Agenda Setting for Health Promotion: Exploring an Adapted Model for the Social Media Era

Health-Related Communication of Social Media Influencers: A Scoping Review

Social media influencers (SMIs) are an essential part of today's digital media landscape and have the ability to significantly impact the health-related attitudes and behavior of their audiences. Despite an increasing number of studies, research has produced mixed results, and a comprehensive overview of the main findings is lacking. Therefore, the goal of this scoping review was to comprehensively map the literature focusing on SMIs and their health-related communication. Specifically, we analyzed the most frequently studied health topics and social media platforms, the methodological characteristics of the studies, as well as the communication techniques employed by SMIs, and the potential positive and negative effects of their communication on their audience. Additionally, we examined the major research gaps in this area. Altogether, we analyzed n = 116 empirical papers. The results reveal a wide range of different outcomes influenced by SMIs, including both positive and negative changes in health-related attitudes and behavioral intentions among their followers. Furthermore, our findings highlight the need for future research to prioritize experimental and longitudinal studies, investigate actual behavioral outcomes resulting from influencer content exposure, and closely examine the potential negative effects of SMIs' health-related communication. More attention needs to be paid to health-related misinformation disseminated by SMIs. Lastly, this study identified several highly relevant health topics and social media platforms that should be the focus of future research.

Spatiotemporal heterogeneity of the association between socioeconomic development and health policy attention: a geographically and temporally weighted regression modeling study in China

Objectives

Health policy attention (HPA) refers to the extent of attention given by governments to health issues in public policy and is generally influenced by socioeconomic development. This study aimed to examine the spatiotemporal heterogeneity and clustering of the associations between socioeconomic factors and HPA.

Study design

Longitudinal study.

Methods

This study examined the spatiotemporal heterogeneity of the association between public and provincial government attention, economic development, and demographic transition and HPA by using geographically and temporally weighted regression (GTWR). Word2Vec machine learning technology was utilized to calculate HPA data in 323 cities and independent variable data was collected in each city in China over the period of 2018-2021.

Results

The results showed that there is a substantial overall rise in HPA levels throughout China following the COVID-19 pandemic. Furthermore, the GTWR results revealed significant spatiotemporal heterogeneity in the associations between HPA and public and provincial government attention, economic development, and demographic transition, particularly in the context of COVID-19. The impact of provincial government attention on HPA decreased from the capital of the political center outward, while the impact of public financial investment decreased in less developed cities during the pandemic. It was only cities with high levels of aging are more likely to receive greater HPA.

Conclusion

The finding highlighted the remarkable spatial and temporal variations in the associations between the variables and HPA across different regions in China, emphasizing the need for region-specific policies to strengthen the focus on health by municipal governments.

Effect of stage-matched educational intervention on use of institutional delivery in Northwest Ethiopia: using community readiness model

Introduction

even though there are many initiatives to improve institutional delivery, there are low service utilization and community readiness for institutional delivery in Ethiopia. This study assessed the role of community readiness on delivery service use.

Methods

a pre-and post-test design with a control group was used for the evaluation of the stage-matched educational intervention following the protocol of the community readiness assessment model. Based on the baseline assessment of community readiness among 15 kebeles where the study was conducted, the overall score of nine kebeles was below stage-5 out of the nine stages, which were targeted for the intervention. The intervention group (n= three kebeles) participated in the stage-matched intervention for 15 months, while the control group (n= three kebeles) were not given the intervention. The data were analyzed using the difference in difference (DiD) method.

Results

there were significant improvements in a stage of change for the promotion of institutional delivery (p-value <0.001) and institutional delivery use (p-value <0.001) in the intervention group as compared to the control group. The study revealed that the intervention influenced community resource allocation (at marginally significant levels), improved leader-ship quality of prevention, and community climate to supportive prevention efforts. There was evidence that the intervention (health promotion) also increased service use at a significant level.

Conclusion

the community readiness-based intervention (health promotion) can be useful to measure the combined attitude and behavior towards institutional delivery services. The village-based mobilizer approach had a positive effect on institutional delivery use and the level of community readiness on the promotion of institutional delivery.

Government-Nongovernmental Organization (NGO) Collaboration in Macao's COVID-19 Vaccine Promotion: Social Media Case Study

BACKGROUND

The COVID-19 pandemic triggered unprecedented global vaccination efforts, with social media being a popular tool for vaccine promotion.

