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Mahtani SL, Viswanath K, Gupte HA, Mandal G, Jagiasi D, Chawla R, D'Costa M, Xuan Z, Minsky S, Ramanadhan S. Adapting and Evaluating a Brief Advice Tobacco Cessation Intervention in High-reach, Low-resource Settings in India: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e57236. [PMID: 39225384 PMCID: PMC11408886 DOI: 10.2196/57236] [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: 02/08/2024] [Revised: 05/31/2024] [Accepted: 07/09/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND About 1.35 million deaths annually are attributed to tobacco use in India. The main challenge, given the magnitude of tobacco use and limited resources, is delivering cessation support at scale, low cost, and through a coordinated cross-system effort; one such example being brief advice interventions. However, highly credentialed staff to identify and counsel tobacco users are scarce. Task-shifting is an important opportunity for scaling these interventions. OBJECTIVE The LifeFirst SWASTH (Supporting Wellbeing among Adults by Stopping Tobacco Habit) program-adapted from the LifeFirst program (developed by the Narotam Sekhsaria Foundation, Mumbai, India)-is a tobacco cessation program focusing on lower-socioeconomic status patients in Mumbai receiving private health care. This parallel-arm, cluster randomized controlled trial investigates whether the LifeFirst SWASTH program increases tobacco cessation rates in low-resource, high-reach health care settings in Mumbai. METHODS This study will target tuberculosis-specific nongovernmental organizations (NGOs), dental clinics, and NGOs implementing general health programs serving lower-socioeconomic status patients. Intervention arm patients will receive a pamphlet explaining tobacco's harmful effects. Practitioners will be trained to deliver brief cessation advice, and interested patients will be referred to a Narotam Sekhsaria Foundation counselor for free telephone counseling for 6 months. Control arm patients will receive the same pamphlet but not brief advice or counseling. Practitioners will have a customized mobile app to facilitate intervention delivery. Practitioners will also have access to a peer network through WhatsApp. The primary outcome is a 30-day point prevalence abstinence from tobacco. Secondary outcomes for patients and practitioners relate to intervention implementation. RESULTS The study was funded in June 2020. Due to the COVID-19 pandemic, the study experienced some delays, and practitioner recruitment commenced in November 2023. As of July 2024, all practitioners have been recruited, and practitioner recruitment and training are complete. Furthermore, 36% (1687/4688) of patients have been recruited. CONCLUSIONS It is hypothesized that those patients who participated in the LifeFirst SWASTH program will be more likely to have been abstinent from tobacco for 30 consecutive days by the end of 6 months or at least decreased their tobacco use. LifeFirst SWASTH, if found to be effective in terms of cessation outcomes and implementation, has the potential to be scaled to other settings in India and other low- and middle-income countries. The study will be conducted in low-resource settings and will reach many patients, which will increase the impact if scaled. It will use task-shifting and an app that can be tailored to different settings, also enabling scalability. Findings will build the literature for translating evidence-based interventions from high-income countries to low- and middle-income countries and from high- to low-resource settings. TRIAL REGISTRATION ClinicalTrials.gov NCT05234983; https://clinicaltrials.gov/study/NCT05234983. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57236.
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Affiliation(s)
| | - Kasisomayajula Viswanath
- Dana-Farber Cancer Institute, Boston, MA, United States
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | | | | | | | | | - Ziming Xuan
- Boston University School of Public Health, Boston, MA, United States
| | - Sara Minsky
- Dana-Farber Cancer Institute, Boston, MA, United States
| | - Shoba Ramanadhan
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Hoekstra D, Mütsch M, Borchard A, Kien C, Griebler U, Von Elm E, Rehfuess E, Gerhardus A, Lhachimi SK. A Structured Approach to Involve Stakeholders in Prioritising Topics for Systematic Reviews in Public Health. Int J Public Health 2024; 69:1606642. [PMID: 39234445 PMCID: PMC11371559 DOI: 10.3389/ijph.2024.1606642] [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: 09/18/2023] [Accepted: 08/06/2024] [Indexed: 09/06/2024] Open
Abstract
Objectives This study aimed to develop and apply a structured approach for prioritising topics for systematic reviews in public health, framed according to the readily applicable PICO format, which encourages the involvement of stakeholders' preferences in a transparent matter. Methods We developed a multi-stage process, consisting of a scoping and two Delphi stages with web-based surveys and invited public health stakeholders in Switzerland to participate: First, respondents specified topics for different public health domains, which were reformulated in a PICO format by content analysis. Second, respondents rated the topics using five stakeholder-refined assessment criteria. Overall rankings were calculated to assess differences between stakeholder groups and rating criteria. Results In total, 215 respondents suggested 728 topics altogether. The response rate in the two Delphi stages was 91.6% and 77.6%, respectively. Most top-rated review topics focused on the effectiveness of interventions providing education to different target groups, followed by interventions to increase access to specific healthcare services. Conclusion Our approach encourages involvement of stakeholders in identifying priorities for systematic reviews and highlights disparities between stakeholders and between individual criteria.
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Affiliation(s)
- Dyon Hoekstra
- Research Group for Evidence-Based Public Health, Leibniz-Institute for Prevention Research and Epidemiology (BIPS), Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department of Special Needs Education and Rehabilitation, University of Oldenburg, Oldenburg, Germany
| | - Margot Mütsch
- Department of Epidemiology, Institute of Epidemiology, Biostatistics and Prevention, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Annegret Borchard
- Department of Epidemiology, Institute of Epidemiology, Biostatistics and Prevention, Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Cochrane Switzerland Center for Primary Care and Public Health, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Christina Kien
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
- Cochrane Austria University for Continuing Education Krems, Krems an der Donau, Austria
| | - Ursula Griebler
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education Krems (Danube University Krems), Krems an der Donau, Austria
- Cochrane Austria University for Continuing Education Krems, Krems an der Donau, Austria
| | - Erik Von Elm
- Cochrane Switzerland Center for Primary Care and Public Health, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Ansgar Gerhardus
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department for Health Services Research, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Stefan K Lhachimi
- Research Group for Evidence-Based Public Health, Leibniz-Institute for Prevention Research and Epidemiology (BIPS), Institute for Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department of Nursing Management, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
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Sykes M, Rosenberg-Yunger ZRS, Quigley M, Gupta L, Thomas O, Robinson L, Caulfield K, Ivers N, Alderson S. Exploring the content and delivery of feedback facilitation co-interventions: a systematic review. Implement Sci 2024; 19:37. [PMID: 38807219 PMCID: PMC11134935 DOI: 10.1186/s13012-024-01365-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 05/13/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Policymakers and researchers recommend supporting the capabilities of feedback recipients to increase the quality of care. There are different ways to support capabilities. We aimed to describe the content and delivery of feedback facilitation interventions delivered alongside audit and feedback within randomised controlled trials. METHODS We included papers describing feedback facilitation identified by the latest Cochrane review of audit and feedback. The piloted extraction proforma was based upon a framework to describe intervention content, with additional prompts relating to the identification of influences, selection of improvement actions and consideration of priorities and implications. We describe the content and delivery graphically, statistically and narratively. RESULTS We reviewed 146 papers describing 104 feedback facilitation interventions. Across included studies, feedback facilitation contained 26 different implementation strategies. There was a median of three implementation strategies per intervention and evidence that the number of strategies per intervention is increasing. Theory was used in 35 trials, although the precise role of theory was poorly described. Ten studies provided a logic model and six of these described their mechanisms of action. Both the exploration of influences and the selection of improvement actions were described in 46 of the feedback facilitation interventions; we describe who undertook this tailoring work. Exploring dose, there was large variation in duration (15-1800 min), frequency (1 to 42 times) and number of recipients per site (1 to 135). There were important gaps in reporting, but some evidence that reporting is improving over time. CONCLUSIONS Heterogeneity in the design of feedback facilitation needs to be considered when assessing the intervention's effectiveness. We describe explicit feedback facilitation choices for future intervention developers based upon choices made to date. We found the Expert Recommendations for Implementing Change to be valuable when describing intervention components, with the potential for some minor clarifications in terms and for greater specificity by intervention providers. Reporting demonstrated extensive gaps which hinder both replication and learning. Feedback facilitation providers are recommended to close reporting gaps that hinder replication. Future work should seek to address the 'opportunity' for improvement activity, defined as factors that lie outside the individual that make care or improvement behaviour possible. REVIEW REGISTRATION The study protocol was published at: https://www.protocols.io/private/4DA5DE33B68E11ED9EF70A58A9FEAC02 .
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Affiliation(s)
| | | | | | | | | | - Lisa Robinson
- Newcastle Upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Karen Caulfield
- Newcastle Upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, UK
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Vossler A, Pinquart M, Forbat L, Stratton P. Efficacy of systemic therapy on adults with depressive disorders: A meta-analysis. Psychother Res 2024:1-17. [PMID: 38776449 DOI: 10.1080/10503307.2024.2352741] [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: 07/20/2023] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This meta-analysis evaluates the efficacy of systemic therapy approaches on adult clients with depressive disorders. METHODS The illness-specific systematic review updates a previous meta-analysis on the efficacy of systemic therapy on psychiatric disorders in adulthood. It integrates the results of 30 randomized controlled trials (RCTs) comparing systemic psychotherapy for depression with an untreated control group or alternative treatments. Studies were identified through systematic searches in relevant electronic databases and cross-referencing. A random-effects model calculated weighted mean effect sizes for each type of comparison (alternative treatments, control group with no alternative treatment/waiting list) on two outcomes (depressive symptoms change, drop-out rates). RESULTS On average, systemic interventions show larger improvements in depressive symptoms compared to no-treatment controls at post-test (g = 1.09) and follow-up (g = 1.23). Changes do not significantly differ when comparing systemic interventions with alternative treatments (post-test g = 0.25; follow-up g = 0.09). Results also vary, in part, by participant age, publication year, and active control condition. CONCLUSION This meta-analysis indicates the potential benefits of systemic interventions for adult patients with depression. Future randomized clinical trials in this area should enhance study quality and include relational and other relevant outcome measures.
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Affiliation(s)
- Andreas Vossler
- School of Psychology and Counselling, Faculty of Arts and Social Science, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK
| | - Martin Pinquart
- Department of Psychology, Philipps University Marburg, Marburg, Germany
| | - Liz Forbat
- Faculty of Social Sciences, University of Stirling, Stirling, UK
| | - Peter Stratton
- Leeds Institute of Health Sciences (LIHS), University of Leeds, Leeds, UK
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Kneale D, Stansfield C, Goldman R, Lester S, Edwards RC, Thomas J. The implementation of embedded researchers in policy, public services, and commercial settings: a systematic evidence and gap map. Implement Sci Commun 2024; 5:41. [PMID: 38627834 PMCID: PMC11020794 DOI: 10.1186/s43058-024-00570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Embedding researchers into policy and other settings may enhance research capacity within organisations to enable them to become more research active. We aimed to generate an evidence map on evaluations of embedded researcher interventions to (i) identify where systematic reviews and primary research are needed and (ii) develop conceptual understandings of 'embedded researchers'. We define 'embedded researchers' through a set of principles that incorporate elements such as the aim of activities, the types of relationships and learning involved, and the affiliations and identities adopted. METHODS We included studies published across all sectors, searching fourteen databases, other web sources and two journals for evaluations published between 1991 and spring 2021. Data were extracted using a coding tool developed for this study. We identified new typologies of embedded researcher interventions through undertaking Latent Class Analysis. RESULTS The map describes 229 evaluations spanning a variety of contexts. Our set of principles allowed us to move beyond a narrow focus on embedded researchers in name alone, towards consideration of the wide range of roles, activities, identities, and affiliations related to embedded researchers. We identified 108 different allied terms describing an embedded researcher. Embedded researcher activity spanned a continuum across lines of physical, cultural, institutional, and procedural embeddedness (from weaker to more intense forms of embeddedness) and took a range of forms that bridge or blur boundaries between academia and policy/practice. CONCLUSIONS We developed a broad map of international embedded researcher activity in a wide range of sectors. The map suggests that embedded researcher interventions occupy a broader suite of models than previously acknowledged and our findings also offer insight on the type and nature of this literature. Given the clear policy interest in this area, a better understanding of the processes involved with becoming embedded within an organisation is needed. Further work is also necessary to address the challenges of evaluating the work of embedded researchers, including consideration for which outcome measures are most appropriate, to better understand their influence.
