Improving adolescent health policy: incorporating a framework for assessing state-level policies.

PubMed

Brindis, Claire D; Moore, Kristin

2014-01-01

Many US policies that affect health are made at the state, not the federal, level. Identifying state-level policies and data to analyze how different policies affect outcomes may help policy makers ascertain the usefulness of their public policies and funding decisions in improving the health of adolescent populations. A framework for describing and assessing the role of federal and state policies on adolescent health and well-being is proposed; an example of how the framework might be applied to the issue of teen childbearing is included. Such a framework can also help inform analyses of whether and how state and federal policies contribute to the variation across states in meeting adolescent health needs. A database on state policies, contextual variables, and health outcomes data can further enable researchers and policy makers to examine how these factors are associated with behaviors they aim to impact.

Pharmaceuticals, political money, and public policy: a theoretical and empirical agenda.

PubMed

Jorgensen, Paul D

2013-01-01

Why, when confronted with policy alternatives that could improve patient care, public health, and the economy, does Congress neglect those goals and tailor legislation to suit the interests of pharmaceutical corporations? In brief, for generations, the pharmaceutical industry has convinced legislators to define policy problems in ways that protect its profit margin. It reinforces this framework by selectively providing information and by targeting campaign contributions to influential legislators and allies. In this way, the industry displaces the public's voice in developing pharmaceutical policy. Unless citizens mobilize to confront the political power of pharmaceutical firms, objectionable industry practices and public policy will not change. Yet we need to refine this analysis. I propose a research agenda to uncover pharmaceutical influence. It develops the theory of dependence corruption to explain how the pharmaceutical industry is able to deflect the broader interests of the general public. It includes empirical studies of lobbying and campaign finance to uncover the means drug firms use to: (1) shape the policy framework adopted and information used to analyze policy; (2) subsidize the work of political allies; and (3) influence congressional voting. © 2013 American Society of Law, Medicine & Ethics, Inc.

Social Management of Gender Imbalance in China: A Holistic Governance Framework

PubMed Central

Shuzhuo, Li; Zijuan, Shang; Feldman, Marcus W.

2015-01-01

Since the 1980s, the sex ratio at birth (abbreviated as SRB) in China has been rising and has remained extremely high. With rapid social transition, gender imbalance has become one of the most significant issues of China's social management and has raised many problems and challenges. Innovation in the management principles and public policies of social management urgently needs a new perspective of holistic governance framework. Based on the latest trends in gender imbalance, using data from China's 2010 Population Census, this paper firstly reviews China's strategic policy responses and actions concerning the governance of the male-skewed SRB. With holistic governance theory, we focus on China's “Care for Girls” campaign to analyze the current public policy system. This paper then reveals fragmentation in the current management of China's gender imbalance. Finally we propose a social management framework for addressing China's gender imbalance. The public system needs to be strengthened, and the Chinese government should focus more on vulnerable groups such as forced bachelors in rural areas, and try to bring those groups into the policy framework for governance of gender imbalance. The proposed theoretical framework may help Chinese governments at various levels to design and implement improved social management of gender imbalance issues. PMID:26663948

Social Management of Gender Imbalance in China: A Holistic Governance Framework.

PubMed

Shuzhuo, Li; Zijuan, Shang; Feldman, Marcus W

2013-08-31

Since the 1980s, the sex ratio at birth (abbreviated as SRB) in China has been rising and has remained extremely high. With rapid social transition, gender imbalance has become one of the most significant issues of China's social management and has raised many problems and challenges. Innovation in the management principles and public policies of social management urgently needs a new perspective of holistic governance framework. Based on the latest trends in gender imbalance, using data from China's 2010 Population Census, this paper firstly reviews China's strategic policy responses and actions concerning the governance of the male-skewed SRB. With holistic governance theory, we focus on China's "Care for Girls" campaign to analyze the current public policy system. This paper then reveals fragmentation in the current management of China's gender imbalance. Finally we propose a social management framework for addressing China's gender imbalance. The public system needs to be strengthened, and the Chinese government should focus more on vulnerable groups such as forced bachelors in rural areas, and try to bring those groups into the policy framework for governance of gender imbalance. The proposed theoretical framework may help Chinese governments at various levels to design and implement improved social management of gender imbalance issues.

POLE.VAULT: A Semantic Framework for Health Policy Evaluation and Logical Testing.

PubMed

Shaban-Nejad, Arash; Okhmatovskaia, Anya; Shin, Eun Kyong; Davis, Robert L; Buckeridge, David L

2017-01-01

The major goal of our study is to provide an automatic evaluation framework that aligns the results generated through semantic reasoning with the best available evidence regarding effective interventions to support the logical evaluation of public health policies. To this end, we have designed the POLicy EVAlUation & Logical Testing (POLE.VAULT) Framework to assist different stakeholders and decision-makers in making informed decisions about different health-related interventions, programs and ultimately policies, based on the contextual knowledge and the best available evidence at both individual and aggregate levels.

Using law to strengthen health professions: frameworks and practice

PubMed Central

Verani, André; Shayo, Peter; Howse, Genevieve

2016-01-01

The lack of sufficient, high-quality health workers is one of the primary barriers to improving health in sub-saharan africa. An approach to address this challenge is for public health practitioners to increase their cooperation with public health lawyers, regulators and other policymakers in order to develop strengthened health workforce laws, regulations, and policies that are vigorously implemented and enforced. Conceptual frameworks can help clarify the meaning of health system governance and the pathways between law and health. International recommendations for policy interventions governing health workers provide countries with valuable guidance for domestic reforms. Monitoring and evaluation of legal, regulatory, and other policy interventions are required to ascertain their public health impact. At the intersection of law and public health, professionals from both fields can collaborate in concrete ways such as those discussed here to improve laws and policies governing health. PMID:26834849

The Political Communication of Strategic Nuclear Policy.

ERIC Educational Resources Information Center

Camden, Carl; Martin, Janet

A study of the different perceptual frameworks of the major parties involved in strategic nuclear policy was conducted by examining the interaction between the Executive Branch, Congress, and the informed public. Public political communication data were gathered from public documents generated by Congress and the Executive branch, and by examining…

Developing an Evidence Base for Policies and Interventions to Address Health Inequalities: The Analysis of “Public Health Regimes”

PubMed Central

Asthana, Sheena; Halliday, Joyce

2006-01-01

Systematic reviews have become an important methodology in the United Kingdom by which research informs health policy, and their use now extends beyond evidence-based medicine to evidence-based public health and, particularly, health inequalities policies. This article reviews the limitations of systematic reviews as stand-alone tools for this purpose and suggests a complementary approach to make better use of the evidence. That is, systematic reviews and other sources of evidence should be incorporated into a wider analytical framework, the public health regime (defined here as the specific legislative, social, political, and economic structures that have an impact on both public health and the appropriateness and effectiveness of public health interventions adopted). At the national level this approach would facilitate analysis at all levels of the policy framework, countering the current focus on individual interventions. It could also differentiate at the international level between those policies and interventions that are effective in different contexts and are therefore potentially generalizable and those that depend on particular conditions for success. PMID:16953811

The Public Health Framework of Legalized Marijuana in Colorado.

PubMed

Ghosh, Tista; Van Dyke, Mike; Maffey, Ali; Whitley, Elizabeth; Gillim-Ross, Laura; Wolk, Larry

2016-01-01

On January 1, 2014, Colorado became the first state in the nation to sell legal recreational marijuana for adult use. As a result, Colorado has had to carefully examine potential population health and safety impacts as well as the role of public health in response to legalization. We have discussed an emerging public health framework for legalized recreational marijuana. We have outlined this framework according to the core public health functions of assessment, policy development, and assurance. In addition, we have discussed challenges to implementing this framework that other states considering legalization may face.

Citizen Science for public health.

PubMed

Den Broeder, Lea; Devilee, Jeroen; Van Oers, Hans; Schuit, A Jantine; Wagemakers, Annemarie

2018-06-01

Community engagement in public health policy is easier said than done. One reason is that public health policy is produced in a complex process resulting in policies that may appear not to link up to citizen perspectives. We therefore address the central question as to whether citizen engagement in knowledge production could enable inclusive health policy making. Building on non-health work fields, we describe different types of citizen engagement in scientific research, or 'Citizen Science'. We describe the challenges that Citizen Science poses for public health, and how these could be addressed. Despite these challenges, we expect that Citizen Science or similar approaches such as participatory action research and 'popular epidemiology' may yield better knowledge, empowered communities, and improved community health. We provide a draft framework to enable evaluation of Citizen Science in practice, consisting of a descriptive typology of different kinds of Citizen Science and a causal framework that shows how Citizen Science in public health might benefit both the knowledge produced as well as the 'Citizen Scientists' as active participants.

Banning shisha smoking in public places in Iran: an advocacy coalition framework perspective on policy process and change.

PubMed

Khayatzadeh-Mahani, Akram; Breton, Eric; Ruckert, Arne; Labonté, Ronald

2017-07-01

Shisha smoking is a widespread custom in Iran with a rapidly growing prevalence especially among the youth. In this article, we analyze the policy process of enforcing a federal/state ban on shisha smoking in all public places in Kerman Province, Iran. Guided by the Advocacy Coalition Framework (ACF), we investigate how a shisha smoking ban reached the political agenda in 2011, how it was framed by different policy actors, and why no significant breakthrough took place despite its inclusion on the agenda. We conducted a qualitative study using a case study approach. Two main sources of data were employed: face-to-face in-depth interviews and document analysis of key policy texts. We interviewed 24 policy actors from diverse sectors. A qualitative thematic framework, incorporating both inductive and deductive analyses, was employed to analyze our data. We found that the health sector was the main actor pushing the issue of shisha smoking onto the political agenda by framing it as a public health risk. The health sector and its allies advocated enforcement of a federal law to ban shisha smoking in all public places including teahouses and traditional restaurants whereas another group of actors opposed the ban. The pro-ban group was unable to neutralize the strategies of the anti-ban group and to steer the debate towards the health harms of shisha smoking. Our analysis uncovers three main reasons behind the policy stasis: lack of policy learning due to lack of agreement over evidence and related analytical conflicts between the two groups linked to differences in core and policy beliefs; the inability of the pro-ban group to exploit opportunities in the external policy subsystem through generating stronger public support for enforcement of the shisha smoking ban; and the nature of the institutional setting, in particular the autocratic governance of CHFS which contributed to a lack of policy learning within the policy subsystem. Our research demonstrated the utility of ACF as a theoretical framework for analyzing the policy process and policy change to promote tobacco control. It shows the importance of accounting for policy actors' belief systems and issue-framing in understanding how some issues get more prominence in the policy-making process than others. Our findings further indicate a need for significant resources employed by the state through public awareness campaigns to change public perceptions of shisha smoking in Iran which is a deeply anchored cultural practice. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2017; all rights reserved.

Analysis of Public Policies for Sexuality Education in Germany and The Netherlands

ERIC Educational Resources Information Center

Aronowitz, Teri; Fawcett, Jacqueline

2015-01-01

The purpose of this article is to present an analysis of the philosophical, historical, sociological, political, and economic perspectives reflected in the public policies about lifespan sexuality education of Germany and The Netherlands. A new conceptual framework for analysis and evaluation of sexuality education policies that integrates the…

One Framework to Unite Them All? Use of the CEFR in European University Entrance Policies

ERIC Educational Resources Information Center

Deygers, Bart; Zeidler, Beate; Vilcu, Dina; Carlsen, Cecilie Hamnes

2018-01-01

Fifteen years after its publication, the Common European Framework of Reference for Languages is a commonly used document in language tests and policies across Europe. This article considers the CEFR's impact on university entrance language tests and policies that are used to regulate the entrance of international L2 students who wish to study in…

Global oral health in the framework of the Global Charter for the Public's Health.

PubMed

Lee, Hyewon; Lomazzi, Marta; Lee, Aimee; Bedi, Raman

2018-05-01

Oral diseases are a neglected epidemic affecting all ages globally and can substantially impact overall health and well-being. Even though most oral diseases are preventable and share major risk factors with other non-communicable diseases, integration of oral health into public health systems is still limited in both clinical and health policy perspectives. This Viewpoint aims to highlight oral health from a global health perspective, calling for all public health leaders to advocate for oral health of all. We strongly recommend oral health as an essential part of public health policy and oral health-related activities to be aligned with the Global Charter for the Public's Health Framework.

