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Forbes RA, Crossley R, Stevens A, James R, Black M, Foster CR, Such E. What's love got to do with it? Exploring social love and public health. Perspect Public Health 2024; 144:182-186. [PMID: 38270083 PMCID: PMC11103914 DOI: 10.1177/17579139231220557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Affiliation(s)
- RA Forbes
- School of Health and Related Research (ScHARR), The University of Sheffield, Regent Street, Sheffield S1 4DA, UK
| | - R Crossley
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - A Stevens
- Yorkshire and Humber School of Public Health, Leeds, UK
| | - R James
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - M Black
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - CR Foster
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - E Such
- Anne McLaren Fellow, School of Health Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
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Oskarsson IML, Vik E. Suggesting a holistic framework for understanding healthcare services leadership competence - a critical interpretive synthesis. Leadersh Health Serv (Bradf Engl) 2024; 37:99-129. [PMID: 38619933 PMCID: PMC11348838 DOI: 10.1108/lhs-08-2023-0059] [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: 08/16/2023] [Revised: 12/20/2023] [Accepted: 02/26/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Healthcare providers are under pressure due to increasing and more complex demands for services. Increased pressure on budgets and human resources adds to an ever-growing problem set. Competent leaders are in demand to ensure effective and well-performing healthcare organisations that deliver balanced results and high-quality services. Researchers have made significant efforts to identify and define determining competencies for healthcare leadership. Broad terms such as competence are, however, inherently at risk of becoming too generic to add analytical value. The purpose of this study is to suggest a holistic framework for understanding healthcare leadership competence, that can be crucial for operationalising important healthcare leadership competencies for researchers, decision-makers as well as practitioners. DESIGN/METHODOLOGY/APPROACH In the present study, a critical interpretive synthesis (CIS) was conducted to analyse competency descriptions for healthcare leaders. The descriptions were retrieved from peer reviewed empirical studies published between 2010 and 2022 that aimed to identify healthcare services leadership competencies. Grounded theory was utilised to code the data and inductively develop new categories of healthcare leadership competencies. The categorisation was then analysed to suggest a holistic framework for healthcare leadership competence. FINDINGS Forty-one papers were included in the review. Coding and analysing the competence descriptions resulted in 12 healthcare leadership competence categories: (1) character, (2) interpersonal relations, (3) leadership, (4) professionalism, (5) soft HRM, (6) management, (7) organisational knowledge, (8) technology, (9) knowledge of the healthcare environment, (10) change and innovation, (11) knowledge transformation and (12) boundary spanning. Based on this result, a holistic framework for understanding and analysing healthcare services leadership competencies was suggested. This framework suggests that the 12 categories of healthcare leadership competencies include a range of knowledge, skills and abilities that can be understood across the dimension personal - and technical, and organisational internal and - external competencies. RESEARCH LIMITATIONS/IMPLICATIONS This literature review was conducted with the results of searching only two electronic databases. Because of this, there is a chance that there exist empirical studies that could have added to the development of the competence categories or could have contradicted some of the descriptions used in this analysis that were assessed as quite harmonised. A CIS also opens for a broader search, including the grey literature, books, policy documents and so on, but this study was limited to peer-reviewed empirical studies. This limitation could also have affected the result, as complex phenomenon such as competence might have been disclosed in greater details in, for example, books. PRACTICAL IMPLICATIONS The holistic framework for healthcare leadership competences offers a common understanding of a "fuzzy" concept such as competence and can be used to identify specific competency needs in healthcare organisations, to develop strategic competency plans and educational programmes for healthcare leaders. ORIGINALITY/VALUE This study reveals a lack of consensus regarding the use and understanding of the concept of competence, and that key competencies addressed in the included papers are described vastly different in terms of what knowledge, skills and abilities they entail. This challenges the operationalisation of healthcare services leadership competencies. The proposed framework for healthcare services leadership competencies offers a common understanding of work-related competencies and a possibility to analyse key leadership competencies based on a holistic framework.
