1
|
Khader Y, Al Nsour M, Abu Khudair S, Saad R, Tarawneh MR, Lami F. Strengthening Primary Healthcare in Jordan for Achieving Universal Health Coverage: A Need for Family Health Team Approach. Healthcare (Basel) 2023; 11:2993. [PMID: 37998485 PMCID: PMC10671215 DOI: 10.3390/healthcare11222993] [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: 09/26/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Achieving Universal Health Coverage (UHC) is a strategic objective of the Jordanian government and has been prioritized in its strategies and plans. However, there are several challenges affecting primary healthcare in Jordan and the health system in general that prevent Jordan from achieving UHC. This paper highlights the importance of team-based care in the form of Family Health Teams (FHTs) to realize Jordan's goal of achieving UHC. FHTs are a team-based approach that brings together diverse professionals to provide a comprehensive, efficient, patient-centered primary care system that meets the changing needs of Jordan's population and refugees. However, the implementation of FHT may encounter obstacles, including individual, organizational, institutional, and external barriers. To overcome such obstacles, several actions and processes need to be taken, including political commitment and leadership, implementing good governance and policy frameworks, allocating resources and funding, multisectoral collaboration, and engagement of communities and stakeholders. The successful implementation of FHTs requires participation from government officials, parliamentarians, civil society, and influential community, religious, and business leaders. A strategic policy framework, effective oversight, coalition building, regulation, attention to system design, and accountability are also essential. In conclusion, adopting the FHT approach in Jordan's Primary Healthcare system offers a promising path towards achieving UHC, improving healthcare access, quality, and efficiency while addressing the unique challenges faced by the country's healthcare system.
Collapse
Affiliation(s)
- Yousef Khader
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohannad Al Nsour
- The Eastern Mediterranean Public Health Network, Amman 11195, Jordan; (M.A.N.); (R.S.)
| | - Sara Abu Khudair
- Global Health and Development, Faculty of Social Sciences, Tampere University, 33520 Tampere, Finland;
| | - Randa Saad
- The Eastern Mediterranean Public Health Network, Amman 11195, Jordan; (M.A.N.); (R.S.)
| | | | - Faris Lami
- Department of Family and Community Medicine, College of Medicine, University of Baghdad, Bab Al Muadham, Baghdad 00964, Iraq;
| |
Collapse
|
2
|
Mondahl J, Hellesø R, Thomsen TG, Homøe P, Rosted EE, Frederiksen K. Obstacles for patients with a low socio-economic status treated within the head and neck cancer pathway: A multiple case study. J Clin Nurs 2023; 32:6585-6598. [PMID: 36916107 DOI: 10.1111/jocn.16691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/07/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
AIMS AND OBJECTIVES Drawing on ethnographic fieldwork exploring various head and neck cancer treatment pathways of patients with low socio-economic status being treated with radiation therapy in Denmark, our aim was to explore how and why inequality in this treatment pathway might occur in the encounter between these patients and Danish healthcare. BACKGROUND In recent years, inequality in cancer treatment of patients with a low socio-economic status has been a growing concern worldwide. The majority of patients with head and neck cancer have a relatively low socio-economic status and are at risk of experiencing inequality in their cancer treatment. DESIGN/METHODS Using a method proposed by Robert Yin, we performed a multiple case study of five treatment pathways of patients with a low socio-economic status. The case studies consisted of participant observations and interviews with patients, relatives and health professionals. We applied Herbert Blumer's theory of symbolic interaction as a framework for our analysis. RESULTS We identified three concepts that all blocked joint action because patients and health professionals had different perceptions of what interaction required of them in terms of (1) Understanding information; (2) Assuming responsibility for managing practical tasks; and (3) Coordinating one's own treatment pathway. CONCLUSIONS We identified how different situations challenged the patients' abilities to assume participation in their own treatment pathway. In their encounter with patients, healthcare professionals did not know which situational impediments to joint action patients were facing. RELEVANCE TO CLINICAL PRACTICE We argue that being aware of how challenges unfold in the interaction with patients with low socio-economic status may serve as a starting point for changing practice to reduce inequality in the treatment of these patients. REPORTING METHOD This study is reported using consolidated criteria for reporting Qualitative research (SRQR). We used the theory and method of Robert Yin of performing a multi-case study and we applied Herbert Blumer's theory of Symbolic interactionism as a framework for understanding data. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Julie Mondahl