Standardization and Digital Enclosure: The Privatization of Standards, Knowledge, and Policy in the Age of Global Information Technology. Part of the Advances in IT Standards and Standardization Research (AISSR) Book Series

ERIC Educational Resources Information Center

Schoechle, Timothy, Ed.

2009-01-01

Recent trends have shown increasing privatization of standardization activities under various corporations, trade associations, and consortia, raising significant public policy issues about how the public interest may be represented. This book establishes a framework of analysis for public policy discussion and debate. Discussing topics such as…

A Policy Framework for Joint Use: Enabling and Supporting Community Use of K-12 Public School Facilities

ERIC Educational Resources Information Center

Filardo, Mary; Vincent, Jeffrey M.

2014-01-01

Joint use of public school facilities is a complex but manageable approach to efficiently enhancing the services and programs available to students and supporting the community use of public schools. Building upon on our 2010 paper titled "Joint Use of Public Schools: A Framework for a New Social Contract," this paper identifies the…

An investigation of the ways in which public health nutrition policy and practices can address climate change.

PubMed

Sulda, Heidi; Coveney, John; Bentley, Michael

2010-03-01

To develop a framework to guide action in the public health nutrition workforce to develop policies and practices addressing factors contributing to climate change. Action/consultative research. Interviews - South Australia, questionnaire - Australia. Interviews - key informants (n 6) were from various government, academic and non-government positions, invited through email. Questionnaire - participants were members of the public health nutrition workforce (n 186), recruited to the study through emails from public health nutrition contacts for each State in Australia (with the exception of South Australia). Support by participants for climate change as a valid role for dietitians and nutritionists was high (78 %). However, climate change was ranked low against other public health nutrition priorities. Support of participants to conduct programmes to address climate change from professional and work organisations was low. The final framework developed included elements of advocacy/lobbying, policy, professional recognition/support, organisational support, knowledge/skills, partnerships and programmes. This research demonstrates a need for public health nutrition to address climate change, which requires support by organisations, policy, improved knowledge and increased professional development opportunities.

Development of a Rural Health Framework: Implications for Program Service Planning and Delivery

PubMed Central

White, Deanna

2013-01-01

Purpose: To describe the development and application of an evidence-based Rural Health Framework to guide rural health program, policy and service planning. Methods: A literature review of rural health programs, focusing on health promotion, chronic disease prevention and population health, was conducted using several bibliographic databases. Findings: Thirty papers met the criteria for review, describing chronic disease interventions and public health policies in rural settings. Twenty-one papers demonstrated effective intervention programs and highlighted potential good practices for rural health programs, which were used to define key elements of a Rural Health Framework. Conclusions: The Rural Health Framework was applied to an influenza immunization program to demonstrate its utility in assisting public health providers to increase uptake of the vaccine. This Rural Health Framework provides an opportunity for program planners to reflect on the key issues facing rural communities to ensure the development of policies and strategies that will prudently and effectively meet population health needs. PMID:23968625

Upending the social ecological model to guide health promotion efforts toward policy and environmental change.

PubMed

Golden, Shelley D; McLeroy, Kenneth R; Green, Lawrence W; Earp, Jo Anne L; Lieberman, Lisa D

2015-04-01

Efforts to change policies and the environments in which people live, work, and play have gained increasing attention over the past several decades. Yet health promotion frameworks that illustrate the complex processes that produce health-enhancing structural changes are limited. Building on the experiences of health educators, community activists, and community-based researchers described in this supplement and elsewhere, as well as several political, social, and behavioral science theories, we propose a new framework to organize our thinking about producing policy, environmental, and other structural changes. We build on the social ecological model, a framework widely employed in public health research and practice, by turning it inside out, placing health-related and other social policies and environments at the center, and conceptualizing the ways in which individuals, their social networks, and organized groups produce a community context that fosters healthy policy and environmental development. We conclude by describing how health promotion practitioners and researchers can foster structural change by (1) conveying the health and social relevance of policy and environmental change initiatives, (2) building partnerships to support them, and (3) promoting more equitable distributions of the resources necessary for people to meet their daily needs, control their lives, and freely participate in the public sphere. © 2015 Society for Public Health Education.

Model-Based Policymaking: A Framework to Promote Ethical "Good Practice" in Mathematical Modeling for Public Health Policymaking.

PubMed

Boden, Lisa A; McKendrick, Iain J

2017-01-01

Mathematical models are increasingly relied upon as decision support tools, which estimate risks and generate recommendations to underpin public health policies. However, there are no formal agreements about what constitutes professional competencies or duties in mathematical modeling for public health. In this article, we propose a framework to evaluate whether mathematical models that assess human and animal disease risks and control strategies meet standards consistent with ethical "good practice" and are thus "fit for purpose" as evidence in support of policy. This framework is derived from principles of biomedical ethics: independence, transparency (autonomy), beneficence/non-maleficence, and justice. We identify ethical risks associated with model development and implementation and consider the extent to which scientists are accountable for the translation and communication of model results to policymakers so that the strengths and weaknesses of the scientific evidence base and any socioeconomic and ethical impacts of biased or uncertain predictions are clearly understood. We propose principles to operationalize a framework for ethically sound model development and risk communication between scientists and policymakers. These include the creation of science-policy partnerships to mutually define policy questions and communicate results; development of harmonized international standards for model development; and data stewardship and improvement of the traceability and transparency of models via a searchable archive of policy-relevant models. Finally, we suggest that bespoke ethical advisory groups, with relevant expertise and access to these resources, would be beneficial as a bridge between science and policy, advising modelers of potential ethical risks and providing overview of the translation of modeling advice into policy.

The Public Health Framework of Legalized Marijuana in Colorado

PubMed Central

Van Dyke, Mike; Maffey, Ali; Whitley, Elizabeth; Gillim-Ross, Laura; Wolk, Larry

2016-01-01

On January 1, 2014, Colorado became the first state in the nation to sell legal recreational marijuana for adult use. As a result, Colorado has had to carefully examine potential population health and safety impacts as well as the role of public health in response to legalization. We have discussed an emerging public health framework for legalized recreational marijuana. We have outlined this framework according to the core public health functions of assessment, policy development, and assurance. In addition, we have discussed challenges to implementing this framework that other states considering legalization may face. PMID:26562117

What can we learn from international comparisons of health systems and health system reform?

PubMed Central

McPake, B.; Mills, A.

2000-01-01

Most commonly, lessons derived from comparisons of international health sector reform can only be generalized in a limited way to similar countries. However, there is little guidance as to what constitutes "similarity" in this respect. We propose that a framework for assessing similarity could be derived from the performance of individual policies in different contexts, and from the cause and effect processes related to the policies. We demonstrate this process by considering research evidence in the "public-private mix", and propose variables for an initial framework that we believe determine private involvement in the public health sector. The most influential model of public leadership places the private role in a contracting framework. Research in countries that have adopted this model suggests an additional list of variables to add to the framework. The variables can be grouped under the headings "demand factors", "supply factors", and "strength of the public sector". These illustrate the nature of a framework that could emerge, and which would help countries aiming to learn from international experience. PMID:10916918

Understanding policies and physical activity: frontiers of knowledge to improve population health.

PubMed

Eyler, Amy; Brownson, Ross; Schmid, Tom; Pratt, Michael

2010-03-01

With increasing evidence of the detrimental effects of physical inactivity, there is interest in enhancing research on policies that may influence physical activity in communities. Given the potential policy impact, a framework that organized and conceptualized policy interventions and priorities for public health efforts to promote physical activity was developed. In addition, the Physical Activity Policy Research Network (PAPRN) was formed as a way to operationalize the contents of the framework. Recommendations for future work in this area include enhancing transdisciplinary collaborations, raising the priority of policy evaluation, studying policies at all levels, and emphasizing dissemination of findings.

Integrating uncertainty into public energy research and development decisions

NASA Astrophysics Data System (ADS)

Anadón, Laura Díaz; Baker, Erin; Bosetti, Valentina

2017-05-01

Public energy research and development (R&D) is recognized as a key policy tool for transforming the world's energy system in a cost-effective way. However, managing the uncertainty surrounding technological change is a critical challenge for designing robust and cost-effective energy policies. The design of such policies is particularly important if countries are going to both meet the ambitious greenhouse-gas emissions reductions goals set by the Paris Agreement and achieve the required harmonization with the broader set of objectives dictated by the Sustainable Development Goals. The complexity of informing energy technology policy requires, and is producing, a growing collaboration between different academic disciplines and practitioners. Three analytical components have emerged to support the integration of technological uncertainty into energy policy: expert elicitations, integrated assessment models, and decision frameworks. Here we review efforts to incorporate all three approaches to facilitate public energy R&D decision-making under uncertainty. We highlight emerging insights that are robust across elicitations, models, and frameworks, relating to the allocation of public R&D investments, and identify gaps and challenges that remain.

Policymaking to preserve privacy in disclosure of public health data: a suggested framework.

PubMed

Mizani, Mehrdad A; Baykal, Nazife

2015-03-01

Health organisations in Turkey gather a vast amount of valuable individual data that can be used for public health purposes. The organisations use rigid methods to remove some useful details from the data while publishing the rest of the data in a highly aggregated form, mostly because of privacy concerns and lack of standardised policies. This action leads to information loss and bias affecting public health research. Hence, organisations need dynamic policies and well-defined procedures rather than a specific algorithm to protect the privacy of individual data. To address this need, we developed a framework for the systematic application of anonymity methods while reducing and objectively reporting the information loss without leaking confidentiality. This framework acts as a roadmap for policymaking by providing high-level pseudo-policies with semitechnical guidelines in addition to some sample scenarios suitable for policymakers, public health programme managers and legislators. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Public-Private Divide in Ethiopian Higher Education: Issues and Policy Implications

ERIC Educational Resources Information Center

Nega, Mulu

2017-01-01

This article explores the current issues on the public-private divide in the Ethiopian higher education landscape and their policy implications. It critically examines issues related to legal and regulatory frameworks in order to understand the public-private divide in the Ethiopian higher education context. The article is based on two premises.…

77 FR 70124 - Policy Statement on the Scenario Design Framework for Stress Testing

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-23

... Statement on the Scenario Design Framework for Stress Testing AGENCY: Board of Governors of the Federal... Board is requesting public comment on a policy statement on the approach to scenario design for stress testing that would be used in connection with the supervisory and company-run stress tests conducted under...

78 FR 9633 - Policy Statement on the Scenario Design Framework for Stress Testing

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... Statement on the Scenario Design Framework for Stress Testing AGENCY: Board of Governors of the Federal... design for stress testing that would be used in connection with the supervisory and company-run stress...) requesting public comment on a policy statement on the approach to scenario design for stress testing that...

Research Needs for Rural Public Services.

ERIC Educational Resources Information Center

Stocker, Frederick D.

The report proposes a conceptual framework for researching key issues relating to rural public facility policy affecting such services as fire protection, water systems, roads, wastewater treatment, hospitals, and others, and identifies important research needs in this area. Major components of the framework are sources of financing (private and…

Alternative Policy Instruments. CPRE Joint Note Series.

ERIC Educational Resources Information Center

McDonnell, Lorraine M.; Elmore, Richard F.

This publication builds a conceptual framework that categorizes alternative policy instruments for educational reform into actions. It defines four categories of policy instruments and hypothesizes how each will operate in addressing different policy problems in different political and organizational contexts. Subsequent research will assess…

Policy feedback and public opinion: the role of employer responsibility in social policy.

PubMed

Gusmano, Michael K; Schlesinger, Mark; Thomas, Tracey

2002-10-01

This study extends the literature on policy feedback and explores the extent to which public attitudes reflect learning from past government initiatives. We analyze the ways in which feedback mechanisms affecting public attitudes may differ from those earlier identified in the literature. We apply this general analytic framework to help explain variation in public attitudes toward private employer involvement in health care, explore possible causal pathways, and offer some preliminary empirical tests of these hypotheses. There are different levels of public support for the notion of employer obligation involving medical care, long-term care, and the treatment of substance abuse. Our evidence suggests that lessons about the performance of institutions in each of these policy domains represent the most important effect of existing policy on public attitudes. Furthermore, these differences correspond to what one would expect based on our model of policy feedback and cannot be explained by other plausible sources of policy legitimacy.