OBJECTIVE

This study probes into Macao's COVID-19 vaccine communication dynamics, with a focus on the multifaceted impacts of government agendas on social media.

METHODS

We scrutinized 22,986 vaccine-related Facebook posts from January 2020 to August 2022 in Macao. Using automated content analysis and advanced statistical methods, we unveiled intricate agenda dynamics between government and nongovernment entities.

RESULTS

"Vaccine importance" and "COVID-19 risk" were the most prominent topics co-occurring in the overall vaccine communication. The government tended to emphasize "COVID-19 risk" and "vaccine effectiveness," while regular users prioritized vaccine safety and distribution, indicating a discrepancy in these agendas. Nonetheless, the government has limited impact on regular users in the aspects of vaccine importance, accessibility, affordability, and trust in experts. The agendas of government and nongovernment users intertwined, illustrating complex interactions.

CONCLUSIONS

This study reveals the influence of government agendas on public discourse, impacting environmental awareness, public health education, and the social dynamics of inclusive communication during health crises. Inclusive strategies, accommodating public concerns, and involving diverse stakeholders are paramount for effective social media communication during health crises.

Content framing role on public sentiment formation for pre-crisis detection on sensitive issue via sentiment analysis and content analysis

Social media has been tremendously used worldwide for a variety of purposes. Therefore, engagement activities such as comments have attracted many scholars due its ability to reveal many critical findings, such as the role of users' sentiment. However, there is a lacuna on how to detect crisis based on users' sentiment through comments, and for such, we explore framing theory in the study herein to determine users' sentiment in predicting crisis. Generic content framing theory consists of conflict, economic, human interest, morality, and responsibility attributes frame as independent variables whilst sentiment as dependent variables. Comments from selected Facebook posting case studies were extracted and analysed using sentiment analysis via Application Programme Interface (API) webtool. The comments were then further analysed using content analysis via Positive and Negative Affect Schedule (PANAS) scale and statistically evaluated using SEM-PLS. Model shows that 44.8% of emotion and reactions towards sensitive issue posting are influenced by independent variables. Only economic consequences and responsibility attributes frame had correlation towards emotion and reaction at p<0.05. News reporting on direction towards economic and responsibility attributes sparks negative sentiment, which proves that it can best be described as pre-crisis detection to assist the Royal Malaysian Police and other relevant stakeholders to prevent criminal activities in their respective social media.

The Mutual Influence of the World Health Organization (WHO) and Twitter Users During COVID-19: Network Agenda-Setting Analysis

BACKGROUND

Little is known about the role of the World Health Organization (WHO) in communicating with the public on social media during a global health emergency. More specifically, there is no study about the relationship between the agendas of the WHO and Twitter users during the COVID-19 pandemic.

OBJECTIVE

This study utilizes the network agenda-setting model to investigate the mutual relationship between the agenda of the WHO's official Twitter account and the agenda of 7.5 million of its Twitter followers regarding COVID-19.

METHODS

Content analysis was applied to 7090 tweets posted by the WHO on Twitter from January 1, 2020, to July 31, 2020, to identify the topics of tweets. The quadratic assignment procedure (QAP) was used to investigate the relationship between the WHO agenda network and the agenda network of the 6 Twitter user categories, including "health care professionals," "academics," "politicians," "print and electronic media," "legal professionals," and the "private sector." Additionally, 98 Granger causality statistical tests were performed to determine which topic in the WHO agenda had an effect on the corresponding topic in each Twitter user category and vice versa.

RESULTS

Content analysis revealed 7 topics that reflect the WHO agenda related to the COVID-19 pandemic, including "prevention," "solidarity," "charity," "teamwork," "ill-effect," "surveillance," and "credibility." Results of the QAP showed significant and strong correlations between the WHO agenda network and the agenda network of each Twitter user category. These results provide evidence that WHO had an overall effect on different types of Twitter users on the identified topics. For instance, the Granger causality tests indicated that the WHO tweets influenced politicians and print and electronic media about "surveillance." The WHO tweets also influenced academics and the private sector about "credibility" and print and electronic media about "ill-effect." Additionally, Twitter users affected some topics in the WHO. For instance, WHO followers affected "charity" and "prevention" in the WHO.

CONCLUSIONS

This paper extends theorizing on agenda setting by providing empirical evidence that agenda-setting effects vary by topic and types of Twitter users. Although prior studies showed that network agenda setting is a "one-way" model, the novel findings of this research confirm a "2-way" or "multiway" effect of agenda setting on social media due to the interactions between the content creators and audiences. The WHO can determine which topics should be promoted on social media during different phases of a pandemic and collaborate with other public health gatekeepers to collectively make them salient in the public.