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Affiliation(s)
| | - Erlend Vik
- Department of Business Administration and Social Sciences,
Molde University College, Molde, Norway
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Krczal E, Behrens DA. Trust-building in temporary public health partnerships: a qualitative study of the partnership formation process of a Covid-19 test, trace and protect service. BMC Health Serv Res 2024; 24:467. [PMID: 38614970 PMCID: PMC11015697 DOI: 10.1186/s12913-024-10930-3] [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: 07/31/2023] [Accepted: 03/29/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Public health initiatives require coordinated efforts from healthcare, social services and other service providers. Organisational theory tells us that trust is essential for reaching collaborative effectiveness. This paper explores the drivers for initiating and sustaining trust in a temporary public health partnership, in response to a sudden health threat. METHODS This qualitative study analysed the formation process of a multisector partnership for a Covid-19 contact tracing service. Data was collected through 12 interviews, two focus groups, one feedback workshop, and an online survey with workforce members from all seven partner organisations. Purposive maximum variation sampling was used to capture the reflections and experiences of workforce members from all seven partner organisations. A deductive code scheme was used to identify drivers for building and sustaining trust in inter-organisational collaboration. RESULTS Relational mechanisms emanating from the commitment to the common aim, shared norms and values, and partnership structures affected trust-building. Shared values and the commitment to the common aim appeared to channel partners' behaviour when interacting, resulting in being perceived as a fair, reliable and supportive partner. Shared values were congruent with the design of the partnership in terms of governance structure and communication lines reflecting flat hierarchies and shared decision-making power. Tensions between partner organisations arose when shared values were infringed. CONCLUSIONS When managing trust in a collaboration, partners should consider structural components like governance structure, organisational hierarchy, and communication channels to ensure equal power distribution. Job rotation, recruitment of candidates with the desired personality traits and attitudes, as well as training and development, encourage inter-organisational networking among employees, which is essential for building and strengthening relationships with partner organisations. Partners should also be aware of managing relational dynamics, channelling behaviours through shared values, objectives and priorities and fostering mutual support and equality among partner organisations.
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Affiliation(s)
- Eva Krczal
- Department for Economy and Health, University of Continuing Education Krems, Krems, Austria.
| | - Doris A Behrens
- Department for Economy and Health, University of Continuing Education Krems, Krems, Austria
- Employee Wellbeing Service, Aneurin Bevan University Health Board, Caerleon, UK
- School of Mathematics, Cardiff University, Cardiff, UK
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Griban GP, Zablotska OS, Lyakhova NA, Shpak II, Adyrkhaiev SG, Adyrkhaieva LV, Tkachenko PP. Maintaining a healthy lifestyle by service members under martial law. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:1211-1216. [PMID: 39106382 DOI: 10.36740/wlek202406115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
OBJECTIVE Aim: To study the peculiarities of maintaining a healthy lifestyle by service members under martial law. PATIENTS AND METHODS Materials and Methods: The research was conducted in 2022-2024 and involved 60 service members aged 22 to 54. According to their military rank, the respondents were divided into the following groups: junior enlisted (51.7 %), non-commissioned officers (25 %) and commissioned officers (23.3 %). Methods: bibliographic, system analysis and generalization, medical and sociological (questionnaire survey), and statistical. RESULTS Results: It was found that a healthy lifestyle for most service members is associated with motor activities (51.7 %), rational nutrition (55.9 %), the ability to cope with stress (42.4 %), and giving up bad habits (37.3 %). Only 46.7 % of service members adhere to the relevant principles, even though 55.0 % of respondents named a HLS as one of the values in their unit. It was found that it is difficult to fully adhere to the principles of a healthy lifestyle under the conditions of war. 76.7 % of service members have bad habits (the most common is smoking - 72.2 %). CONCLUSION Conclusions: Promising means of forming a healthy lifestyle for service members are: positive motivation and personal conviction in the need to maintain a healthy lifestyle, high-quality medical care, conducting educational work with personnel about the benefits of leading a healthy lifestyle, etc. However, these measures will become fully effective only if we end the war with victory and liberate all Ukrainian lands from the occupying forces.
