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Lennox L, Linwood-Amor A, Maher L, Reed J. Making change last? Exploring the value of sustainability approaches in healthcare: a scoping review. Health Res Policy Syst 2020; 18:120. [PMID: 33050921 PMCID: PMC7556957 DOI: 10.1186/s12961-020-00601-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022] Open
Abstract
Background Numerous models, tools and frameworks have been produced to improve the sustainability of evidence-based interventions. Due to the vast number available, choosing the most appropriate one is increasingly difficult for researchers and practitioners. To understand the value of such approaches, evidence warranting their use is needed. However, there is limited understanding of how sustainability approaches have been used and how they have impacted research or practice. This review aims to consolidate evidence on the application and impact of sustainability approaches in healthcare settings. Methods A systematic scoping review was designed to search for peer-reviewed publications detailing the use of sustainability approaches in practice. A 5-stage framework for scoping reviews directed the search strategy, and quality assessment was performed using the Mixed Method Appraisal Tool. Searches were performed through electronic citation tracking and snowballing of references. Articles were obtained through Web of Science, PubMed and Google Scholar. Six outcome variables for sustainability were explored to ascertain impact of approaches. Results This review includes 68 articles demonstrating the application of sustainability approaches in practice. Results show an increase in the use of sustainability approaches in peer-reviewed studies. Approaches have been applied across a range of healthcare settings, including primary, secondary, tertiary and community healthcare. Approaches are used for five main purposes, namely analysis, evaluation, guidance, assessment and planning. Results outline benefits (e.g. improved conceptualisation of sustainability constructs and improved ability to interpret sustainability data) and challenges (e.g. issues with approach constructs and difficulty in application) associated with using a sustainability approach in practice. Few articles (14/68) reported the sustainability outcome variables explored; therefore, the impact of approaches on sustainability remains unclear. Additional sustainability outcome variables reported in retrieved articles are discussed. Conclusions This review provides practitioners and researchers with a consolidated evidence base on sustainability approaches. Findings highlight the remaining gaps in the literature and emphasise the need for improved rigour and reporting of sustainability approaches in research studies. To guide future assessment and study of sustainability in healthcare settings an updated list of sustainability outcome variables is proposed. Trial Registration This review was registered on the PROSPERO database CRD 42016040081 in June 2016.
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Affiliation(s)
- L Lennox
- National Institute for Health Research, Applied Research Collaboration North West London. Imperial College London, 369 Fulham Road, SW10 9NH, London, United Kingdom.
| | - A Linwood-Amor
- Ministry of Health, Environment, Culture and Housing, George Town, Grand Cayman KY1-9000, Cayman Islands
| | - L Maher
- Ko Awatea Health System Innovation and Improvement, Middlemore Hospital, 100 Hospital Road, Otahuhu, New Zealand
| | - J Reed
- Julie Reed Consultancy, 27 Molasses House, London, SW113TN, United Kingdom
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Lithopoulos A, Rhodes RE. The Effects of Branding on Physical Activity: A Systematic Review. JOURNAL OF HEALTH COMMUNICATION 2020; 25:303-312. [PMID: 32306858 DOI: 10.1080/10810730.2020.1749734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
It is important to increase the number of people regularly physically active to enhance health. Physical activity (PA) promotion organizations with strong brands may be more effective at motivating PA. However, these organizations must know which brand equity variables (e.g., brand awareness) to prioritize in their marketing. No previous review has examined whether brand equity variables are associated with PA-related variables. The primary objective of this study was to learn whether brand equity variables are associated with PA behaviors (e.g., moderate or vigorous PA). A secondary objective was to evaluate whether brand equity variables are associated with potential correlates of PA (e.g., self-efficacy). In addition to other search methods, four databases were searched for articles (PsycINFO, MEDLINE, SPORTDiscus, Business Source Complete). Thirty articles met the eligibility criteria. Regarding behavior, brand awareness and associations were associated with moderate or vigorous PA but not less intense activities such as walking. For correlates, brand awareness was associated with self-efficacy, outcome expectations, attitude, and parental approval of child PA. Brand associations were only associated with attitude. Age and brand awareness measure emerged as moderators of the awareness to moderate or vigorous PA relationship. Future research should examine the antecedents of brand awareness and use experimental designs.