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
| | - Ragnhild Hellesø
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Thora Grothe Thomsen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
| | | | - Kirsten Frederiksen
- Section for Nursing, Department of Public Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
3
|
Gavurova B, Kelemen M, Polishchuk V, Mudarri T, Smolanka V. A fuzzy decision support model for the evaluation and selection of healthcare projects in the framework of competition. Front Public Health 2023; 11:1222125. [PMID: 37614458 PMCID: PMC10442559 DOI: 10.3389/fpubh.2023.1222125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/05/2023] [Indexed: 08/25/2023] Open
Abstract
Our research aims to support decision-making regarding the financing of healthcare projects by structural funds with policies targeting reduction of the development gap among different regions and countries of the European Union as well as the achievement of economic and social cohesion. A fuzzy decision support model for the evaluation and selection of healthcare projects should rank the project applications for the selected region, accounting for the investor's wishes in the form of a regional coefficient in order to reduce the development gap between regions. On the one hand, our proposed model evaluates project applications based on selected criteria, which may be structured, weakly structured, or unstructured. On the other hand, it also incorporates information on the level of healthcare development in the region. The obtained ranking increases the degree of validity of the decision regarding the selection of projects for financing by investors, considering the level of development of the region where the project will be implemented. At the expense of European Union (EU) structural funds, a village, city, region, or state can receive funds for modernization and development of the healthcare sector and all related processes. To minimize risks, it is necessary to implement adequate support systems for decision-making in the assessment of project applications, as well as regional policy in the region where the project will be implemented. The primary goal of this study was to develop a complex fuzzy decision support model for the evaluation and selection of projects in the field of healthcare with the aim of reducing the development gap between regions. Based on the above description, we formed the following scientific hypothesis for this research: if the project selected for financing can successfully achieve its stated goals and increase the level of development of its region, it should be evaluated positively. This evaluation can be obtained using a complex fuzzy model constructed to account for the region's level of development in terms of the availability and quality of healthcare services in the region where the project will be implemented.
Collapse
Affiliation(s)
- Beata Gavurova
- Department of Addictology, First Faculty of Medicine, Charles University and General Teaching Hospital in Prague, Prague, Czechia
| | - Miroslav Kelemen
- Department of Flight Training, Faculty of Aeronautics, Technical University of Košice, Košice, Slovakia
| | - Volodymyr Polishchuk
- Department of Software Systems, Faculty of Information Technology, Uzhhorod National University, Uzhhorod, Ukraine
| | - Tawfik Mudarri
- Technical University of Košice, Faculty of Mining, Ecology, Process Control and Geotechnologies, Košice, Slovakia
| | - Volodymyr Smolanka
- Department of Neurology, Neurosurgery and Psychiatry, Faculty of Medicine, Uzhhorod National University, Uzhhorod, Ukraine
| |
Collapse
|
4
|
Harms LSE, van Assema P, Gubbels JS, Gerards SMPL, Linssen E, Vonken L, Bessems KMHH. Context matters-the phased development of an adaptable food literacy intervention: Up for Cooking. Health Promot Int 2023; 38:daad071. [PMID: 37449817 PMCID: PMC10347970 DOI: 10.1093/heapro/daad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Adapting interventions to the context increases the impact and sustainability of interventions. Literature acknowledges the need to adapt existing interventions and that these adaptations should be clearly reported. However, little is known about how to incorporate adaptation from the beginning. This paper argues that interventions should be developed and adaptations should be made using an ongoing non-linear approach. An action-oriented research approach with feedback loops is proposed. We illustrate this with the development of a food literacy intervention 'Up for Cooking' (Dutch: Zin in Koken) and present lessons learned in developing, implementing and studying such adaptable interventions. Interventions should clearly define and differentiate the intervention function and form. Implementers, in turn, should be encouraged to tailor interventions within a form that fits with a specific context. Sufficient time, continuous adaptation based on co-creation, feedback loops and interdisciplinary collaboration are important prerequisites for the development of adaptable interventions.