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Affiliation(s)
- Dylan Kneale
- EPPI Centre, UCL Social Research Institute, University College London, London, UK.
| | - Claire Stansfield
- EPPI Centre, UCL Social Research Institute, University College London, London, UK
| | | | - Sarah Lester
- EPPI Centre, UCL Social Research Institute, University College London, London, UK
| | - Rachael C Edwards
- EPPI Centre, UCL Social Research Institute, University College London, London, UK
| | - James Thomas
- EPPI Centre, UCL Social Research Institute, University College London, London, UK
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Wilbur J, Crow CL, Poilapa R, Morrison C. Feasibility study of a menstrual health behaviour change intervention for women and girls with intellectual disabilities and their caregivers for Vanuatu's humanitarian responses. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002244. [PMID: 38241243 PMCID: PMC10798467 DOI: 10.1371/journal.pgph.0002244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024]
Abstract
The Veivanua campaign is a menstrual health intervention for people with intellectual disabilities and their caregivers in Vanuatu's humanitarian setting. The campaign was adapted from the Bishesta campaign delivered in Nepal's development setting. This feasibility study is designed to assess the feasibility and acceptability of the Veivanua campaign to understand if efficacy testing is warranted. The Veivanua campaign was delivered to a preselected group of 30 young people (individuals with intellectual disabilities) and 35 caregivers (males and females). Data were collected through several qualitative tools to allow for methods triangulation: process monitoring, post-intervention in-depth interviews with caregivers and nine young people, observation of young persons, photovoice and ranking with two young people, campaign resource ranking, and key informant interviews with staff involved in the intervention. Data were analysed thematically using Nvivo 12. Results show that the Veivanua campaign is feasible. Male and female caregivers reported an increased ability to support young people's menstrual health and greater preparedness for the next emergency. Young people understood the training and applied their learning. Key informants want to scale up the intervention in their humanitarian responses. Several changes were made to the adapted campaign, but similar outcomes were recorded in Nepal and Vanuatu. All target behaviours improved, and campaign resources were used, but many caregivers found the menstrual calendar confusing. The intervention was not delivered with fidelity but responded to the context. The campaign cost more than the Bishesta campaign because procurement was more expensive in Vanuatu. In conclusion, this is the first intervention globally, so it begins to fill a substantial gap, but more must be done. As the Veivanua campaign is feasible, it requires efficacy testing in Vanuatu. It should also be adapted to humanitarian crises in other countries to support the menstrual health of this previously excluded population.
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Affiliation(s)
- Jane Wilbur
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Casey-Lynn Crow
- International Centre for Evidence in Disability (ICED), London School of Hygiene & Tropical Medicine, London, United Kingdom
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Nordeström F, Granbom M, Iwarsson S, Zingmark M. Ageing in the right place-usability of a web-based housing counselling service. Scand J Occup Ther 2023; 31:2294777. [PMID: 38151044 DOI: 10.1080/11038128.2023.2294777] [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: 07/03/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
INTRODUCTION Residential reasoning is a complex process that includes decisions on whether to age in place or to relocate. Ageing in the Right Place (ARP), a web-based housing counselling service was created to support older adults in this process. The study's aim was to evaluate the usability of the ARP as regards content, design, specific functions, and self-administration as a mode of delivery and to lay the ground for further optimisation. MATERIAL AND METHOD Nine women and five men (aged 66-82) completed a series of tasks using the ARP. Qualitative and quantitative usability data were collected through online interviews. Data were analysed using qualitative content analysis and descriptive statistics. RESULTS Experiences of the specific functions, content, and design of the ARP were described as mainly positive. Additions to the content and optimisation to assist in the general navigation of the website were suggested. The participants disagreed regarding the preferred mode of delivery, which indicates a need for selectable options. A system usability scale median score of 84 indicated acceptable usability. CONCLUSION The ARP seems to have acceptable usability, which paves the way for further evaluation. SIGNIFICANCE By enabling residential reasoning, older adults are supported to make proactive choices based on informed decisions.
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Affiliation(s)
| | | | | | - Magnus Zingmark
- Department of Health Sciences, Lund University, Lund, Sweden
- Health and Social Care Administration, Östersund Municipality, Östersund, Sweden
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Ghotme KA, Arynchyna-Smith A, Maleknia P, Kancherla V, Pachon H, J. Van der Wees P, Bocchino JM, Rosseau GL. Barriers and facilitators to the implementation of mandatory folate fortification as an evidence-based policy to prevent neural tube defects. Childs Nerv Syst 2023; 39:1805-1812. [PMID: 37209199 PMCID: PMC10290612 DOI: 10.1007/s00381-023-05944-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 03/28/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Neural tube defects continue to be one of the main congenital malformations affecting the development of the nervous system and a significant cause of disability and disease burden to individuals living with these conditions. Mandatory food fortification with folic acid is, by far, one of the most efficacious, safe, and cost-effective interventions to prevent neural tube defects. However, most countries fail to effectively fortify staple foods with folic acid, impacting public health and healthcare systems and generating dismal disparities. AIM This article discusses the main barriers and facilitators for implementing mandatory food fortification as an evidence-based policy to prevent neural tube defects worldwide. METHODS A comprehensive review of the scientific literature allowed the identification of the determinant factors acting as barriers or facilitators for the reach, adoption, implementation, and scaling up of mandatory food fortification with folic acid as an evidence-based policy. RESULTS We identified eight barriers and seven facilitators as determinant factors for food fortification policies. The identified factors were classified as individual, contextual, and external, inspired by the Consolidated Framework for Implementation of Research (CFIR). We discuss mechanisms to overcome obstacles and seize the opportunities to approach this public health intervention safely and effectively. CONCLUSIONS Several determinant factors acting as barriers or facilitators influence the implementation of mandatory food fortification as an evidence-based policy worldwide. Notoriously, policymakers in many countries may lack knowledge of the benefits of scaling up their policies to prevent folic acid-sensitive neural tube defects, improve the health status of their communities, and promote the protection of many children from these disabling but preventable conditions. Not addressing this problem negatively affects four levels: public health, society, family, and individuals. Science-driven advocacy and partnerships with essential stakeholders can help overcome the barriers and leverage the facilitators for safe and effective food fortification.
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Affiliation(s)
- Kemel A. Ghotme
- Translational Neuroscience Research Lab, School of Medicine, Universidad de La Sabana, Campus Universitario Puente del Común, Autopista Norte, Km 7, Chia, Colombia
- Neurosurgery Department, Fundacion Santa Fe De Bogota, Bogota, DC Colombia
| | | | - Pedram Maleknia
- School of Medicine, University of Alabama, Birmingham, AL USA
| | - Vijaya Kancherla
- Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Helena Pachon
- Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Philip J. Van der Wees
- The School of Medicine and Health Sciences, The George Washington University, Washington, DC USA
- Radboud Institute of Health Sciences, Nijmegen, Netherlands
| | - Joseph M. Bocchino
- The School of Medicine and Health Sciences, The George Washington University, Washington, DC USA
| | - Gail L. Rosseau
- Department of Neurosurgery, The School of Medicine and Health Sciences, The George Washington University, Washington, DC USA
- The Barrow Neurological Institute, Phoenix, AZ USA
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Krishnamoorthy S, Mathieu S, Armstrong G, Ross V, Francis J, Reifels L, Kõlves K. Utilisation and application of implementation science in complex suicide prevention interventions: A systematic review. J Affect Disord 2023; 330:57-73. [PMID: 36870455 DOI: 10.1016/j.jad.2023.02.140] [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: 10/19/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES Little is known about how complex, multilevel, and multicomponent suicide prevention interventions work in real life settings. Understanding the methods used to systematically adopt, deliver, and sustain these interventions could ensure that they have the best chance of unfolding their full effect. This systematic review aimed to examine the application and extent of utilisation of implementation science in understanding and evaluating complex suicide prevention interventions. METHODS The review adhered to updated PRISMA guidelines and was prospectively registered with PROSPERO (CRD42021247950). PubMed, CINAHL, PsycINFO, ProQuest, SCOPUS and CENTRAL were searched. All English-language records (1990-2022) with suicide and/or self-harm as the primary aims or targets of intervention were eligible. A forward citation search and a reference search further bolstered the search strategy. Interventions were considered complex if they consisted of three or more components and were implemented across two or more levels of socio-ecology or levels of prevention. RESULTS One hundred thirty-nine records describing 19 complex interventions were identified. In 13 interventions, use of implementation science approaches, primarily process evaluations, was explicitly stated. However, extent of utilisation of implementation science approaches was found to be inconsistent and incomprehensive. LIMITATIONS The inclusion criteria, along with a narrow definition of complex interventions may have limited our findings. CONCLUSION Understanding the implementation of complex interventions is crucial for unlocking key questions about theory-practice knowledge translation. Inconsistent reporting and inadequate understanding of implementation processes can lead to loss of critical, experiential knowledge related to what works to prevent suicide in real world settings.
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Affiliation(s)
- Sadhvi Krishnamoorthy
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Queensland, Australia.
| | - Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Queensland, Australia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Queensland, Australia
| | - Jillian Francis
- School of Health Sciences, The University of Melbourne, Victoria, Australia; Department of Health Services Research, Peter MacCallum Cancer Centre, Victoria, Australia; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Lennart Reifels
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, World Health Organization Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Queensland, Australia
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Farah Saliba L, Allen P, Mazzucca SL, Rodriguez Weno E, Moreland-Russell S, Padek M, Brownson RC. Program adaptation by health departments. Front Public Health 2022; 10:892258. [PMID: 36172214 PMCID: PMC9512313 DOI: 10.3389/fpubh.2022.892258] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/22/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction The dissemination of evidence-based interventions (i.e., programs, practices, and policies) is a core function of US state health departments (SHDs). However, interventions are originally designed and tested with a specific population and context. Hence, adapting the intervention to meet the real-world circumstances and population's needs can increase the likelihood of achieving the expected health outcomes for the target population from the implemented intervention. This study identified how SHD employees decide to adapt public health programs and what influences decisions on how to adapt them. Materials and methods SHD employees (n = 45) were interviewed using a qualitative semi-structured interview guide. Telephone interviews were audio-recorded and transcribed verbatim. The transcripts were consensus-coded and themes were identified using thematic analysis. Several themes aligned with the Model for Adaptation Design and Impact. Results Data, outcomes, and health department evaluations influenced decisions to adapt a program (pre-adaptation), and reasons to adapt a program included organizational and sociopolitical contextual factors. SHD middle-level managers, program managers and staff, and local agencies were involved in the decisions to adapt the programs. Finally, the goals for adapting a program included enhancing effectiveness/outcomes, reach and satisfaction with the program; funding; and partner engagement. After SHD employees decided to adapt a program, data and evidence guided the changes. Program staff and evaluators were engaged in the adaptation process. Program managers consulted partners to gather ideas on how best to adapt a program based on partners' experiences implementing the program and obtaining community input. Lastly, program managers also received input on adapting content and context from coalition meetings and periodic technical assistance calls. Discussion The findings related to decisions to adapt public health programs provide practitioners with considerations for adapting them. Findings reaffirm the importance of promoting public health competencies in program evaluation and adaptation, as well as systematically documenting and evaluating the adaptation processes. In addition, the themes could be studied in future research as mechanisms, mediators, and moderators to implementation outcomes.
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Affiliation(s)
- Louise Farah Saliba
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Peg Allen
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Stephanie L. Mazzucca
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Emily Rodriguez Weno
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Sarah Moreland-Russell
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Margaret Padek
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Ross C. Brownson
- Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO, United States
- Division of Public Health Sciences, Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
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Igelström E, Craig P, Lewsey J, Lynch J, Pearce A, Katikireddi SV. Causal inference and effect estimation using observational data. J Epidemiol Community Health 2022. [PMCID: PMC9554068 DOI: 10.1136/jech-2022-219267] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Observational studies aiming to estimate causal effects often rely on conceptual frameworks that are unfamiliar to many researchers and practitioners. We provide a clear, structured overview of key concepts and terms, intended as a starting point for readers unfamiliar with the causal inference literature. First, we introduce theoretical frameworks underlying causal effect estimation methods: the counterfactual theory of causation, the potential outcomes framework, structural equations and directed acyclic graphs. Second, we define the most common causal effect estimands, and the issues of effect measure modification, interaction and mediation (direct and indirect effects). Third, we define the assumptions required to estimate causal effects: exchangeability, positivity, consistency and non-interference. Fourth, we define and explain biases that arise when attempting to estimate causal effects, including confounding, collider bias, selection bias and measurement bias. Finally, we describe common methods and study designs for causal effect estimation, including covariate adjustment, G-methods and natural experiment methods.
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Affiliation(s)
- Erik Igelström
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jim Lewsey
- Health Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Lynch
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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What Are Complex Interventions in Suicide Research? Definitions, Challenges, Opportunities, and the Way Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148591. [PMID: 35886443 PMCID: PMC9315522 DOI: 10.3390/ijerph19148591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 12/10/2022]
Abstract
It has been argued that effective action towards addressing a complex concern such as suicide requires a combination of evidence-based strategies. While these complex public health approaches have recently gained importance, little is known about their characteristics and what contributes to their complexity. The use of interchangeable terms such as multilevel, multicomponent, community based, and inconsistent definitions of these approaches creates confusion around what it is and what it is not. In practice, this disorder is reflected in a substantial variation in the design, implementation, and evaluation of complex approaches in suicide research. While it is impossible to resolve all existing inconsistencies in terminology, this review explores a range of terms and definitions to connote complex interventions. It aims to unpack multiple meanings of these terms and their diverse usage in suicide literature. The potential implications of this fluidity and plausible pathways to make sense of this complexity for suicide research are also discussed. With a shared understanding of what constitutes a complex intervention, we can expect to see an improved representation of the real-world complexities in our efforts to address suicide. This common language can also contribute toward quality implementation and dissemination and thereby advance our understanding of complex interventions.
