geneva, Switzerland.,Operations Research Unit (LuxOR), Médecins sans Frontières, Luxembourg
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Mihalicza P, Leys M, Borbás I, Szigeti S, Biermann O, Kuchenmüller T. Qualitative assessment of opportunities and challenges to improve evidence-informed health policy-making in Hungary - an EVIPNet situation analysis pilot. Health Res Policy Syst 2018; 16:50. [PMID: 29914525 PMCID: PMC6006924 DOI: 10.1186/s12961-018-0331-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In evidence-informed policy-making (EIP), major knowledge gaps remain in understanding the context and possibilities for institutionalisation of knowledge translation. In 2014, the WHO Evidence-informed Policy Network (EVIPNet) Europe initiated a number of pilot countries, with Hungary among them, to engage in a 'situation analysis' (SA) in order to fill some of those gaps. This contribution discusses the results of the SA in Hungary on research-policy interactions, facilitating factors and potential barriers to establish a knowledge translation platform (KTP). METHODS In line with the EVIPNet Europe SA Manual, a document analysis, 13 interviews, 3 focus group discussions with 21 participants, and an online survey with 31 respondents were carried out from April to October, 2015. A SA aims to assess the context in which EIP takes form and seeks opportunities to establish a KTP, so information was gathered on the current practice of EIP and knowledge translation, its relevant actors, enablers and barriers for EIP, and opinions on a future KTP. Methodological and researcher triangulation resulted in a narrative synthesis of data, including a comparison with literature. A stakeholder consultation was organised to validate findings. RESULTS This study reveals that stakeholders show commitment to produce and use research evidence in Hungarian health policy-making. All stakeholders endorsed the idea of strengthening the systematic use of evidence in decision-making and favoured the idea of establishing a KTP. In line with literature on other countries, some good practices exist on the uptake of evidence in policy-making; however, a systematic approach of developing, translating and using research evidence in health policy processes is lacking. EIP is currently hampered by scattered capacity, coordination problems, high fluctuation in government, an often legalistic and a more 'symbolic' rather than practical support for knowledge translation and EIP. The article summarises recommendations on a Hungarian KTP. CONCLUSIONS Pragmatic adaptation of the SA Manual to local needs proved to be a useful mechanism to provide insight into the Hungarian EIP field and the establishment of a potential KTP. Despite the success of a KTP pilot, it remains unclear how a KTP in Hungary will be institutionalised in a sustainable way.
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Affiliation(s)
- Péter Mihalicza
- Semmelweis University Doctoral School, 2 Kőhalom street, Budapest, 1118 Hungary
| | - Mark Leys
- Vrije Universiteit Brussel, OPIH and EVIPNet Europe steering group, Jette, Belgium
| | - Ilona Borbás
- National Healthcare Service Centre, Budapest, Hungary
| | | | - Olivia Biermann
- WHO Regional Office for Europe, WHO Secretariat of EVIPNet Europe, Copenhagen, Denmark
| | - Tanja Kuchenmüller
- WHO Regional Office for Europe, WHO Secretariat of EVIPNet Europe, Copenhagen, Denmark
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Tudisca V, Valente A, Castellani T, Stahl T, Sandu P, Dulf D, Spitters H, Van de Goor I, Radl-Karimi C, Syed MA, Loncarevic N, Lau CJ, Roelofs S, Bertram M, Edwards N, Aro AR. Development of measurable indicators to enhance public health evidence-informed policy-making. Health Res Policy Syst 2018; 16:47. [PMID: 29855328 PMCID: PMC5984390 DOI: 10.1186/s12961-018-0323-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ensuring health policies are informed by evidence still remains a challenge despite efforts devoted to this aim. Several tools and approaches aimed at fostering evidence-informed policy-making (EIPM) have been developed, yet there is a lack of availability of indicators specifically devoted to assess and support EIPM. The present study aims to overcome this by building a set of measurable indicators for EIPM intended to infer if and to what extent health-related policies are, or are expected to be, evidence-informed for the purposes of policy planning as well as formative and summative evaluations. METHODS The indicators for EIPM were developed and validated at international level by means of a two-round internet-based Delphi study conducted within the European project 'REsearch into POlicy to enhance Physical Activity' (REPOPA). A total of 82 researchers and policy-makers from the six European countries (Denmark, Finland, Italy, the Netherlands, Romania, the United Kingdom) involved in the project and international organisations were asked to evaluate the relevance and feasibility of an initial set of 23 indicators developed by REPOPA researchers on the basis of literature and knowledge gathered from the previous phases of the project, and to propose new indicators. RESULTS The first Delphi round led to the validation of 14 initial indicators and to the development of 8 additional indicators based on panellists' suggestions; the second round led to the validation of a further 11 indicators, including 6 proposed by panellists, and to the rejection of 6 indicators. A total of 25 indicators were validated, covering EIPM issues related to human resources, documentation, participation and monitoring, and stressing different levels of knowledge exchange and involvement of researchers and other stakeholders in policy development and evaluation. CONCLUSION The study overcame the lack of availability of indicators to assess if and to what extent policies are realised in an evidence-informed manner thanks to the active contribution of researchers and policy-makers. These indicators are intended to become a shared resource usable by policy-makers, researchers and other stakeholders, with a crucial impact on fostering the development of policies informed by evidence.