Towards Integration of Ecosystem and Human Health: A Novel Conceptual Framework to Operationalise Ecological Public Health and to Incorporate Distal and Proximal Effects of Climate Change

NASA Astrophysics Data System (ADS)

Reis, S.; Fleming, L. E.; Beck, S.; Austen, M.; Morris, G.; White, M.; Taylor, T. J.; Orr, N.; Osborne, N. J.; Depledge, M.

2014-12-01

Conceptual models for problem framing in environmental (EIA) and health impact assessment (HIA) share similar concepts, but differ in their scientific or policy focus, methodologies and underlying causal chains, and the degree of complexity and scope. The Driver-Pressure-State-Impact-Response (DPSIR) framework used by the European Environment Agency, the OECD and others and the Integrated Science for Society and the Environment (ISSE) frameworks are widely applied in policy appraisal and impact assessments. While DPSIR is applied across different policy domains, the ISSE framework is used in Ecosystem Services assessments. The modified Driver-Pressure-State-Exposure-Effect-Action (DPSEEA) model extends DPSIR by separating exposure from effect, adding context as a modifier of effect, and susceptibility to exposures due to socio-economic, demographic or other determinants. While continuously evolving, the application of conceptual frameworks in policy appraisals mainly occurs within established discipline boundaries. However, drivers and environmental states, as well as policy measures and actions, affect both human and ecosystem receptors. Furthermore, unintended consequences of policy actions are seldom constrained within discipline or policy silos. Thus, an integrated conceptual model is needed, accounting for the full causal chain affecting human and ecosystem health in any assessment. We propose a novel model integrating HIA methods and ecosystem services in an attempt to operationalise the emerging concept of "Ecological Public Health." The conceptual approach of the ecosystem-enriched DPSEEA model ("eDPSEEA") has stimulated wide-spread debates and feedback. We will present eDPSEEA as a stakeholder engagement process and a conceptual model, using illustrative case studies of climate change as a starting point, not a complete solution, for the integration of human and ecosystem health impact assessment as a key challenge in a rapidly changing world. Rayner G and Lang T Ecological Public Health: Reshaping the Conditions for Good Health. Routledge Publishers; 2012.Reis S, Morris G, Fleming LE, Beck S, Taylor T, White M, Depledge MH, Steinle S, Sabel CE, Cowie H, Hurley F, Dick JMcP, Smith RI, Austen M (2013) Integrating Health & Environmental Impact Analysis. Public Health.

Model-Based Policymaking: A Framework to Promote Ethical “Good Practice” in Mathematical Modeling for Public Health Policymaking

PubMed Central

Boden, Lisa A.; McKendrick, Iain J.

2017-01-01

Mathematical models are increasingly relied upon as decision support tools, which estimate risks and generate recommendations to underpin public health policies. However, there are no formal agreements about what constitutes professional competencies or duties in mathematical modeling for public health. In this article, we propose a framework to evaluate whether mathematical models that assess human and animal disease risks and control strategies meet standards consistent with ethical “good practice” and are thus “fit for purpose” as evidence in support of policy. This framework is derived from principles of biomedical ethics: independence, transparency (autonomy), beneficence/non-maleficence, and justice. We identify ethical risks associated with model development and implementation and consider the extent to which scientists are accountable for the translation and communication of model results to policymakers so that the strengths and weaknesses of the scientific evidence base and any socioeconomic and ethical impacts of biased or uncertain predictions are clearly understood. We propose principles to operationalize a framework for ethically sound model development and risk communication between scientists and policymakers. These include the creation of science–policy partnerships to mutually define policy questions and communicate results; development of harmonized international standards for model development; and data stewardship and improvement of the traceability and transparency of models via a searchable archive of policy-relevant models. Finally, we suggest that bespoke ethical advisory groups, with relevant expertise and access to these resources, would be beneficial as a bridge between science and policy, advising modelers of potential ethical risks and providing overview of the translation of modeling advice into policy. PMID:28424768

Ethical Frameworks in Public Health Decision-Making: Defending a Value-Based and Pluralist Approach.

PubMed

Grill, Kalle; Dawson, Angus

2017-12-01

A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim's and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health.

An intersectionality-based policy analysis framework: critical reflections on a methodology for advancing equity.

PubMed

Hankivsky, Olena; Grace, Daniel; Hunting, Gemma; Giesbrecht, Melissa; Fridkin, Alycia; Rudrum, Sarah; Ferlatte, Olivier; Clark, Natalie

2014-12-10

In the field of health, numerous frameworks have emerged that advance understandings of the differential impacts of health policies to produce inclusive and socially just health outcomes. In this paper, we present the development of an important contribution to these efforts - an Intersectionality-Based Policy Analysis (IBPA) Framework. Developed over the course of two years in consultation with key stakeholders and drawing on best and promising practices of other equity-informed approaches, this participatory and iterative IBPA Framework provides guidance and direction for researchers, civil society, public health professionals and policy actors seeking to address the challenges of health inequities across diverse populations. Importantly, we present the application of the IBPA Framework in seven priority health-related policy case studies. The analysis of each case study is focused on explaining how IBPA: 1) provides an innovative structure for critical policy analysis; 2) captures the different dimensions of policy contexts including history, politics, everyday lived experiences, diverse knowledges and intersecting social locations; and 3) generates transformative insights, knowledge, policy solutions and actions that cannot be gleaned from other equity-focused policy frameworks. The aim of this paper is to inspire a range of policy actors to recognize the potential of IBPA to foreground the complex contexts of health and social problems, and ultimately to transform how policy analysis is undertaken.

Qualifications Frameworks in Europe: Forging the Right Links. Briefing Note

ERIC Educational Resources Information Center

Cedefop - European Centre for the Development of Vocational Training, 2013

2013-01-01

As national qualifications frameworks in Europe move closer to operation, policy integration becomes a key challenge. Introducing qualifications frameworks based on learning outcomes is now a global phenomenon. According to the recent joint publication by Cedefop, ETF and Unesco, frameworks are either established or being developed in 142…

Nudges, shoves and budges: Behavioural economic policy frameworks.

PubMed

Oliver, Adam

2018-01-01

Behavioural economics-the study of human decision making and how it sometimes deviates systematically from the assumptions of standard economic theory-has attracted a lot of attention in the health policy discourse over recent years. Many appear to believe that behavioural economic findings can be used only to help inform policies that manipulate the choices made by citizens, ie, the so-called nudge policy. However, these findings can be used to inform several different policy frameworks, from seemingly innocuous liberty-preserving changes to the contexts people operate in, to the outlawing of certain corporate behaviours. This article depicts diagrammatically, with the aid of a "behavioural policy cube" and in relation to smoking cessation interventions, the conceptual parameters of several behavioural economic-informed policy frameworks, which could be easily extended to other areas of health, and indeed broader public, policy. Copyright © 2017 John Wiley & Sons, Ltd.

Obesity Policy Action framework and analysis grids for a comprehensive policy approach to reducing obesity.

PubMed

Sacks, G; Swinburn, B; Lawrence, M

2009-01-01

A comprehensive policy approach is needed to control the growing obesity epidemic. This paper proposes the Obesity Policy Action (OPA) framework, modified from the World Health Organization framework for the implementation of the Global Strategy on Diet, Physical Activity and Health, to provide specific guidance for governments to systematically identify areas for obesity policy action. The proposed framework incorporates three different public health approaches to addressing obesity: (i) 'upstream' policies influence either the broad social and economic conditions of society (e.g. taxation, education, social security) or the food and physical activity environments to make healthy eating and physical activity choices easier; (ii) 'midstream' policies are aimed at directly influencing population behaviours; and (iii) 'downstream' policies support health services and clinical interventions. A set of grids for analysing potential policies to support obesity prevention and management is presented. The general pattern that emerges from populating the analysis grids as they relate to the Australian context is that all sectors and levels of government, non-governmental organizations and private businesses have multiple opportunities to contribute to reducing obesity. The proposed framework and analysis grids provide a comprehensive approach to mapping the policy environment related to obesity, and a tool for identifying policy gaps, barriers and opportunities.

Making Policy in the Classroom

ERIC Educational Resources Information Center

Hohmann, Ulrike

2016-01-01

The concept of street-level bureaucracy (Lipsky, 1980, 2010) examines the form and extent discretion takes in teachers' and other public policy enactors' work and how they negotiate their way through sometimes contradictory policy imperatives. It provides a framework for straddling top-down and bottom-up perspectives on policy making. In this…

[Undue tobacco industry interference in tobacco control policies in Mexico].

PubMed

Madrazo-Lajous, Alejandro; Guerrero-Alcántara, Angela

2012-06-01

OBJECTIVO: To identify tobacco industry's strategies aimed at containing the full adoption of public health policies established by the Framework Convention on Tobacco Control. Tobacco industry interference in the design, adoption and implementation of tobacco control policies has intensified since the signing of the FCTC. However, it is back in 1997 when one can trace a shift in tobacco industry strategies, adapting to political change in Mexico. This adaptation has consisted mostly in identifying emerging veto points in the chain of public policy development. Tobacco industry's interfering strategies have successfully affected Mexican policies.

Public health within the EU policy space: a qualitative study of Organized Civil Society (OCS) and the Health in All Policies (HiAP) approach.

PubMed

Franklin, P K

2016-07-01

This article reviews how Organized Civil Society (OCS) groups in the field of public health work across the boundaries between European institutions and policy areas. In particular, it explores 1) how the Health in All Policies (HiAP) approach is conducted by these groups informally within the formal governance structures, and 2) how this advocacy work creates space for public health within the broader political determinants of health. A qualitative mixed-methods framework. Political ethnography, including 20 semi-structured interviews conducted with EU health strategy stakeholders and participant observations in public health events (n = 22) in Brussels over a three-year period (2012-2015), as well as four interviews with EU Member State representatives. Three additional semi-structured interviews were conducted with World Health Organization Regional Office for Europe staff members who had been involved in the drafting of the Health 2020 framework and strategy and the accompanying main implementation pillar, European Action Plan for Strengthening Public Health Capacities and Services (EAP-PHS). The findings provide an insight into OCS work in the field of European public health, offering an account of the experiences of HiAP work conducted by the research participants. The OCS groups perceive themselves as communicators between policy areas within European institutions and between local and supranational levels. The structures and political determinants of health that impose limitations on a public institution can at points be transcended by stakeholders, who conduct HiAP work at supranational level, thus negotiating space for public health within the competitive, globalized policy space. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

77 FR 11785 - Energy Conservation Program: Public Meeting and Availability of the Framework Document for High...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Conservation Program: Public Meeting and Availability of the Framework Document for High-Intensity Discharge...) is initiating the rulemaking and data collection process to consider establishing energy conservation... Policy and Conservation Act (EPCA) (42 U.S.C. 6291, et seq.; EPCA or ``the Act'') sets forth a variety of...

Review of "The Policy Framework for Online Charter Schools"

ERIC Educational Resources Information Center

Miron, Gary

2016-01-01

Relative to earlier research, this study from the Center for Reinventing Public Education provides a more in-depth analysis of policy features across the 27 states that allow online charter schools. It presents a well-organized description of policy features and includes a set of policy recommendations that generally, but not always, follow well…

Federal Policy for Higher Education and the Dilemma of Student Financial Assistance in the 1980's.

ERIC Educational Resources Information Center

Bowman, Robert A.; Fenske, Robert H.

1982-01-01

A conceptual framework is provided for analyzing public policy formation and current federal efforts to change student aid policy by budget manipulation rather than the political process that shapes legislation. The role of the National Commission on Student Financial Assistance in future policy is discussed. (MSE)

A proposed approach to systematically identify and monitor the corporate political activity of the food industry with respect to public health using publicly available information.

