1
|
Harding KB, Di Ruggiero E, Gonzalez E, Hicks A, Harrington DW, Carsley S. Supporting Ontario public health units to address adverse childhood experiences in pandemic recovery planning: A priority-setting exercise. Health Res Policy Syst 2024; 22:68. [PMID: 38872217 PMCID: PMC11170865 DOI: 10.1186/s12961-024-01156-0] [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: 10/19/2023] [Accepted: 05/22/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are potentially traumatic exposures experienced during childhood, for example, neglect. There is growing evidence that the coronavirus disease 2019 (COVID-19) pandemic and related socioeconomic conditions contributed to an increased risk of ACEs. As public health programs/services are re-evaluated and restored following the state of emergency, it is important to plan using an ACEs-informed lens. The aim of this study was to identify and prioritize initiatives or activities that Public Health Ontario (PHO) could undertake to support Ontario public health units' work towards ACEs-informed pandemic recovery plans. METHODS The Child Health and Nutrition Research Initiative method was adapted to conduct a priority-setting exercise (May-October 2022). Two online surveys were administered with members of the Healthy Growth and Development (HGD) Evidence Network, comprised of public health unit staff working in child and family health/HGD from Ontario's 34 public health units. In the first survey, participants were asked to propose activities or initiatives that PHO could undertake to support Ontario public health units' work towards ACEs-informed planning. In the second survey, participants were asked to score the final list of options against pre-determined prioritization criteria (for example, relevance). Responses were numerically coded and used to calculate prioritization scores, which were used to rank the options. RESULTS In all, 76% of public health units (n = 26) responded to the first survey to identify options. The 168 proposed ideas were consolidated into a final list of 13 options, which fall under PHO's scientific and technical support mandate areas (data and surveillance, evidence synthesis, collaboration and networking, knowledge exchange and research). A total of 79% of public health units (n = 27) responded to the follow-up survey to prioritize options. Prioritization scores ranged from 76.4% to 88.6%. The top-ranked option was the establishment of a new provincial ACEs community of practice. CONCLUSIONS Over three quarters of public health units contributed to identifying and ranking 13 options for PHO to support public health units in considering and addressing ACEs through pandemic recovery planning. In consultation with the ACEs and Resilience Community of Practice, recently formed on the basis of this exercise, PHO will continue to use the ranked list of options to inform work-planning activities/priorities.
Collapse
Affiliation(s)
- Kimberly B Harding
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
| | - Erick Gonzalez
- Family Health Division, Niagara Region Public Health and Emergency Services, 1815 Sir Isaac Brock Way, Thorold, ON, L2V 4Y6, Canada
| | - Amanda Hicks
- Family Health Division, Niagara Region Public Health and Emergency Services, 1815 Sir Isaac Brock Way, Thorold, ON, L2V 4Y6, Canada
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Daniel W Harrington
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, 661 University Avenue, Suite 1701, Toronto, ON, M5G 1M1, Canada
| | - Sarah Carsley
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, 661 University Avenue, Suite 1701, Toronto, ON, M5G 1M1, Canada.