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Affiliation(s)
| | | | | | - Timo Stahl
- The National Institute for Health and Welfare (THL), Tampere, Finland
| | - Petru Sandu
- Babeș-Bolyai University (BBU), Cluj-Napoca, Romania
| | - Diana Dulf
- Babeș-Bolyai University (BBU), Cluj-Napoca, Romania
| | | | | | - Christina Radl-Karimi
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Odense, Denmark
| | | | - Natasa Loncarevic
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Odense, Denmark
| | - Cathrine Juel Lau
- Center for Clinical Research and Disease Prevention, previously called Research Centre for Prevention and Health (RCPH), Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | | | - Maja Bertram
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Odense, Denmark
| | | | - Arja R. Aro
- Unit for Health Promotion Research, University of Southern Denmark (SDU), Odense, Denmark
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Haynes A, Rowbotham SJ, Redman S, Brennan S, Williamson A, Moore G. What can we learn from interventions that aim to increase policy-makers' capacity to use research? A realist scoping review. Health Res Policy Syst 2018; 16:31. [PMID: 29631606 PMCID: PMC5892006 DOI: 10.1186/s12961-018-0277-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/09/2018] [Indexed: 11/11/2022] Open
Abstract
Background Health policy-making can benefit from more effective use of research. In many policy settings there is scope to increase capacity for using research individually and organisationally, but little is known about what strategies work best in which circumstances. This review addresses the question: What causal mechanisms can best explain the observed outcomes of interventions that aim to increase policy-makers’ capacity to use research in their work? Methods Articles were identified from three available reviews and two databases (PAIS and WoS; 1999–2016). Using a realist approach, articles were reviewed for information about contexts, outcomes (including process effects) and possible causal mechanisms. Strategy + Context + Mechanism = Outcomes (SCMO) configurations were developed, drawing on theory and findings from other studies to develop tentative hypotheses that might be applicable across a range of intervention sites. Results We found 22 studies that spanned 18 countries. There were two dominant design strategies (needs-based tailoring and multi-component design) and 18 intervention strategies targeting four domains of capacity, namely access to research, skills improvement, systems improvement and interaction. Many potential mechanisms were identified as well as some enduring contextual characteristics that all interventions should consider. The evidence was variable, but the SCMO analysis suggested that tailored interactive workshops supported by goal-focused mentoring, and genuine collaboration, seem particularly promising. Systems supports and platforms for cross-sector collaboration are likely to play crucial roles. Gaps in the literature are discussed. Conclusion This exploratory review tentatively posits causal mechanisms that might explain how intervention strategies work in different contexts to build capacity for using research in policy-making. Electronic supplementary material The online version of this article (10.1186/s12961-018-0277-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abby Haynes
- Sax Institute, 235 Jones Street, Ultimo, NSW, 2007, Australia. .,Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Samantha J Rowbotham
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia.,The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia
| | - Sally Redman
- Sax Institute, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Sue Brennan
- Australasian Cochrane Centre, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, 3800, Australia
| | - Anna Williamson
- Sax Institute, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Gabriel Moore
- Sax Institute, 235 Jones Street, Ultimo, NSW, 2007, Australia.,Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Camperdown, NSW, 2006, Australia
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Shankardass K, Muntaner C, Kokkinen L, Shahidi FV, Freiler A, Oneka G, M Bayoumi A, O'Campo P. The implementation of Health in All Policies initiatives: a systems framework for government action. Health Res Policy Syst 2018; 16:26. [PMID: 29544496 PMCID: PMC5856219 DOI: 10.1186/s12961-018-0295-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 02/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There has been a renewed interest in broadening the research agenda in health promotion to include action on the structural determinants of health, including a focus on the implementation of Health in All Policies (HiAP). Governments that use HiAP face the challenge of instituting governance structures and processes to facilitate policy coordination in an evidence-informed manner. Due to the complexity of