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Affiliation(s)
| | - Olha S Zablotska
- ZHYTOMYR MEDICAL INSTITUTE OF ZHYTOMYR REGIONAL COUNCIL, ZHYTOMYR, UKRAINE
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Rebryna AA, Bazhenkov YV, Rebryna AA, Kolomoiets HA, Bondar TK, Malechko TA. Applied value of modern fitness technologies in improving the health and physical development of students. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:1181-1187. [PMID: 39106378 DOI: 10.36740/wlek202406111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
OBJECTIVE Aim: To study the impact of modern fitness technologies on the health and physical development of students in the learning process. PATIENTS AND METHODS Materials and Methods: The research involved 108 students (52 male and 56 female students), which formed the experimental (EG) and the control (CG) groups. The EG male students were engaged in such type of fitness technologies as Strenflex during physical education training sessions, and the EG female students - Dance Aerobics. Students' health was assessed by Stange and Genchi tests, Rufier and strength indices; and physical development - by the level of development of physical qualities. RESULTS Results: It was found that Strenflex training sessions have a positive effect on all studied health indicators of male students (Stangea and Genchi tests, Rufie and strength indices), and Dance Aerobics training sessions are more effective in improving the functional capabilities of the respiratory and cardiovascular systems, and less effective in developing the strength capabilities of female students. It has also been established that the most pronounced effect of the applied modern fitness technologies is on the development of strength qualities in men, endurance, and flexibility in men and women. CONCLUSION Conclusions: The effectiveness of modern fitness technologies in physical education in educational institutions to improve students' health and physical development has been proven. The level of health and physical development of students, formed in the process of conscious training, will contribute to their successful learning and life-sustaining activities, as well as to maintaining the necessary level of motor activity in the future.
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Affiliation(s)
- Andrii A Rebryna
- NATIONAL UNIVERSITY OF PHYSICAL EDUCATION AND SPORTS OF UKRAINE, KYIV, UKRAINE
| | - Yevhen V Bazhenkov
- STATE SCIENTIFIC INSTITUTION "INSTITUTE FOR MODERNIZATION OF THE CONTENT OF EDUCATION", KYIV, UKRAINE
| | | | - Halyna A Kolomoiets
- STATE SCIENTIFIC INSTITUTION "INSTITUTE FOR MODERNIZATION OF THE CONTENT OF EDUCATION", KYIV, UKRAINE
| | | | - Tetiana A Malechko
- STATE SCIENTIFIC INSTITUTION "INSTITUTE FOR MODERNIZATION OF THE CONTENT OF EDUCATION", KYIV, UKRAINE
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Yang T, Rui B, Zhang C. Assessing health human resource structure at Urumqi's center for disease control and prevention. Medicine (Baltimore) 2023; 102:e36209. [PMID: 38050251 PMCID: PMC10695540 DOI: 10.1097/md.0000000000036209] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/30/2023] [Indexed: 12/06/2023] Open
Abstract
By conducting an in-depth investigation and analysis of the health human resource framework within the Urumqi Center for Disease Control and Prevention (CDC), this study aims to offer valuable insights for the objective assessment and future enhancement of its talent development endeavors. A questionnaire survey was administered, followed by a descriptive analysis, involving the healthcare professionals affiliated with the Urumqi Center for CDC. The Urumqi Center for CDC exhibited a lower compilation number than its on-duty personnel count. When compared to county (district) level, the municipal level CDC displayed a higher educational attainment, a more favorable title distribution, and a younger workforce demographic. The human resource count in both Urumqi's city and county (district) level CDCs has decreased, but the relative numbers have improved, indicating enhanced quality and a younger workforce. The municipal-level CDC boasts a superior human resource structure compared to the county (district) level, with better fairness in population distribution by area than geography. Allocation equity within the central urban area is higher than in distant urban areas, highlighting regional disparities as a significant factor.
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Affiliation(s)
- Tong Yang
- Department of Public Health, Xinjiang Medical University, Urumqi, Xijiang, China
| | - Baoling Rui
- Urumqi Center for Disease Control and Prevention, Urumqi, Xijiang, China
| | - Chen Zhang
- Department of Public Health, Xinjiang Medical University, Urumqi, Xijiang, China
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Samper Amargós M, González-Viana A, Vergara Duarte M, Rua MIP. [The role of the nurse in the field of public health]. GACETA SANITARIA 2023; 37:102337. [PMID: 38007960 DOI: 10.1016/j.gaceta.2023.102337] [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: 11/26/2022] [Revised: 09/28/2023] [Accepted: 10/01/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE Identify the role of public health nurses and differentiate it from that of community care nurses in the context of Catalonia, through the experiences and perspectives of professionals in the field of public health. METHOD Descriptive phenomenological qualitative study. Fourteen interviews were conducted with key informants, from the field of public health and community care, selected by i purposive sampling. Content analysis using thematic methodology, creation of categories from the triangulation of results. RESULTS The professional competencies and functions performed by nursing in the field of public health are analysed. Most of the specific functions were the ones related to "care" and the "global vision" of health. The indeterminacy of functions and roles, related to gender inequality, leads to a low recognition of the profession and a lack of appropriateness of the professional category, reflected in a low presence of nurses in management positions in public health. Although some competencies are shared with the family and community nurse, there are also differences. CONCLUSIONS This study sheds light on the role of public health nursing, often overlooked. It is urgent to define public health nurses role and functions, in order to avoid inequalities and increase their recognition.