| |
Collapse
|
2
|
Nair S, Attal-Juncqua A, Reddy A, Sorrell EM, Standley CJ. Assessing barriers, opportunities and future directions in health information sharing in humanitarian contexts: a mixed-method study. BMJ Open 2022; 12:e053042. [PMID: 35379617 PMCID: PMC8981313 DOI: 10.1136/bmjopen-2021-053042] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Health information sharing continues to play a crucial yet underappreciated role in humanitarian settings, to guide evidence-based disease prevention, detection and response. We conducted a mixed-methods study to investigate and analyse existing approaches and practices to health information sharing across humanitarian settings over the past 20 years. SETTING We sought to identify studies from any self-described humanitarian setting worldwide, and also targeted experts familiar with refugee settings, specifically long-term camps in Kenya, Jordan and Bangladesh, for key informant interviews. PARTICIPANTS The systematic review did not directly involve participants. The identified reports were largely retrospective and observational, and focused on populations affected by humanitarian crises worldwide. Participants in the key informant interviews were experts with either broad geographical expertise or direct experience in refugee camp settings. PRIMARY AND SECONDARY OUTCOME MEASURES Our study was qualitative, and both the systematic review and analysis of key informant interview responses focused on identifying themes related to barriers, tools and recommendations used between stakeholders to share health information, with a particular emphasis on infectious disease and surveillance data. RESULTS We identified logistical challenges, difficulties with data collection and a lack of health information sharing frameworks as the most significant barriers to health information sharing. The most important tools to health information sharing included the use of third-party technologies for data collection and standardisation, formalised health information sharing frameworks, establishment of multilevel coordination mechanisms and leadership initiatives which prioritised the sharing of health information. CONCLUSIONS We conclude that health information sharing can be strengthened in humanitarian settings with improvements to existing frameworks, coordination and leadership tools, in addition to promotion of health information communication. Furthermore, specific recommendations for improving health information sharing should be pursued according to the nature of the humanitarian setting and the efficacy of the health system present.
Collapse
Affiliation(s)
- Shuait Nair
- Walsh School of Foreign Service, Georgetown University, Washington, District of Columbia, USA
| | - Aurelia Attal-Juncqua
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | - Aashna Reddy
- School of Nursing and Health Studies, Georgetown University, Washington, District of Columbia, USA
| | - Erin M Sorrell
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
- Department of Microbiology & Immunology, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Claire J Standley
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| |
Collapse
|
3
|
Powell J, Brooks C, Watanabe M, Balaji LN. Assessing socio-economic profile of U-Reporters: Towards establishing a pool for equity analysis of future crowdsourced surveys. J Glob Health 2021; 11:09001. [PMID: 33791099 PMCID: PMC7979256 DOI: 10.7189/jogh.11.09001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Crowdsourcing was recognized as having the potential to collect information rapidly, inexpensively and accurately. U-Report is a mobile empowerment platform that connects young people all over the world to information that will change their lives and influence decisions. Previous studies of U-Report’s effectiveness highlight strengths in the timeliness, low cost and high credibility for collecting and sending information, however they also highlight areas to improve on concerning data representation. EquityTool has developed a simpler approach to assess the wealth quintiles of respondents based on fewer questions derived from large household surveys such as Multiple Indicators Cluster Surveys (MICS) and Demographic and Health Surveys (DHS). Methods The methodology of Equity Tool was adopted to assess the socio-economic profile of U-Reporters (ie, enrolled participants of U-Report) in Bangladesh. The RapidPro flow collected the survey responses and scored them against the DHS national wealth index using the EquityTool methodology. This helped placing each U-Reporter who completed all questions into the appropriate wealth quintile. Results With 19% of the respondents completing all questions, the respondents fell into all 5 wealth quintiles, with 79% in the top-two quintiles and only 21% in the lower-three resulting in an Equity Index of 53/100 where 100 is completely in line with Bangladesh equity distribution and 1 is the least in line. An equitable random sample of 1828 U-Reporters from among the regular and frequent respondents was subsequently created for future surveys and the sample has an Equity Index of 98/100. Conclusions U-Report in Bangladesh does reach the poorest quintiles while the initial recruitment skews to respondents towards better off families. It is possible to create an equitable random sub-sample of respondents from all five wealth quintiles and thus process information and data for future surveys. Moving forward, U-Reporters from the poorly represented quintiles may be incentivized to recruit peers to increase equity and representation. In times of COVID-19, U-Report in combination with the EquityTool has the potential to enhance the quality of crowdsourced data for statistical analysis.