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Salmi LR, Noël L, Saillour-Glénisson F. [Decision-making process and evaluation of public health interventions]. Rev Epidemiol Sante Publique 2022; 71:101384. [PMID: 35831220 PMCID: PMC9271323 DOI: 10.1016/j.respe.2022.06.307] [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: 03/28/2022] [Revised: 05/07/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022] Open
Abstract
Objectif Nous proposons un cadre méthodologique destiné aux experts impliqués dans l'appui à la décision concernant les interventions de santé publique. Méthodes Le cadre méthodologique comprend quatre éléments : 1) une série de neuf questions, formulées en termes non techniques, pertinentes pour juger de l'utilité d'une intervention, considérée à un moment donné dans un contexte donné ; 2) une traduction de ces questions en concepts liés à l'évaluation des interventions (définition de l'intervention, de sa cible et de son objectif, efficacités potentielle et réelle, sécurité, efficience et équité) ; 3) une organisation logique des informations nécessaires pour répondre aux questions ; 4) un algorithme permettant de traduire les informations disponibles en recommandations sur l'utilité réelle de l'intervention dans le contexte où les questions ont été posées. Résultats Chaque étape est illustrée par des questions posées sur des interventions de sécurité routière, le dépistage, la transfusion sanguine et des mesures proposées pendant la pandémie de COVID-19. Conclusion La décision peut être facilitée si les experts fournissent aux décideurs un résumé formel des forces et faiblesses des connaissances, fondé sur une analyse de toutes les facettes de l'utilité potentielle d'une intervention.
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Affiliation(s)
- L-R Salmi
- Université de Bordeaux, ISPED, F-33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219-Bordeaux Population Health, F-33000 Bordeaux, France.
| | - L Noël
- Consultant, F-74940 Annecy-Le-Vieux, France
| | - F Saillour-Glénisson
- Université de Bordeaux, ISPED, F-33000 Bordeaux, France; Inserm, ISPED, Centre Inserm U1219-Bordeaux Population Health, F-33000 Bordeaux, France; CHU de Bordeaux, Pôle de Santé Publique, Service d'information médicale, F-33000 Bordeaux, France
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14
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Design and Validation of a Virtual Physical Education and Sport Science-Related Course: A Learner's Engagement Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137636. [PMID: 35805306 PMCID: PMC9265633 DOI: 10.3390/ijerph19137636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 01/10/2023]
Abstract
Learners’ engagement is shown to be a major predictor of learning, performance, and course completion as well as course satisfaction. It is easier to engage learners in a face-to-face teaching and learning format since the teacher can observe and interpret the learner’s facial expression and body language. However, in a virtual setting with the students sitting behind cameras, it is difficult to ascertain engagement as the students might be absent-mindedly attending the class. Henceforth, with the rapid transition to online learning, designing course content that could actively engage the students towards achieving the said elements is, therefore, necessary. We applied a data-driven approach in designing a virtual physical education and sport science−related course via a learner engagement model. A fully online course catering to 132 students that runs for a total of 14 weeks was used as a case study to develop the course. The study was conducted during the 2020/2021 academic year, which was the period of the peak COVID-19 pandemic in Malaysia. The delivery of the course content was implemented in stages to achieve three essential educational outcomes namely, skill and knowledge acquisition, and personal development as well as course satisfaction. We hypothesised that the developed learners’ engagement approach will promote the students’ acquisition of skills and knowledge and foster the personal development of the students through fitness improvement. It is also hypothesised that the students will be satisfied with the course developed upon successful completion. A chi-square analysis projected a statistically significant difference in the skill and knowledge acquisition before and after the programme (p < 0.001). A Wilcoxon rank-sum test demonstrated personal improvement in the overall fitness of the student upon completing the prescribed activity of the course content. Moreover, a total of 96.2%, 95.5% and 93.2% of students expressed their satisfaction with the clarity of the learning objectives, good organisational and course content plan, and appropriate workload of the course designed, respectively. There is sufficient evidence to accept all hypotheses formulated, and hence, we postulated that, since students spend more time outside the classroom, out-of-class learners’ engagement activity should be considered when designing a virtual course to promote lifelong learning, experience, and higher-order thinking. The techniques presented herein could be useful to academics, professionals, and other relevant stakeholders in developing virtual course content within a specific domain of interest.
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15
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Ramírez AS, Garibay KK, Payán DD, Campos Gática V, Merino Salmeron Y. News coverage of Mexico's front-of-package food label policy. BMJ Glob Health 2022; 7:bmjgh-2022-008803. [PMID: 35550339 PMCID: PMC9109016 DOI: 10.1136/bmjgh-2022-008803] [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: 02/15/2022] [Accepted: 04/22/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives To examine news coverage of Mexico’s front-of-package food labelling policy. Methods We used Lexis Nexis to identify newspaper articles that mention the proposed law in four Mexican newspapers representing politically centre-left and centre-right perspectives. We coded for type and valence of arguments, sources and research evidence cited. Results We identified N=361 relevant articles. Coverage of the front-of-package food label policy was primarily news (vs editorial/opinion). While most were neutral in tone, left-leaning newspapers had slightly more positive overall coverage compared with right-leaning newspapers, indicated by publishing more stories in favour of the policy, fewer in opposition, more propolicy arguments and more frequent inclusion of perspectives by government officials and public health advocates. Despite some evidence of bias, there was a general lack of credible opposition to the policy and mention of opponents across newspapers. Conclusions and policy implications The relative absence of food and beverage industry stakeholders in news coverage of the food label policy is unexpected given their documented involvement in prior food policy debates. We discuss possible reasons for their conspicuous absence and lessons for public health advocates around the globe.
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Affiliation(s)
- A Susana Ramírez
- Department of Public Health, University of California Merced, Merced, California, USA
| | - Kesia K Garibay
- Department of Public Health, University of California Merced, Merced, California, USA
| | - Denise Diaz Payán
- Department of Health, Society, and Behavior, University of California Irvine, Irvine, CA, USA
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Brownson RC, Shelton RC, Geng EH, Glasgow RE. Revisiting concepts of evidence in implementation science. Implement Sci 2022; 17:26. [PMID: 35413917 PMCID: PMC9004065 DOI: 10.1186/s13012-022-01201-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 04/04/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Evidence, in multiple forms, is a foundation of implementation science. For public health and clinical practice, evidence includes the following: type 1 evidence on etiology and burden; type 2 evidence on effectiveness of interventions; and type 3: evidence on dissemination and implementation (D&I) within context. To support a vision for development and use of evidence in D&I science that is more comprehensive and equitable (particularly for type 3 evidence), this article aims to clarify concepts of evidence, summarize ongoing debates about evidence, and provide a set of recommendations and tools/resources for addressing the "how-to" in filling evidence gaps most critical to advancing implementation science. MAIN TEXT Because current conceptualizations of evidence have been relatively narrow and insufficiently characterized in our opinion, we identify and discuss challenges and debates about the uses, usefulness, and gaps in evidence for implementation science. A set of questions is proposed to assist in determining when evidence is sufficient for dissemination and implementation. Intersecting gaps include the need to (1) reconsider how the evidence base is determined, (2) improve understanding of contextual effects on implementation, (3) sharpen the focus on health equity in how we approach and build the evidence-base, (4) conduct more policy implementation research and evaluation, and (5) learn from audience and stakeholder perspectives. We offer 15 recommendations to assist in filling these gaps and describe a set of tools for enhancing the evidence most needed in implementation science. CONCLUSIONS To address our recommendations, we see capacity as a necessary ingredient to shift the field's approach to evidence. Capacity includes the "push" for implementation science where researchers are trained to develop and evaluate evidence which should be useful and feasible for implementers and reflect community or stakeholder priorities. Equally important, there has been inadequate training and too little emphasis on the "pull" for implementation science (e.g., training implementers, practice-based research). We suggest that funders and reviewers of research should adopt and support a more robust definition of evidence. By critically examining the evolving nature of evidence, implementation science can better fulfill its vision of facilitating widespread and equitable adoption, delivery, and sustainment of scientific advances.
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Affiliation(s)
- Ross C. Brownson
- Prevention Research Center, Brown School at Washington University in St. Louis, One Brookings Drive, Campus, Box 1196, St. Louis, MO 63130 USA
- Department of Surgery, Division of Public Health Sciences, and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63130 USA
| | - Rachel C. Shelton
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY 10032 USA
| | - Elvin H. Geng
- Division of Infectious Diseases, Department of Medicine and Center for Dissemination and Implementation in the Institute for Public Health, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO 63110 USA
| | - Russell E. Glasgow
- Department of Family Medicine and Adult & Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
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17
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Projecting the Impacts of a Changing Climate: Tropical Cyclones and Flooding. Curr Environ Health Rep 2022; 9:244-262. [PMID: 35403997 DOI: 10.1007/s40572-022-00340-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW There is clear evidence that the earth's climate is changing, largely from anthropogenic causes. Flooding and tropical cyclones have clear impacts on human health in the United States at present, and projections of their health impacts in the future will help inform climate policy, yet to date there have been few quantitative climate health impact projections. RECENT FINDINGS Despite a wealth of studies characterizing health impacts of floods and tropical cyclones, many are better suited for qualitative, rather than quantitative, projections of climate change health impacts. However, a growing number have features that will facilitate their use in quantitative projections, features we highlight here. Further, while it can be difficult to project how exposures to flood and tropical cyclone hazards will change in the future, climate science continues to advance in its capabilities to capture changes in these exposures, including capturing regional variation. Developments in climate epidemiology and climate science are opening new possibilities in projecting the health impacts of floods and tropical cyclones under a changing climate.
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18
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Uwizeye CB, Zomahoun HTV, Bussières A, Thomas A, Kairy D, Massougbodji J, Rheault N, Tchoubi S, Philibert L, Abib Gaye S, Khadraoui L, Ben Charif A, Diendéré E, Langlois L, Dugas M, Légaré F. Implementation strategies for knowledge products in primary healthcare: a systematic review of systematic reviews (Preprint). Interact J Med Res 2022; 11:e38419. [PMID: 35635786 PMCID: PMC9315889 DOI: 10.2196/38419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/20/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background The underuse or overuse of knowledge products leads to waste in health care, and primary care is no exception. Objective This study aimed to characterize which knowledge products are frequently implemented, the implementation strategies used in primary care, and the implementation outcomes that are measured. Methods We performed a systematic review (SR) of SRs using the Cochrane systematic approach to include eligible SRs. The inclusion criteria were any primary care contexts, health care professionals and patients, any Effective Practice and Organization of Care implementation strategies of specified knowledge products, any comparators, and any implementation outcomes based on the Proctor framework. We searched the MEDLINE, EMBASE, CINAHL, Ovid PsycINFO, Web of Science, and Cochrane Library databases from their inception to October 2019 without any restrictions. We searched the references of the included SRs. Pairs of reviewers independently performed selection, data extraction, and methodological quality assessment by using A Measurement Tool to Assess Systematic Reviews 2. Data extraction was informed by the Effective Practice and Organization of Care taxonomy for implementation strategies and the Proctor framework for implementation outcomes. We performed a descriptive analysis and summarized the results by using a narrative synthesis. Results Of the 11,101 records identified, 81 (0.73%) SRs were included. Of these 81, a total of 47 (58%) SRs involved health care professionals alone. Moreover, 15 SRs had a high or moderate methodological quality. Most of them addressed 1 type of knowledge product (56/81, 69%), common clinical practice guidelines (26/56, 46%) or management, and behavioral or pharmacological health interventions (24/56, 43%). Mixed strategies were used for implementation (67/81, 83%), predominantly education-based (meetings in 60/81, 74%; materials distribution in 59/81, 73%; and academic detailing in 45/81, 56%), reminder (53/81, 36%), and audit and feedback (40/81, 49%) strategies. Education meetings (P=.13) and academic detailing (P=.11) seemed to be used more when the population was composed of health care professionals alone. Improvements in the adoption of knowledge products were the most commonly measured outcome (72/81, 89%). The evidence level was reported in 12% (10/81) of SRs on 62 outcomes (including 48 improvements in adoption), of which 16 (26%) outcomes were of moderate or high level. Conclusions Clinical practice guidelines and management and behavioral or pharmacological health interventions are the most commonly implemented knowledge products and are implemented through the mixed use of educational, reminder, and audit and feedback strategies. There is a need for a strong methodology for the SR of randomized controlled trials to explore their effectiveness and the entire cascade of implementation outcomes.