Examining U.S. Newspapers’ Effects on COVID-19 Infection Rates Among Racial/Ethnic Minorities

Background: The coronavirus disease 2019 (COVID-19) pandemic reveals health disparities in the United States. News media are expected to play a major role in reducing racial/ethnic disparities.

Methods: Guided by agenda-setting theory in the context of health promotion and the structural approach of media effects, this study assessed the impacts of COVID-19 newspaper articles about racial/ethnic minorities on minorities' infection rates in the early stages of the pandemic, while controlling for social determinants of health (SDOHs).

Results: Racial/ethnic minorities are underrepresented in COVID-19 newspaper articles, although newspapers' attention to racial/ethnic minorities' health increased over time. Public exposure to newspaper articles about racial/ethnic minorities was the only significant factor that predicted infection rates among general racial/ethnic minorities. The more the general public in the United States was exposed to related newspaper articles, the lower the infection rates among general racial/ethnic minorities would be. The impacts of SDOHs varied across different racial/ethnic minority groups. Blue states were more likely to be exposed to COVID-19 newspaper articles about racial/ethnic minorities than red states.

Discussion: Findings suggest that news exposure to any racial/ethnic group can benefit all minorities. Findings also demonstrate the influence of media agenda on public agenda and policy agenda regarding minority health.

Effects of Prednisolone Derivative and Panaxydol: Biosurfactants on Cell Wall Integrity of Acne-Causing Resistant Bacteria

Acne is one of the most common dermatological skin problem caused due to inflammation of the skin, leading to unfavorable growth of Propionibacterium acnes. It is a slow growing anaerobic, gram-positive bacterium that releases chemotactic factors and leads to the complex pathogenicity of acne. There are several acne treatments/therapies available, but topical therapy is usually the first choice for mild to moderate acne, and as the severity of the acne increases, the treatment modalities fail. There are many acne treatment options available, but topical therapy is best suited for mild - to - moderate skin problems, and then as the seriousness of the acne grows, the therapeutic approaches fall short. Biosurfactants are surfactants produced from plants or animals; Saponins are plant derived non-ionic biosurfactants which have steroidal and triterpenic glycosides distributed largely in plant kingdom. Numerous studies conducted by scientists have established the antimicrobial activity of and are considered more advantageous over synthetic precursors as they are eco-friendly, cheap and non-toxic. The present study was undertaken to investigate the antibacterial activity of saponins (bio-surfactants) characterized using mass spectroscopy against acne-causing bacteria. The discharge of cellular components including protein and UV-sensitive materials in the cell-free supernatant was provoked by saponin, confirming the cellular and membrane disturbances.. Furthermore, various morphological changes on the bacterial cell surface structure by Transmission electron microscopy and scanning electron microscopy revealed the disruption of the cell integrity leading to death. Results confirmed presence of non-ionic surfactants primarily affecting the disruption and destruction to the bacteria which indicates that saponins are efficient components with great potential applications in various pharmaceutical preparations. Effects of Prednisolone derivative and Panaxydol: Biosurfactants on cell wall integrity of Acne-Causing Resistant Bacteria.

The public health community's use of social media for policy advocacy: a scoping review and suggestions to advance the field

OBJECTIVES

This study aimed to investigate the extent and key characteristics of academic research and scholarship on the public health community's use of social media for policy advocacy purposes. This will enable an evaluation of extant research and provide insight into directions for future research.

STUDY DESIGN

This study was a scoping review of academic literature.

METHODS

A scoping review of academic literature published between 1 January 2011 and 31 December 2020 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Boolean searches were conducted using a university library platform, which included databases, such as EBSCO host, Informit, Scopus, and ScienceDirect. Data were extracted using an a priori code frame, and publication, content, and disciplinary characteristics were analysed. The results of coding and screening comparison checks were within acceptable limits.

RESULTS

In total, 2672 works from around the world were identified and screened for inclusion. Twenty-two English language articles were included in the final analysis. The public health community's use of social media for policy advocacy purposes has largely been approached from a health perspective, despite research and scholarship about social media in communication and policy disciplines (among others). Reported research aims or questions emphasised functional rather than theoretical contributions. Most analysed works used empirical or case study-based methods and were produced by authors in Western geographies. Among the health issues discussed, tobacco and tobacco control were discussed most frequently. While recognising issues with social media, most publications framed social media as more of an opportunity than a problem.