Collapse
Affiliation(s)
| | - Patricia van Assema
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Jessica S Gubbels
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Sanne M P L Gerards
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Evelyne Linssen
- Department of Knowledge & Innovation, Public Health Service South Limburg, PO Box 33, 6400 AA Heerlen, The Netherlands
| | - Lieve Vonken
- Department of Health Promotion, School of Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Kathelijne M H H Bessems
- Department of Health Promotion, School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| |
Collapse
|
5
|
Missiou A, Lionis C, Evangelou E, Tatsioni A. Health outcomes in primary care: a 20-year evidence map of randomized controlled trials. Fam Pract 2023; 40:128-137. [PMID: 35809039 PMCID: PMC9909671 DOI: 10.1093/fampra/cmac067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To quantify the different types of health outcomes assessed as primary outcomes in randomized controlled trials (RCTs) in the primary care (PC) setting during the last 20 years and identify whether potential gaps exist in specific types of health care and types of intervention. METHODS We systematically searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials, from January 2000 to September 2020 for published RCTs in PC. We recorded characteristics of eligible studies and mapped evidence by health outcome category (patient health outcomes, health services outcomes); and for each outcome category, by types of health care (preventive, acute, chronic, palliative), and by types of intervention (drug, behavioural, on structure, and on process). For RCTs assessing patient health outcomes as primary outcomes, we further mapped using the quality-of-care dimensions, that is, effectiveness, safety, and patient-centredness. RESULTS Of the 518 eligible RCTs in PC, 357 (68.9%) evaluated a patient health outcome as the primary outcome, and 161 (31.1%) evaluated only health services outcomes as primary outcomes. Many focused on population with chronic illness (224 trials; 43.2%) and evaluated interventions on processes of health care (239 trials; 46.1%). Research gaps identified include preventive and palliative care, behavioural interventions, and safety and patient-centredness outcomes as primary outcomes. CONCLUSION Our evidence map showed research gaps in certain types of health care and interventions. It also showed research gaps in assessing safety and measures to place patient at the centre of health care delivery as primary outcomes.
Collapse
Affiliation(s)
- Aristea Missiou
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.,Department of Health, Medicine and Care, General Practice, Linköping University, Linköping, Sweden
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.,Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Athina Tatsioni
- Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| |
Collapse
|
6
|
Bhatia D, Mishra S, Kirubarajan A, Yanful B, Allin S, Di Ruggiero E. Identifying priorities for research on financial risk protection to achieve universal health coverage: a scoping overview of reviews. BMJ Open 2022; 12:e052041. [PMID: 35264342 PMCID: PMC8915291 DOI: 10.1136/bmjopen-2021-052041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Financial risk protection (FRP) is an indicator of the Sustainable Development Goal 3 universal health coverage (UHC) target. We sought to characterise what is known about FRP in the UHC context and to identify evidence gaps to prioritise in future research. DESIGN Scoping overview of reviews using the Arksey & O'Malley and Levac & Colquhoun framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines. DATA SOURCES MEDLINE, PsycINFO, CINAHL-Plus and PAIS Index were systematically searched for studies published between 1 January 1995 and 20 July 2021. ELIGIBILITY CRITERIA Records were screened by two independent reviewers in duplicate using the following criteria: (1) literature review; (2) focus on UHC achievement through FRP; (3) English or French language; (4) published after 1995 and (5) peer-reviewed. DATA EXTRACTION AND SYNTHESIS Two reviewers extracted data using a standard form and descriptive content analysis was performed to synthesise findings. RESULTS 50 studies were included. Most studies were systematic reviews focusing on low-income and middle-income countries. Study periods spanned 1990 and 2020. While FRP was recognised as a dimension of UHC, it was rarely defined as a concept. Out-of-pocket, catastrophic and impoverishing health expenditures were most commonly used to measure FRP. Pooling arrangements, expansion of insurance coverage and financial incentives were the main interventions for achieving FRP. Evidence gaps pertained to the effectiveness, cost-effectiveness and equity implications of efforts aimed at increasing FRP. Methodological gaps related to trade-offs between single-country and multicountry analyses; lack of process evaluations; inadequate mixed-methods evidence, disaggregated by relevant characteristics; lack of comparable and standardised measurement and short follow-up periods. CONCLUSIONS This scoping overview of reviews characterised what is known about FRP as a UHC dimension and found evidence gaps related to the effectiveness, cost-effectiveness and equity implications of FRP interventions. Theory-informed mixed-methods research using high-quality, longitudinal and disaggregated data is needed to address these objectives.