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Affiliation(s)
- Claude Bernard Uwizeye
- Learning Health System Component of the Québec Strategy for Patient-Oriented Research (SPOR) - Support for People and Patient-Oriented and Trials (SUPPORT) Unit, Québec, QC, Canada
- VITAM Research Center on Sustainable Health, Laval University, Québec, QC, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
| | - Hervé Tchala Vignon Zomahoun
- Learning Health System Component of the Québec Strategy for Patient-Oriented Research (SPOR) - Support for People and Patient-Oriented and Trials (SUPPORT) Unit, Québec, QC, Canada
- VITAM Research Center on Sustainable Health, Laval University, Québec, QC, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
- Department of Social and Preventive Medicine, Laval University, Québec, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - André Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal métropolitain (CRIR), Montreal, QC, Canada
- Réseau Provincial de recherche en Adaptation-Réadaptation (REPAR), Montreal, QC, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal métropolitain (CRIR), Montreal, QC, Canada
- Réseau Provincial de recherche en Adaptation-Réadaptation (REPAR), Montreal, QC, Canada
| | - Dahlia Kairy
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal métropolitain (CRIR), Montreal, QC, Canada
- Réseau Provincial de recherche en Adaptation-Réadaptation (REPAR), Montreal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, QC, Canada
| | - José Massougbodji
- Department of Social and Preventive Medicine, Laval University, Québec, QC, Canada
- Institut National de Santé Publique du Québec, Québec, QC, Canada
| | - Nathalie Rheault
- Learning Health System Component of the Québec Strategy for Patient-Oriented Research (SPOR) - Support for People and Patient-Oriented and Trials (SUPPORT) Unit, Québec, QC, Canada
- VITAM Research Center on Sustainable Health, Laval University, Québec, QC, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
| | - Sébastien Tchoubi
- Learning Health System Component of the Québec Strategy for Patient-Oriented Research (SPOR) - Support for People and Patient-Oriented and Trials (SUPPORT) Unit, Québec, QC, Canada
- Department of Social and Preventive Medicine, Laval University, Québec, QC, Canada
| | - Leonel Philibert
- Learning Health System Component of the Québec Strategy for Patient-Oriented Research (SPOR) - Support for People and Patient-Oriented and Trials (SUPPORT) Unit, Québec, QC, Canada
- Faculty of Nursing, Laval University, Québec, QC, Canada
| | - Serigne Abib Gaye
- Learning Health System Component of the Québec Strategy for Patient-Oriented Research (SPOR) - Support for People and Patient-Oriented and Trials (SUPPORT) Unit, Québec, QC, Canada
| | - Lobna Khadraoui
- Learning Health System Component of the Québec Strategy for Patient-Oriented Research (SPOR) - Support for People and Patient-Oriented and Trials (SUPPORT) Unit, Québec, QC, Canada
- VITAM Research Center on Sustainable Health, Laval University, Québec, QC, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
| | - Ali Ben Charif
- VITAM Research Center on Sustainable Health, Laval University, Québec, QC, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Laval University, Québec, QC, Canada
- CubecXpert, Québec, QC, Canada
| | - Ella Diendéré
- Institut National de Santé Publique du Québec, Québec, QC, Canada
| | - Léa Langlois
- VITAM Research Center on Sustainable Health, Laval University, Québec, QC, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
| | - Michèle Dugas
- VITAM Research Center on Sustainable Health, Laval University, Québec, QC, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
| | - France Légaré
- Learning Health System Component of the Québec Strategy for Patient-Oriented Research (SPOR) - Support for People and Patient-Oriented and Trials (SUPPORT) Unit, Québec, QC, Canada
- VITAM Research Center on Sustainable Health, Laval University, Québec, QC, Canada
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Laval University, Québec, QC, Canada
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Larouche A, Bilodeau A, Laurin I, Potvin L. Health promotion innovations scale up: combining insights from framing and actor-network to foster reflexivity. Health Promot Int 2022; 37:daab026. [PMID: 33724367 DOI: 10.1093/heapro/daab026] [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] [Indexed: 11/14/2022] Open
Abstract
There are numerous hurdles down the road for successfully scaling up health promotion innovations into formal programmes. The challenges of the scaling-up process have mainly been conceived in terms of available resources and technical or management problems. However, aiming for greater impact and sustainability involves addressing new contexts and often adding actors whose perspectives may challenge established orientations. The social dimension of the scaling-up process is thus critical. Building on existing conceptualizations of interventions as dynamic networks and of evolving framing of health issues, this paper elaborates a social view of scaling up that accounts for the transformations of innovations, using framing analysis and the notion of 'expanding scaling-up networks'. First, we discuss interventions as dynamic networks. Second, we conceptualize scaling-up processes as networks in expansion within which social learning and change occur. Third, we propose combining a 'representational approach' to frame analysis and an 'interactional approach' that illustrates framing processes related to the micro-practices of leading public health actors within expanding networks. Using an example concerning equity in early childhood development, we show that this latter approach allows documenting how frames evolve in the process. Considering the process in continuity with existing conceptualizations of interventions as actor-networks and transformation of meanings enriches our conceptualization of scaling up, improves our capacity to anticipate its outcomes, and promotes reflexivity about health promotion goals and means.
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Affiliation(s)
- Annie Larouche
- Chaire de recherche du Canada Approches communautaires et inégalités de santé (CACIS), Université de Montréal, Qc, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Qc, Canada
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Qc, Canada
- Direction régionale de santé publique, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Qc, Canada
| | - Angèle Bilodeau
- Chaire de recherche du Canada Approches communautaires et inégalités de santé (CACIS), Université de Montréal, Qc, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Qc, Canada
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Qc, Canada
- Centre de recherche Léa-Roback, Montréal, Qc, Canada
| | - Isabelle Laurin
- Centre de recherche en santé publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Qc, Canada
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Qc, Canada
- Centre de recherche Léa-Roback, Montréal, Qc, Canada
- Direction régionale de santé publique, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Qc, Canada
| | - Louise Potvin
- Chaire de recherche du Canada Approches communautaires et inégalités de santé (CACIS), Université de Montréal, Qc, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Qc, Canada
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Qc, Canada
- Centre de recherche Léa-Roback, Montréal, Qc, Canada
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Venugopal V, Lennqvist R, Latha PK, S R, Suraya A, Jakobsson K, Kjellstrom T. Challenges in conducting epidemiological field studies evaluating associations between heat stress and renal health among workers in informal sectors: experiences from India. ENVIRONMENTAL RESEARCH 2021; 200:111343. [PMID: 34015298 DOI: 10.1016/j.envres.2021.111343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/28/2021] [Accepted: 05/13/2021] [Indexed: 06/12/2023]
Abstract
Well-designed Environmental Epidemiological Studies (EES) play a crucial role in quantifying the influence of environmental exposures and their associated risks on health in the wider population. They provide critical research evidence for identifying and developing interventions to avert adverse health consequences from those exposures. However, uncertainty and variability inherent to any field based EES could hinder the nature and magnitude of association between an exposure and health outcome. This is particularly pronounced in resource limited settings and resource-tight research projects. The present study evaluated the association between occupational heat stress and renal health among informal work sectors in India which had some significant challenges. Informal workers exposed to chronic occupational heat stress had significantly higher adverse renal health outcomes than the unexposed workers. Our field challenges included gaining access and permissions to conduct the study, participant recalls bias and attrition, accurately estimating exposures, confounding from causes of both exposure and disease, and to a large extent tight-funding. Though opportunities are abundant, we must ensure field conditions are optimized to attain study objectives. A keen understanding and sensitivity towards the cultural and work settings is essential for successful project completion. Based on our experiences, we provide strategies to adopt to improve fieldwork and provide recommendations to help overcome the field challenges and achieve better results for future EES studies in developing country settings.
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Affiliation(s)
- Vidhya Venugopal
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India.
| | - Robin Lennqvist
- Occupational and Environmental Medicine, Gothenburg University, Sweden
| | - P K Latha
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Rekha S
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Anna Suraya
- CIHLMU Center for International Health, University Hospital, LMU Munich, Germany
| | | | - Tord Kjellstrom
- National Center for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia; HEAT-SHIELD Project, Center for Technology Research and Innovation Ltd, (CETRI), Limassol, Cyprus; Health and Environment International Trust, Mapua, New Zealand
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Analyzing Twitter Data to Evaluate People's Attitudes towards Public Health Policies and Events in the Era of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126272. [PMID: 34200576 PMCID: PMC8296042 DOI: 10.3390/ijerph18126272] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022]
Abstract
Policymakers and relevant public health authorities can analyze people’s attitudes towards public health policies and events using sentiment analysis. Sentiment analysis focuses on classifying and analyzing text sentiments. A Twitter sentiment analysis has the potential to monitor people’s attitudes towards public health policies and events. Here, we explore the feasibility of using Twitter data to build a surveillance system for monitoring people’s attitudes towards public health policies and events since the beginning of the COVID-19 pandemic. In this study, we conducted a sentiment analysis of Twitter data. We analyzed the relationship between the sentiment changes in COVID-19-related tweets and public health policies and events. Furthermore, to improve the performance of the early trained model, we developed a data preprocessing approach by using the pre-trained model and early Twitter data, which were available at the beginning of the pandemic. Our study identified a strong correlation between the sentiment changes in COVID-19-related Twitter data and public health policies and events. Additionally, the experimental results suggested that the data preprocessing approach improved the performance of the early trained model. This study verified the feasibility of developing a fast and low-human-effort surveillance system for monitoring people’s attitudes towards public health policies and events during a pandemic by analyzing Twitter data. Based on the pre-trained model and early Twitter data, we can quickly build a model for the surveillance system.
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Cyr PR, Jain V, Chalkidou K, Ottersen T, Gopinathan U. Evaluations of public health interventions produced by health technology assessment agencies: A mapping review and analysis by type and evidence content. Health Policy 2021; 125:1054-1064. [PMID: 34112508 DOI: 10.1016/j.healthpol.2021.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/30/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Health technology assessments (HTAs) have been suggested as a strategy to bridge the evidence-to-policy gap in public health. It is unclear to what extent HTAs have been prepared to assist decisions to implement public health interventions (PHIs). We aimed to describe the experience of HTA agencies by mapping, classifying, and analyzing the evidence content of HTAs of PHIs. METHODS We systematically searched databases of 35 HTA agencies from 18 countries for evaluations of PHIs between 2008-2018. Interventions were classified using the International Classification of Health Interventions and the evidence content analysed with the INAHTA Product-Type-mark checklist. RESULTS Only 1010 (9%) of HTAs were on PHIs. 500 (50%) publications targeted Body Systems and Functions, 302 (30%) Health-related Behaviours, 137 (14%) the Environment and 44 (4%) Activities and Participation Domains. Out of 734 publications perused, few met the criteria of full-HTAs (71;10%) or mini-HTAs (110;15%). Most were rapid reviews (420;57%). 72% of all reports came from only 6 countries. CONCLUSION HTAs on PHIs were uncommon relative to clinical interventions. HTAs on population-based PHIs were less comprehensive in quality and rigor of the evidence. Countries with more resources and mature HTA-systems had done the most evaluations. Exploring the experiences of forerunners could help overcome barriers to evaluations of PHIs and exploit the full potential of HTAs to promote evidence-based public health.
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Affiliation(s)
- Pascale Renée Cyr
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, P.O. Box 1089 Blindern, 0317 Oslo, Norway.
| | - Vageesh Jain
- Public Health England, London, United Kingdom; Institute for Global Health, University College London (UCL), London, United Kingdom
| | - Kalipso Chalkidou
- Department of Infectious Disease Epidemiology School of Public Health, Imperial College London, London, United Kingdom; Center for Global Development, London, United Kingdom
| | - Trygve Ottersen
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, P.O. Box 1089 Blindern, 0317 Oslo, Norway; Division for Health Services, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
| | - Unni Gopinathan
- Cluster for Global Health, Division for Health Services, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213 Oslo, Norway
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23
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[Evidence-based public health: perspectives and specific implementation factors]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:514-523. [PMID: 33851222 PMCID: PMC8087605 DOI: 10.1007/s00103-021-03308-x] [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: 12/04/2020] [Accepted: 03/12/2021] [Indexed: 11/30/2022]
Abstract
Evidenzbasierung stellt auch im öffentlichen Gesundheitswesen eine zentrale Anforderung dar. 5 allgemeine Prinzipien gelten in der evidenzbasierten Medizin wie in der evidenzbasierten Public Health (EBPH). Sie umfassen Systematik, Transparenz im Umgang mit Unsicherheit, Integration und Partizipation, Umgang mit Interessenkonflikten sowie einen strukturierten, reflektierten Prozess. Dieser Artikel hat das Ziel, ein gemeinsames Verständnis von evidenzbasierter Public Health zu fördern. Mit einer systematischen Literaturrecherche zu Perspektiven der Evidenzbasierung in Public Health wurde das internationale Verständnis von EBPH beleuchtet. So wurden 20 englischsprachige und eine deutschsprachige Quelle identifiziert und einer Inhaltsanalyse unterzogen. Über die allgemeinen Prinzipien hinausgehende Charakteristika dieser Perspektiven befassen sich mit Aspekten der Bevölkerungsorientierung, dem zugrunde liegenden Verständnis von Evidenz, zu beteiligenden Disziplinen und Interessengruppen sowie relevanten Kriterien und notwendigen Kompetenzen für eine Umsetzung von Evidenzbasierung. Darauf aufbauend und unter Berücksichtigung methodischer Entwicklungen im Umgang mit Komplexität lassen sich 4 spezifische Umsetzungsfaktoren der EBPH ableiten. Sie umfassen Theorie, Interdisziplinarität, Kontextabhängigkeit und Komplexität sowie allgemeine gesellschaftliche Aspekte. Die praktische Umsetzung von EBPH erfordert personelle und finanzielle Ressourcen sowie Kompetenzen – unter anderem für die Durchführung systematischer Übersichtsarbeiten zur Wirksamkeit von Maßnahmen unter Alltagsbedingungen, für die wissenschaftliche Betrachtung weiterer relevanter Fragestellungen sowie für die Etablierung transparenter Prozesse zur Formulierung von Empfehlungen.