CONCLUSIONS

The public health community's use of social media for policy advocacy purposes is an emerging field. There is considerable potential to expand scholarship and research in this field internationally, especially by integrating transdisciplinary knowledge and perspectives and by applying social media to foster policy change around identified global health challenges. Greater representation of authors from institutions in the Global South is also encouraged, as are applied and theoretical contributions.

Using Twitter to promote a youth mental health agenda

Agenda-setting theory suggests the media shapes public perceptions. Guided by this theory, this study examines the effects of organizational Twitter accounts on public discourse in the Twittersphere. The tweets that mention one of three youth mental health organizations were theorized to emanate the particular focus of the organization mentioned. This was investigated by analysing: randomly selected tweets that mentioned one of three national mental health organizations-ReachOut, headspace or the Young and Well Cooperative Research Centre but not authored by these organizations (n = 600); and the population of tweets that mentioned one of these three organizations and authored by either of the two counterparts of the mentioned organization (n = 115). Findings supported anticipated patterns, whereby the tweets reflected the remit of the three organizations. These findings reveal the influential role of social media in setting a youth mental health agenda. The implications for practitioners and researchers are discussed.

What Do Social Media Influencers Say about Health? A Theory-Driven Content Analysis of Top Ten Health Influencers' Posts on Sina Weibo

Social media health influencers play an increasingly important role in disseminating health-related information to the public. To explore how health influencers in China communicate with their followers, we conducted a content analysis of the top ten health influencers' posts (n = 1000) on Sina Weibo guided by the Extended Parallel Processing Model (EPPM) and the transportation theory. These posts were coded in terms of demographic information, topics, message properties (informative, persuasive, and interactive), EPPM variables, and types of evidence (statistical and narrative) used. Results showed that these influencers had a clear emphasis on women's health (OB/GYN diseases and risks related to pregnancy and childcare) and beauty and skincare (in terms of risks and benefits). Overall, they used low fear appeal and high efficacy messages. However, messages containing efficacy information were less likely to be liked. These influencers relied heavily on narrative evidence; however, there was no significant relationship between the use of either narrative or statistical evidence and the number of likes. Differences in the communication strategies in posts about different diseases did exist but were not prevalent.

Characterizing Weibo Social Media Posts From Wuhan, China During the Early Stages of the COVID-19 Pandemic: Qualitative Content Analysis

BACKGROUND

The COVID-19 pandemic has reached 40 million confirmed cases worldwide. Given its rapid progression, it is important to examine its origins to better understand how people's knowledge, attitudes, and reactions have evolved over time. One method is to use data mining of social media conversations related to information exposure and self-reported user experiences.

OBJECTIVE

This study aims to characterize the knowledge, attitudes, and behaviors of social media users located at the initial epicenter of the outbreak by analyzing data from the Sina Weibo platform in Chinese.

METHODS

We used web scraping to collect public Weibo posts from December 31, 2019, to January 20, 2020, from users located in Wuhan City that contained COVID-19-related keywords. We then manually annotated all posts using an inductive content coding approach to identify specific information sources and key themes including news and knowledge about the outbreak, public sentiment, and public reaction to control and response measures.

RESULTS

We identified 10,159 COVID-19 posts from 8703 unique Weibo users. Among our three parent classification areas, 67.22% (n=6829) included news and knowledge posts, 69.72% (n=7083) included public sentiment, and 47.87% (n=4863) included public reaction and self-reported behavior. Many of these themes were expressed concurrently in the same Weibo post. Subtopics for news and knowledge posts followed four distinct timelines and evidenced an escalation of the outbreak's seriousness as more information became available. Public sentiment primarily focused on expressions of anxiety, though some expressions of anger and even positive sentiment were also detected. Public reaction included both protective and elevated health risk behavior.

CONCLUSIONS

Between the announcement of pneumonia and respiratory illness of unknown origin in late December 2019 and the discovery of human-to-human transmission on January 20, 2020, we observed a high volume of public anxiety and confusion about COVID-19, including different reactions to the news by users, negative sentiment after being exposed to information, and public reaction that translated to self-reported behavior. These findings provide early insight into changing knowledge, attitudes, and behaviors about COVID-19, and have the potential to inform future outbreak communication, response, and policy making in China and beyond.