Collapse
Affiliation(s)
- Dominika Bhatia
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sujata Mishra
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Abirami Kirubarajan
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Bernice Yanful
- Public Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sara Allin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Erica Di Ruggiero
- Public Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
7
|
Gender and Social Inequalities in Awareness of Coronary Artery Disease in European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031388. [PMID: 35162415 PMCID: PMC8835179 DOI: 10.3390/ijerph19031388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 12/13/2022]
Abstract
Coronary artery disease (CAD) is the single leading cause of death in Europe and the most common form of cardiovascular disease. Little is known about awareness in the European population. A cross-sectional telephone survey of 2609 individuals from six European countries was conducted to gather information on perceptions of CAD, risk factors, preventive measures, knowledge of heart attack symptoms and ability to seek emergency medical care. Level of awareness was compared according to gender, age, socioeconomic status (SES) and educational level. Women were approximately five times less likely than men to consider heart disease as a main health issue or leading cause of death (OR = 0.224, 95% CI: 0.178–0.280, OR = 0.196, 95% CI: 0.171–0.226). Additionally, women were significantly less likely to have ever had a cardiovascular screening test (OR = 0.515, 95% CI: 0.459–0.578). Only 16.3% of men and 15.3% of women were able to spontaneously identify the main symptoms of a heart attack. Almost half of the sample failed to state that they would call emergency services in case of a cardiac event. Significant differences according to age, SES and education were found for many indicators amongst both men and women. Development of a European strategy targeting improved awareness of CAD and reduced gender and social inequalities within the European population is warranted.
Collapse
|
8
|
Audiger C, Bovagnet T, Deghaye M, Kaufmanis A, Pelisson C, Bochaton A, Menvielle G. Factors associated with participation in the organized cervical cancer screening program in the greater Paris area (France): An analysis among more than 200,000 women. Prev Med 2021; 153:106831. [PMID: 34624389 DOI: 10.1016/j.ypmed.2021.106831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
We aimed to identify the contextual factors associated with participation in the organized Cervical Cancer Screening (CCS) pilot program, which includes specific interventions to reach vulnerable women, in the Greater Paris region. Study population consisted of 231,712 women aged 25-65 years, who were not up to date to their smear test and had been invited to take part in the program from July 2014 to September 2017. Using a multilevel mixed logistic regression with random effects, we investigated the effect of grassroots interventions targeting vulnerable women, healthcare provider accessibility, social environment and municipal policy-related factors. The CCS rate was two times higher in women who had received their first invitation to the program during the study period (32·9%) compared to those who were already invited before the study period (15·3%). In both populations, there were no significant trends in participation with regards to the type of grassroots interventions, level of accessibility of healthcare services or municipal commitment to healthcare. Among women invited previously and aged above 35 increased participation was seen in neighborhoods with low proportion of single women or in less deprived neighborhoods. Our results identified groups of women who participated less in the organized CCS program and suggested that additional interventions targeting the barriers faced by vulnerable women, especially those aged 35-45 years old, are needed.
Collapse
Affiliation(s)
- Céline Audiger
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 27 rue Chaligny, F75012 Paris, France; Le Centre Régional de Coordination des Dépistages des Cancers- CRCDC-Région Ile de France, 8 place Adolphe Cherioux, 75015 Paris, France.
| | - Thomas Bovagnet
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 27 rue Chaligny, F75012 Paris, France
| | - Michel Deghaye
- Le Centre Régional de Coordination des Dépistages des Cancers- CRCDC-Région Ile de France, 8 place Adolphe Cherioux, 75015 Paris, France
| | - Aldis Kaufmanis
- Le Centre Régional de Coordination des Dépistages des Cancers- CRCDC-Région Ile de France, 8 place Adolphe Cherioux, 75015 Paris, France
| | - Caroline Pelisson
- Le Centre Régional de Coordination des Dépistages des Cancers- CRCDC-Région Ile de France, 8 place Adolphe Cherioux, 75015 Paris, France
| | - Audrey Bochaton
- Université Paris Nanterre, UMR CNRS 7533 LADYSS, 200 Avenue de la République, 92000 Nanterre, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 27 rue Chaligny, F75012 Paris, France
| |
Collapse
|
9
|
Hübelová D, Kuncová M, Vojáčková H, Coufalová J, Kozumplíková A, Lategan FS, Chromková Manea BE. Inequalities in Health: Methodological Approaches to Spatial Differentiation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312275. [PMID: 34886004 PMCID: PMC8656580 DOI: 10.3390/ijerph182312275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/07/2021] [Accepted: 11/18/2021] [Indexed: 11/23/2022]
Abstract
The prevalence of inequalities in the general health position of communities can be assessed by using selected determinants. The aims of this article are three-fold: (1) to apply a comprehensive approach to the assessment of inequalities in the general health position of communities, (2) to determine the spatial differentiation of determinants, and (3) to present selected assessment methods and their impact on the results. To present a quantitative assessment of these inequalities in health status in communities, a composite indicator (Health Index) was developed. This Health Index is composed of 8 areas of evaluation and 60 indicators which include, amongst others, determinants of health status and healthcare at district level (LAU 1) in the Czech Republic. The data are evaluated using multicriteria decision-making methods (the WSA and TOPSIS methods). Findings suggest that, when all eight domains are assigned the same weight of one, the spatial differentiation among the districts is similar when using both methods. If different weightings are assigned to the districts, changes occur in both the index values and the rankings of the analyzed districts. For example, the allocation of weightings in both methods results in a rearrangement of the ranking of districts for which the Health Index is around the average.