PubMed

Mialon, M; Swinburn, B; Sacks, G

2015-07-01

Unhealthy diets represent one of the major risk factors for non-communicable diseases. There is currently a risk that the political influence of the food industry results in public health policies that do not adequately balance public and commercial interests. This paper aims to develop a framework for categorizing the corporate political activity of the food industry with respect to public health and proposes an approach to systematically identify and monitor it. The proposed framework includes six strategies used by the food industry to influence public health policies and outcomes: information and messaging; financial incentive; constituency building; legal; policy substitution; opposition fragmentation and destabilization. The corporate political activity of the food industry could be identified and monitored through publicly available data sourced from the industry itself, governments, the media and other sources. Steps for country-level monitoring include identification of key food industry actors and related sources of information, followed by systematic data collection and analysis of relevant documents, using the proposed framework as a basis for classification of results. The proposed monitoring approach should be pilot tested in different countries as part of efforts to increase the transparency and accountability of the food industry. This approach has the potential to help redress any imbalance of interests and thereby contribute to the prevention and control of non-communicable diseases. © 2015 World Obesity.

Helping Health Care Providers and Clinical Scientists Understand Apparently Irrational Policy Decisions.

PubMed

Demeter, Sandor J

2016-12-21

Health care providers (HCP) and clinical scientists (CS) are generally most comfortable using evidence-based rational decision-making models. They become very frustrated when policymakers make decisions that, on the surface, seem irrational and unreasonable. However, such decisions usually make sense when analysed properly. The goal of this paper to provide a basic theoretical understanding of major policy models, to illustrate which models are most prevalent in publicly funded health care systems, and to propose a policy analysis framework to better understand the elements that drive policy decision-making. The proposed policy framework will also assist HCP and CS achieve greater success with their own proposals.

Inducing the Development and Adoption of Socially Efficient Automotive Technology

DOT National Transportation Integrated Search

1978-02-01

Federal policies for inducing the development and adoption of innovative automobile technology are examined using a welfare economics framework. Socially efficient technology is defined, and criteria are identified for evaluating public policies; the...

Moving towards a new vision: implementation of a public health policy intervention.

PubMed

Valaitis, Ruta; MacDonald, Marjorie; Kothari, Anita; O'Mara, Linda; Regan, Sandra; Garcia, John; Murray, Nancy; Manson, Heather; Peroff-Johnston, Nancy; Bursey, Gayle; Boyko, Jennifer

2016-05-17

Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public's health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced their implementation. This paper explores policy implementation in two exemplar public health programs -chronic disease prevention and sexually-transmitted infection prevention - in Ontario, Canada. It examines public health service providers', managers' and senior managements' perspectives on the process of implementation of the Ontario Public Health Standards 2008 and factors influencing implementation. Public health staff from six health units representing rural, remote, large and small urban settings were included. We conducted 21 focus groups and 18 interviews between 2010 (manager and staff focus groups) and 2011 (senior management interviews) involving 133 participants. Research assistants coded transcripts and researchers reviewed these; the research team discussed and resolved discrepancies. To facilitate a breadth of perspectives, several team members helped interpret the findings. An integrated knowledge translation approach was used, reflected by the inclusion of academics as well as decision-makers on the team and as co-authors. Front line service providers often were unaware of the new policies but managers and senior management incorporated them in operational and program planning. Some participants were involved in policy development or provided feedback prior to their launch. Implementation was influenced by many factors that aligned with Greenhalgh and colleagues' empirically-based Diffusion of Innovations in Service Organizations Framework. Factors and related components that were most clearly linked to the OPHS policy implementation were: attributes of the innovation itself; adoption by individuals; diffusion and dissemination; the outer context - interorganizational networks and collaboration; the inner setting - implementation processes and routinization; and, linkage at the design and implementation stage. Multiple factors influenced public health policy implementation. Results provide empirical support for components of Greenhalgh et al's framework and suggest two additional components - the role of external organizational collaborations and partnerships as well as planning processes in influencing implementation. These are important to consider by government and public health organizations when promoting new or revised public health policies as they evolve over time. A successful policy implementation process in Ontario has helped to move public health towards the new vision.

Trauma is a public health issue.

PubMed

Magruder, Kathryn M; McLaughlin, Katie A; Elmore Borbon, Diane L

2017-01-01

Exposure to trauma is pervasive in societies worldwide and is associated with substantial costs to the individual and society, making it a significant global public health concern. We present evidence for trauma as a public health issue by highlighting the role of characteristics operating at multiple levels of influence - individual, relationship, community, and society - as explanatory factors in both the occurrence of trauma and its sequelae. Within the context of this multi-level framework, we highlight targets for prevention of trauma and its downstream consequences and provide examples of where public health approaches to prevention have met with success. Finally, we describe the essential role of public health policies in addressing trauma as a global public health issue, including key challenges for global mental health and next steps for developing and implementing a trauma-informed public health policy agenda. A public health framework is critical for understanding risk and protective factors for trauma and its aftermath operating at multiple levels of influence and generating opportunities for prevention.

People with Disability in Vocational High Schools: between School and Work

NASA Astrophysics Data System (ADS)

Haryanti, R. H.

2018-02-01

Vocational education is positioned within the framework of Vocational Education for All. Therefore, the alignment between the world of education and the world of work is an issue that is always actual within the framework of vocational education, including being an actual issue for people with disabilities. This article aims to map how the state frames disability and vocational education issues within the framework of public policy. The research was conducted using qualitative research method in which the data obtained from the study of documentation. Analysis of the data using content analysis. The results of the study show that the State Policy has not fully framed the issue of vocational education for the disabled into special policies. The vocational education policy for the disabled is still integrated in the major policies in certain institutions. No policy innovations have yet significantly provided a special place for the disabled.

Environmental performance policy indicators for the public sector: the case of the defence sector.

PubMed

Ramos, Tomás B; Alves, Inês; Subtil, Rui; Joanaz de Melo, João

2007-03-01

The development of environmental performance policy indicators for public services, and in particular for the defence sector, is an emerging issue. Despite a number of recent initiatives there has been little work done in this area, since the other sectors usually focused on are agriculture, transport, industry, tourism and energy. This type of tool can be an important component for environmental performance evaluation at policy level, when integrated in the general performance assessment system of public missions and activities. The main objective of this research was to develop environmental performance policy indicators for the public sector, specifically applied to the defence sector. Previous research included an assessment of the environmental profile, through the evaluation of how environmental management practices have been adopted in this sector and an assessment of environmental aspects and impacts. This paper builds upon that previous research, developing an indicator framework--SEPI--supported by the selection and construction of environmental performance indicators. Another aim is to discuss how the current environmental indicator framework can be integrated into overall performance management. The Portuguese defence sector is presented and the usefulness of this methodology demonstrated. Feasibility and relevancy criteria are applied to evaluate the set of indicators proposed, allowing indicators to be scored and indicators for the policy level to be obtained.

Public Health Professionals as Policy Entrepreneurs: Arkansas's Childhood Obesity Policy Experience

PubMed Central

Craig, Rebekah L.; Felix, Holly C.; Phillips, Martha M.

2010-01-01

In response to a nationwide rise in obesity, several states have passed legislation to improve school health environments. Among these was Arkansas's Act 1220 of 2003, the most comprehensive school-based childhood obesity legislation at that time. We used the Multiple Streams Framework to analyze factors that brought childhood obesity to the forefront of the Arkansas legislative agenda and resulted in the passage of Act 1220. When 3 streams (problem, policy, and political) are combined, a policy window is opened and policy entrepreneurs may advance their goals. We documented factors that produced a policy window and allowed entrepreneurs to enact comprehensive legislation. This historical analysis and the Multiple Streams Framework may serve as a roadmap for leaders seeking to influence health policy. PMID:20864715

Bridging the gap between evidence and policy for infectious diseases: How models can aid public health decision-making.

PubMed

Knight, Gwenan M; Dharan, Nila J; Fox, Gregory J; Stennis, Natalie; Zwerling, Alice; Khurana, Renuka; Dowdy, David W

2016-01-01

The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy), the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Canadian framework for applying the precautionary principle to public health issues.

PubMed

Weir, Erica; Schabas, Richard; Wilson, Kumanan; Mackie, Chris

2010-01-01

The precautionary principle has influenced environmental and public health policy. It essentially states that complete evidence of a potential risk is not required before action is taken to mitigate the effects of the potential risk. The application of precaution to public health issues is not straightforward and could paradoxically cause harm to the public's health when applied inappropriately. To avoid this, we propose a framework for applying the precautionary principle to potential public health risks. The framework consists of ten guiding questions to help establish whether a proposed application of the precautionary principle on a public health matter is based on adequacy of the evidence of causation, severity of harm and acceptability of the precautionary measures.

A critical analysis of the South African Disaster Management Act and Policy Framework.

PubMed

van Niekerk, Dewald

2014-10-01

The promulgation of the South African Disaster Management Act No. 57 of 2002 and the National Disaster Management Policy Framework of 2005 placed South Africa at the international forefront by integrating disaster risk reduction into all spheres of government through a decentralised approach. Yet, good policy and legislation do not necessarily translate into good practice. This paper provides a critical analysis of the Act and Policy Framework. Using qualitative research methods, it analyses the attitudes and perceptions of senior public officials on all levels of government, the private sector and academia. The study finds that one of the weakest aspects of the Act and Framework is the absence of clear guidance to local municipalities. The placement of the disaster risk management function on all tiers of government remains problematic, funding is inadequate and overall knowledge and capacities for disaster risk reduction are insufficient. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Contested Spaces in Policy Enactment: A Bourdieusian Analysis of Language Policy in Singapore

ERIC Educational Resources Information Center

Bokhorst-Heng, Wendy D.; Silver, Rita Elaine

2017-01-01

The basic structure and rhetoric of national language policy in multilingual Singapore has remained essentially unchanged since independence with four official languages positioned within the national quadrilingual framework and used in all public spheres, and individual bilingualism encouraged in the private sphere. However, also since…

Defense Procurement: An Analysis of Contract Management Internal Controls

DTIC Science & Technology

2015-03-22

monitoring activities component of the internal control framework. Acquisition Research Program Graduate School of Business & Public Policy - 7...Research Program Graduate School of Business & Public Policy - 24 - Naval Postgraduate School Tan, L. H. J. (2013). An analysis of internal controls and...Naval Postgraduate School, Monterey, CA 93943. Defense Procurement: An Analysis of Contract Management Internal Controls 22 March 2015 Dr. Juanita

AskFuse Origins: System Barriers to Providing the Research That Public Health Practice and Policy Partners Say They Need

ERIC Educational Resources Information Center

Rushmer, Rosemary; Shucksmith, Janet

2018-01-01

In this paper the development of askFuse is used as a case study to illustrate contextual and system barriers to universities providing useful, usable and timely research evidence in response to local practice and policy partners' stated public health research needs. Entrenched systems (research excellence framework, academic career pathways,…

Redesigning the Identities of Teachers and Leaders: A Framework for Studying New Professionalism and Educator Resistance

ERIC Educational Resources Information Center

Anderson, Gary; Cohen, Michael I.

2015-01-01

Market-based reforms of public education do more than shape policy and curriculum; they also influence educators' understanding of themselves as professionals, driving at the very core of what it means to be a teacher or leader. This article explores the effects of neoliberal policies and New Public Management practices on teachers and principals…

Exploring Nurse Leaders' Policy Participation Within the Context of a Nursing Conceptual Framework.

PubMed

Waddell, Ashley; Adams, Jeffrey M; Fawcett, Jacqueline

2017-11-01

This study was designed to describe and quantify the experiences of nurse leaders working to influence policy and to build consensus for priority skills and knowledge useful in policy efforts within the context of a nursing conceptual framework. The conceptual model for nursing and health policy and the Adams influence model were combined into a conceptual framework used to guide this two-round modified Delphi study. Twenty-two nurse leaders who were members of a state action coalition participated in the Round 1 focus group; 15 of these leaders completed the Round 2 electronic survey. Round 1 themes indicated the value of a passion for policy, the importance of clear communication, and an understanding the who and when of policy work. Round 2 data reinforced the importance of clear communication regarding policy engagement; knowing the who and when of policy closely followed, and having a passion for policy work was identified as least important. These themes inform learning objectives for nursing education and preparation for interactions with public officials because influencing policy requires knowledge, skills, and persistence. Study findings begin to describe how nurse leaders influence policy within the context of a nursing conceptual framework and generate implications for research, education, and professional practice.