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Affiliation(s)
- Alexander Lithopoulos
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria , Victoria, Canada
| | - Ryan E Rhodes
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria , Victoria, Canada
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Shelton RC, Cooper BR, Stirman SW. The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care. Annu Rev Public Health 2018; 39:55-76. [PMID: 29328872 DOI: 10.1146/annurev-publhealth-040617-014731] [Citation(s) in RCA: 343] [Impact Index Per Article: 57.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is strong interest in implementation science to address the gap between research and practice in public health. Research on the sustainability of evidence-based interventions has been growing rapidly. Sustainability has been defined as the continued use of program components at sufficient intensity for the sustained achievement of desirable program goals and population outcomes. This understudied area has been identified as one of the most significant translational research problems. Adding to this challenge is uncertainty regarding the extent to which intervention adaptation and evolution are necessary to address the needs of populations that differ from those in which interventions were originally tested or implemented. This review critically examines and discusses conceptual and methodological issues in studying sustainability, summarizes the multilevel factors that have been found to influence the sustainability of interventions in a range of public health and health care settings, and highlights key areas for future research.
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Affiliation(s)
- Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Brittany Rhoades Cooper
- Department of Human Development, Washington State University, Pullman, Washington 99164, USA;
| | - Shannon Wiltsey Stirman
- Dissemination and Training Division, National Center for PTSD and Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94024, USA;
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Muellmann S, Steenbock B, De Cocker K, De Craemer M, Hayes C, O'Shea MP, Horodyska K, Bell J, Luszczynska A, Roos G, Langøien LJ, Rugseth G, Terragni L, De Bourdeaudhuij I, Brug J, Pischke CR. Views of policy makers and health promotion professionals on factors facilitating implementation and maintenance of interventions and policies promoting physical activity and healthy eating: results of the DEDIPAC project. BMC Public Health 2017; 17:932. [PMID: 29207993 PMCID: PMC5718005 DOI: 10.1186/s12889-017-4929-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 11/20/2017] [Indexed: 12/15/2022] Open
Abstract
Background The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. We aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors facilitating adoption, implementation, and maintenance of multi-level interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland. Methods Six interventions and six policies were identified based on pre-defined criteria. Forty semi-structured interviews were conducted with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies. All interview transcripts were coded in NVivo, using a common categorization matrix. Coding in the respective countries was done by one researcher and validated by a second researcher. Results Active involvement of relevant stakeholders and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementation of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured. Conclusions Despite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identify similar factors facilitating adoption, implementation, and maintenance of these interventions and policies. Electronic supplementary material The online version of this article (10.1186/s12889-017-4929-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saskia Muellmann
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Berit Steenbock
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Katrien De Cocker
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Catherine Hayes
- Department of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Miriam P O'Shea
- Department of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Karolina Horodyska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Justyna Bell
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Aleksandra Luszczynska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Trauma, Health, & Hazards Center, University College of Applied Sciences Colorado, Colorado Springs, CO, USA
| | - Gun Roos
- Consumption Research Norway - SIFO, Oslo and Akershus, Oslo, Norway
| | - Lars Jørun Langøien
- Department for Physical Education, Norwegian School of Sports Science, Oslo, Norway
| | - Gro Rugseth
- Department for Physical Education, Norwegian School of Sports Science, Oslo, Norway
| | - Laura Terragni
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | | | - Johannes Brug
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Claudia R Pischke
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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Oliveira SRDA, Medina MG, Figueiró AC, Potvin L. Strategic factors for the sustainability of a health intervention at municipal level of Brazil. CAD SAUDE PUBLICA 2017; 33:e00063516. [PMID: 28767958 DOI: 10.1590/0102-311x00063516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 09/08/2016] [Indexed: 11/22/2022] Open
Abstract
The present study aims to describe the evolution of an intervention, using a methodology that adopts the critical event as the unit of analysis, and to identify strategic factors that facilitate the continuation of the interventions. Six critical events were identified: dispute care models for health; area of advice: dispute field; change policy; break of interorganizational relations; lack of physical structure and turnover of staff; difficulty in organizing practices in the work process. these are developed into strategic factors: enabling network of allies; meetings and educational activities/building capacity; benefits perceived by community members; mobilization of key actors; intervention's compatibility with the government's vision; restoration of interrelationship; and stability of the workforce. These strategic factors form a group of interrelated conditions that provide the strengthened linkages between elements in the intervention, supporting the hypothesis that they collaborate for the sustainability of the interventions in health. Tracking down the transformations of an intervention set by the critical events, it was verified that these factors performed a protective role at times of changes in the intervention process.