Collapse
Affiliation(s)
- Dana Hübelová
- Department of Social Studies, Faculty of Regional Development and International Studies, Mendel University in Brno, 613 00 Brno, Czech Republic;
- Correspondence: (D.H.); (A.K.); Tel.: +420-545-136-282 (D.H. & A.K.)
| | - Martina Kuncová
- Department of Economic Studies, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic;
| | - Hana Vojáčková
- Department of Technical Studies, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic;
| | - Jitka Coufalová
- Department of Development, City Municipality of Břeclav, 690 02 Břeclav, Czech Republic;
| | - Alice Kozumplíková
- Department of Environmental Studies, Faculty of Regional Development and International Studies, Mendel University in Brno, 613 00 Brno, Czech Republic
- Correspondence: (D.H.); (A.K.); Tel.: +420-545-136-282 (D.H. & A.K.)
| | - Francois Stefanus Lategan
- Department of Regional and Business Economics, Faculty of Regional Development and International Studies, Mendel University in Brno, 613 00 Brno, Czech Republic;
| | - Beatrice-Elena Chromková Manea
- Department of Social Studies, Faculty of Regional Development and International Studies, Mendel University in Brno, 613 00 Brno, Czech Republic;
| |
Collapse
|
10
|
Dupin CM, Estaquio C, Nabi H. Theoretical conceptions of intervention research addressing cancer control issues. Health Promot Int 2021; 36:206-215. [PMID: 32243507 DOI: 10.1093/heapro/daaa032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Population health intervention research (PHIR) involves the use of scientific methods to produce knowledge about policy and program interventions that operate within or outside of the health sector and have the potential to impact health at the population level. PHIR is a relatively new research field that has gained momentum internationally. When developing PHIR, it is important to have a program theory with the potential to increase intervention success by identifying underlying mechanisms, areas of failure and unintended outcomes. Since 2010, the French National Cancer Institute (Institut National du Cancer-INCa) has supported a national, competitive, dedicated call for proposals in PHIR to tackle cancer control issues. After 5 years of activity, specific analysis of the proposals submitted for funding and/or funded (n = 63) from descriptive and analytic perspectives was called for. Analysis of the data revealed diversity in terms of targeted populations, partnerships engaged and methodological approaches. Projects were more likely to be funded (n = 15) if presented with a robust methodological approach and diversity in methodology, and/or with research objectives at different levels of action. The analysis also revealed that researchers do not explicitly describe theoretical constructs underpinning their interventions to combat cancer. PHIR still needs improvement to better incorporate social, institutional and policy approaches to cancer control. Researchers should apply a theory-driven approach to distinguish between 'program failure' and 'theory failure'. Following up the funded projects will allow successes and failures to be evaluated with respect to the use (or non-use) of theory-driven approaches.
Collapse
Affiliation(s)
- Cécile-Marie Dupin
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Faculty of Medicine and Nursing Science, Aix Marseille Université, Marseille, F-13000, France
| | - Carla Estaquio
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Strategic Evaluation and Impact Program, Institut National du Cancer, Boulogne-Billancourt F-92513, France
| | - Hermann Nabi
- Department for Research in Social and Human Sciences, Public Health and Epidemiology, Institut National du Cancer, Boulogne-Billancourt F-92513, France.,Axe Oncologie, Centre de Recherche du CHU de Québec, Québec, Canada.,Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, Canada.,INSERM, Centre for Research in Epidemiology and Population Health, U1018, F-94807 Villejuif, France
| |
Collapse
|
11
|
Sense of Coherence and Quality of Life in Patients Treated with Antivitamin K Oral Anticoagulants: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041668. [PMID: 33572412 PMCID: PMC7916212 DOI: 10.3390/ijerph18041668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/18/2022]
Abstract
The aim of this study was to analyze the correlation between the participants’ self-reported quality of life and their sense of coherence in a sample (n = 85) of patients on treatment with oral antivitamin K anticoagulants. A cross-sectional design was used. The measurement instruments included a questionnaire on sociodemographic variables, the Spanish version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF), an oral-anticoagulant-treatment-specific quality-of-life questionnaire, and the sense-of-coherence (SOC) scale. We analyzed the correlations between the participants’ characteristics and the results from the quality-of-life and SOC scales. Age, level of education, employment status, living arrangement, and treatment length were the determinants of the quality of life in people treated with oral anticoagulants. We found a significant association between the four domains of the WHOQOL-BREF questionnaire and general treatment satisfaction (p < 0.01); no significant correlations were found between the SOC subscales and the oral-anticoagulant-treatment-specific quality of life in our sample. Women had a worse level of self-management than men. Nursing interventions should be tailored to the needs of the populations on treatment with oral anticoagulants in order to facilitate a higher level of self-management.