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Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making. Health Res Policy Syst 2021; 19:38. [PMID: 33736670 PMCID: PMC7977245 DOI: 10.1186/s12961-020-00662-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 11/19/2020] [Indexed: 12/20/2022] Open
Abstract
Background Health policy and management decisions rarely reflect research evidence. As part of a broader randomized controlled study exploring implementation science strategies we examined how allied health managers respond to two distinct recommendations and the evidence that supports them. Methods A qualitative study nested in a larger randomized controlled trial. Allied health managers across Australia and New Zealand who were responsible for weekend allied health resource allocation decisions towards the provision of inpatient service to acute general medical and surgical wards, and subacute rehabilitation wards were eligible for inclusion. Consenting participants were randomized to (1) control group or (2) implementation group 1, which received an evidence-based policy recommendation document guiding weekend allied health resource allocation decisions, or (3) implementation group 2, which received the same policy recommendation document guiding weekend allied health resource allocation decisions with support from a knowledge broker. As part of the trial, serial focus groups were conducted with a sample of over 80 allied health managers recruited to implementation group 2 only. A total 17 health services participated in serial focus groups according to their allocated randomization wave, over a 12-month study period. The primary outcome was participant perceptions and data were analysed using an inductive thematic approach with constant comparison. Thematic saturation was achieved. Results Five key themes emerged: (1) Local data is more influential than external evidence; (2) How good is the evidence and does it apply to us? (3) It is difficult to change things; (4) Historically that is how we have done things; and (5) What if we get complaints? Conclusions This study explored implementation of strategies to bridge gaps in evidence-informed decision-making. Results provide insight into barriers, which prevent the implementation of evidence-based practice from fully and successfully occurring, such as attitudes towards evidence, limited skills in critical appraisal, and lack of authority to promote change. In addition, strategies are needed to manage the risk of confirmation biases in decision-making processes. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12618000029291). Universal Trial Number (UTN): U1111-1205-2621.
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Kriegner S, Ottersen T, Røttingen JA, Gopinathan U. Promoting Intersectoral Collaboration Through the Evaluations of Public Health Interventions: Insights From Key Informants in 6 European Countries. Int J Health Policy Manag 2021; 10:67-76. [PMID: 32610746 PMCID: PMC7947666 DOI: 10.34172/ijhpm.2020.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 02/01/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Intersectoral collaboration is critical to the successful implementation of many public health interventions (PHIs). Little attention has been paid to whether and how processes at the stage of evaluation can promote intersectoral collaboration. The objective of this study was to examine European experiences and views on whether and how the evaluation of PHIs promote intersectoral collaboration. METHODS A qualitative study design was used. We conducted semi-structured interviews with 15 individuals centrally involved in the evaluation of PHIs in 6 European countries (Austria, Denmark, England, Germany, Norway, and Switzerland). Questions pertained to current processes for evaluating PHIs in the country and current and potential strategies for promoting intersectoral collaboration. Transcripts were analyzed using thematic analysis to identify key themes responding to our primary objective. RESULTS Experiences with promoting intersectoral collaboration through the evaluation of PHIs could be summarized in 4 themes: (1) Early involvement of non-health sectors in the evaluative process and inclusion of non-health benefits can promote intersectoral collaboration, but should be combined with greater influence of these sectors in shaping PHIs; (2) Harmonization of methodological approaches may enable comparison of results and facilitate intersectoral collaboration, but should not be an overriding goal; (3) Involvement in health impact assessments (HIAs) can promote intersectoral collaboration, but needs to be incentivized and be conducted without putting overwhelming demands on non-health sectors; (4) A designated body for evaluating PHIs may promote intersectoral collaboration, but its design needs to take account of realities of policy-making. CONCLUSION The full potential for promoting intersectoral collaboration through the evaluation of PHIs appears currently unrealized in the settings we studied. To further promote intersectoral collaboration, evaluators and decision-makers may consider the full range of strategies characterized in this study. This may be most effective if the strategies are deployed so that they reinforce each other, value outcomes beyond health, and are tailored to maximize political priority for PHIs across sectors.
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Affiliation(s)
- Sabrina Kriegner
- Oslo Group on Global Health Policy, Department of Community Medicine and Global Health and Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Trygve Ottersen
- Oslo Group on Global Health Policy, Department of Community Medicine and Global Health and Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Unni Gopinathan
- Oslo Group on Global Health Policy, Department of Community Medicine and Global Health and Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
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Strengthening the Evidence for Maternal and Child Health: Implementing the New Performance Measurement Framework for the Title V Maternal and Child Health Block Grant. Matern Child Health J 2021; 25:221-229. [PMID: 33392933 DOI: 10.1007/s10995-020-03018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA MCHB) developed a three-tiered performance measure framework for the Title V Maternal and Child Health Block Grant program (MCH Title V). The third tier, evidence-based/informed strategy measures (ESMs) are developed by states to address National Performance Measures (NPM) goals. To support states' efforts, MCHB funded the "Strengthen the Evidence for Maternal and Child Health" (STE) to: (1) define the concept of evidence for the field with an emphasis on strength; (2) identify available evidence for each NPM, (3) translate ESM research for use at the state level; and (4) provide technical assistance (TA) to states to facilitate implementation. DESCRIPTION The program conducted evidence reviews defining an "evidence continuum" emphasizing a continuum of strength, provided individual and group TA to MCH Title V grantees, launched a TA referral system, and reviewed state ESMs to assess use of evidence-based/informed strategies. ASSESSMENT Ten evidence reviews identified multiple strategies as having "emerging" or "moderate" evidence. TA reached all MCH Title V programs, encompassing 59 US states and jurisdictions, and the TA referral system effectively partnered with MCHB resources. All MCH Title V states and territories submitted ESMs for the Block Grant program's first year reporting requirement. CONCLUSION STE is the first program to review available evidence on effective strategies addressing NPMs for MCH Title V. Identifying actionable next steps responsive to state needs will be a key factor for continued implementation of ESMs and achieving improvements in MCH.
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Zhao N, Koch-Weser S, Lischko A, Chung M. Knowledge translation strategies designed for public health decision-making settings: a scoping review. Int J Public Health 2020; 65:1571-1580. [PMID: 33095270 DOI: 10.1007/s00038-020-01506-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/24/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To review and describe available Knowledge Translation (KT) strategies that are designed for or applied in public health decision-making settings. INTRODUCTION KT is the exchange, synthesis, and ethically sound application of knowledge. This review proposes that KT strategies in public health settings should be understood as action plans that promote evidence use and facilitate evidence-informed decision-making. METHODS This scoping review included studies that reported on KT strategies applied in public health settings, published between 2010 and 2017. Studies were searched using Medline, online KT database, and citation tracing. Data from 305 included studies were synthesized using a coding form and conceptually mapped to identify KT strategies used in public health settings. RESULTS A total of 124 unique examples of KT methods or tools were identified and summarized into 38 recommended and promising KT strategies. Built on the lists of recommended strategies, this review synthesized a framework that matched all 38 KT strategies to 10 key components of the evidence-informed decision-making process. CONCLUSIONS The public health KT strategies summarized and organized by this review promote a better understanding and more effective use of KT strategies.
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Affiliation(s)
- Naisi Zhao
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, 136 Harrison Ave, Boston, MA, 02111, USA
| | - Susan Koch-Weser
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, 136 Harrison Ave, Boston, MA, 02111, USA
| | - Amy Lischko
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, 136 Harrison Ave, Boston, MA, 02111, USA
| | - Mei Chung
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, 136 Harrison Ave, Boston, MA, 02111, USA.
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Ahmad P, Arshad AI, Della Bella E, Khurshid Z, Stoddart M. Systemic Manifestations of the Periodontal Disease: A Bibliometric Review. Molecules 2020; 25:E4508. [PMID: 33019648 PMCID: PMC7582719 DOI: 10.3390/molecules25194508] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022] Open
Abstract
This bibliometric review aimed to identify and analyze the top 100 most-cited publications on the systemic manifestations of periodontal disease (PD). A literature search was performed using the Web of Science (WoS) 'All Databases', without any restriction of language, publication year, or study design. Of 4418 articles, the top 100 were included based on their citation count. After downloading the full texts, their bibliometric information was extracted and analyzed. The citation counts for the top 100 articles ranged from 156 to 4191 (median 217). The most productive years were 2003 and 2005, with 20 articles on the list. Majority of the articles were published in the Journal of Periodontology (n = 25). The top 100 articles were generated primarily from the USA (n = 61). Most of the publications were clinical trials (n = 27) and focused on the cardiovascular manifestations of PD (n = 31). Most of the articles were within the evidence level V (n = 41). A total of 58 studies received funding and the most frequently used keyword in the top articles was "periodontal disease" (n = 39). The current citation analysis presents insights into the current trends in the systemic manifestations of periodontal disease.
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Affiliation(s)
- Paras Ahmad
- AO Research Institute Davos, 7270 Davos Platz, Switzerland; (P.A.); (E.D.B.)
- Oral Medicine Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Anas Imran Arshad
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia;
- Paedodontics Department, Rashid Latif Dental College, Lahore 54600, Pakistan
| | - Elena Della Bella
- AO Research Institute Davos, 7270 Davos Platz, Switzerland; (P.A.); (E.D.B.)
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Martin Stoddart
- AO Research Institute Davos, 7270 Davos Platz, Switzerland; (P.A.); (E.D.B.)
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Wickramasinghe ND, Samarutilake N, Wettasinghe MC, Feiler J, Morgan A, Kousoulis AA, Van Bortel T. Public health programmes to promote mental health in young people: a systematic integrative review protocol. BMJ Open 2020; 10:e037241. [PMID: 32978192 PMCID: PMC7520825 DOI: 10.1136/bmjopen-2020-037241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION In light of the ever-growing mental health disease burden among young people worldwide, we aim to systematically review the global literature to identify the public health programmes targeted at promoting mental health and well-being in young people, the reported/anticipated mental health-related outcomes of the implemented public health programmes and the reported facilitators and barriers in relation to the implementation of those public health programmes. METHODS AND ANALYSIS A comprehensive literature search will be carried out in the following electronic bibliographic databases: MEDLINE, EMBASE, PsycINFO, Scopus, ASSIA, Web of Science, Global Health, AMED, Health Source and The Cochrane Library. Further, a manual search of the reference lists of eligible studies and reviews will be carried out. The search strategy will include combinations of three key blocks of terms, namely: 'young people', 'mental health' and 'public health programme', using database-specific subject headings and text words. Two reviewers will independently screen, assess data quality and extract data for synthesis. Disagreements at any stage will be resolved by consensus with the involvement of a third reviewer. Given the anticipated methodological pluralism of the potential eligible studies, we will provide a narrative synthesis of the findings on public health programmes aimed at promoting the mental health and well-being of young people according to identified thematic areas. Furthermore, a narrative synthesis of the reported facilitators and barriers in relation to the implementation of public health programmes will be provided. ETHICS AND DISSEMINATION Given that the review findings will be focused on understanding the breadth and depth of the global research into public health programmes to promote mental health in young people with a particular emphasis on the facilitators and barriers of programmatic implementation, the findings will be of great value to inform future interventions, programmes and approaches to promote mental health and well-being of young people worldwide. PROSPERO REGISTRATION NUMBER CRD42018099551.
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Affiliation(s)
- Nuwan Darshana Wickramasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Nelum Samarutilake
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
- Ministry of Health, Nutrition and Indigenous Medicine, Colombo, Sri Lanka
| | | | - Julie Feiler
- Glasgow Caledonian University London, London, United Kingdom
| | - Antony Morgan
- Glasgow Caledonian University London, London, United Kingdom
| | | | - Tine Van Bortel
- Cambridge Public Health, University of Cambridge, Cambridge, United Kingdom
- Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
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Mazur J, Dzielska A, Kleszczewska D, Oblacińska A, Fijałkowska A. Changes in physical activity of adolescent girls in the context of their perception of the Healthy Me programme. Eur J Public Health 2020; 30:461-466. [PMID: 31990328 DOI: 10.1093/eurpub/ckz242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND An assumption was made that results of programme evaluation lead to better understanding for whom this intervention may work. The aim of the article is to compare the changes in physical activity of the intervention programme participants depending on subjective assessment of its impact. METHODS The data were obtained from 14- to15-year-old Polish girls (N = 1120) from 48 random selected secondary schools participating in the 1-year Healthy Me programme in the 2017/2018. Schools were randomly assigned to one of two types of intervention or to a control (null) group. Satisfaction with the programme according to 21 criteria was measured retrospectively just after the intervention. Change in MVPA (moderate-to-vigorous physical activity) during the programme implementation was assessed in relation to satisfaction level, and adjusted for initial MVPA. RESULTS In total, the MVPA did not change significantly comparing pre- and post-intervention surveys (3.94 ± 1.94 vs. 3.87 ± 1.93)-P = 0.093. However, the perceived notable improvement of functioning in 10 out of 21 areas was related to the unquestionable increase in MVPA (P ≤ 0.001). With respect to the four impact areas, an interaction was demonstrated between an intervention group and an improvement in the domain-specific functioning. The beneficial impact of the programme on these areas was associated with the improvement of physical activity only in case of full and null intervention. CONCLUSIONS Indicators related to the implementation process and the results obtained during the Healthy Me programme evaluation could represent a change in motivational and environmental factors that indirectly affects adolescent girl's physical activity.