government institutions and the policy process, systems theory has been proposed as a tool for evaluating the implementation of HiAP. METHODS Our multiple case study research programme (HiAP Analysis using Realist Methods On International Case Studies - HARMONICS) has relied on systems theory and realist methods to make sense of how and why the practices of policy-makers (including politicians and civil servants) from specific institutional environments (policy sectors) has either facilitated or hindered the implementation of HiAP. Herein, we present a systems framework for the implementation of HiAP based on our experience and empirical findings in studying this process. RESULTS We describe a system of 14 components within three subsystems of government. Subsystems include the executive (heads of state and their appointed political elites), intersectoral (the milieu of policy-makers and experts working with governance structures related to HiAP) and intrasectoral (policy-makers within policy sectors). Here, HiAP implementation is a process involving interactions between subsystems and their components that leads to the emergence of implementation outcomes, as well as effects on the system components themselves. We also describe the influence of extra-governmental systems, including (but not limited to) the academic sector, third sector, private sector and intergovernmental sector. Finally, we present a case study that applies this framework to understand the implementation of HiAP - the Health 2015 Strategy - in Finland, from 2001 onward. CONCLUSIONS This framework is useful for helping to explain how, why and under what circumstances HiAP has been successfully and unsuccessfully implemented in a sustainable manner. It serves as a tool for researchers to study this process, and for policy-makers and other public health actors to manage this process.
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Affiliation(s)
- Ketan Shankardass
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. .,Department of Health Sciences, Wilfrid Laurier University, 75 University Ave W, Waterloo, ON, N2L 3C5, Canada.
| | - Carles Muntaner
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada.,Bloomberg School of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Lauri Kokkinen
- Finnish Institute of Occupational Health, PL 40, 00251, Helsinki, Finland
| | - Faraz Vahid Shahidi
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Alix Freiler
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada
| | - Goldameir Oneka
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Ahmed M Bayoumi
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.,Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Patricia O'Campo
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
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Makkar SR, Haynes A, Williamson A, Redman S. Organisational capacity and its relationship to research use in six Australian health policy agencies. PLoS One 2018. [PMID: 29513669 PMCID: PMC5841661 DOI: 10.1371/journal.pone.0192528] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
There are calls for policymakers to make greater use of research when formulating policies. Therefore, it is important that policy organisations have a range of tools and systems to support their staff in using research in their work. The aim of the present study was to measure the extent to which a range of tools and systems to support research use were available within six Australian agencies with a role in health policy, and examine whether this was related to the extent of engagement with, and use of research in policymaking by their staff. The presence of relevant systems and tools was assessed via a structured interview called ORACLe which is conducted with a senior executive from the agency. To measure research use, four policymakers from each agency undertook a structured interview called SAGE, which assesses and scores the extent to which policymakers engaged with (i.e., searched for, appraised, and generated) research, and used research in the development of a specific policy document. The results showed that all agencies had at least a moderate range of tools and systems in place, in particular policy development processes; resources to access and use research (such as journals, databases, libraries, and access to research experts); processes to generate new research; and mechanisms to establish relationships with researchers. Agencies were less likely, however, to provide research training for staff and leaders, or to have evidence-based processes for evaluating existing policies. For the majority of agencies, the availability of tools and systems was related to the extent to which policymakers engaged with, and used research when developing policy documents. However, some agencies did not display this relationship, suggesting that other factors, namely the organisation's culture towards research use, must also be considered.