Public health, science, and policy debate: being right is not enough.

PubMed

Camargo, Kenneth; Grant, Roy

2015-02-01

Public health is usually enacted through public policies, necessitating that the public engage in debates that, ideally, are grounded in solid scientific findings. Mistrust in science, however, has compromised the possibility of deriving sound policy from such debates, partially owing to justified concerns regarding undue interference and even outright manipulation by commercial interests. This situation has generated problematic impasses, one of which is the emergence of an anti-vaccination movement that is already affecting public health, with a resurgence in the United States of preventable diseases thought to have been eradicated. Drawing on British sociologist Harry Collins' work on expertise, we propose a theoretical framework in which the paralyzing, undue public distrust of science can be analyzed and, it is hoped, overcome.

Ethical analysis in public health.

PubMed

Roberts, Marc J; Reich, Michael R

2002-03-23

Public-health regularly encounters serious ethical dilemmas, such as rationing scarce resources, influencing individuals to change their behaviour, and limiting freedom to diminish disease transmission. Yet unlike medical ethics, there is no agreed-upon framework for analysing these difficulties. We offer such a framework. It distinguishes three philosophical views, often invoked in public-health discourse: positions based on outcomes (utilitarianism), positions focused on rights and opportunities (liberalism), and views that emphasise character and virtue (communitarianism). We explore critical variations within each approach, and identify practical problems that arise in addressing the ethical dimensions of health policy. We conclude by examining challenges posed by the feminist argument of ethics-of-care and by postmodern views about the nature of ethics. Health professionals need enhanced skills in applied philosophy to improve the coherence, transparency, and quality of public deliberations over ethical issues inherent in health policy.

Creating and sustaining disadvantage: the relevance of a social exclusion framework.

PubMed

Grenier, Amanda M; Guberman, Nancy

2009-03-01

Over the last decade, public home-care services for elderly people have been subject to increased rationing and changes in resource allocation. We argue that a social exclusion framework can be used to explain the impacts of current policy priorities and organisational practices. In this paper, we use the framework of social exclusion to highlight the disadvantages experienced by elderly people, particularly those who cannot afford to supplement public care with private services. We illustrate our argument by drawing on examples from previous studies with persons giving and receiving care in the province of Québec. Our focus is on seven forms of exclusion: symbolic, identity, socio-political, institutional, economic, exclusion from meaningful relations, and territorial exclusion. These illustrations suggest that policy-makers, practitioners and researchers must address the various ways in which current policy priorities can create and sustain various types of exclusion of elderly people. They also highlight the need to reconsider the current decisions made regarding the allocation of services for elderly people.

Measuring public opinion on alcohol policy: a factor analytic study of a US probability sample.

PubMed

Latimer, William W; Harwood, Eileen M; Newcomb, Michael D; Wagenaar, Alexander C

2003-03-01

Public opinion has been one factor affecting change in policies designed to reduce underage alcohol use. Extant research, however, has been criticized for using single survey items of unknown reliability to define adult attitudes on alcohol policy issues. The present investigation addresses a critical gap in the literature by deriving scales on public attitudes, knowledge, and concerns pertinent to alcohol policies designed to reduce underage drinking using a US probability sample survey of 7021 adults. Five attitudinal scales were derived from exploratory and confirmatory factor analyses addressing policies to: (1) regulate alcohol marketing, (2) regulate alcohol consumption in public places, (3) regulate alcohol distribution, (4) increase alcohol taxes, and (5) regulate youth access. The scales exhibited acceptable psychometric properties and were largely consistent with a rational framework which guided the survey construction.

'Are we there yet?' - operationalizing the concept of Integrated Public Health Policies.

PubMed

Hendriks, Anna-Marie; Habraken, Jolanda; Jansen, Maria W J; Gubbels, Jessica S; De Vries, Nanne K; van Oers, Hans; Michie, Susan; Atkins, L; Kremers, Stef P J

2014-02-01

Although 'integrated' public health policies are assumed to be the ideal way to optimize public health, it remains hard to determine how far removed we are from this ideal, since clear operational criteria and defining characteristics are lacking. A literature review identified gaps in previous operationalizations of integrated public health policies. We searched for an approach that could fill these gaps. We propose the following defining characteristics of an integrated policy: (1) the combination of policies includes an appropriate mix of interventions that optimizes the functioning of the behavioral system, thus ensuring that motivation, capability and opportunity interact in such a way that they promote the preferred (health-promoting) behavior of the target population, and (2) the policies are implemented by the relevant policy sectors from different policy domains. Our criteria should offer added value since they describe pathways in the process towards formulating integrated policy. The aim of introducing our operationalization is to assist policy makers and researchers in identifying truly integrated cases. The Behavior Change Wheel proved to be a useful framework to develop operational criteria to assess the current state of integrated public health policies in practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A state policy framework for integrating health and social services.

PubMed

McGinnis, Tricia; Crawford, Maia; Somers, Stephen A

2014-07-01

Recognizing that health is determined by a variety of interrelated factors, states are looking to connect health care, public health, and social services to help achieve improved population health, better care, and reduced cost of care. This issue brief describes three essential components for integrating health, including physical and behavioral health services and public health, and social services: (1) a coordinating mechanism, (2) quality measurement and data-sharing tools, and (3) aligned financing and payment. It also presents a five-step policy framework to help states move beyond isolated pilot efforts and establish the infrastructure necessary to support ongoing integration of health and social services, particularly for Medicaid beneficiaries.

Towards understanding the drivers of policy change: a case study of infection control policies for multi-drug resistant tuberculosis in South Africa.

PubMed

Saidi, Trust; Salie, Faatiema; Douglas, Tania S

2017-05-30

Explaining policy change is one of the central tasks of contemporary policy analysis. In this article, we examine the changes in infection control policies for multi-drug resistant tuberculosis (MDR-TB) in South Africa from the time the country made the transition to democracy in 1994, until 2015. We focus on MDR-TB infection control and refer to decentralised management as a form of infection control. Using Kingdon's theoretical framework of policy streams, we explore the temporal ordering of policy framework changes. We also consider the role of research in motivating policy changes. Policy documents addressing MDR-TB in South Africa over the period 1994 to 2014 were extracted. Literature on MDR-TB infection control in South Africa was extracted from PubMed using key search terms. The documents were analysed to identify the changes that occurred and the factors driving them. During the period under study, five different policy frameworks were implemented. The policies were meant to address the overwhelming challenge of MDR-TB in South Africa, contextualised by high prevalence of HIV infection, that threatened to undermine public health programmes and the success of antiretroviral therapy rollouts. Policy changes in MDR-TB infection control were supported by research evidence and driven by the high incidence and complexity of the disease, increasing levels of dissatisfaction among patients, challenges of physical, human and financial resources in public hospitals, and the ideologies of the political leadership. Activists and people living with HIV played an important role in highlighting the importance of MDR-TB as well as exerting pressure on policymakers, while the mass media drew public attention to infection control as both a cause of and a solution to MDR-TB. The critical factors for policy change for infection control of MDR-TB in South Africa were rooted in the socioeconomic and political environment, were supported by extensive research, and can be framed using Kingdon's policy streams approach as an interplay of the problem of the disease, political forces that prevailed and alternative proposals.

Intersection of Language, Class, Ethnicity, and Policy: Toward Disrupting Inequality for English Language Learners

ERIC Educational Resources Information Center

Jiménez-Castellanos, Oscar; García, Eugene

2017-01-01

This chapter proposes a conceptual framework that merges intersectionality and policy analysis as an analytical tool to understand the nuanced, multilayered, compounded educational inequality encountered specifically by low-income, Latino Spanish-speaking students in Arizona K-12 public schools as a function of intersecting educational policies.…

75 FR 8953 - Office of the National Coordinator for Health Information Technology HIT Policy Committee...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... a policy framework for the development and adoption of a nationwide health information technology...

How Will Welfare Reform Affect Childbearing and Family Structure Decisions? Discussion Paper.

ERIC Educational Resources Information Center

Peters, H. Elizabeth; Plotnick, Robert D.; Jeong, Se-Ook

This paper summarizes changes in key elements of welfare policy and in closely related policies on child support enforcement and sex education and family planning programs. Drawing on a conceptual framework that highlights how incentives created by public policy can affect demographic behaviors, the paper concludes that, as Congress intended,…

Smoke-Free Policies in New Zealand Public Tertiary Education Institutions

ERIC Educational Resources Information Center

Robertson, Lindsay A.; Marsh, L.

2015-01-01

The Framework Convention on Tobacco Control mandates the creation of smoke-free environments to protect non-smokers from second-hand smoke and reduce demand for tobacco. We aimed to examine the extent and nature of smoke-free campus policies at tertiary education institutions throughout New Zealand, and examine the policy development process.…

The rise and fall of Australian physical activity policy 1996 - 2006: a national review framed in an international context.

PubMed

Bellew, Bill; Schöeppe, Stephanie; Bull, Fiona C; Bauman, Adrian

2008-07-31

This paper provides an historical review of physical activity policy development in Australia for a period spanning a decade since the release of the US Surgeon General's Report on Physical Activity and Health in 1996 and including the 2004 WHO Global Strategy on Diet, Physical Activity and Health. Using our definition of 'HARDWIRED' policy criteria, this Australian review is compared with an international perspective of countries with established national physical activity policies and strategies (New Zealand, Canada, Brazil, Scotland, Switzerland, the Netherlands and Finland). Methods comprised a literature and policy review, audit of relevant web sites, document searches and surveys of international stakeholders. All these selected countries embraced multi-strategic policies and undertook monitoring of physical activity through national surveys. Few committed to policy of more than three years duration and none undertook systematic evaluation of national policy implementation. This Australian review highlights phases of innovation and leadership in physical activity-related policy, as well as periods of stagnation and decline; early efforts were amongst the best in the world but by the mid-point of this review (the year 2000), promising attempts towards development of a national intersectoral policy framework were thwarted by reforms in the Federal Sport and Recreation sector. Several well received reviews of evidence on good practices in physical activity and public health were produced in the period but leadership and resources were lacking to implement the policies and programs indicated. Latterly, widespread publicity and greatly increased public and political interest in chronic disease prevention, (especially in obesity and type 2 diabetes) have dominated the framework within which Australian policy deliberations have occurred. Finally, a national physical activity policy framework for the Health sector emerged, but not as a policy vision that was inclusive of the other essential sectors such as Education, Transport, Urban Planning as well as Sport and Recreation. Despite some progression of physical activity policy in the decade since 1995/6, this review found inconsistent policy development, both in Australia and elsewhere. Arguably, Australia has done no worse than other countries, but more effective responses to physical inactivity in populations can be built only on sustainable multi-sectoral public health policy partnerships that are well informed by evidence of effectiveness and good practice. In Australia and elsewhere prerequisites for success are political support, long-term investment and commitment to program implementation and evaluation. An urgent priority is media and political advocacy for physical activity focussed on these factors.