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Affiliation(s)
- Joanna Mazur
- Department of Humanization in Medicine and Sexology, University of Zielona Gora, Collegium Medicum, Zielona Gora, Poland.,Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | - Anna Dzielska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | | | - Anna Oblacińska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
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Windle M, Lee HD, Cherng ST, Lesko CR, Hanrahan C, Jackson JW, McAdams-DeMarco M, Ehrhardt S, Baral SD, D’Souza G, Dowdy DW. From Epidemiologic Knowledge to Improved Health: A Vision for Translational Epidemiology. Am J Epidemiol 2019; 188:2049-2060. [PMID: 30927354 DOI: 10.1093/aje/kwz085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 12/18/2022] Open
Abstract
Epidemiology should aim to improve population health; however, no consensus exists regarding the activities and skills that should be prioritized to achieve this goal. We performed a scoping review of articles addressing the translation of epidemiologic knowledge into improved population health outcomes. We identified 5 themes in the translational epidemiology literature: foundations of epidemiologic thinking, evidence-based public health or medicine, epidemiologic education, implementation science, and community-engaged research (including literature on community-based participatory research). We then identified 5 priority areas for advancing translational epidemiology: 1) scientific engagement with public health; 2) public health communication; 3) epidemiologic education; 4) epidemiology and implementation; and 5) community involvement. Using these priority areas as a starting point, we developed a conceptual framework of translational epidemiology that emphasizes interconnectedness and feedback among epidemiology, foundational science, and public health stakeholders. We also identified 2-5 representative principles in each priority area that could serve as the basis for advancing a vision of translational epidemiology. We believe an emphasis on translational epidemiology can help the broader field to increase the efficiency of translating epidemiologic knowledge into improved health outcomes and to achieve its goal of improving population health.
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Affiliation(s)
- Michael Windle
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Hojoon D Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Sarah T Cherng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Catherine R Lesko
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Colleen Hanrahan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - John W Jackson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Mara McAdams-DeMarco
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Gypsyamber D’Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - David W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
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Mirzoev T, Poudel AN, Gissing S, Doan TTD, Ferdous T, Regmi S, Duong MD, Baral S, Chand O, Huque R, Hoang VM, Elsey H. Is evidence-informed urban health planning a myth or reality? Lessons from a qualitative assessment in three Asian cities. Health Policy Plan 2019; 34:773-783. [PMID: 31603206 PMCID: PMC6913712 DOI: 10.1093/heapol/czz097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2019] [Indexed: 11/23/2022] Open
Abstract
City governments are well-positioned to effectively address urban health challenges in the context of rapid urbanization in Asia. They require good quality and timely evidence to inform their planning decisions. In this article, we report our analyses of degree of data-informed urban health planning from three Asian cities: Dhaka, Hanoi and Pokhara. Our theoretical framework stems from conceptualizations of evidence-informed policymaking, health planning and policy analysis, and includes: (1) key actors, (2) approaches to developing and implementing urban health plans, (3) characteristics of the data itself. We collected qualitative data between August 2017 and October 2018 using: in-depth interviews with key actors, document review and observations of planning events. Framework approach guided the data analysis. Health is one of competing priorities with multiple plans being produced within each city, using combinations of top-down, bottom-up and fragmented planning approaches. Mostly data from government information systems are used, which were perceived as good quality though often omits the urban poor and migrants. Key common influences on data use include constrained resources and limitations of current planning approaches, alongside data duplication and limited co-ordination within Dhaka's pluralistic system, limited opportunities for data use in Hanoi and inadequate and incomplete data in Pokhara. City governments have the potential to act as a hub for multi-sectoral planning. Our results highlight the tensions this brings, with health receiving less attention than other sector priorities. A key emerging issue is that data on the most marginalized urban poor and migrants are largely unavailable. Feasible improvements to evidence-informed urban health planning include increasing availability and quality of data particularly on the urban poor, aligning different planning processes, introducing clearer mechanisms for data use, working within the current systemic opportunities and enhancing participation of local communities in urban health planning.
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Affiliation(s)
- Tolib Mirzoev
- University of Leeds, Leeds Institute of Health Sciences, Nuffield Centre for International Health and Development, 10.31b, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK
| | - Ak Narayan Poudel
- University of Leeds, Leeds Institute of Health Sciences, Nuffield Centre for International Health and Development, 10.31b, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK
| | - Stefanie Gissing
- University of Leeds, Leeds Institute of Health Sciences, Nuffield Centre for International Health and Development, 10.31b, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK
| | - Thi Thuy Duong Doan
- Hanoi University of Public Health, 1A Duc Thang, North Tu Liem, Hanoi, Vietnam
| | - Tarana Ferdous
- ARK Foundation, C4, House 6, Road 109, Gulshan 2, Dhaka-1212, Bangladesh
| | - Shophika Regmi
- HERD International, PO Box 24144, Thapathali Height 11, Kathmandu, Nepal 44600
| | - Minh Duc Duong
- Hanoi University of Public Health, 1A Duc Thang, North Tu Liem, Hanoi, Vietnam
| | - Sushil Baral
- HERD International, PO Box 24144, Thapathali Height 11, Kathmandu, Nepal 44600
| | - Obindra Chand
- HERD International, PO Box 24144, Thapathali Height 11, Kathmandu, Nepal 44600
| | - Rumana Huque
- ARK Foundation, C4, House 6, Road 109, Gulshan 2, Dhaka-1212, Bangladesh
| | - Van Minh Hoang
- Hanoi University of Public Health, 1A Duc Thang, North Tu Liem, Hanoi, Vietnam
| | - Helen Elsey
- University of Leeds, Leeds Institute of Health Sciences, Nuffield Centre for International Health and Development, 10.31b, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK
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Payán DD, Lewis LB. Use of research evidence in state health policymaking: Menu labeling policy in California. Prev Med Rep 2019; 16:101004. [PMID: 31709136 PMCID: PMC6831831 DOI: 10.1016/j.pmedr.2019.101004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/30/2019] [Accepted: 09/27/2019] [Indexed: 11/28/2022] Open
Abstract
Addressing the translational gap between research evidence and state health policy requires an understanding of the current use of research evidence in the state policymaking process. In this study, we explore the use of research evidence to inform the legislative debate about restaurant nutrition labeling policy in California. In 2008, California was the first state to enact a mandatory menu calorie labeling policy in the U.S. Using a qualitative approach, we examine data sources and types of evidence used in legislative documents (n = 87) related to six menu labeling bills introduced in California's state legislature between 2003 and 2008. Federal- and state-level government agency reports were the most frequently cited sources of technical knowledge. Advocacy coalition members who were active participants involved in the policy debate were also cited as experts. Five of the six bills included evidence in related legislative documents. While documents included considerable evidence on the magnitude and severity of the obesity problem to justify policy enactment, there were a limited number of statements referring to policy effectiveness and only one statement identified attesting to implementation context and acceptability. Reference to evidence on related policy suggests policy precedence may also play an important role in policy decision making. There is a need to improve the dissemination of obesity policy effectiveness and implementation studies in a politically time sensitive manner to influence state health policy debates. Strategies are discussed to effectively integrate the use of research evidence in the state health policymaking process.
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Affiliation(s)
- Denise D Payán
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, USA
| | - LaVonna B Lewis
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA
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Abstract
Purpose
Models of integrated care are prime examples of complex interventions, incorporating multiple interacting components that work through varying mechanisms to impact numerous outcomes. The purpose of this paper is to explore summative, process and developmental approaches to evaluating complex interventions to determine how to best test this mess.
Design/methodology/approach
This viewpoint draws on the evaluation and complex intervention literatures to describe the advantages and disadvantages of different methods. The evaluation of the electronic patient reported outcomes (ePRO) mobile application and portal system is presented as an example of how to evaluate complex interventions with critical lessons learned from this ongoing study.
Findings
Although favored in the literature, summative and process evaluations rest on two problematic assumptions: it is possible to clearly identify stable mechanisms of action; and intervention fidelity can be maximized in order to control for contextual influences. Complex interventions continually adapt to local contexts, making stability and fidelity unlikely. Developmental evaluation, which is more conceptually aligned with service-design thinking, moves beyond these assumptions, emphasizing supportive adaptation to ensure meaningful adoption.
Research limitations/implications
Blended approaches that incorporate service-design thinking and rely more heavily on developmental strategies are essential for complex interventions. To maximize the benefit of this approach, three guiding principles are suggested: stress pragmatism over stringency; adopt an implementation lens; and use multi-disciplinary teams to run studies.
Originality/value
This viewpoint offers novel thinking on the debate around appropriate evaluation methodologies to be applied to complex interventions like models of integrated care.
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Hailemariam M, Bustos T, Montgomery B, Barajas R, Evans LB, Drahota A. Evidence-based intervention sustainability strategies: a systematic review. Implement Sci 2019; 14:57. [PMID: 31171004 PMCID: PMC6554955 DOI: 10.1186/s13012-019-0910-6] [Citation(s) in RCA: 155] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sustainability of evidence-based interventions (EBI) remains a challenge for public health community-based institutions. The conceptual definition of sustainment is not universally agreed upon by researchers and practitioners, and strategies utilized to facilitate sustainment of EBI are not consistently reported in published literature. Given these limitations in the field, a systematic review was conducted to summarize the existing evidence supporting discrete sustainment strategies for public health EBIs and facilitating and hindering factors of sustainment. METHODS We searched PsychINFO, Embase, ProQuest, PubMed, and Google Scholar. The initial search was run in March 2017 and an update was done in March 2019. Study eligibility criteria included (a) public health evidence-based interventions, (b) conducted in the community or community-based settings, and (c) reported outcomes related to EBI sustainment. Details characterizing the study setting, design, target population, and type of EBI sustained were extracted. RESULTS A total of 26 articles published from 2004 to 2019 were eligible for data extraction. Overall, the importance of sustainability was acknowledged across all of the studies. However, only seven studies presented a conceptual definition of sustainment explicitly within the text. Six of the included studies reported specific sustainment strategies that were used to facilitate the sustainment of EBI. Only three of the studies reported their activities related to sustainment by referencing a sustainment framework. Multiple facilitators (i.e., adaptation/alignment, funding) and barriers (i.e., limited funding, limited resources) were identified as influencing EBI sustainment. The majority (n = 20) of the studies were conducted in high-income countries. Studies from low-income countries were mostly naturalistic. All of the studies from low-income countries reported lack of funding as a hindrance to sustainment. IMPLICATION FOR DISSEMINATION AND IMPLEMENTATION RESEARCH Literature focused on sustainment of public health EBIs should present an explicit definition of the concept. Better reporting of the framework utilized, steps followed, and adaptations made to sustain the intervention might contribute to standardizing and developing the concept. Moreover, encouraging longitudinal dissemination and implementation (D&I) research especially in low-income countries might help strengthen D&I research capacity in public health settings.
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Affiliation(s)
- Maji Hailemariam
- College of Human Medicine, Division of Public Health, Michigan State University, Flint, MI USA
| | - Tatiana Bustos
- Department of Psychology, Michigan State University, East Lansing, MI USA
| | - Barrett Montgomery
- College of Human Medicine, Division of Public Health, Michigan State University, Flint, MI USA
| | - Rolando Barajas
- College of Human Medicine, Division of Public Health, Michigan State University, Flint, MI USA
| | - Luther B. Evans
- College of Human Medicine, Division of Public Health, Michigan State University, Flint, MI USA
- Community-Based Organizational Partners (CBOP), Flint, MI USA
| | - Amy Drahota
- Department of Psychology, Michigan State University, East Lansing, MI USA
- Child & Adolescent Services Research Center (CASRC), San Diego, CA USA
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Henriksson DK, Peterson SS, Waiswa P, Fredriksson M. Decision-making in district health planning in Uganda: does use of district-specific evidence matter? Health Res Policy Syst 2019; 17:57. [PMID: 31170988 PMCID: PMC6554923 DOI: 10.1186/s12961-019-0458-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 04/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In a decentralised health system, district health managers are tasked with planning for health service delivery, which should be evidence based. However, planning in low-income countries such as Uganda has been described as ad hoc. A systematic approach to the planning process using district-specific evidence was introduced to district health managers in Uganda. However, little is known about how the use of district-specific evidence informs the planning process. In this study, we investigate how the use of this evidence affects decision-making in the planning process and how stakeholders in the planning process perceived the use of evidence. METHODS A convergent parallel mixed-methods study design was used, where quantitative data was collected from district health annual work plans for the financial years 2012/2013, 2013/2014, 2014/2015 and 2015/2016 as well as from bottleneck analysis reports for 2012, 2013, 2014 and 2015. Qualitative data was collected through semi-structured interviews with key informants from the two study districts. RESULTS District managers reported that they were able to produce more robust district annual work plans when they used the systematic approach of using district-specific evidence. Approximately half of the prioritised activities in the annual work plans were evidence based. Procurement and logistics, training, and support supervision activities were the most prioritised activities. Between 4% and 5.5% of the total planned expenditure was for child survival, of which 47% to 94% was from donor and other partner contributions. CONCLUSION District-specific evidence and a structured process for its use to prioritise activities and make decisions in the planning process at the district level helped systematise the planning process. However, the reported limited decision and fiscal space, inadequate funding and high dependency on donor funding did not always allow for the use of district-specific evidence in the planning process.