Collapse
Affiliation(s)
- James Powell
- Office of Innovation, UNICEF, Copenhagen, Denmark
| | | | | | | |
Collapse
|
4
|
Macauley R, Elster N, Fanaroff JM. Ethical Considerations in Pediatricians' Use of Social Media. Pediatrics 2021; 147:peds.2020-049685. [PMID: 33619046 DOI: 10.1542/peds.2020-049685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Increasing use of social media by patients and clinicians creates opportunities as well as dilemmas for pediatricians, who must recognize the inherent ethical and legal complexity of these communication platforms and maintain professionalism in all contexts. Social media can be a useful tool in the practice of medicine by educating both physicians and patients, expanding access to health care, identifying high-risk behaviors, contributing to research, promoting networking and online support, enhancing advocacy, and nurturing professional compassion. At the same time, there are confidentiality, privacy, professionalism, and boundary issues that need to be considered whenever potential interactions occur between physicians and patients via social media. This clinical report is designed to assist pediatricians in identifying and navigating ethical issues to harness the opportunities and avoid the pitfalls of social media.
Collapse
Affiliation(s)
- Robert Macauley
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon;
| | - Nanette Elster
- Neiswanger Institute for Bioethics, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois; and
| | - Jonathan M Fanaroff
- Department of Pediatrics, School of Medicine, Case Western Reserve University and Rainbow Center for Pediatric Ethics and Division of Neonatology, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | | |
Collapse
|
5
|
Vermicelli S, Cricelli L, Grimaldi M. How can crowdsourcing help tackle the COVID‐19 pandemic? An explorative overview of innovative collaborative practices. R&D MANAGEMENT 2021; 51:183-194. [PMCID: PMC7753275 DOI: 10.1111/radm.12443] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/27/2020] [Accepted: 10/22/2020] [Indexed: 05/23/2023]
Abstract
The COVID‐19 pandemic has caused unprecedented public health and economic crises. As a response to face the current emergency, science and innovation communities are realizing a fundamental contribution to tackle the crisis. During the past few months, we have witnessed an impressive number of initiatives to encourage networking opportunities, to foster interactions between the different stakeholders involved (health care, industry, governments, academics, ordinary people), and to develop innovative solutions and collaborative infrastructures in support of the health sector. Adopting an open and collaborative approach and joining forces is essential in the fight against the COVID‐19 crisis. Also, the involvement of crowds as innovation partners can be of great support. Therefore, our work aims to review and classify those initiatives, based on the crowdsourcing model, that have been put into place to face the emergency generated by the novel coronavirus pandemic. We illustrate the 16 crowdsourcing initiatives devoted to the SARS‐CoV‐2 outbreak that we identified, detailing their development and implementation. Then, we propose a classification of them, along two dimensions: type of crowdsourcing configuration and kind of tasks, being able to find a relationship between these two aspects. Evidence from the analyzed projects suggests that across disparate domains, crowdsourcing can be an effective strategy in the response to the COVID‐19 pandemic. To conclude, we suggest some important implications for innovation best practices and lessons that can be learned for the future: crowdsourcing, harnessing the power of crowds and online communities, can help tackle the COVID‐19 pandemic, by providing original, actionable, quick, and low‐cost solutions to the challenges of the current health and economic crisis.