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Affiliation(s)
| | | | - Ana Cláudia Figueiró
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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McPherson C, Ploeg J, Edwards N, Ciliska D, Sword W. A catalyst for system change: a case study of child health network formation, evolution and sustainability in Canada. BMC Health Serv Res 2017; 17:100. [PMID: 28143621 PMCID: PMC5286844 DOI: 10.1186/s12913-017-2018-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 01/16/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine key processes and supportive and inhibiting factors involved in the development, evolution, and sustainability of a child health network in rural Canada. This study contributes to a relatively new research agenda aimed at understanding inter-organizational and cross-sectoral health networks. These networks encourage collaboration focusing on complex issues impacting health - issues that individual agencies cannot effectively address alone. This paper presents an overview of the study findings. METHODS An explanatory qualitative case study approach examined the Network's 13-year lifespan. Data sources were documents and Network members, including regional and 71 provincial senior managers from 11 child and youth service sectors. Data were collected through 34 individual interviews and a review of 127 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. RESULTS Three themes related to network development, evolution and sustainability were identified: (a) Network relationships as system triggers, (b) Network-mediated system responsiveness, and (c) Network practice as political. CONCLUSIONS Study findings have important implications for network organizational development, collaborative practice, interprofessional education, public policy, and public system responsiveness research. Findings suggest it is important to explicitly focus on relationships and multi-level socio-political contexts, such as supportive policy environments, in understanding health networks. The dynamic interplay among the Network members; central supportive and inhibiting factors; and micro-, meso-, and macro-organizational contexts was identified.
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Affiliation(s)
- Charmaine McPherson
- School of Nursing, Faculty of Science, St. Francis Xavier University, Box 5000, Antigonish, Nova Scotia B2G 2W5 Canada
| | - Jenny Ploeg
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5 Canada
| | - Nancy Edwards
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario KlH 8M5 Canada
| | - Donna Ciliska
- School of Nursing, Faculty of Health Sciences, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5 Canada
| | - Wendy Sword
- School of Nursing, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario KlH 8M5 Canada
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Rospo G, Valsecchi V, Bonomi AG, Thomassen IW, van Dantzig S, La Torre A, Sartor F. Cardiorespiratory Improvements Achieved by American College of Sports Medicine's Exercise Prescription Implemented on a Mobile App. JMIR Mhealth Uhealth 2016; 4:e77. [PMID: 27339153 PMCID: PMC4937178 DOI: 10.2196/mhealth.5518] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/30/2016] [Accepted: 05/19/2016] [Indexed: 11/19/2022] Open
Abstract
Background Strong evidence shows that an increase in cardiorespiratory fitness (CRF) and physical activity (PA) reduces cardiovascular disease risk. Objective To test whether a scientifically endorsed program to increase CRF and PA, implemented on an easy-to-use, always-accessible mobile app would be effective in improving CRF. Methods Of 63 healthy volunteers participating, 18 tested the user interface of the Cardio-Fitness App (CF-App); and 45 underwent a 2-week intervention period, of whom 33 eventually concluded it. These were assigned into three groups. The Step-based App (Step-App) group (n=8), followed 10,000 steps/day prescription, the CF-App group (n=13), and the Supervised Cardio-Fitness (Super-CF) group (n=12), both followed a heart rate (HR)-based program according to American College of Sports Medicine (ACSM) guidelines, but either implemented on the app, or at the gym, respectively. Participants were tested for CRF, PA, resting systolic and diastolic blood pressures (SBP, DBP), resting, exercise, and recovery HR. Results CRF increased in all groups (+4.9%; P<.001). SBP decreased in all groups (-2.6 mm Hg; P=.03). DBP decrease was higher in the Super-CF group (-3.5 mm Hg) than in the Step-App group (-2.1 mm Hg; P<.001). Posttest exercise HR decreased in all groups (-3.4 bpm; P=.02). Posttest recovery HR was lower in the Super-CF group (-10.1 bpm) than in the other two groups (CF-App: -4.9 bpm, Step-App: -3.3 bpm; P<.001). The CF-App group, however, achieved these improvements with more training heart beats (P<.01). Conclusions A 10,000 steps/day target-based app improved CRF similar to an ACSM guideline-based program whether it was implemented on a mobile app or in supervised gym sessions.