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Affiliation(s)
| | - Angelina González-Viana
- Agència de Salut Pública de Catalunya, Barcelona, España; Departamento de Enfermería de Salud Pública, Salud Mental y Maternoinfantil, Escuela Universitaria de Enfermería, Universidad de Barcelona, Barcelona, España; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), España
| | - Montserrat Vergara Duarte
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat (Barcelona), España; Agència de Salut Pública de Barcelona, Barcelona, España
| | - M Isabel Pasarín Rua
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau, Barcelona, España
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Nield L. Empowering and including 'seldom heard' communities in systems thinking for weight management. Perspect Public Health 2023; 143:310-312. [PMID: 38009247 PMCID: PMC10683328 DOI: 10.1177/17579139231180732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Affiliation(s)
- L Nield
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Olympic Legacy Park, Sheffield S9 3TU, UK
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Horváth K, Túri G, Kaposvári C, Cseh B, Dózsa CL. Challenges and opportunities for improvement in the management and financing system of Health Promotion Offices in Hungary. Front Public Health 2023; 11:1219186. [PMID: 37965520 PMCID: PMC10641462 DOI: 10.3389/fpubh.2023.1219186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Background One hundred ten Health Promotion Offices (HPOs) have started operating in Hungary in response to public health challenges. Many of them have been active for almost 10 years, yet their operational experience has not been evaluated. The specific objectives of our study were: (1) to describe the current operational and funding system of HPOs, (2) to identify challenges related to the current management and funding practices, and (3) to formulate recommendations for improvement based on gathered experience and international experience. Design In order to gain a deeper insight into the operational experience of HPOs, an online survey was conducted with the professional or economic managers of HPOs. A scoping review was carried out to gather international experiences about best practices to formulate recommendations for improvement in developing the operational and financing scheme for HPOs. Results We found that current HPO network in Hungary faces three main challenges: a deficient management system, inflexible financing scheme, and unequal ability to purchase or provide services for the population. Conclusions Based on the survey complemented by international experiences, we propose the overhaul of the professional management system and switching toa combination of fixed and performance-based financing scheme for the HPOs in Hungary.
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Affiliation(s)
- Krisztián Horváth
- Department of Public Health, Semmelweis University, Budapest, Hungary
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
| | - Gergo Túri
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
| | - Csilla Kaposvári
- Med-Econ Human Services Ltd., Budapest, Hungary
- Synthesis Health Research Foundation, Budapest, Hungary
- Faculty of Health Sciences, Doctoral School, University of Pécs, Pécs, Hungary
| | - Borbála Cseh
- Med-Econ Human Services Ltd., Budapest, Hungary
- Doctoral School of Medical Sciences, Semmelweis University, Budapest, Hungary
| | - Csaba László Dózsa
- Med-Econ Human Services Ltd., Budapest, Hungary
- Department of Theoretical Health Sciences, Faculty of Health Sciences, University of Miskolc, Miskolc, Hungary
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Fedorowicz S, Dempsey RC, Ellis NJ, Mulvey O, Gidlow CJ. Quantitative content analysis of Freedom of Information requests examining the extent and variations of tools and training for conducting suicide risk assessments in NHS Trusts across England. BMJ Open 2023; 13:e072004. [PMID: 37884387 PMCID: PMC10603533 DOI: 10.1136/bmjopen-2023-072004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/31/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVES Determining the risk for suicide is a difficult endeavour. Clinical guidance in the UK explicitly advises against using risk assessment tools and scales to determine suicide risk. Based on Freedom of Information (FoI) requests made to NHS Trusts in England, this study provides an overview of suicide risk assessment tools in use, training provided in how to use such assessments, and explores implementation of suicide risk assessment guidance in practice in English NHS Trusts. DESIGN A cross-sectional survey of suicide risk assessment tools and training gathered via FoI requests and subjected to a content analysis. SETTING FoI requests were submitted to NHS Trusts across England. RESULTS A wide variety of suicide risk assessments tools were identified as being used in practice, with several trusts reported using more than one tool to determine suicide risk. Forty-one trusts reported using locally developed, unvalidated, tools to assess risk of suicide and 18 stated they do not use a tool. Ten trusts stated they do not train their staff in suicide risk assessment while 13 reported use of specific suicide risk assessment training. Sixty-two trusts stated they do not centrally record the number of assessments conducted or how many individuals are identified as at risk. Content analysis indicated the frequent wider assessment of risk not restricted to suicide risk. CONCLUSIONS There is wide variation in suicide risk assessment tools being used in practice and some lack of specific training for healthcare staff in determining suicide risk. Few trusts routinely record the number of assessments being conducted or the number of individuals identified at high risk. Implementation of specific training is necessary for the suicide risk assessment process to identify patient needs and develop therapeutic engagement. Routinely recording how many assessments are conducted is a crucial step in improving suicide prevention.