Collapse
|
12
|
Prevo L, Kremers S, Jansen M. Small Successes Make Big Wins: A Retrospective Case Study towards Community Engagement of Low-SES Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020612. [PMID: 31963678 PMCID: PMC7014447 DOI: 10.3390/ijerph17020612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/07/2020] [Accepted: 01/16/2020] [Indexed: 12/16/2022]
Abstract
In health-promoting interventions, a main difficulty is that low socioeconomic status (SES) groups especially seem to experience barriers to participation. To overcome this barrier, the current study focused on the success factors and obstacles in the process of supporting low-SES families in becoming partners, while carrying out small-scale activities based on their needs. A retrospective case study design was used to construct a timeline of activities organized by and together with low-SES families based on mainly qualitative data. Next, key events were grouped into the four attributes of the resilience activation framework: human, social, political, and economic capital. The following key lessons were defined: professionals should let go of work routines and accommodate the talents of the families, start doing, strive for small successes; create a functional social network surrounding the families, maintaining professional support over time as back-up; and create collaborative governance to build upon accessibility, transparency and trust among the low-SES families. Continuous and flexible ‘navigating the middle’ between bottom-up and top-down approaches was seen as vital in the partnership process between low-SES families and local professional partners. Constant feedback loops made the evaluation points clear, which supported both families and professionals to enhance their partnership.
Collapse
Affiliation(s)
- Lotte Prevo
- NUTRIM, Department of Health Promotion, Maastricht University, 6229 HA Maastricht, The Netherlands;
- Correspondence:
| | - Stef Kremers
- NUTRIM, Department of Health Promotion, Maastricht University, 6229 HA Maastricht, The Netherlands;
| | - Maria Jansen
- CAPHRI, Department of Health Services Research, Maastricht University, 6229 HA Maastricht, The Netherlands;
- Academic Collaborative Center for Public Health, Public Health Service Southern Limburg, 6411 TE Heerlen, The Netherlands
| |
Collapse
|
13
|
Costa C, Freitas Â, Stefanik I, Krafft T, Pilot E, Morrison J, Santana P. Evaluation of data availability on population health indicators at the regional level across the European Union. Popul Health Metr 2019; 17:11. [PMID: 31391120 PMCID: PMC6686464 DOI: 10.1186/s12963-019-0188-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/22/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The ability to measure regional health inequalities across Europe and to build adequate population health indices depends significantly on the availability of reliable and comparable data at the regional level. Within the scope of the EU-funded project EURO-HEALTHY, a Population Health Index (PHI) was built. This model aggregates 39 indicators considered relevant by experts and stakeholders to evaluate and monitor population health on the regional level within the European Union (269 regions). The aim of this research was to assess the data availability for those indicators. As a subsequent aim, an adequate protocol to overcome issues arising from missing data will be presented, as well as key messages for both national and European statistical authorities meant to improve data collection on population health. METHODS The methodology for the study includes three consecutive phases: (i) assessing the data availability for the respective indicators at the regional level for the last year available (ii) applying a protocol for missing data and completing the database and (iii) developing a scoring system ranging from 0 (no data available; worst) to 1 (all data available; best) to evaluate the availability of data by indicator and EU region. RESULTS Although the missing data on the set of the PHI indicators was significant, the mean availability score for the EURO-HEALTHY PHI indicators is 0.8 and the regional availability score is 0.7, which reveal the strength of the indicators as well as the data completeness protocol for missing data. CONCLUSIONS This study provides a comprehensive data availability assessment for population health indicators from multiple areas of concern, at the EU regional level. The results highlight that the data completeness protocol and availability scores are suitable tools to apply on any indicator's data source mapping. It also raises awareness to the urgent need for sub-national data in several domains and for closing the data gaps between and within countries. This will require policies clearly focused on improving equity between regions and a coordinated effort from the producers of data (the EU28 national statistics offices and EUROSTAT) and the stakeholders who design policies at EU, regional and local level.