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Affiliation(s)
- Steve R. Makkar
- The Sax Institute, Ultimo, New South Wales, Australia
- * E-mail:
| | - Abby Haynes
- The Sax Institute, Ultimo, New South Wales, Australia
- Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | | | - Sally Redman
- The Sax Institute, Ultimo, New South Wales, Australia
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Wu S, Legido-Quigley H, Spencer J, Coker RJ, Khan MS. Designing evaluation studies to optimally inform policy: what factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes? Health Res Policy Syst 2018; 16:16. [PMID: 29471840 PMCID: PMC5824449 DOI: 10.1186/s12961-018-0292-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 01/30/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. METHODS Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. RESULTS Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. CONCLUSIONS Our qualitative study indicates that training programme evaluations that focus narrowly on direct training outcomes may not provide sufficient information for policy-makers to make decisions on future training programmes. Based on our findings, we have developed an evidence-based framework, which incorporates but expands beyond the Kirkpatrick model, to provide conceptual and practical guidance that aids in the design of training programme evaluations better suited to meet the information needs of policy-makers and to inform policy decisions.
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Affiliation(s)
- Shishi Wu
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Singapore, 117549 Singapore
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Singapore, 117549 Singapore
- Communicable Diseases Policy Research Group, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT United Kingdom
| | - Julia Spencer
- Communicable Diseases Policy Research Group, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT United Kingdom
| | - Richard James Coker
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Singapore, 117549 Singapore
- Communicable Diseases Policy Research Group, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT United Kingdom
- Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Mishal Sameer Khan
- Communicable Diseases Policy Research Group, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT United Kingdom
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Kim C, Wilcher R, Petruney T, Krueger K, Wynne L, Zan T. A research utilisation framework for informing global health and development policies and programmes. Health Res Policy Syst 2018; 16:9. [PMID: 29426325 PMCID: PMC5807737 DOI: 10.1186/s12961-018-0284-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 01/11/2018] [Indexed: 12/02/2022] Open
Abstract
A shift in the culture and practice of health and development research is required to maximise the real-world use of evidence by non-academic or non-research-oriented audiences. Many frameworks have been developed to guide and measure the research utilisation process, yet none have been widely applied. Some frameworks are simplified to an unrealistic linear representation while others are rendered overly complex and unusable in an attempt to capture all aspects of the research utilisation process. Additionally, many research utilisation frameworks have focused on the policy development process or within a clinical setting, with less application of the translation process at the programme level. In response to this gap – and drawing from over a decade of experience implementing research utilisation strategies – we developed a simple, four-phase framework to guide global health and development efforts that seek to apply evidence to policies and programmes. We present a detailed description of each phase in our framework, with examples of its relevance and application illustrated through our own case study experiences in global health. We believe the utility of this framework extends beyond the health sector and is relevant for maximising use of evidence to achieve the Sustainable Development Goals.
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Affiliation(s)
- Christine Kim
- Gillings School of Global Public Health, Health Policy and Management, University of North Carolina, Chapel Hill, NC, United States of America
| | | | | | | | - Leigh Wynne
- FHI 360, Durham, NC, United States of America
| | - Trinity Zan
- FHI 360, Durham, NC, United States of America.
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Shroff ZC, Javadi D, Gilson L, Kang R, Ghaffar A. Institutional capacity to generate and use evidence in LMICs: current state and opportunities for HPSR. Health Res Policy Syst 2017; 15:94. [PMID: 29121958 PMCID: PMC5680819 DOI: 10.1186/s12961-017-0261-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 10/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence-informed decision-making for health is far from the norm, particularly in many low- and middle-income countries (LMICs). Health policy and systems research (HPSR) has an important role in providing the context-sensitive and -relevant evidence that is needed. However, there remain significant challenges both on the supply side, in terms of capacity for generation of policy-relevant knowledge such as HPSR, and on the demand side in terms of the demand for and use of evidence for policy decisions. This paper brings together elements from both sides to analyse institutional capacity for the generation of HPSR and the use of evidence (including HPSR) more broadly in LMICs. METHODS The paper uses literature review methods and two survey instruments (directed at research institutions and Ministries of Health, respectively) to explore the types of institutional support required to enhance the generation and use of evidence. RESULTS Findings from the survey of research institutions identified the absence of core funding, the lack of definitional clarity and academic incentive structures for HPSR as significant constraints. On the other hand, the survey of Ministries of Health identified a lack of locally relevant evidence, poor presentation of research findings and low institutional prioritisation of evidence use as significant constraints to evidence uptake. In contrast, improved communication between researchers and decision-makers and increased availability of relevant evidence were identified as facilitators of evidence uptake. CONCLUSION The findings make a case for institutional arrangements in research that provide support for career development, collaboration and cross-learning for researchers, as well as the setting up of institutional arrangements and processes to incentivise the use of evidence among Ministries of Health and other decision-making institutions. The paper ends with a series of recommendations to build institutional capacity in HPSR through engaging multiple stakeholders in identifying and maintaining incentive structures, improving research (including HPSR) training, and developing stronger tools for synthesising non-traditional forms of local, policy-relevant evidence such as grey literature. Addressing challenges on both the supply and demand side can build institutional capacity in the research and policy worlds and support the enhanced uptake of high quality evidence in policy decisions.