Collapse
Affiliation(s)
- Silvia Vermicelli
- Department of Enterprise EngineeringUniversity of Rome ‘Tor Vergata’Viale del Politecnico, 1 – 00133RomeItaly
| | - Livio Cricelli
- Department of Industrial EngineeringUniversity of Naples “Federico II”Piazzale Tecchio 80NaplesItaly
| | - Michele Grimaldi
- Department of Civil and Mechanical EngineeringUniversity of Cassino and Southern LazioVia G. Di Biasio 43CassinoFRItaly
| |
Collapse
|
6
|
Alobo M, Mgone C, Lawn J, Adhiambo C, Wazny K, Ezeaka C, Molyneux E, Temmerman M, Okong P, Malata A, Kariuki T. Research priorities in maternal and neonatal health in Africa: results using the Child Health and Nutrition Research Initiative method involving over 900 experts across the continent. AAS Open Res 2021; 4:8. [PMID: 34151141 PMCID: PMC8204196 DOI: 10.12688/aasopenres.13189.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Africa will miss the maternal and neonatal health (MNH) Sustainable Development Goals (SDGs) targets if the current trajectory is followed. The African Academy of Sciences has formed an expert maternal and newborn health group to discuss actions to improve MNH SDG targets. The team, among other recommendations, chose to implement an MNH research prioritization exercise for Africa covering four grand challenge areas. Methods: The team used the Child Health and Nutrition Research Initiative (CHNRI) research prioritization method to identify research priorities in maternal and newborn health in Africa. From 609 research options, a ranking of the top 46 research questions was achieved. Research priority scores and agreement statistics were calculated, with sub-analysis possible for the regions of East Africa, West Africa and those living out of the continent. Results: The top research priorities generally fell into (i) improving identification of high-risk mothers and newborns, or diagnosis of high-risk conditions in mothers and newborns to improve health outcomes; (ii) improving access to treatment through improving incentives to attract and retain skilled health workers in remote, rural areas, improving emergency transport, and assessing health systems' readiness; and (iii) improving uptake of proven existing interventions such as Kangaroo Mother Care. Conclusions: The research priorities emphasized building interventions that improved access to quality healthcare in the lowest possible units of the provision of MNH interventions. The lists prioritized participation of communities in delivering MNH interventions. The current burden of disease from MNCH in Africa aligns well with the list of priorities listed from this exercise but provides extra insights into current needs by African practitioners. The MNCH Africa expert group believes that the recommendations from this work should be implemented by multisectoral teams as soon as possible to provide adequate lead time for results of the succeeding programmes to be seen before 2030.
Collapse
Affiliation(s)
| | | | - Joy Lawn
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Kerri Wazny
- Bloomberg School of Public Health, Johns Hopkins University, Maryland, USA
| | - Chinyere Ezeaka
- College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | | | | | - Pius Okong
- Health Service Commission, Kampala, Uganda
| | - Address Malata
- Malawi University of Science and Technology,, Thyolo, Malawi
| | | | - African Academy of Sciences Maternal and Neonatal Health Working Group for Africa
- African Academy of Sciences, Nairobi, Kenya
- Hubert Kairuki University, Dar es Salaam, Tanzania
- London School of Hygiene and Tropical Medicine, London, UK
- Bloomberg School of Public Health, Johns Hopkins University, Maryland, USA
- College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
- College of Medicine, University of Malawi, Malawi, Blantyre, Malawi
- Aga Khan University, Nairobi, Kenya
- Health Service Commission, Kampala, Uganda
- Malawi University of Science and Technology,, Thyolo, Malawi
| |
Collapse
|
7
|
Moodley K, Beyer C. Tygerberg Research Ubuntu-Inspired Community Engagement Model: Integrating Community Engagement into Genomic Biobanking. Biopreserv Biobank 2019; 17:613-624. [PMID: 31603696 PMCID: PMC6921246 DOI: 10.1089/bio.2018.0136] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Introduction: Community engagement (CE) is an ethical imperative in research, but the knowledge base for what constitutes effective and ethically sound CE is limited. Ubuntu, as a component of responsive communitarianism where communal welfare is valued together with individual autonomy, is useful in furthering our understanding of effective CE and how it could best be achieved. Similarly, a relative solidarity model serves as a compromise between extreme individualism and extreme communalism and is more appropriate in a heterogenous African context. Approaching CE from an Ubuntu philosophical perspective in southern Africa is particularly important in genomic biobanking, given the implications for individuals, families, and communities. Discussion: CE is often implemented in a tokenistic manner as an ancillary component of research. Understanding consent information is challenging where genomic biobanking is concerned due to scientific complexity. We started a process of CE around genomic biobanking and conducted empirical research in an attempt to develop a model to promote effective and ethically sound CE, using relative solidarity to create a nuanced application of Ubuntu. The TRUCE model is an eight-step model that uses social mapping to identify potential communities, establishes the scope of CE, and requires that communities are approached early. Co-creation strategies for CE are encouraged and co-ownership of knowledge production is emphasized. Recruiting and engaging communities at each stage of research is necessary. Evaluation and adaptation of CE strategies are included. Discussion and dissemination of results after the research is completed are encouraged. Conclusions: There is a significant gap between the theory of CE and its authentic application to research in Africa. This Ubuntu-inspired model facilitates bridging that gap and is particularly suited to genomic biobanking. The CE model enhances and complements the consent process and should be integrated into research as a funding and regulatory requirement where applicable.