The rise and fall of Australian physical activity policy 1996 – 2006: a national review framed in an international context

PubMed Central

Bellew, Bill; Schöeppe, Stephanie; Bull, Fiona C; Bauman, Adrian

2008-01-01

Background This paper provides an historical review of physical activity policy development in Australia for a period spanning a decade since the release of the US Surgeon General's Report on Physical Activity and Health in 1996 and including the 2004 WHO Global Strategy on Diet, Physical Activity and Health. Using our definition of 'HARDWIRED' policy criteria, this Australian review is compared with an international perspective of countries with established national physical activity policies and strategies (New Zealand, Canada, Brazil, Scotland, Switzerland, the Netherlands and Finland). Methods comprised a literature and policy review, audit of relevant web sites, document searches and surveys of international stakeholders. Results All these selected countries embraced multi-strategic policies and undertook monitoring of physical activity through national surveys. Few committed to policy of more than three years duration and none undertook systematic evaluation of national policy implementation. This Australian review highlights phases of innovation and leadership in physical activity-related policy, as well as periods of stagnation and decline; early efforts were amongst the best in the world but by the mid-point of this review (the year 2000), promising attempts towards development of a national intersectoral policy framework were thwarted by reforms in the Federal Sport and Recreation sector. Several well received reviews of evidence on good practices in physical activity and public health were produced in the period but leadership and resources were lacking to implement the policies and programs indicated. Latterly, widespread publicity and greatly increased public and political interest in chronic disease prevention, (especially in obesity and type 2 diabetes) have dominated the framework within which Australian policy deliberations have occurred. Finally, a national physical activity policy framework for the Health sector emerged, but not as a policy vision that was inclusive of the other essential sectors such as Education, Transport, Urban Planning as well as Sport and Recreation. Conclusion Despite some progression of physical activity policy in the decade since 1995/6, this review found inconsistent policy development, both in Australia and elsewhere. Arguably, Australia has done no worse than other countries, but more effective responses to physical inactivity in populations can be built only on sustainable multi-sectoral public health policy partnerships that are well informed by evidence of effectiveness and good practice. In Australia and elsewhere prerequisites for success are political support, long-term investment and commitment to program implementation and evaluation. An urgent priority is media and political advocacy for physical activity focussed on these factors. PMID:18667088

Decision support framework for evaluating the operational environment of forest bioenergy production and use: Case of four European countries.

PubMed

Pezdevšek Malovrh, Špela; Kurttila, Mikko; Hujala, Teppo; Kärkkäinen, Leena; Leban, Vasja; Lindstad, Berit H; Peters, Dörte Marie; Rhodius, Regina; Solberg, Birger; Wirth, Kristina; Zadnik Stirn, Lidija; Krč, Janez

2016-09-15

Complex policy-making situations around bioenergy production and use require examination of the operational environment of the society and a participatory approach. This paper presents and demonstrates a three-phase decision-making framework for analysing the operational environment of strategies related to increased forest bioenergy targets. The framework is based on SWOT (strengths, weaknesses, opportunities and threats) analysis and the Simple Multi-Attribute Rating Technique (SMART). Stakeholders of four case countries (Finland, Germany, Norway and Slovenia) defined the factors that affect the operational environments, classified in four pre-set categories (Forest Characteristics and Management, Policy Framework, Technology and Science, and Consumers and Society). The stakeholders participated in weighting of SWOT items for two future scenarios with SMART technique. The first scenario reflected the current 2020 targets (the Business-as-Usual scenario), and the second scenario contained a further increase in the targets (the Increase scenario). This framework can be applied to various problems of environmental management and also to other fields where public decision-making is combined with stakeholders' engagement. The case results show that the greatest differences between the scenarios appear in Germany, indicating a notably negative outlook for the Increase scenario, while the smallest differences were found in Finland. Policy Framework was a highly rated category across the countries, mainly with respect to weaknesses and threats. Intensified forest bioenergy harvesting and utilization has potentially wide country-specific impacts which need to be anticipated and considered in national policies and public dialogue. Copyright © 2016 Elsevier Ltd. All rights reserved.

Community-Based Dialogue: Engaging Communities of Color in the United States’ Genetics Policy Conversation

PubMed Central

Bonham, Vence L.; Citrin, Toby; Modell, Stephen M.; Franklin, Tené Hamilton; Bleicher, Esther W. B.; Fleck, Leonard M.

2009-01-01

Engaging communities of color in the genetics public policy conversation is important for the translation of genetics research into strategies aimed at improving the health of all. Implementing model public participation and consultation processes can be informed by the Communities of Color Genetics Policy Project, which engaged individuals from African American and Latino communities of diverse socioeconomic levels in the process of “rational democratic deliberation” on ethical and policy issues stretching from genome research to privacy and discrimination concerns to public education. The results of the study included the development of a participatory framework based on a combination of the theory of democratic deliberation and the community-based public health model which we describe as “community-based dialogue.” PMID:19451407

LOCAL ENVIRONMENTAL POLICY CAPACITY: A FRAMEWORK FOR RESEARCH. (R825226)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Migration Related to Climate Change: Impact, Challenges and Proposed Policy Initiatives

NASA Astrophysics Data System (ADS)

Sarkar, A.

2015-12-01

Migration of human population possesses a great threat to human development and nation building. A significant cause for migration is due to change in climatic conditions and vulnerabilities associated with it. Our case study focuses on the consequent reason and impact of such migration in the coastal areas of West Bengal, India. The changes in rainfall pattern and the variation of temperature have been considered as parameters which have resulted in migration. It is worthy to note that the agricultural pattern has subsequently changed over the last two decades due to change in rainfall and temperature. India being an agriculture oriented economy, the changes in the meteorological variables have not only altered the rate of agricultural pattern but also the rate of migration. A proposed framework depicting relationship between changes in meteorological variables and the migration pattern, and an estimate of how the migration pattern is expected to change over the next century by utilizing the downscaled values of future rainfall and temperature has been analyzed. Moreover, various public policy frameworks has also been proposed through the study for addressing the challenges of migration related to climate change. The proposed public policy framework has been streamlined along the lines of various international treaties and conventions in order to integrate the policy initiatives through universalization of law and policy research.

Interest Group Conflict Over Medicaid Expansion: The Surprising Impact of Public Advocates.

PubMed

Callaghan, Timothy; Jacobs, Lawrence R

2016-02-01

We examined the potential economic, policy, and political influences on the decisions of the 50 US states to expand Medicaid under the Affordable Care Act. We related a measure of relative state progress toward Medicaid expansion updated to 2015 to each state's economic circumstances, established policy frameworks in states, partisan control of state government, and lobbyists for businesses, medical professionals, unions, and public interest organizations. The 9201 lobbyists working on health care reform in state capitols exerted a strong and significant impact on Medicaid expansion. Controlling for confounding factors (including partisanship and existing policy frameworks), we found that business and professional lobbyists exerted a negative effect on state Medicaid expansion and, unexpectedly, that public interest advocates exerted a positive effect. There are 3.1 million adults who lack coverage because they live in the 20 states that refused to expand Medicaid. Although political party and lobbyists for private interests present significant barriers in these states, legislative lobbying on behalf of the uninsured appears likely to be effective.

Policies on pets for healthy cities: a conceptual framework

PubMed Central

Rock, Melanie J.; Adams, Cindy L.; Degeling, Chris; Massolo, Alessandro; McCormack, Gavin R.

2015-01-01

Drawing on the One Health concept, and integrating a dual focus on public policy and practices of caring from the Ottawa Charter for Health Promotion, we outline a conceptual framework to help guide the development and assessment of local governments' policies on pets. This framework emphasizes well-being in human populations, while recognizing that these outcomes relate to the well-being of non-human animals. Five intersecting spheres of activity, each associated with local governments' jurisdiction over pets, are presented: (i) preventing threats and nuisances from pets, (ii) meeting pets' emotional and physical needs, (iii) procuring pets ethically, (iv) providing pets with veterinary services and (v) licensing and identifying pets. This conceptual framework acknowledges the tenets of previous health promotion frameworks, including overlapping and intersecting influences. At the same time, this framework proposes to advance our understanding of health promotion and, more broadly, population health by underscoring interdependence between people and pets as well as the dynamism of urbanized ecologies. PMID:24694682

Financing Public Education in Brazil: The Constitutional Framework

ERIC Educational Resources Information Center

Ranieri, Nina Beatriz Stocco

2010-01-01

The Brazilian government plays a significant role in both public and private education. It plans, establishes, and implements policies and legislates, regulates, finances, and subsidizes teaching and research. At the same time, the federal government in Brazil maintains public schools; authorizes, recognizes, accredits, and supervises courses and…

Using theory to identify beliefs associated with support for policies to raise the price of high-fat and high-sugar foods.

PubMed

Niederdeppe, Jeff; Porticella, Norman; Shapiro, Michael A

2012-01-01

Public policies designed to dramatically raise the price of high-fat and high-sugar foods have received substantial attention from researchers and the media. Although econometric studies suggest that these policies could reduce obesity rates, they are likely to face substantial public opposition. This study used the theory of perceived responsibility and social motivation as a framework to analyze data from a politically diverse convenience sample of 500 adults in upstate New York. The authors examined associations between attribution beliefs and policy support to identify what types of scientific evidence and accompanying messages appear most likely to generate public support for price-raising policies. Results suggest that public health advocates and health communicators could benefit from an increased emphasis on advertising for unhealthy foods as a cause of obesity and the food industry's (manufacturers, advertisers, markets, and restaurants) responsibility for addressing the problem.

A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation

PubMed Central

Dubois, Sara; Fraser, David

2013-01-01

Simple Summary Human feeding of wildlife is a world-wide phenomenon with very diverse effects on conservation, animal welfare and public safety. From a review of the motivations, types and consequences of wildlife feeding, an evaluative framework is presented to assist policy-makers, educators and managers to make ethical- and biologically-based decisions about the appropriateness of feeding wildlife in the context of research, wildlife management, tourism and recreation. Abstract Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable. PMID:26479747

Measuring Security Effectiveness and Efficiency at U.S. Commercial Airports

DTIC Science & Technology

2013-03-01

formative program evaluation and policy analysis to investigate current airport security programs. It identifies innovative public administration and...policy-analysis tools that could provide potential benefits to airport security . These tools will complement the System Based Risk Management framework if

The role of the law in reducing tuberculosis transmission in Botswana, South Africa and Zambia

PubMed Central

Emerson, Courtney N; Lederer, Philip; Lipke, Ginny; Kapata, Nathan; Lanje, Samson; Peters, Annatjie C; Zulu, Isaac; Marston, Barbara J; Miller, Bess

2016-01-01

Abstract Objective To determine whether laws and regulations in Botswana, South Africa and Zambia – three countries with a high tuberculosis and HIV infection burden – address elements of the World Health Organization (WHO) policy on tuberculosis infection control. Methods An online desk review of laws and regulations that address six selected elements of the WHO policy on tuberculosis infection control in the three countries was conducted in November 2015 using publicly available domestic legal databases. The six elements covered: (i) national policy and legal framework; (ii) health facility design, construction and use; (iii) tuberculosis disease surveillance among health workers; (iv) patients’ and health workers’ rights; (v) monitoring of infection control measures; and (vi) relevant research. Findings The six elements were found to be adequately addressed in the three countries’ laws and regulations. In all three, tuberculosis case-reporting is required, as is tuberculosis surveillance among health workers. Each country’s legal and regulatory framework also addresses the need to respect individuals’ rights and privacy while safeguarding public health. These laws and regulations create a strong foundation for tuberculosis infection control. Although the legal and regulatory frameworks thoroughly address tuberculosis infection control, their dissemination, implementation and enforcement were not assessed, nor was their impact on public health. Conclusion Laws and regulations in Botswana, South Africa and Zambia address all six selected elements of the WHO policy on tuberculosis infection control. However, the lack of data on their implementation is a limitation. Future research should assess the implementation and public health impact of laws and regulations. PMID:27274593

An evaluation framework for obesity prevention policy interventions.

PubMed

Leeman, Jennifer; Sommers, Janice; Vu, Maihan; Jernigan, Jan; Payne, Gayle; Thompson, Diane; Heiser, Claire; Farris, Rosanne; Ammerman, Alice

2012-01-01

As the emphasis on preventing obesity has grown, so have calls for interventions that extend beyond individual behaviors and address changes in environments and policies. Despite the need for policy action, little is known about policy approaches that are most effective at preventing obesity. The Centers for Disease Control and Prevention (CDC) and others are funding the implementation and evaluation of new obesity prevention policies, presenting a distinct opportunity to learn from these practice-based initiatives and build the body of evidence-based approaches. However, contributions from this policy activity are limited by the incomplete and inconsistent evaluation data collected on policy processes and outcomes. We present a framework developed by the CDC-funded Center of Excellence for Training and Research Translation that public health practitioners can use to evaluate policy interventions and identify the practice-based evidence needed to fill the gaps in effective policy approaches to obesity prevention.