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Affiliation(s)
- Zubin Cyrus Shroff
- Alliance for Health Policy and Systems Research, World Health Organization, Avenue Appia 20, Geneva, 1211, Switzerland.
| | - Dena Javadi
- Alliance for Health Policy and Systems Research, World Health Organization, Avenue Appia 20, Geneva, 1211, Switzerland
| | - Lucy Gilson
- Health Economics Unit, Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rockie Kang
- University of Queensland, Brisbane, Australia
| | - Abdul Ghaffar
- Alliance for Health Policy and Systems Research, World Health Organization, Avenue Appia 20, Geneva, 1211, Switzerland
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48
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Janati A, Hasanpoor E, Hajebrahimi S, Sadeghi-Bazargani H. Health Care Managers' Perspectives on the Sources of Evidence in Evidence-Based Hospital Management: A Qualitative Study in Iran. Ethiop J Health Sci 2017; 27:659-668. [PMID: 29487475 PMCID: PMC5811945 DOI: 10.4314/ejhs.v27i6.11] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 05/10/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Evidence-based management (EBMgt) has been developed as a management framework for improving the quality of management decisions. To use that, we need to identify the source of evidence in decision-making. Therefore, the purpose of this study was to identify the sources of evidence in managing hospitals. METHODS Qualitative methods were used to explore the sources of evidence and to identify hospital managers' attitudes towards evidence-based management. A series of semi-structured interviews (n=48), with a purposive sample of 48 participants, were conducted in 2016. Also, four focus group discussions (FGDs) were conducted with health managers and specialists in the field of management. A questionnaire was used for collection of demographic characteristics and managers' perspectives. RESULTS Six main themes emerged from the interviews including: scientific and research evidence, facts and information of hospital, political-social development plans, managers' professional expertise and ethical-moral evidence. Also, the results showed that the majority of participants believed to use the evidence-based hospital management (95.83%). CONCLUSIONS Our study suggested that a full evidence-based hospital manager someone who is using all the sources of evidence for making hospital decisions. Using hexagon of evidence sources, managers can identify the best available evidence for hospital decisions and to make the best decision in the process of evidence-based decision making.
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Affiliation(s)
- Ali Janati
- Iranian Center of Excellence in Health Management (ICEHM), School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Edris Hasanpoor
- Iranian Center of Excellence in Health Management (ICEHM), School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Hajebrahimi
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Khamis AM, Hakoum MB, Bou-Karroum L, Habib JR, Ali A, Guyatt G, El-Jardali F, Akl EA. Requirements of health policy and services journals for authors to disclose financial and non-financial conflicts of interest: a cross-sectional study. Health Res Policy Syst 2017; 15:80. [PMID: 28927424 PMCID: PMC5606121 DOI: 10.1186/s12961-017-0244-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 08/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The requirements of the health policy and services journals for authors to report their financial and non-financial conflicts of interest (COI) are unclear. The present article aims to assess the requirements of health policy and services journals for authors to disclose their financial and non-financial COIs. METHODS This is a cross-sectional study of journals listed by the Web of Science under the category of 'Health Policy and Services'. We reviewed the 'Instructions for Authors' on the journals' websites and then simulated the submission of a manuscript to obtain any additional relevant information made available during that step. We abstracted data in duplicate and independently using a standardised form. RESULTS Out of 72 eligible journals, 67 (93%) had a COI policy. A minority of policies described how the disclosed COIs of authors would impact the editorial process (34%). None of the policies had clear-cut criteria for rejection based on the content of the disclosure. Approximately a fifth of policies (21%) explicitly stated that inaccurate or incomplete disclosures might lead to manuscript rejection or retraction. No policy described whether the journal would verify the accuracy or completeness of authors' disclosed COIs. Most journals' policies (93%) required the disclosure of at least one form of financial COI. While the majority asked for specification of source of payment (71%), a minority asked for the amount (18%). Overall, 81% of policies explicitly required disclosure of non-financial COIs. CONCLUSION A majority of health policy and services journal policies required the disclosure of authors' financial and non-financial COIs, but few required details on disclosed COIs. Health policy journals should provide specific definitions and instructions for disclosing non-financial COIs. A framework providing clear typology and operational definitions of the different types of COIs will facilitate both their disclosure by authors and reviewers and their assessment and management by the editorial team and the readers.