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8
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Oliveira SRDA, Potvin L, Medina MG. Sustentabilidade de intervenções em promoção da saúde: uma sistematização do conhecimento produzido. SAÚDE EM DEBATE 2015. [DOI: 10.1590/0103-110420161070357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Foi realizada revisão da literatura com intuito de sistematizar o conhecimento produzido no campo da promoção da saúde em relação ao tema sustentabilidade. As bases de dados consultadas foram Lilacs, SciELO e Web of Science, no período entre 1989 e 2014. O corpus contou com 35 artigos, sendo analisados conceito de sustentabilidade, metodologia e resultados dos estudos. Verificou-se que os estudos têm se dedicado a encontrar fatores que influenciam a sustentabilidade de intervenções de saúde, no entanto, não há evidências sobre que fatores são suficientes para a sustentabilidade. Conclui-se que há pouca literatura sobre o tema em questão no âmbito nacional e se recomenda novas investigações.
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Compernolle S, De Cocker K, Lakerveld J, Mackenbach JD, Nijpels G, Oppert JM, Rutter H, Teixeira PJ, Cardon G, De Bourdeaudhuij I. A RE-AIM evaluation of evidence-based multi-level interventions to improve obesity-related behaviours in adults: a systematic review (the SPOTLIGHT project). Int J Behav Nutr Phys Act 2014; 11:147. [PMID: 25480391 PMCID: PMC4266878 DOI: 10.1186/s12966-014-0147-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 11/17/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This systematic literature review describes the potential public health impact of evidence-based multi-level interventions to improve obesity-related behaviours in adults, using the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework. METHODS Electronic databases (PubMed, Embase, and The Cochrane Library) were searched to identify intervention studies published between January 2000 and October 2013. The following inclusion criteria were used: (1) the study included at least one outcome measure assessing obesity-related behaviours (i.e. diet, physical activity or sedentary behaviour), (2) the study collected data over at least one year and (3) the study's intervention targeted adults, was conducted in a specified geographical area or worksite, and was multi-level (i.e. targeting both individual and environmental level). Evidence of RE-AIM of the selected interventions was assessed. Potential public health impact of an intervention was evaluated if information was provided on at least four of the five RE-AIM dimensions. RESULTS Thirty-five multi-level interventions met the inclusion criteria. RE-AIM evaluation revealed that the included interventions generally had the potential to: reach a large number of people (on average 58% of the target population was aware of the intervention); achieve the assumed goals (89% found positive outcomes); be broadly adopted (the proportion of intervention deliverers varied from 9% to 92%) and be sustained (sixteen interventions were maintained). The highest potential public health impact was found in multi-level interventions that: 1) focused on all levels at the beginning of the planning process, 2) guided the implementation process using diffusion theory, and 3) used a website to disseminate the intervention. CONCLUSIONS Although most studies underreported results within the RE-AIM dimensions, the reported Reach, Effectiveness, Adoption, Implementation and Maintenance were positively evaluated. However, more information on external validity and sustainability is needed in order to take informed decisions on the choice of interventions that should be implemented in real-world settings to accomplish long-term changes in obesity-related behaviours.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders (FWO), B-1000, Ghent, Belgium.