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Affiliation(s)
- Sophia Fedorowicz
- Centre for Health and Development, Staffordshire University, Stoke-on-Trent, UK
| | - Robert C Dempsey
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Naomi J Ellis
- Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent, UK
| | - Olivia Mulvey
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Christopher J Gidlow
- Centre for Sport, Health and Exercise Research, Staffordshire University, Stoke on Trent, UK
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Owusu I, Adu C, Aboagye RG, Mpangah RA, Acheampong GK, Akyereko E, Bonsu EO, Peprah P. Preparing for future outbreaks in Ghana: An overview of current COVID-19, monkeypox, and Marburg disease outbreaks. Health Promot Perspect 2023; 13:202-211. [PMID: 37808942 PMCID: PMC10558975 DOI: 10.34172/hpp.2023.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/18/2023] [Indexed: 10/10/2023] Open
Abstract
Amidst the ongoing COVID-19 pandemic, Ghana is currently grappling with simultaneous outbreaks of Marburg virus disease and human monkeypox virus. The coexistence of these outbreaks emphasizes the imperative for a collaborative and global approach to enhance surveillance and expedite case detection. While Ghana has made efforts to respond to these outbreaks, this paper outlines the lessons learned and proposes recommendations in this regard. It is crucial to intensify response efforts at the local, regional, and national levels to effectively contain the spread of these infectious diseases. Therefore, this paper suggests prioritizing the following recommendations as crucial for assisting Ghana in adequately preparing for future outbreaks and safeguarding global public health: strengthening surveillance system through digitization, rapid and effective response; risk communication and community engagement; healthcare system readiness; and research and collaboration. Also, prioritizing building healthy public policies and developing personal skills of health personnel across the country is key for future outbreak response.
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Affiliation(s)
- Isaac Owusu
- Ghana Health Service, Headquarters, Accra, Ghana
| | - Collins Adu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland 4811, Australia
| | - Richard Gyan Aboagye
- Fred Newton Binka School of Public Health, University of Health, and Allied Sciences, Hohoe, Ghana
| | | | | | - Ernest Akyereko
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - Emmanuel Osei Bonsu
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Peprah
- Centre for Primary Health Care and Equity/Social Policy Research Centre, University of New South Wales, Sydney, Australia
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O’Neill M, De Prophetis E, Allin S, Pinto AD, Smith RW, Di Ruggiero E, Schwartz R, Pawa J, Ammi M, Rosella LC. “We cobble together a storyline of system performance using a diversity of things”: a qualitative study of perspectives on public health performance measurement in Canada. Arch Public Health 2022; 80:177. [PMID: 35906667 PMCID: PMC9335461 DOI: 10.1186/s13690-022-00931-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There have been longstanding calls for public health systems transformations in many countries, including Canada. Core to these calls has been strengthening performance measurement. While advancements have been made in performance measurement for certain sectors of the health care system (primarily focused on acute and primary health care), effective use of indicators for measuring public health systems performance are lacking. This study describes the current state, anticipated challenges, and future directions in the development and implementation of a public health performance measurement system for Canada.
Methods
We conducted a qualitative study using semi-structured interviews with public health leaders (n = 9) between July and August 2021. Public health leaders included researchers, government staff, and former medical officers of health who were purposively selected due to their expertise and experience with performance measurement with relevance to public health systems in Canada. Thematic analysis included both a deductive approach for themes consistent with the conceptual framework and an inductive approach to allow new themes to emerge from the data.