Collapse
Affiliation(s)
- Claudia Costa
- Centre of Studies in Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, 3004-530 Coimbra, Portugal
| | - Ângela Freitas
- Centre of Studies in Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, 3004-530 Coimbra, Portugal
| | - Iwa Stefanik
- Centre of Studies in Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, 3004-530 Coimbra, Portugal
| | - Thomas Krafft
- Faculty of Health, Medicine and Life Sciences (FHML), Care and Public Health Research Institute (CAPHRI), Department of Health, Ethics and Society, Maastricht University, Maastricht, The Netherlands
| | - Eva Pilot
- Faculty of Health, Medicine and Life Sciences (FHML), Care and Public Health Research Institute (CAPHRI), Department of Health, Ethics and Society, Maastricht University, Maastricht, The Netherlands
| | - Joana Morrison
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Paula Santana
- Centre of Studies in Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, 3004-530 Coimbra, Portugal
| |
Collapse
|
14
|
Enhancing Equitable Access to Assistive Technologies in Canada: Insights from Citizens and Stakeholders. Can J Aging 2019; 39:69-88. [DOI: 10.1017/s0714980819000187] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
RÉSUMÉLes besoins en technologies d’assistance augmentent au Canada, mais l’accès à ces technologies est inégal et fragmentaire, ce qui ferait en sorte que des besoins demeureraient non comblés. Cette étude visait à identifier les valeurs et préférences des citoyens concernant les moyens à utiliser pour favoriser un accès équitable aux technologies d’assistance. Elle visait également à impliquer les décideurs politiques, les parties prenantes et les chercheurs dans des discussions afin d’élaborer des actions dans ce domaine. Au printemps 2017, nous avons organisé trois panels de citoyens et un dialogue avec les parties prenantes. Les principales conclusions des panels ont été incluses dans une synthèse qui a été partagée avec les participants du dialogue. Trente-sept citoyens ont participé aux panels et ont souligné l’importance de l’accès à de l’information fiable, d’un accès équitable aux technologies d’assistance (et ce, quelle que soit la capacité de payer), et de la collaboration. Les vingt-deux participants au dialogue ont fait valoir la nécessité d’un cadre d’orientation pour appuyer l’évolution des pratiques dans l’ensemble au pays. Le cadre d’orientation proposé combinerait des politiques et programmes simplifiés incluant la collecte et l’évaluation de données robustes pour appuyer l’innovation et l’imputabilité à travers le pays.
Collapse
|
15
|
Barsanti S. Hospitalization among migrants in Italy: Access to health care as an opportunity for integration and inclusion. Int J Health Plann Manage 2018; 33:637-651. [PMID: 29602177 DOI: 10.1002/hpm.2516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 04/24/2016] [Accepted: 02/05/2018] [Indexed: 11/08/2022] Open
Abstract
This paper analyzes migrant access to health care by comparing hospitalizations of native and immigrant population with respect the Tuscany Region (Italy). In the analyses, a critical gap both for legal and undocumented migrant population is highlighted. Indeed, we found some key differences between the migrant and native populations related to the use of specific hospital services in Tuscany and, indirectly, of community and primary care services. Moreover, especially for undocumented migrants, hospitals seem to be the only point of access to the health-care system for migrant populations. The results suggest that the Italian health-care system is unable to ensure an equitable access to health services. In this context, maternity care could be a key point of access to the welfare system that allows participation in the health system not only for mothers but also for all migrant family members.
Collapse
Affiliation(s)
- Sara Barsanti
- Laboratorio Management e Sanità, Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| |
Collapse
|
16
|
Barsanti S, Salmi LR, Bourgueil Y, Daponte A, Pinzal E, Ménival S. Strategies and governance to reduce health inequalities: evidences from a cross-European survey. Glob Health Res Policy 2017; 2:18. [PMID: 29202086 PMCID: PMC5683456 DOI: 10.1186/s41256-017-0038-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 05/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The main objective of the paper is to identify the governance system related to policies to reduce health inequalities in the European regions. Considering the Action Spectrum of inequalities and the check list of health equity governance, we developed a survey in the framework of the AIR Project - Addressing Inequalities Intervention in Regions - was an European project funded by the Executive Agency of Health and Consumers. METHODS A web-based qualitative questionnaire was developed that collected information about practiced strategies to reduce health inequalities. In total 28 questionnaires from 28 different regions, related to 13countries, were suitable for the analysis. RESULTS Progress in health equity strategies at the national and regional levels has been made by countries such as France, Portugal, Poland, and Germany. On the other hand, Spain, Italy, and Belgium have a variable situation depending on the region. However, the results of the survey indicate that the governance system for health equity different in terms of commitment, resources and tools. CONCLUSIONS The survey highlights a weakness of governance system for the majority of countries in terms of evaluation actions and of impact of interventions in reducing inequalities, and the difficulties in having a clear and integrated vision between the national and regional levels.