An Evaluation Framework for Obesity Prevention Policy Interventions

PubMed Central

Sommers, Janice; Vu, Maihan; Jernigan, Jan; Payne, Gayle; Thompson, Diane; Heiser, Claire; Farris, Rosanne; Ammerman, Alice

2012-01-01

As the emphasis on preventing obesity has grown, so have calls for interventions that extend beyond individual behaviors and address changes in environments and policies. Despite the need for policy action, little is known about policy approaches that are most effective at preventing obesity. The Centers for Disease Control and Prevention (CDC) and others are funding the implementation and evaluation of new obesity prevention policies, presenting a distinct opportunity to learn from these practice-based initiatives and build the body of evidence-based approaches. However, contributions from this policy activity are limited by the incomplete and inconsistent evaluation data collected on policy processes and outcomes. We present a framework developed by the CDC-funded Center of Excellence for Training and Research Translation that public health practitioners can use to evaluate policy interventions and identify the practice-based evidence needed to fill the gaps in effective policy approaches to obesity prevention. PMID:22742594

Advancing the Framework: Use of Health Data—A Report of a Working Conference of the American Medical Informatics Association

PubMed Central

Bloomrosen, Meryl; Detmer, Don

2008-01-01

The fields of health informatics and biomedical research increasingly depend on the availability of aggregated health data. Yet, despite over fifteen years of policy work on health data issues, the United States (U.S.) lacks coherent policy to guide users striving to navigate the ethical, political, technical, and economic challenges associated with health data use. In 2007, building on more than a decade of previous work, the American Medical Informatics Association (AMIA) convened a panel of experts to stimulate discussion about and action on a national framework for health data use. This initiative is being carried out in the context of rapidly accelerating advances in the fields of health informatics and biomedical research, many of which are dependent on the availability of aggregated health data. Use of these data poses complex challenges that must be addressed by public policy. This paper highlights the results of the meeting, presents data stewardship as a key building block in the national framework, and outlines stewardship principles for the management of health information. The authors also introduce a taxonomy developed to focus definitions and terminology in the evolving field of health data applications. Finally, they identify areas for further policy analysis and recommend that public and private sector organizations elevate consideration of a national framework on the uses of health data to a top priority. PMID:18755988

Public trust in vaccination: an analytical framework.

PubMed

Gopichandran, Vijayaprasad

2017-01-01

While vaccination is one of the most successful public health interventions, there has always been a parallel movement against vaccines. Apart from scientific factors, the uptake of vaccinations is influenced by historical, political, sociocultural and economic factors. In India, the health system is struggling with logistical weaknesses in taking vaccination to the remotest corners; while on the other hand, some people in places where vaccination is available resist it. Unwillingness to be vaccinated is a growing problem in the developed world. This trend is gradually emerging in several parts of India as well. Other factors, such as heightened awareness of the profit motives of the vaccine industry, conflicts of interest among policy-makers, and social, cultural and religious considerations have eroded the people's trust in vaccination. This paper develops an analytical framework to assess trust in vaccination. The framework considers trust in vaccination from four perspectives - trust in the health system, the vaccine policy, vaccination providers and specific vaccines. The framework considers specific issues involved in vaccination trust, including the increasing scepticism towards medical technology, perceptions of conflicts of interest in the vaccine policy, and of lack of transparency and openness, the presence of strong alternative schools of thought, influence of the social media. The paper will conclude by arguing that engaging with communities and having a dialogue about the vaccination policy is an ethical imperative.

Trauma-Informed Social Policy: A Conceptual Framework for Policy Analysis and Advocacy

PubMed Central

Murshid, Nadine Shaanta

2016-01-01

Trauma-informed care is a service provision model used across a range of practice settings. Drawing on an extensive body of research on trauma (broadly defined as experiences that produce enduring emotional pain and distress) and health outcomes, we have argued that the principles of trauma-informed care can be extended to social policy. Citing a variety of health-related policy examples, we have described how policy can better reflect 6 core principles of trauma-informed care: safety, trustworthiness and transparency, collaboration, empowerment, choice, and intersectionality. This framework conveys a politicized understanding of trauma, reflecting the reality that trauma and its effects are not equally distributed, and offers a pathway for public health professionals to disrupt trauma-driven health disparities through policy action. PMID:26691122

From Manaus to Maputo: toward a public health and biodiversity framework.

PubMed

Romanelli, Cristina; Corvalan, Carlos; Cooper, H David; Manga, Lucien; Maiero, Marina; Campbell-Lendrum, Diarmid

2014-09-01

The linkages between human health, biodiversity, ecosystems, and the life-supporting services that they provide are varied and complex. The traditional neglect of this nexus by policy-makers perpetuates threats posed to ecosystems with potentially critical impacts on global health. The Convention on Biological Diversity and the World Health Organization recently co-convened two regional workshops on these intricate but vital linkages. From discussions held with policy-makers and experts in the biodiversity and health sectors, spanning some 50 countries in Africa and the Americas, we derive a broad framework for the development of national and regional public health and biodiversity strategies relevant to strategic planning processes in the emerging post-2015 development context.

Trying to Include but Supporting Exclusion Instead? Constructing the Roma in Slovak Educational Policies

ERIC Educational Resources Information Center

Miškolci, Jozef; Kovácová, Lucia; Kubánová, Martina

2017-01-01

Based on a social constructivist theoretical framework, this research study examines how the design of proinclusive educational policies and the general public construct the Roma students and parents in Slovakia. For this purpose, data from two selected educational policies and five focus groups conducted in five regions in Slovakia were analyzed.…

Citizen Participation in Politics: The Role of the Jury

ERIC Educational Resources Information Center

Jacobsohn, Gary J.

1977-01-01

Investigates the manner in which petit juries participate in the formulation of public policy. Of central concern is the nature of jury policy-making, involving analysis of ways in which such policy-making is manifested, and the description of a conceptual framework for political analysis of the jury. For journal availability, see SO 505 536.…

Structural adjustment and health: A conceptual framework and evidence on pathways.

PubMed

Kentikelenis, Alexander E

2017-08-01

Economic reform programs designed by the International Monetary Fund and the World Bank-so-called 'structural adjustment programs'-have formed one of the most influential policy agendas of the past four decades. To gain access to financial support from these organizations, countries-often in economic crisis-have reduced public spending, limited the role of the state, and deregulated economic activity. This article identifies the multiple components of structural adjustment, and presents a conceptual framework linking them to health systems and outcomes. Based on a comprehensive review of the academic literature, the article identifies three main pathways through which structural adjustment affects health: policies directly targeting health systems; policies indirectly impacting health systems; and policies affecting the social determinants of health. The cogency of the framework is illustrated by revisiting Greece's recent experience with structural adjustment, drawing on original IMF reports and secondary literature. Overall, the framework offers a lens through which to analyze the health consequences of structural adjustment across time, space and levels of socioeconomic development, and can be utilized in ex ante health impact assessments of these policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Public Good vs. Commercial Interest: Research Scientists in Search of an Accommodation

ERIC Educational Resources Information Center

Wong, Rose H. C.; Westwood, Robert

2010-01-01

The environment for scientific research in public organisations is undergoing radical change, particularly with commercialisation pressures and blurring of the distinction between public and private research. The commercialisation pressures are reflected in government policy frameworks and institutional contexts for scientific work which are…

Corporate practices and health: a framework and mechanisms.

PubMed

Madureira Lima, Joana; Galea, Sandro

2018-02-15

The Global Burden of Disease estimates that approximately a third of deaths worldwide are attributable to behavioural risk factors that, at their core, have the consumption of unhealthful products and exposures produced by profit driven commercial entities. We use Steven Lukes' three-dimensional view of power to guide the study of the practices deployed by commercial interests to foster the consumption of these commodities. Additionally, we propose a framework to systematically study corporations and other commercial interests as a distal, structural, societal factor that causes disease and injury. Our framework offers a systematic approach to mapping corporate activity, allowing us to anticipate and prevent actions that may have a deleterious effect on population health. Our framework may be used by, and can have utility for, public health practitioners, researchers, students, activists and other members of civil society, policy makers and public servants in charge of policy implementation. It can also be useful to corporations who are interested in identifying key actions they can take towards improving population health.

THE SHEFFIELD ALCOHOL POLICY MODEL - A MATHEMATICAL DESCRIPTION.

PubMed

Brennan, Alan; Meier, Petra; Purshouse, Robin; Rafia, Rachid; Meng, Yang; Hill-Macmanus, Daniel; Angus, Colin; Holmes, John

2014-09-30

This methodology paper sets out a mathematical description of the Sheffield Alcohol Policy Model version 2.0, a model to evaluate public health strategies for alcohol harm reduction in the UK. Policies that can be appraised include a minimum price per unit of alcohol, restrictions on price discounting, and broader public health measures. The model estimates the impact on consumers, health services, crime, employers, retailers and government tax revenues. The synthesis of public and commercial data sources to inform the model structure is described. A detailed algebraic description of the model is provided. This involves quantifying baseline levels of alcohol purchasing and consumption by age and gender subgroups, estimating the impact of policies on consumption, for example, using evidence on price elasticities of demand for alcohol, quantification of risk functions relating alcohol consumption to harms including 47 health conditions, crimes, absenteeism and unemployment, and finally monetary valuation of the consequences. The results framework, shown for a minimum price per unit of alcohol, has been used to provide policy appraisals for the UK government policy-makers. In discussion and online appendix, we explore issues around valuation and scope, limitations of evidence/data, how the framework can be adapted to other countries and decisions, and ongoing plans for further development. © 2014 The Authors. Health Economics published by John Wiley & Sons Ltd. © 2014 The Authors. Health Economics published by John Wiley & Sons Ltd.

Development of the role of public health nurses in addressing child and family poverty: a framework for action.

PubMed

Cohen, Benita E; Reutter, Linda

2007-10-01

The purpose of this paper is to invite dialogue about how public health nurses could best address child and family poverty. Their current role is reviewed and a framework for expanding this role is presented. The negative health consequences of poverty for children are well-documented worldwide. The high levels of children living in poverty in wealthy industrialized countries such as Canada should be of concern to the health sector. What role(s) can public health nurses play in addressing child and family poverty? A review of scholarly literature from Canada, the United States of America and the United Kingdom was conducted to ascertain support for public health nurses' roles in reducing poverty and its effects. We then reviewed professional standards and competencies for nursing practice in Canada. The data were collected between 2005 and 2006. Numerous nursing scholars have called for public health nurses to address the causes and consequences of poverty through policy advocacy. However, this role was less likely to be identified in professional standards and competencies, and we found little empirical evidence documenting Canadian public health nurses' efforts to engage in this role. Public health nurses' roles in relation to poverty focus primarily on assisting families living in poverty to access appropriate services rather than directing efforts at the policy level. Factors associated with this limited involvement are identified. We suggest that the conceptual framework developed by Blackburn in the United Kingdom offers direction for a more fully developed public health nursing role. Prerequisites to engaging in the strategies articulated in the framework are discussed. Given more organizational support and enhanced knowledge and skills, public health nurses could be playing a greater role in working with others to make child and family poverty history.

Behavioral economics and empirical public policy.

PubMed

Hursh, Steven R; Roma, Peter G

2013-01-01

The application of economics principles to the analysis of behavior has yielded novel insights on value and choice across contexts ranging from laboratory animal research to clinical populations to national trends of global impact. Recent innovations in demand curve methods provide a credible means of quantitatively comparing qualitatively different reinforcers as well as quantifying the choice relations between concurrently available reinforcers. The potential of the behavioral economic approach to inform public policy is illustrated with examples from basic research, pre-clinical behavioral pharmacology, and clinical drug abuse research as well as emerging applications to public transportation and social behavior. Behavioral Economics can serve as a broadly applicable conceptual, methodological, and analytical framework for the development and evaluation of empirical public policy. © Society for the Experimental Analysis of Behavior.

How do we define the policy impact of public health research? A systematic review.