Results
Conceptual, methodological, contextual, and infrastructure challenges were highlighted by participants in designing a performance measurement system for public health. Specifically, six major themes evolved that encompass 1) the mission and purpose of public health systems, including challenges inherent in measuring the functions and services of public health; 2) the macro context, including the impacts of chronic underinvestment and one-time funding injections on the ability to sustain a measurement system; 3) the organizational structure/governance of public health systems including multiple forms across Canada and underdevelopment of information technology systems; 4) accountability approaches to performance measurement and management; and 5) timing and unobservability in public health indicators. These challenges require dedicated investment, strong leadership, and political will from the federal and provincial/territorial governments.
Conclusion
Unprecedented attention on public health due to the coronavirus disease 2019 pandemic has highlighted opportunities for system improvements, such as addressing the lack of a performance measurement system. This study provides actionable knowledge on conceptual, methodological, contextual, and infrastructure challenges needed to design and build a pan-Canadian performance measurement system for public health.
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Sandhu HS, Smith RW, Jarvis T, O'Neill M, Di Ruggiero E, Schwartz R, Rosella LC, Allin S, Pinto AD. Early Impacts of the COVID-19 Pandemic on Public Health Systems and Practice in 3 Canadian Provinces From the Perspective of Public Health Leaders: A Qualitative Study. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:702-711. [PMID: 36027605 PMCID: PMC9528938 DOI: 10.1097/phh.0000000000001596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
CONTEXT The COVID-19 pandemic has impacted health systems worldwide. Studies to date have largely focused on the health care system with less attention to the impact on public health systems and practice. OBJECTIVE To describe the early impacts of COVID-19 on public health systems and practice in 3 Canadian provinces from the perspective of public health system leaders and synthesize lessons learned. DESIGN A qualitative study using semistructured virtual interviews with public health leaders between October 2020 and April 2021. The World Health Organization's essential public health operations framework guided data collection and analysis. SETTING This study involved the Canadian provinces of Alberta, Ontario, and Québec. These provinces were chosen for their large populations, relatively high COVID-19 burden, and variation in public health systems. PARTICIPANTS Public health leaders from Alberta (n = 21), Ontario (n = 18), and Québec (n = 19) in organizations with a primary mandate of stewardship and/or administration of essential public health operations (total n = 58). RESULTS We found that the COVID-19 pandemic led to intensified collaboration in public health systems and a change in workforce capacity to respond to the pandemic. This came with opportunities but also challenges of burnout and disruption of non-COVID-19 services. Information systems and digital technologies were increasingly used and there was greater proximity between public health leaders and other health system leaders. A renewed recognition for public health work was also highlighted. CONCLUSIONS The COVID-19 pandemic impacted several aspects of public health systems in the provinces studied. Our findings can help public health leaders and policy makers identify areas for further investment (eg, intersectoral collaboration, information systems) and develop plans to address challenges (eg, disrupted services, workforce burnout) that have surfaced.
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Affiliation(s)
- Harman S. Sandhu
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Robert W. Smith
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Tamika Jarvis
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Meghan O'Neill
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Robert Schwartz
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Laura C. Rosella
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Sara Allin
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
| | - Andrew D. Pinto
- Dalla Lana School of Public Health (Mr Sandhu, Drs Smith, Di Ruggiero, Schwartz, Rosella, Allin, and Pinto, and Ms O'Neill), North American Observatory on Health Systems and Policies (Mr Sandhu and Dr Allin), Population Health Analytics Lab (Ms O'Neill and Dr Rosella), and Department of Family and Community Medicine, Faculty of Medicine (Dr Pinto), University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada (Ms Jarvis); Upstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada (Dr Pinto); and Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada (Dr Pinto)
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14
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Tuck CZ, Akparibo R, Gray LA, Aryeetey RNO, Cooper R. What influences cancer treatment service access in Ghana? A critical interpretive synthesis. BMJ Open 2022; 12:e065153. [PMID: 36198450 PMCID: PMC9535186 DOI: 10.1136/bmjopen-2022-065153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Multiple social-cultural and contextual factors influence access to and acceptance of cancer treatment in Ghana. The aim of this research was to assess existing literature on how these factors interplay and could be susceptible to local and national policy changes. DESIGN This study uses a critical interpretive synthesis approach to review qualitative and quantitative evidence about access to adult cancer treatment services in Ghana, applying the socioecological model and candidacy framework. RESULTS Our findings highlighted barriers to accessing cancer services within each level of the socioecological model (intrapersonal, interpersonal community, organisational and policy levels), which are dynamic and interacting, for example, community level factors influenced individual perceptions and how they managed financial barriers. Evidence was lacking in relation to determinants of treatment non-acceptance across all cancers and in the most vulnerable societal groups due to methodological limitations. CONCLUSIONS Future policy should prioritise multilevel approaches, for example, improving the quality and affordability of medical care while also providing collaboration with traditional and complementary care systems to refer patients. Research should seek to overcome methodological limitations to understand the determinants of accessing treatment in the most vulnerable populations.