| | - Jeroen Lakerveld
- The EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
| | - Joreintje D Mackenbach
- The EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
| | - Giel Nijpels
- The EMGO Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | - Jean-Michel Oppert
- Université Paris 13, Sorbonne Paris Cité - UREN (Unité de Recherche en Epidémiologie Nutritionnelle), U557 Inserm; U1125 Inra; Cnam, Centre for Research on Human Nutrition Ile-de-France (CRNH IdF), Bobigny, France. .,Université Pierre et Marie Curie-Paris 6, Department of Nutrition Pitié-Salpêtrière Hospital (AP-HP), (CRNH IdF), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France.
| | - Harry Rutter
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, London, UK.
| | - Pedro J Teixeira
- Interdisciplinary Center for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
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Abstract
The increases in preventable chronic diseases and the rising costs of health care are unsustainable. The US Army Surgeon General's vision to transition from a health care system to a system of health requires the identification of key health enablers to facilitate the adoption of healthy behaviors. In support of this vision, the US Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health." Members of government and academia participated to identify key health enablers that could ultimately be leveraged by technology. The key health enablers discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior-change intervention, and (5) the role of peer and social networks on change. This report summarizes leading evidence and the group consensus on evidence-based practices with respect to the key enablers in creating healthy behavior change.
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Manning MA, Bollig-Fischer A, Bobovski LB, Lichtenberg P, Chapman R, Albrecht TL. Modeling the sustainability of community health networks: novel approaches for analyzing collaborative organization partnerships across time. Transl Behav Med 2014; 4:46-59. [PMID: 24653776 DOI: 10.1007/s13142-013-0220-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sustainability is important if community health organizations are to be effective in collaborating to achieve long term health goals. We present a multi-method set of longitudinal analyses examining structural markers applied to a group of organizations brought together to reduce cancer disparities among older African American adults. At the overall network level, sustainability was seen in the growth of outgoing connections and multiplexity. Results of hierarchical clustering analyses identified distinct patterns of collaborative activation over time at the relationship level. Growth modeling indicated the effects of continuing network membership and participation in collaborative events on several structural markers of sustainability. Results of these analyses provide longitudinal indicators for how collaborations among partner organizations impacted their likelihood of continuing in the community network program. The strategy presented here introduces novel methods to assist with planning and evaluation of future community based public health endeavors.
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Affiliation(s)
- Mark A Manning
- Karmanos Cancer Institute and Wayne State University, Detroit, MI USA
| | | | | | | | - Robert Chapman
- Josephine Ford Cancer Center, Henry Ford Health System, Detroit, USA
| | - Terrance L Albrecht
- Karmanos Cancer Institute and Wayne State University, Detroit, MI USA ; Wayne State University, Detroit, MI USA
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Shigayeva A, Coker RJ. Communicable disease control programmes and health systems: an analytical approach to sustainability. Health Policy Plan 2014; 30:368-85. [PMID: 24561988 DOI: 10.1093/heapol/czu005] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
There is renewed concern over the sustainability of disease control programmes, and re-emergence of policy recommendations to integrate programmes with general health systems. However, the conceptualization of this issue has remarkably received little critical attention. Additionally, the study of programmatic sustainability presents methodological challenges. In this article, we propose a conceptual framework to support analyses of sustainability of communicable disease programmes. Through this work, we also aim to clarify a link between notions of integration and sustainability. As a part of development of the conceptual framework, we conducted a systematic literature review of peer-reviewed literature on concepts, definitions, analytical approaches and empirical studies on sustainability in health systems. Identified conceptual proposals for analysis of sustainability in health systems lack an explicit conceptualization of what a health system is. Drawing upon theoretical concepts originating in sustainability sciences and our review here, we conceptualize a communicable disease programme as a component of a health system which is viewed as a complex adaptive system. We propose five programmatic characteristics that may explain a potential for sustainability: leadership, capacity, interactions (notions of integration), flexibility/adaptability and performance. Though integration of elements of a programme with other system components is important, its role in sustainability is context specific and difficult to predict. The proposed framework might serve as a basis for further empirical evaluations in understanding complex interplay between programmes and broader health systems in the development of sustainable responses to communicable diseases.
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Affiliation(s)
- Altynay Shigayeva
- Communicable Diseases Policy Research Group, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Coker
- Communicable Diseases Policy Research Group, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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