HPV vaccine, Twitter, and gay, bisexual and other men who have sex with men

This study aimed to quantify human papillomavirus (HPV) vaccine Twitter messaging addressing gay, bisexual and other men who have sex with men (GB+MSM) and describes messaging by vaccine sentiment (attitudes towards vaccine) and characteristics (topic of messaging). Between August 2014 and July 2015, we collected 193 379 HPV-related tweets and classified them by vaccine sentiment and characteristics. We analysed a subsample of tweets containing the terms 'gay', 'bisexual' and 'MSM' (N = 2306), and analysed distributions of sentiment and characteristics using chi-square. HPV-related tweets containing GB+MSM terms occupied 1% of our sample. The subsample had a largely positive vaccine sentiment. However, a proportion of 'gay' and 'bisexual' tweets did not mention the vaccine, and a proportion of 'gay' and 'MSM' tweets had a negative sentiment. Topics varied by GB+MSM term-HPV risk messaging was prevalent in 'bisexual' (25%) tweets, and HPV transmission through sex/promiscuity messaging was prevalent in 'gay' (18%) tweets. Prevention/protection messaging was prevalent only in 'MSM' tweets (49%). Although HPV vaccine sentiment was positive in GB+MSM messaging, we identified deficits in the volume of GB+MSM messaging, a lack of focus on vaccination, and a proportion of negative tweets. While HPV vaccine promotion has historically focused on heterosexual HPV transmission, there are opportunities to shape vaccine uptake in GB+MSM through public health agenda setting using social media messaging that increases knowledge and minimizes HPV vaccine stigma. Social media-based HPV vaccine promotion should also address the identities of those at risk to bolster vaccine uptake and reduce the risk of HPV-attributable cancers.

Health communication research in the Arab world: A bibliometric analysis

Objective

Health communication is a novel field in the Arab world. This study aimed to describe and characterise health communication research activity in the region.

Methods and analysis

The PubMed database was used to search for publications related to health communication from Arab states. Publications were classified according to country of origin, without limiting for date. Research activity and output were examined with respect to population and the gross domestic product (GDP) of each Arab state.

Results

A total of 66 contributions related to health communication came from the Arab countries, with the first paper published from Lebanon in 2004. Health communication-related publications constituted 0.03% of the total biomedical research contributions published by the Arab world since 2004 and 1% of the world’s health communication literature. Number of health communication contributions ranged between 0 and 12, with Lebanon producing the most output. Qatar ranked first with respect to contributions per population, whereas Lebanon ranked first with respect to contributions per GDP. Algeria, Comoros, Djibouti, Iraq, Kuwait, Libya, Mauritania, Somalia, Sudan and Yemen had nil health communication publications.

Conclusion

Recognising the barriers facing the health communication field and addressing them carefully are vital in the plan to better the Arab world’s output and contribution in the field.

Barriers to and Facilitators of Road Traffic Injuries Prevention in Iran; A Qualitative Study

Objective:

To identify the barriers to and facilitators of the prevention of road traffic accidents (RTIs) in Iran.

Methods:

In this qualitative study 42 key stakeholders and experts in the field of traffic injuries in Iran were selected based on purpose and theoretical sampling to reach informational saturation. Their views concerning barriers to and facilitators of the prevention of traffic injuries in Iran were studied using semi-structured interviews. Data were analyzed using Content Analysis method.

Results:

Five themes were identified: structural barriers, organizational barriers and planning, socio-cultural barriers, scientific barriers, and inter-sector barriers and 22 sub-themes were extracted. The lack of lead agency, which was among structural barriers, was selected as the main barrier. The five general facilitators included: sensitization of society and authorities, improving the resources and infrastructure (software and hardware), increasing the attention to safety of vehicles and roads, increasing the information and awareness, and use of expert manpower. The sensitization of society and authorities was selected as the most important facilitator.

Conclusion:

According to the key experts, the barriers of policy changes to prevent the RTIs are more numerous than its facilitators. Therefore, planning and paying more attention to removing these barriers and promoting the facilitators seems necessary to reduce RTIs. Having a lead agency in this regard should be the highest priority.

Monitoring Twitter Conversations for Targeted Recruitment in Cancer Trials in Los Angeles County: Protocol for a Mixed-Methods Pilot Study

BACKGROUND

Insufficient recruitment of participants remains a critical roadblock to successful clinical research, particularly clinical trials. Social media provide new ways for connecting potential participants with research opportunities. Researchers suggest that the social network Twitter may serve as a rich avenue for exploring how patients communicate about their health issues and increasing enrollment in cancer clinical trials. However, there is a lack of evidence that Twitter offers practical utility and impact.