Collapse
Affiliation(s)
- Keymanthri Moodley
- Department of Medicine, Faculty of Medicine and Health Sciences, Centre for Medical Ethics & Law, Stellenbosch University, Cape Town, South Africa
- Address correspondence to: Keymanthri Moodley, MBChB, MFamMed, MPhil, FCFP (SA), Executive MBA, DPhil, Department of Medicine, Faculty of Medicine and Health Sciences, Centre for Medical Ethics & Law, Stellenbosch University, P.O. Box 241, Cape Town 7505, South Africa
| | - Chad Beyer
- Department of Medicine, Faculty of Medicine and Health Sciences, Centre for Medical Ethics & Law, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
8
|
Wazny K, Ravenscroft J, Chan KY, Bassani DG, Anderson N, Rudan I. Setting weights for fifteen CHNRI criteria at the global and regional level using public stakeholders: an Amazon Mechanical Turk study. J Glob Health 2019; 9:010702. [PMID: 30992986 PMCID: PMC6445564 DOI: 10.7189/jogh.09.010702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Stakeholder involvement has been described as an indispensable part of health research priority setting. Yet, more than 75% of the exercises using the Child Health and Nutrition Research Initiative (CHNRI) methodology have omitted the step involving stakeholders in priority setting. Those that have used stakeholders have rarely used the public, possibly due to the difficulty of assembling and/or accessing a public stakeholder group. In order to strengthen future exercises using the CHNRI methodology, we have used a public stakeholder group to weight 15 CHNRI criteria, and have explored regional differences or being a health stakeholder is influential, and whether the criteria are collapsible. Methods Using Amazon Mechanical Turk (AMT), an online crowdsourcing platform, we collected demographic information and conducted a Likert-scale format survey about the importance of the CHNRI criteria from 1051 stakeholders. The Kruskal-Wallis test, with Dunn's test for posthoc comparisons, was used to examine regional differences and Wilcoxon rank-sum test was used to analyse differences between stakeholders with health training/background and stakeholders without a health background and by region. A Factor Analysis (FA) was conducted on the criteria to identify the main domains connecting them. Criteria means were converted to weights. Results There were regional differences in thirteen of fifteen criteria according to the Kruskal-Wallis test and differences in responses from health stakeholders vs those who were not in eleven of fifteen criteria using the Wilcoxon rank-sum test. Three components were identified: improve and impact results; implementation and affordability; and, study design and dissemination. A formula is provided to convert means to weights for future studies. Conclusion In future CHNRI studies, researchers will need to ensure adequate representation from stakeholders to undue bias of CHNRI results. These results should be used in combination with other stakeholder groups, including government, donors, policy makers, and bilateral agencies. Global and regional stakeholder groups scored CHNRI criteria differently; due to this, researchers should consider which group to use in their CHNRI exercises.
Collapse
Affiliation(s)
- Kerri Wazny
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - John Ravenscroft
- Moray House School of Education, University of Edinburgh, Edinburgh, UK
| | - Kit Yee Chan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Diego G Bassani
- Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.,Centre for Global Child Health and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Niall Anderson
- Centre for Global Child Health and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| |
Collapse
|