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Affiliation(s)
- Assem M Khamis
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Maram B Hakoum
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lama Bou-Karroum
- Center for Systematic Reviews for Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
| | - Joseph R Habib
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ahmed Ali
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Fadi El-Jardali
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.,Center for Systematic Reviews for Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Elie A Akl
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon. .,Center for Systematic Reviews for Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon. .,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada. .,Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad-El-Solh Beirut, 1107 2020, Beirut, Lebanon.
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Yazdi Feyzabadi V, Keshavarz Mohammadi N, Omidvar N, Karimi-Shahanjarini A, Nedjat S, Rashidian A. Factors Associated With Unhealthy Snacks Consumption Among Adolescents in Iran's Schools. Int J Health Policy Manag 2017; 6:519-528. [PMID: 28949464 PMCID: PMC5582438 DOI: 10.15171/ijhpm.2017.09] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 01/18/2017] [Indexed: 12/03/2022] Open
Abstract
Background: Well-informed interventions are needed if school-based health promotion is to be effective. Among other aims, the Iranian Health Promoting School (IHPS) program that was launched in 2011, has an important aim
of promoting dietary behaviors of adolescents. The present study, therefore, aimed to investigate the factors affecting
unhealthy snacking of adolescents and provide evidence for a more effective IHPS program.
Methods: In a cross-sectional study design, 1320 students from 40 schools in Kerman city were selected using a
proportional stratified random sampling method. A modified qualitative Food Frequency Questionnaire (FFQ) was
used to gather data about unhealthy snacking behavior. Data about intrapersonal and environmental factors were
obtained using a validated and reliable questionnaire. A mixed-effects negative-binomial regression model was used
to analyze the data.
Results: Taste and sensory perception (prevalence rate ratio [PRR]=1.18; 95% CI: 1.09-1.27), being a male (PRR=1.20;
95% CI: 1.05-1.38) and lower nutritional knowledge (PRR=0.96; 95% CI: 0.91-0.99) were associated with higher weekly
unhealthy snaking. Perceived self-efficacy (PRR=0.95; 95% CI: 0.91-1.00) negatively influenced the frequency of
unhealthy snaking, with this approaching significance (P<.06). In case of environmental factors, high socio-economic
status (SES) level (PRR=1.45; 95% CI: 1.26-1.67), single-parent family (PRR=1.14; 95% CI: 1.01-1.30), more social
norms pressure (PRR=1.08; 95% CI: 1.01-1.17), pocket money allowance (PRR=1.21; 95% CI: 1.09-1.34), easy
accessibility (PRR=1.06; 95% CI:1.01-1.11), and less perceived parental control (PRR=0.96; 95% CI: 0.92-0.99) all had
a role in higher consumption of unhealthy snacks. Interestingly, larger school size was associated with less unhealthy
snacking (PRR=0.79; 95% CI: 0.68-0.92).
Conclusion: Unhealthy snacking behavior is influenced by individual, socio-cultural and physical-environmental
influences, namely by factors relating to poor parenting practices, high SES level, family characteristics, improper social
norms pressure, and less knowledge and self-efficacy of students. This evidence can be used to inform a more evidencebased
IHPS program through focusing on supportive strategies at the home, school, and local community levels.
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Affiliation(s)
- Vahid Yazdi Feyzabadi
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akram Karimi-Shahanjarini
- Social Determinants of Health Research Center and Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saharnaz Nedjat
- Epidemiology and Biostatistics Department, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Rashidian
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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