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Affiliation(s)
- Chloe Zabrina Tuck
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Robert Akparibo
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Laura A Gray
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | | | - Richard Cooper
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
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15
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Study to Identify and Evaluate Predictor Factors for Primary Open-Angle Glaucoma in Tertiary Prophylactic Actions. J Pers Med 2022; 12:jpm12091384. [PMID: 36143169 PMCID: PMC9506575 DOI: 10.3390/jpm12091384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/04/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to develop a predictive model with several explanatory variables that can guide ophthalmologists to make a more objective assessment of the evolution of open-angle glaucoma (OAG) during tertiary prevention. Objectives: The evaluation of risk factors and different predictors of symptom progression between patients with POAG and non-glaucoma patients (NG), as well as between primary open-angle glaucoma with high intraocular pressure (POAG) and primary open-angle glaucoma with normal intraocular pressure (NTG), in tertiary prophylactic activities. Methods: This research is an analytical epidemiological study of a prospective cohort. For the study, we took into account personal medical history, physical ophthalmological examination, intraocular pressure (IOP) values, and visual field (VF) parameters, examined with the Opto AP-300 Automated Perimeter using the “fast threshold” strategy. The results of gonioscopy were inconsistently recorded; they were not considered in the study due to missing values, the processing of which would have seriously distorted the statistical analysis. Ophthalmological examination was completed with a dichotomous questionnaire entitled “Symptom Inventory”, made according to the accusations of patients resulting from a “focus group” study. The study was carried out in the ophthalmology office within the Integrated Outpatient Clinic of the Emergency Clinical Hospital of Oradea, Bihor County (IOCECHO) between January−December 2021. The threshold of statistical significance was defined for p value < 0.05. The obtained results were statistically processed with specialized software SPSS 22. Results: The study included 110 people, of which 71 (64.54%) had POAG (IOP > 21 mmHg) and 39 people (35.46%) had NTG (IOP < 21 mmHg), the two groups being statistically significantly different (χ2 = 9.309, df = 1, p = 0.002). For the POAG group, glaucomatous loss was early, AD < −6 dB, according to the staging of glaucomatous disease, HODAPP classification. In addition, the groups of POAG and NTG patients was compared with a group of 110 NG patients, these three groups being statistically significantly different (χ2 = 34.482, df = 2, p = 0.000). Analysis of confounding factors (age, sex, residence, marital status) shows a statistically significant relationship only for age (F = 2.381, df = 40, p = 0.000). Sex ratio for the study groups = 5.11 for OAG and =5.87 for NG. After treatment (prostaglandin analogues and neuroprotective drugs) IOP decreased statistically significantly for both POAG and NTG. Conclusions: this study identified possible predictors of OAG, at the 5% level (risk factors and symptoms as independent variables) using a dichotomous questionnaire tool with a complementary role in tertiary prophylactic activities. The implementation of the focus group interview results as a socio-human research technique will be supportive to clinicians.