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Affiliation(s)
| | - Stefan Swartling Peterson
- United Nations Children's Fund, New York, Karolinska Institutet, Stockholm, Uppsala University, Uppsala, Sweden
| | - Peter Waiswa
- School of Public Health, Kampala and Karolinska Institutet, Makerere University College of Health Sciences, Stockholm, Sweden
| | - Mio Fredriksson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Csanadi M, Agh T, Tordai A, Webb T, Jeyakumaran D, Sengupta N, Schain F, Mattsson J. A systematic literature review of incidence, mortality, and relapse of patients diagnosed with chronic graft versus host disease. Expert Rev Hematol 2019; 12:311-323. [DOI: 10.1080/17474086.2019.1605288] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Tamas Agh
- Syreon Research Institute, Budapest, Hungary
| | - Attila Tordai
- Department of Pathophysiology, Semmelweis University, Budapest, Hungary
| | - Thomas Webb
- Janssen Research & Development, High Wycombe, UK
| | | | | | | | - Jonas Mattsson
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
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Gómez-Gómez I, Motrico E, Moreno-Peral P, Rigabert A, Conejo-Cerón S, Ortega-Calvo M, Recio JI, Bellón JA. Effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression: a study protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2019; 9:e026842. [PMID: 30878992 PMCID: PMC6429884 DOI: 10.1136/bmjopen-2018-026842] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 01/11/2019] [Accepted: 01/25/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Many studies have explored the impact of lifestyle interventions on depression. However, little is known about the effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression. Our objective is to assess the effectiveness of complex multiple-risk lifestyle interventions in reducing depressive symptoms in the adult population by the acquisition of at least two healthy habits-healthy diet, physical activity and/or smoking cessation. For such purpose, a systematic review and meta-analysis of randomised controlled trials will be conducted. METHOD AND ANALYSIS MEDLINE (through Ovid and PubMed), Scopus, Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO, OpenGrey Register (System for Information on Grey Literature in Europe) and the International Clinical Trials Registry Platform will be searched for relevant articles. Additionally, a supplementary manual search will be performed using lists of references, references to expert authors and other systematic reviews and/or meta-analyses. Study selection, data extraction (target habits, country, target populations, conditions and statistical data to name a few) and assessment of the risk of bias will be performed separately by two independent researchers. The primary outcome measure will be the reduction of depression symptoms, as measured by validated instruments. We will calculate pooled standardised mean differences and 95% CIs using random-effect models. Heterogeneity, sensitivity and publication bias will be assessed, and sub-group analysis will be performed. Heterogeneity will be explored by random-effects meta-regression analysis. ETHICS AND DISSEMINATION Ethical approval is not required for this study. The results of this systematic review and meta-analysis will be presented in relevant conferences and published in a peer-review journal. The findings of this study could have important clinical and scientific implications for the improvement of symptoms of depression. PROSPERO REGISTRATION NUMBER CRD42018100253; Pre-results.
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Affiliation(s)
- Irene Gómez-Gómez
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
| | - Patricia Moreno-Peral
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
- Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain
| | - Alina Rigabert
- Department of Psychology, Universidad Loyola Andalucia, Seville, Spain
| | - Sonia Conejo-Cerón
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
- Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain
| | - Manuel Ortega-Calvo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Family Medicine, Primary Care Division of Seville, Seville, Spain
| | - José-Ignacio Recio
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
- Institute of Biomedical Research of Salamanca (IBSAL), Primary Health Care Research Unit, La Alamedilla Health Center, Health Service of Castilla y León (SACyL), Salamanca, Spain
| | - Juan A Bellón
- Prevention and Health Promotion Research Network (redIAPP), ISCIII, Barcelona, Spain
- Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain
- Research Unit of the Health District of Primary Care Málaga-Guadalhorce, Málaga, Spain
- Department of Public Health and Psychiatry, University of Málaga (UMA), Málaga, Spain
- El Palo Health Centre, Andalusian Health Service (SAS), Málaga, Spain
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Cognitive biases in public health and how economics and sociology can help overcome them. Public Health 2019; 169:163-172. [PMID: 30879646 DOI: 10.1016/j.puhe.2019.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 10/16/2018] [Accepted: 02/04/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The objective of this study was to identify important gaps in the public health evidence base and consider the implications of these for public health and public health economics. STUDY DESIGN This was a review and critique of public health policy in the UK. METHODS Using two key psychological concepts relating to cognitive biases, viz. cognitive dissonance and heuristics, the shortcomings in public health approaches to confronting the prevalence of non-communicable diseases are described. The implications are drawn out. RESULTS Two cognitive biases in public health thinking are identified. (i) A dissonance between what is known and what is done, resulting in the repetition of solutions that have previously been shown to have had little or no effect. (ii) The habitual use of set of heuristics which mean that simple solutions to complex problems are preferred to undertaking the detailed assessment of how to bring about change. These biases mean that the evidence about the dynamics of populations and the ways that the mechanisms of prevention actually operate seldom feature in the way interventions, policy and practice are undertaken. The evidence base is consequently highly skewed. CONCLUSIONS Health economics combined with sociological reasoning has potentially an important role to play in developing the ideas that will overcome the problems attaching to the cognitive biases.
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Williams O, Swierad EM. A Multisensory Multilevel Health Education Model for Diverse Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E872. [PMID: 30857345 PMCID: PMC6427730 DOI: 10.3390/ijerph16050872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/18/2019] [Accepted: 03/05/2019] [Indexed: 11/16/2022]
Abstract
Owing to their enormous capacity to improve health and save lives, effective health promotion frameworks have been at the forefront of public health research and practice. A multilevel focus, as exemplified by the Socio-Ecological Model (SEM), is one common denominator among these frameworks. The SEM highlights important social and ecological influences on health behavior by delineating the different levels of influence. These include public policy, organizational, community, interpersonal, and intrapersonal levels, which, when considered during the development of health promotion campaigns, especially those that focus on health education, strengthen the potential influence of that campaign on targeted behaviors. However, the SEM lacks a complimenting framework for understanding the role of conventional and unconventional approaches to health education; that is, how to design a health education intervention that considers both the context, such as the social and ecological levels of influence, and the best approaches for developing and delivering the health education in a manner that optimizes their effectiveness in today's modern and increasingly diverse world. Addressing this gap, the current article presents an integrative Multisensory Multilevel Health Education Model (MMHEM), which incorporates three key domains-(1) Art (innovativeness/creativity), (2) Culture (cultural tailoring), and (3) Science (evidence-based), while promoting the importance of considering the socio-ecological levels of influence on targeted behaviors. Using a successful health education intervention, called the Hip Hop Stroke, we deconstruct the Multisensory Multilevel Health Education Model and discuss its potential role as a guide for developing public health education interventions.
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Affiliation(s)
- Olajide Williams
- Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA.
| | - Ewelina M Swierad
- Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA.
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Steele Gray C, Gravesande J, Hans PK, Nie JX, Sharpe S, Loganathan M, Lyons R, Cott C. Using Exploratory Trials to Identify Relevant Contexts and Mechanisms in Complex Electronic Health Interventions: Evaluating the Electronic Patient-Reported Outcome Tool. JMIR Form Res 2019; 3:e11950. [PMID: 30810532 PMCID: PMC6414821 DOI: 10.2196/11950] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/23/2018] [Accepted: 12/09/2018] [Indexed: 12/04/2022] Open
Abstract
Background Designing appropriate studies for evaluating complex interventions, such as electronic health solutions to support integrated care, remains a methodological challenge. With the many moving parts of complex interventions, it is not always clear how program activities are connected to anticipated and unanticipated outcomes. Exploratory trials can be used to uncover determinants (or mechanisms) to inform content theory that underpins complex interventions before designing a full evaluation plan. Objective A multimethod exploratory trial of the electronic patient-reported outcome (ePRO) tool was conducted to uncover contexts, processes and outcome variables, and the mechanisms that link these variables before full-scale evaluation. ePRO is a mobile app and portal designed to support goal-oriented care in interdisciplinary primary health care practices (clinical-level integration). This paper offers evaluation findings and methodological insight on how to use exploratory trial data to identify relevant context, process, and outcome variables, as well as central (necessary to achieving outcomes) versus peripheral (less critical and potentially context dependent) mechanisms at play. Methods The 4-month trial was conducted in 2 primary health care practices in Toronto, Canada. The patients were randomized into control and intervention groups and compared pre and post on quality of life and activation outcome measures. Semistructured interviews were conducted with providers and patients in the intervention group. Narrative analysis was used to uncover dominant mechanisms that inform the intervention’s content theory (how context and process variables are linked to outcomes). Results Overall, 7 providers, 1 administrator, and 16 patients (7-control, 9-intervention) participated in the study. This study uncovered many complex and nuanced context, process, and outcome variables at play in the intervention. Narrative analysis of patient and provider interviews revealed dominant story lines that help to tease apart central and peripheral mechanisms driving the intervention. Provider and patient story lines centered around fitting the new intervention into everyday work and life of patients and providers and meaningfulness of the intervention. These themes were moderated by patient-provider relationships going into and throughout the intervention, their comfort with technology, and the research process. Conclusions Identifying dominant story lines using narrative analysis helps to identify the most relevant context and process variables likely to influence study outcomes. Normalization process theory emerges as a useful theory to uncover underlying mechanisms because of its emphasis on the social production and normalization of technological, processual, and social aspects of work; all found to be critical to our intervention. The number of complex, overlapping influencing variables suggests that complex interventions such as ePRO require us to pay careful attention to central versus peripheral mechanisms that will influence study outcomes. The narrative methods presented here are shown to be useful in uncovering these mechanisms and help to guide subsequent larger evaluation studies.
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Affiliation(s)
- Carolyn Steele Gray
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | | | - Jason X Nie
- Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada
| | | | - Mayura Loganathan
- Ray D Wolfe Department of Family Medicine, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Renee Lyons
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cheryl Cott
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Kamel Ghalibaf A, Nazari E, Gholian-Aval M, Tara M. Comprehensive overview of computer-based health information tailoring: a systematic scoping review. BMJ Open 2019; 9:e021022. [PMID: 30782671 PMCID: PMC6340008 DOI: 10.1136/bmjopen-2017-021022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To explore the scope of the published literature on computer-tailoring, considering both the development and the evaluation aspects, with the aim of identifying and categorising main approaches and detecting research gaps, tendencies and trends. SETTING Original researches from any country and healthcare setting. PARTICIPANTS Patients or health consumers with any health condition regardless of their specific characteristics. METHOD A systematic scoping review was undertaken based on the York's five-stage framework outlined by Arksey and O'Malley. Five leading databases were searched: PubMed, Scopus, Science Direct, EBSCO and IEEE for articles published between 1990 and 2017. Tailoring concept was investigated for three aspects: system design, information delivery and evaluation. Both quantitative (ie, frequencies) and qualitative (ie, theme analysis) methods have been used to synthesis the data. RESULTS After reviewing 1320 studies, 360 articles were identified for inclusion. Two main routes were identified in tailoring literature including public health research (64%) and computer science research (17%). The most common facets used for tailoring were sociodemographic (73 %), target behaviour status (59%) and psycho-behavioural determinants (56%), respectively. The analysis showed that only 13% of the studies described the tailoring algorithm they used, from which two approaches revealed: information retrieval (12%) and natural language generation (1%). The systematic mapping of the delivery channel indicated that nearly half of the articles used the web (57%) to deliver the tailored information; printout (19%) and email (10%) came next. Analysis of the evaluation approaches showed that nearly half of the articles (53%) used an outcome-based approach, 44% used process evaluation and 3% assessed cost-effectiveness. CONCLUSIONS This scoping review can inform researchers to identify the methodological approaches of computer tailoring. Improvements in reporting and conduct are imperative. Further research on tailoring methodology is warranted, and in particular, there is a need for a guideline to standardise reporting.