Collapse
Affiliation(s)
- Sara Barsanti
- Laboratorio Management e Sanità, Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Louis-Rachid Salmi
- Institut de Santé Publique, Épidémiologie et de Développement, INSERM U-1219 Bordeaux Population Health Research Center, Université de Bordeaux et CHU de Bordeaux, Pôle de Santé publique, Bordeaux, France
| | - Yann Bourgueil
- Institut de Recherche et de Documentation en Economie de la Santé, Paris, France
| | - Antonio Daponte
- Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN), Escuela Andaluza de Salud Pública, Granada, Spain
| | | | | |
Collapse
|
17
|
Bonmatí-Tomás A, Malagón-Aguilera MDC, Bosch-Farré C, Gelabert-Vilella S, Juvinyà-Canal D, Garcia Gil MDM. Reducing health inequities affecting immigrant women: a qualitative study of their available assets. Global Health 2016; 12:37. [PMID: 27388538 PMCID: PMC4936252 DOI: 10.1186/s12992-016-0174-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Immigrant women often experience health inequities, whether for reasons of gender, country of origin, or socioeconomic status. The view of immigrant women has always focussed on their needs, without taking into account their available assets. A salutogenic approach incorporating an assets analysis could provide a new perspective on the design of health promotion interventions to reduce health inequities. The study objective was to identify the assets of this group of women as a necessary first step in changing the paradigm used in such health promotion interventions. METHODS This qualitative study combined focus groups, in-depth interviews, and a photovoice session. The aim was to describe the assets of this group, based on Antonovsky's salutogenic approach and assets model. Qualitative results were interpreted with a phenomenological focus, identifying each individual's internal, community, and institutional assets. RESULTS The self awareness of skills was linked to a person's description of herself as being optimistic, having religious beliefs, and having motivations and objectives in life, for herself, her family or her children. Being motivated helped the women to persist in doing or learning things that could be useful in confronting difficult situations. Another selfawareness skill was feeling useful to others, whether this was due to religious beliefs about their role in life or to the importance of the mutual support of interpersonal relationships. CONCLUSIONS High optimism, strong capacity for struggle and self-initiative, the importance of religious beliefs, social support, and concern for their children's future were described as assets of immigrant women. Identification of these assets allows us to develop more in-depth knowledge and better tools for health promotion programs and policies intended to reduce health inequities in this population of immigrant women.
Collapse
Affiliation(s)
- Anna Bonmatí-Tomás
- />Nursing Department, Faculty of Nursing, University of Girona, Emili Grahit, 77, 17003 Girona, Catalonia Spain
| | - Maria del Carmen Malagón-Aguilera
- />Nursing Department, Faculty of Nursing, University of Girona, Emili Grahit, 77, 17003 Girona, Catalonia Spain
- />Health and Health Care Research Group, University of Girona, Girona, Catalonia Spain
| | - Cristina Bosch-Farré
- />Nursing Department, Faculty of Nursing, University of Girona, Emili Grahit, 77, 17003 Girona, Catalonia Spain
| | - Sandra Gelabert-Vilella
- />Nursing Department, Faculty of Nursing, University of Girona, Emili Grahit, 77, 17003 Girona, Catalonia Spain
| | - Dolors Juvinyà-Canal
- />Nursing Department, Faculty of Nursing, University of Girona, Emili Grahit, 77, 17003 Girona, Catalonia Spain
- />Health and Health Care Research Group, University of Girona, Girona, Catalonia Spain
- />Director of Health Promotion Chair, University of Girona, Pic de la Peguera 15. Parc Científic i Tecnològic, 17003 Girona, Catalonia Spain
| | - Maria del Mar Garcia Gil
- />Research Unit of Family Medicine Girona (Vascular Health Group), Primary Care Research Institute Jordi Gol, Girona, Spain
- />TransLab Research Group, Department of Medical Sciences, School of Medicine, University of Girona, Maluquer Salvador, núm. 11, 17002 Girona, Catalonia Spain
| |
Collapse
|