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16
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Hommes F, Mohsenpour A, Kropff D, Pilgram L, Matusall S, von Philipsborn P, Sell K. [Supra-regional public health actors in Germany-an overview and categorization]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 65:96-106. [PMID: 34860263 PMCID: PMC8641290 DOI: 10.1007/s00103-021-03456-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/07/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Public health actors contribute significantly to health protection, promotion, and prevention at the population level. An overview of the public health landscape can facilitate collaboration among the stakeholders and increase transparency of career paths for young professionals. OBJECTIVES This study aims to develop an overview and category system of supra-regional public health actors in Germany. METHODS Based on a list of institutional actors that participated in the national conference Future Forum Public Health ("Zukunftsforum Public Health") and a targeted online search by the authors, supra-regional institutions and organizations with a public health focus were identified. All actors were screened independently by ≥ 2 authors. Community-level actors as well as those without a direct public health focus were excluded. Additional actors were identified via a snowballing process. In order to cluster the actors thematically, a category system was formed inductively. RESULTS Out of a total of 645 screened actors, 307 (47.6%) were included and subsequently assigned to 12 main and 30 subcategories. Professional associations (n = 60) made up the largest category, followed by civil society (n = 49) and state actors (n = 40). In addition to a tabular and graphical overview, an interactive visualization of the actors was created ( www.noeg.org ). CONCLUSIONS This study provides a comprehensive overview of supra-regional institutional public health actors in Germany and highlights the breadth of the German public health landscape. The results of this work offer new opportunities for collaboration and can support young professionals in their career paths. Building on this work, further research on public health actors is recommended.
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Affiliation(s)
- Franziska Hommes
- Nachwuchsnetzwerk Öffentliche Gesundheit, Berlin, Deutschland.,Charité - Universitätsmedizin Berlin, Institut für Tropenmedizin und Internationale Gesundheit, Berlin, Deutschland
| | - Amir Mohsenpour
- Nachwuchsnetzwerk Öffentliche Gesundheit, Berlin, Deutschland. .,AG Bevölkerungsmedizin und Versorgungsforschung, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Universitätsstraße 25, 33615, Bielefeld, Deutschland.
| | - Dana Kropff
- Nachwuchsnetzwerk Öffentliche Gesundheit, Berlin, Deutschland.,Institut für Afrikastudien, Universität Leipzig, Leipzig, Deutschland
| | - Lisa Pilgram
- Nachwuchsnetzwerk Öffentliche Gesundheit, Berlin, Deutschland.,Abteilung für Innere Medizin, Hämatologie/Onkologie, Goethe-Universität Frankfurt, Frankfurt am Main, Deutschland
| | | | - Peter von Philipsborn
- Nachwuchsnetzwerk Öffentliche Gesundheit, Berlin, Deutschland.,Pettenkofer School of Public Health, München, Deutschland.,Lehrstuhl für Public Health und Versorgungsforschung, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie - IBE, LMU München, München, Deutschland
| | - Kerstin Sell
- Nachwuchsnetzwerk Öffentliche Gesundheit, Berlin, Deutschland.,Pettenkofer School of Public Health, München, Deutschland.,Lehrstuhl für Public Health und Versorgungsforschung, Institut für medizinische Informationsverarbeitung, Biometrie und Epidemiologie - IBE, LMU München, München, Deutschland
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Plante C, Bandara T, Baugh Littlejohns L, Sandhu N, Pham A, Neudorf C. Surveying the local public health response to COVID-19 in Canada: Study protocol. PLoS One 2021; 16:e0259590. [PMID: 34793490 PMCID: PMC8601475 DOI: 10.1371/journal.pone.0259590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/19/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Public health services and systems research is under-developed in Canada and this is particularly the case with respect to research on local public health unit operational functioning and capacity. The purpose of this paper is to report on a study that will collect retrospective information on the local public health response to COVID-19 throughout Canada between 2020 and 2021. METHODS/DESIGN The goal of the study is to develop and implement a study framework that will collect retrospective information on the local public health system response to the COVID-19 pandemic in Canada. This study will involve administering a mixed-method survey to Medical Health Officers/Medical Officers of Health in every local and regional public health unit across the country, followed by a process of coding and grouping these responses in a consistent and comparable way. Coded responses will be assessed for patterns of divergent or convergent roles and approaches of local public health across the country with respect to interventions in their response to COVID-19. The Framework Method of thematic analysis will be applied to assess the qualitative answers to the open-ended questions that speak to public health policy features. DISCUSSION The strengths of the study protocol include the engagement of Medical Health Officers/Medical Officers of Health as research partners and a robust integrated knowledge translation approach to further public health services and systems research in Canada.
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Affiliation(s)
- Charles Plante
- Johnson Shoyama Graduate School of Public Policy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Thilina Bandara
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Lori Baugh Littlejohns
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Navdeep Sandhu
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Anh Pham
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Cory Neudorf
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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