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Affiliation(s)
- Azadeh Kamel Ghalibaf
- Department of Medical Informatics, Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, The Islamic Republic of Iran
| | - Elham Nazari
- Department of Medical Informatics, Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, The Islamic Republic of Iran
| | - Mahdi Gholian-Aval
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, The Islamic Republic of Iran
| | - Mahmood Tara
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Razavi Khorasan, The Islamic Republic of Iran
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Freund M, Zucca A, Sanson-Fisher R, Milat A, Mackenzie L, Turon H. Barriers to the evaluation of evidence-based public health policy. J Public Health Policy 2018; 40:114-125. [PMID: 30279448 DOI: 10.1057/s41271-018-0145-9] [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] [Indexed: 11/21/2022]
Abstract
Public health policy has the potential to produce great benefits for individuals and communities. There is growing demand that such efforts be rigorously evaluated to ensure that the expected benefits are, in fact, realised. Commonly, public health policy is evaluated by consumer acceptability, reach, or changes in knowledge and attitudes. Non-robust research designs are often used. But these approaches to evaluation do not answer three critical questions: Has a change in the desired outcome occurred? Was it a consequence of the policy and not some extraneous factor? Was the size of the change considered significant and cost-effective? We, a team of government and academic scholars working in research and evaluation, have examined some of the more common impediments to robust evaluation: political impediments, a lack of investment in evaluation capacity within bureaucracy, and the failure of academic researchers to understand the need for the evaluation of public health policy.
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Affiliation(s)
- Megan Freund
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, New Lambton, NSW, Australia.
| | - Alison Zucca
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Robert Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Andrew Milat
- Sydney Medical School, University of Sydney, City Road, Camperdown, NSW, 2006, Australia
| | - Lisa Mackenzie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Heidi Turon
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
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Pérez MC, Minoyan N, Ridde V, Sylvestre MP, Johri M. Comparison of registered and published intervention fidelity assessment in cluster randomised trials of public health interventions in low- and middle-income countries: systematic review. Trials 2018; 19:410. [PMID: 30064484 PMCID: PMC6069979 DOI: 10.1186/s13063-018-2796-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/09/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cluster randomised trials (CRTs) are a key instrument to evaluate public health interventions. Fidelity assessment examines study processes to gauge whether an intervention was delivered as initially planned. Evaluation of implementation fidelity (IF) is required to establish whether the measured effects of a trial are due to the intervention itself and may be particularly important for CRTs of complex interventions conducted in low- and middle-income countries (LMICs). However, current CRT reporting guidelines offer no guidance on IF assessment. The objective of this review was to study current practices concerning the assessment of IF in CRTs of public health interventions in LMICs. METHODS CRTs of public health interventions in LMICs that planned or reported IF assessment in either the trial protocol or the main trial report were included. The MEDLINE/PubMed, CINAHL and EMBASE databases were queried from January 2012 to May 2016. To ensure availability of a study protocol, CRTs reporting a registration number in the abstract were included. Relevant data were extracted from each study protocol and trial report by two researchers using a predefined screening sheet. Risk of bias for individual studies was assessed. RESULTS We identified 90 CRTs of public health interventions in LMICs with a study protocol in a publicly available trial registry published from January 2012 to May 2016. Among these 90 studies, 25 (28%) did not plan or report assessing IF; the remaining 65 studies (72%) addressed at least one IF dimension. IF assessment was planned in 40% (36/90) of trial protocols and reported in 71.1% (64/90) of trial reports. The proportion of overall agreement between the trial protocol and trial report concerning occurrence of IF assessment was 66.7% (60/90). Most studies had low to moderate risk of bias. CONCLUSIONS IF assessment is not currently a systematic practice in CRTs of public health interventions carried out in LMICs. In the absence of IF assessment, it may be difficult to determine if CRT results are due to the intervention design, to its implementation, or to unknown or external factors that may influence results. CRT reporting guidelines should promote IF assessment. TRIAL REGISTRATION Protocol published and available at: https://doi.org/10.1186/s13643-016-0351-0.
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Affiliation(s)
- Myriam Cielo Pérez
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900, rue Saint-Denis, Pavillon R, Tour Saint-Antoine Porte S03.414, Montréal, Québec, H2X 0A9, Canada.,Département de médicine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, 7101, avenue du Parc, 3e étage, Montréal, Québec, H3N 1X9, Canada
| | - Nanor Minoyan
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900, rue Saint-Denis, Pavillon R, Tour Saint-Antoine Porte S03.414, Montréal, Québec, H2X 0A9, Canada.,Département de médicine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, 7101, avenue du Parc, 3e étage, Montréal, Québec, H3N 1X9, Canada
| | - Valéry Ridde
- Institut de Recherche en Santé Publique Université de Montréal (IRSPUM), Pavillon 7101 Avenue du Parc, P.O. Box 6128, Centre-ville Station, Montréal, Québec, H3C 3J7, Canada.,Institut de Recherche Pour le Développement (IRD), Le Sextant 44, bd de Dunkerque, CS 90009 13572, Cedex 02, Marseille, France
| | - Marie-Pierre Sylvestre
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900, rue Saint-Denis, Pavillon R, Tour Saint-Antoine Porte S03.414, Montréal, Québec, H2X 0A9, Canada.,Département de médicine sociale et préventive, École de santé publique (ESPUM), Université de Montréal, 7101, avenue du Parc, 3e étage, Montréal, Québec, H3N 1X9, Canada
| | - Mira Johri
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900, rue Saint-Denis, Pavillon R, Tour Saint-Antoine Porte S03.414, Montréal, Québec, H2X 0A9, Canada. .,Département de gestion, d'évaluation, et de politique de santé, École de santé publique, Université de Montréal, 7101, avenue du Parc, 3e étage, Montréal, Québec, H3N 1X9, Canada.
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Chen FP, Fu TS, Lin YC, Fan CM. Risk factors and quality of life for the occurrence of hip fracture in postmenopausal women. Biomed J 2018; 41:202-208. [PMID: 30080660 PMCID: PMC6138757 DOI: 10.1016/j.bj.2018.04.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/13/2018] [Accepted: 04/12/2018] [Indexed: 01/01/2023] Open
Abstract
Background To identify the risk factors and changes of quality of life in the first occurrence of hip fracture in Taiwanese postmenopausal women. Methods In this case-control study, we enrolled 100 postmenopausal women with accidental first-incident hip fracture and 100 women without hip fracture. The control group was matched to the study group according to age. Evaluation consisted of a questionnaire, an interview to both assess quality of life via a 36-item Short Form Health Survey and document risk factors, a physical examination to record height and body weight, and bone mineral density (BMD) of the hip and spine using dual-energy X-ray absorptiometry (DXA). Results The mean age of the patients was 77.9 years old. Compared with the controls, the patients with first-incident hip fracture had a lower level of education, increased body height, higher parity, no experience of estrogen therapy, prior history of diabetes mellitus and rheumatoid arthritis, walking aid use, less weight-bearing exercise, and steroid use. Total hip BMD was a stronger predictor than BMD at different sites. Quality of life was significantly higher in the control group at the baseline and 4-month follow-up. Conclusions Quality of life was related to the first-incident hip fracture. The increased risk of falls, lower level of education, and total hip BMD are the strongest predictors of first-incident hip fracture in Asian elderly postmenopausal women.
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Affiliation(s)
- Fang-Ping Chen
- Department of Obstetrics and Gynecology, Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Tsai-Sheng Fu
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ching Lin
- Department of Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Ming Fan
- Department of Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Brownson RC, Fielding JE, Green LW. Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research. Annu Rev Public Health 2018; 39:27-53. [PMID: 29166243 PMCID: PMC5972383 DOI: 10.1146/annurev-publhealth-040617-014746] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Timely implementation of principles of evidence-based public health (EBPH) is critical for bridging the gap between discovery of new knowledge and its application. Public health organizations need sufficient capacity (the availability of resources, structures, and workforce to plan, deliver, and evaluate the preventive dose of an evidence-based intervention) to move science to practice. We review principles of EBPH, the importance of capacity building to advance evidence-based approaches, promising approaches for capacity building, and future areas for research and practice. Although there is general agreement among practitioners and scientists on the importance of EBPH, there is less clarity on the definition of evidence, how to find it, and how, when, and where to use it. Capacity for EBPH is needed among both individuals and organizations. Capacity can be strengthened via training, use of tools, technical assistance, assessment and feedback, peer networking, and incentives. Modest investments in EBPH capacity building will foster more effective public health practice.
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Affiliation(s)
- Ross C Brownson
- Prevention Research Center in St. Louis, Brown School; Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri 63130, USA;
| | - Jonathan E Fielding
- Fielding School of Public Health and Geffen School of Medicine, University of California, Los Angeles, California 90095, USA;
| | - Lawrence W Green
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California 94127, USA;
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Padek M, Allen P, Erwin PC, Franco M, Hammond RA, Heuberger B, Kasman M, Luke DA, Mazzucca S, Moreland-Russell S, Brownson RC. Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation. Implement Sci 2018; 13:49. [PMID: 29566717 PMCID: PMC5865376 DOI: 10.1186/s13012-018-0742-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 03/13/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes. METHODS This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation. DISCUSSION This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with significant expertise in practice-based research; (3) use agent-based modeling to address cancer control implementation; and (4) use a participatory, evidence-based, stakeholder-driven approach that will identify key leverage points for addressing mis-implementation among state public health programs. This research is expected to provide replicable computational simulation models that can identify leverage points and public health system dynamics to reduce mis-implementation in cancer control and may be of interest to other health areas.
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Affiliation(s)
- Margaret Padek
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Peg Allen
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Paul C. Erwin
- Department of Public Health, University of Tennessee, Knoxville, TN USA
| | - Melissa Franco
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Ross A. Hammond
- Center on Social Dynamics and Policy, The Brookings Institution, Washington DC, USA
| | - Benjamin Heuberger
- Center on Social Dynamics and Policy, The Brookings Institution, Washington DC, USA
| | - Matt Kasman
- Center on Social Dynamics and Policy, The Brookings Institution, Washington DC, USA
| | - Doug A. Luke
- Center for Public Health System Science, Brown School at Washington University in St Louis, St. Louis, MO USA
| | - Stephanie Mazzucca
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Sarah Moreland-Russell
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, 1 Brookings Drive, Campus Box 1196, St. Louis, MO 63130 USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, USA
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Abstract
Meta-analysis is a prominent method for estimating the effects of public health interventions, yet these interventions are often complex in ways that pose challenges to using conventional meta-analytic methods. This article discusses meta-analytic techniques that can be used in research syntheses on the effects of complex public health interventions. We first introduce the use of complexity frameworks to conceptualize public health interventions. We then present a menu of meta-analytic procedures for addressing various sources of complexity when answering questions about the effects of public health interventions in research syntheses. We conclude with a review of important practices and key resources for conducting meta-analyses on complex interventions, as well as future directions for research synthesis more generally. Overall, we argue that it is possible to conduct meaningful quantitative syntheses of research on the effects of public health interventions, though these meta-analyses may require the use of advanced techniques to properly consider and attend to issues of complexity.
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Affiliation(s)
- Emily E Tanner-Smith
- Peabody Research Institute, Vanderbilt University, Nashville, Tennessee 37203, USA.,Current affiliation: Department of Counseling Psychology and Human Services, University of Oregon, Eugene, Oregon 97403-1215, USA;
| | - Sean Grant
- RAND Corporation, Santa Monica, California 90407-2138, USA;
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Mensah GA. Charting the Future for Ethnicity and Health Research: Clinical and Population Science Insights From the MESA. Glob Heart 2018; 11:365-367. [PMID: 27741983 DOI: 10.1016/j.gheart.2016.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The MESA (Multi-Ethnic Study of Atherosclerosis) has been highly successful in investigating the prevalence, characteristics, and progression of subclinical cardiovascular disease (CVD) in a multiethnic American cohort of adult men and women free of CVD at baseline. MESA has also championed the use of novel biomarkers and emerging imaging techniques for the assessment of subclinical CVD and has created an extensive set of data that continues to fuel dozens of ongoing analyses. Insights from MESA include the first demonstration of ethnic differences in coronary artery calcification and its association with subclinical disease progression and incident CVD. Other findings include ethnic differences in the prevalence of pharmacological, behavioral, and lifestyle interventions for the primary prevention of CVD. MESA has also shown the association between residential neighborhood characteristics and behavioral and biomedical risk factors for CVD. This vast amount of data documenting ethnic differences in progression of subclinical CVD, diabetes, kidney disease, and pulmonary disease contrasts sharply with the relative scarcity of specific information that can pave the way for the elimination of racial and ethnic disparities. Intervention research, however, goes beyond the original objectives of MESA and other observational studies. The time has now come to build on the legacy of MESA by supporting rigorous intervention research that informs clinical and public health strategies as well as policy and environmental changes for eliminating racial and ethnic disparities in CVD and other chronic diseases and advancing the health of multiethnic communities.
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Affiliation(s)
- George A Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
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Evidence-Based Public Health 2017. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2607397. [PMID: 29270427 PMCID: PMC5705863 DOI: 10.1155/2017/2607397] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 10/04/2017] [Indexed: 11/17/2022]
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