OBJECTIVE

This pilot study aimed to examine the feasibility and impact of using Twitter monitoring data (ie, user activity and their conversations about cancer-related conditions and concerns expressed by Twitter users in Los Angeles County) as a tool for enhancing clinical trial recruitment at a comprehensive cancer center.

METHODS

We will conduct a mixed-methods interrupted time series study design with a before-and-after social media recruitment intervention. On the basis of a preliminary analysis of eligible trials, we plan to onboard at least 84 clinical trials across 6 disease categories: breast cancer, colon cancer, kidney cancer, lymphoma, non-small cell lung cancer, and prostate cancer that are open to accrual at the University of Southern California (USC) Norris Comprehensive Cancer Center. We will monitor messages about these 6 cancer conditions posted by Twitter users in Los Angeles County. Recruitment for the trials will occur through the Twitter account (@USCTrials). Primary study outcomes-feasibility and acceptance of the social media intervention among targeted Twitter users and the study teams of the onboarded trials-will be assessed using qualitative interviews and the 4-point Likert scale and by calculating the proportion of targeted Twitter users who engaged with outreach messages. Second, impact of the social media intervention will be measured by calculating the proportion of enrollees in trials. The enrollment rate will be compared between the active intervention period and the prior 10 months as historical control for each disease trial group. This study has been funded by the National Center for Advancing Translational Science through a Clinical and Translational Science Award. Study approval was obtained from the clinical investigations committee at USC Norris and the institutional review board at USC.

RESULTS

Recruitment on Twitter started in February 2018. Data collection will be completed in November 2018.

CONCLUSIONS

This pilot project will provide preliminary data and practical insight into the application of publicly available Twitter data to identify and recruit clinical trial participants across 6 cancer disease types. We will shed light on the acceptance of the social media intervention among Twitter users and study team members of the onboarded trials. If successful, the findings will inform a multisite randomized controlled trial to determine the efficacy of the social media intervention across different locations and populations.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03408561; https://clinicaltrials.gov/ct2/show/NCT03408561 (Archived by WebCite at http://www.webcitation.org/72LihauzW).

REGISTERED REPORT IDENTIFIER

RR1-10.2196/9762.

A systematic review of frameworks for the interrelationships of mental health evidence and policy in low- and middle-income countries

BACKGROUND

The interrelationships between research evidence and policy-making are complex. Different theoretical frameworks exist to explain general evidence-policy interactions. One largely unexplored element of these interrelationships is how evidence interrelates with, and influences, policy/political agenda-setting. This review aims to identify the elements and processes of theories, frameworks and models on interrelationships of research evidence and health policy-making, with a focus on actionability and agenda-setting in the context of mental health in low- and middle-income countries (LMICs).

METHODS

A systematic review of theories was conducted based on the BeHeMOTh search method, using a tested and refined search strategy. Nine electronic databases and other relevant sources were searched for peer-reviewed and grey literature. Two reviewers screened the abstracts, reviewed full-text articles, extracted data and performed quality assessments. Analysis was based on a thematic analysis. The included papers had to present an actionable theoretical framework/model on evidence and policy interrelationships, such as knowledge translation or evidence-based policy, specifically target the agenda-setting process, focus on mental health, be from LMICs and published in English.

RESULTS

From 236 publications included in the full text analysis, no studies fully complied with our inclusion criteria. Widening the focus by leaving out 'agenda-setting', we included ten studies, four of which had unique conceptual frameworks focusing on mental health and LMICs but not agenda-setting. The four analysed frameworks confirmed research gaps from LMICs and mental health, and a lack of focus on agenda-setting. Frameworks and models from other health and policy areas provide interesting conceptual approaches and lessons with regards to agenda-setting.

CONCLUSION

Our systematic review identified frameworks on evidence and policy interrelations that differ in their elements and processes. No framework fulfilled all inclusion criteria. Four actionable frameworks are applicable to mental health and LMICs, but none specifically target agenda-setting. We have identified agenda-setting as a research theory gap in the context of mental health knowledge translation in LMICs. Frameworks from other health/policy areas could offer lessons on agenda-setting and new approaches for creating policy impact for mental health and to tackle the translational gap in LMICs.