PubMed

Alla, Kristel; Hall, Wayne D; Whiteford, Harvey A; Head, Brian W; Meurk, Carla S

2017-10-02

In order to understand and measure the policy impact of research we need a definition of research impact that is suited to the task. This article systematically reviewed both peer-reviewed and grey literature for definitions of research impact to develop a definition of research impact that can be used to investigate how public health research influences policy. Keyword searches of the electronic databases Web of Science, ProQuest, PubMed, EMBASE, CINAHL, Informit, PsycINFO, The Cochrane Database of Systematic Reviews and Google Scholar were conducted between August 2015 and April 2016. Keywords included 'definition' and 'policy' and 'research impact' or 'research evidence'. The search terms 'health', public health' or 'mental health' and 'knowledge transfer' or 'research translation' were used to focus the search on relevant health discipline approaches. Studies included in the review described processes, theories or frameworks associated with public health, health services or mental health policy. We identified 108 definitions in 83 publications. The key findings were that literature on research impact is growing, but only 23% of peer-reviewed publications on the topic explicitly defined the term and that the majority (76%) of definitions were derived from research organisations and funding institutions. We identified four main types of definition, namely (1) definitions that conceptualise research impacts in terms of positive changes or effects that evidence can bring about when transferred into policies (example Research Excellence Framework definition), (2) definitions that interpret research impacts as measurable outcomes (Research Councils UK), and (3) bibliometric and (4) use-based definitions. We identified four constructs underpinning these definitions that related to concepts of contribution, change, avenues and levels of impact. The dominance of bureaucratic definitions, the tendency to discuss but not define the concept of research impact, and the heterogeneity of definitions confirm the need for conceptual clarity in this area. We propose a working definition of research impact that can be used in a range of health policy contexts.

Application of a policy framework for the public funding of drugs for rare diseases.

PubMed

Winquist, Eric; Coyle, Doug; Clarke, Joe T R; Evans, Gerald A; Seager, Christine; Chan, Winnie; Martin, Janet

2014-08-01

In many countries, decisions about the public funding of drugs are preferentially based on the results of randomized trials. For truly rare diseases, such trials are not typically available, and approaches by public payers are highly variable. In view of this, a policy framework intended to fairly evaluate these drugs was developed by the Drugs for Rare Diseases Working Group (DRDWG) at the request of the Ontario Public Drug Programs. To report the initial experience of applying a novel evaluation framework to funding applications for drugs for rare diseases. Retrospective observational cohort study. Clinical effectiveness, costs, funding recommendations, funding approval. Between March 2008 and February 2013, eight drugs were evaluated using the DRDWG framework. The estimated average annual drug cost per patient ranged from 28,000 to 1,200,000 Canadian dollars (CAD). For five drugs, full evaluations were completed, specific funding recommendations were made by the DRDWG, and funding was approved after risk-sharing agreements with the manufacturers were negotiated. For two drugs, the disease indications were determined to be ineligible for consideration. For one drug, there was insufficient natural history data for the disease to provide a basis for recommendation. For the five drugs fully evaluated, 32 patients met the predefined eligibility criteria for funding, and five were denied based on predefined exclusion criteria. The framework improved transparency and consistency for evaluation and public funding of drugs for rare diseases in Ontario. The evaluation process will continue to be iteratively refined as feedback on actual versus expected clinical and economic outcomes is incorporated.

Use of evidence to support healthy public policy: a policy effectiveness–feasibility loop

PubMed Central

Bowman, Sarah; Critchley, Julia; Capewell, Simon; Husseini, Abdullatif; Maziak, Wasim; Zaman, Shahaduz; Ben Romdhane, Habiba; Fouad, Fouad; Phillimore, Peter; Unal, Belgin; Khatib, Rana; Shoaibi, Azza; Ahmad, Balsam

2012-01-01

Abstract Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a “policy effectiveness–feasibility loop” (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach. PMID:23226897

An ecofeminist conceptual framework to explore gendered environmental health inequities in urban settings and to inform healthy public policy.

PubMed

Chircop, Andrea

2008-06-01

This theoretical exploration is an attempt to conceptualize the link between gender and urban environmental health. The proposed ecofeminist framework enables an understanding of the link between the urban physical and social environments and health inequities mediated by gender and socioeconomic status. This framework is proposed as a theoretical magnifying glass to reveal the underlying logic that connects environmental exploitation on the one hand, and gendered health inequities on the other. Ecofeminism has the potential to reveal an inherent, normative conceptual analysis and argumentative justification of western society that permits the oppression of women and the exploitation of the environment. This insight will contribute to a better understanding of the mechanisms underlying gendered environmental health inequities and inform healthy public policy that is supportive of urban environmental health, particularly for low-income mothers.

Who runs public health? A mixed-methods study combining qualitative and network analyses.

PubMed

Oliver, Kathryn; de Vocht, Frank; Money, Annemarie; Everett, Martin

2013-09-01

Persistent health inequalities encourage researchers to identify new ways of understanding the policy process. Informal relationships are implicated in finding evidence and making decisions for public health policy (PHP), but few studies use specialized methods to identify key actors in the policy process. We combined network and qualitative data to identify the most influential individuals in PHP in a UK conurbation and describe their strategies to influence policy. Network data were collected by asking for nominations of powerful and influential people in PHP (n = 152, response rate 80%), and 23 semi-structured interviews were analysed using a framework approach. The most influential PHP makers in this conurbation were mid-level managers in the National Health Service and local government, characterized by managerial skills: controlling policy processes through gate keeping key organizations, providing policy content and managing selected experts and executives to lead on policies. Public health professionals and academics are indirectly connected to policy via managers. The most powerful individuals in public health are managers, not usually considered targets for research. As we show, they are highly influential through all stages of the policy process. This study shows the importance of understanding the daily activities of influential policy individuals.

Engaging policy makers in road safety research in Malaysia: a theoretical and contextual analysis.

PubMed

Tran, Nhan T; Hyder, Adnan A; Kulanthayan, Subramaniam; Singh, Suret; Umar, R S Radin

2009-04-01

Road traffic injuries (RTIs) are a growing public health problem that must be addressed through evidence-based interventions including policy-level changes such as the enactment of legislation to mandate specific behaviors and practices. Policy makers need to be engaged in road safety research to ensure that road safety policies are grounded in scientific evidence. This paper examines the strategies used to engage policy makers and other stakeholder groups and discusses the challenges that result from a multi-disciplinary, inter-sectoral collaboration. A framework for engaging policy makers in research was developed and applied to describe an example of collective road safety research in Malaysia. Key components of this framework include readiness, assessment, planning, implementation/evaluation, and policy development/sustainability. The case study of a collaborative intervention trial for the prevention of motorcycle crashes and deaths in Malaysia serves as a model for policy engagement by road safety and injury researchers. The analytic description of this research process in Malaysia demonstrates that the framework, through its five stages, can be used as a tool to guide the integration of needed research evidence into policy for road safety and injury prevention.

75 FR 25883 - China: Intellectual Property Infringement, Indigenous Innovation Policies, and Frameworks for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

...Following receipt of a request from the United States Senate Committee on Finance (Committee) dated April 19, 2010, the U.S. International Trade Commission (Commission) instituted investigation No. 332-514, China: Intellectual Property Infringement, Indigenous Innovation Policies, and Frameworks for Measuring the Effects on the U.S. Economy, for the purpose of preparing the first of two reports requested by the Committee, and has scheduled a public hearing in connection with investigations relating to both reports for June 15, 2010.

Policy guidance on threats to legislative interventions in public health: a realist synthesis.

PubMed

Wong, Geoff; Pawson, Ray; Owen, Lesley

2011-04-10

Legislation is one of the most powerful weapons for improving population health and is often used by policy and decision makers. Little research exists to guide them as to whether legislation is feasible and/or will succeed. We aimed to produce a coherent and transferable evidence based framework of threats to legislative interventions to assist the decision making process and to test this through the 'case study' of legislation to ban smoking in cars carrying children. We conceptualised legislative interventions as a complex social interventions and so used the realist synthesis method to systematically review the literature for evidence. 99 articles were found through searches on five electronic databases (MEDLINE, HMIC, EMBASE, PsychINFO, Social Policy and Practice) and iterative purposive searching. Our initial searches sought any studies that contained information on smoking in vehicles carrying children. Throughout the review we continued where needed to search for additional studies of any type that would conceptually contribute to helping build and/or test our framework. Our framework identified a series of transferable threats to public health legislation. When applied to smoking bans in vehicles; problem misidentification; public support; opposition; and enforcement issues were particularly prominent threats. Our framework enabled us to understand and explain the nature of each threat and to infer the most likely outcome if such legislation were to be proposed in a jurisdiction where no such ban existed. Specifically, the micro-environment of a vehicle can contain highly hazardous levels of second hand smoke. Public support for such legislation is high amongst smokers and non-smokers and their underlying motivations were very similar - wanting to practice the Millian principle of protecting children from harm. Evidence indicated that the tobacco industry was not likely to oppose legislation and arguments that such a law would be 'unenforceable' were unfounded. It is possible to develop a coherent and transferable evidence based framework of the ideas and assumptions behind the threats to legislative intervention that may assist policy and decision makers to analyse and judge if legislation is feasible and/or likely to succeed.

Policy guidance on threats to legislative interventions in public health: a realist synthesis

PubMed Central

2011-01-01

Background Legislation is one of the most powerful weapons for improving population health and is often used by policy and decision makers. Little research exists to guide them as to whether legislation is feasible and/or will succeed. We aimed to produce a coherent and transferable evidence based framework of threats to legislative interventions to assist the decision making process and to test this through the 'case study' of legislation to ban smoking in cars carrying children. Methods We conceptualised legislative interventions as a complex social interventions and so used the realist synthesis method to systematically review the literature for evidence. 99 articles were found through searches on five electronic databases (MEDLINE, HMIC, EMBASE, PsychINFO, Social Policy and Practice) and iterative purposive searching. Our initial searches sought any studies that contained information on smoking in vehicles carrying children. Throughout the review we continued where needed to search for additional studies of any type that would conceptually contribute to helping build and/or test our framework. Results Our framework identified a series of transferable threats to public health legislation. When applied to smoking bans in vehicles; problem misidentification; public support; opposition; and enforcement issues were particularly prominent threats. Our framework enabled us to understand and explain the nature of each threat and to infer the most likely outcome if such legislation were to be proposed in a jurisdiction where no such ban existed. Specifically, the micro-environment of a vehicle can contain highly hazardous levels of second hand smoke. Public support for such legislation is high amongst smokers and non-smokers and their underlying motivations were very similar - wanting to practice the Millian principle of protecting children from harm. Evidence indicated that the tobacco industry was not likely to oppose legislation and arguments that such a law would be 'unenforceable' were unfounded. Conclusion It is possible to develop a coherent and transferable evidence based framework of the ideas and assumptions behind the threats to legislative intervention that may assist policy and decision makers to analyse and judge if legislation is feasible and/or likely to succeed. PMID:21477347

Towards a Better Distributed Framework for Learning Big Data

DTIC Science & Technology

2017-06-14

UNLIMITED: PB Public Release 13. SUPPLEMENTARY NOTES 14. ABSTRACT This work aimed at solving issues in distributed machine learning. The PI’s team proposed...communication load. Finally, the team proposed the parallel least-squares policy iteration (parallel LSPI) to parallelize a reinforcement policy learning. 15

Putting Public Health Ethics into Practice: A Systematic Framework

PubMed Central

Marckmann, Georg; Schmidt, Harald; Sofaer, Neema; Strech, Daniel

2015-01-01

It is widely acknowledged that public health practice raises ethical issues that require a different approach than traditional biomedical ethics. Several frameworks for public health ethics (PHE) have been proposed; however, none of them provides a practice-oriented combination of the two necessary components: (1) a set of normative criteria based on an explicit ethical justification and (2) a structured methodological approach for applying the resulting normative criteria to concrete public health (PH) issues. Building on prior work in the field and integrating valuable elements of other approaches to PHE, we present a systematic ethical framework that shall guide professionals in planning, conducting, and evaluating PH interventions. Based on a coherentist model of ethical justification, the proposed framework contains (1) an explicit normative foundation with five substantive criteria and seven procedural conditions to guarantee a fair decision process, and (2) a six-step methodological approach for applying the criteria and conditions to the practice of PH and health policy. The framework explicitly ties together ethical analysis and empirical evidence, thus striving for evidence-based PHE. It can provide normative guidance to those who analyze the ethical implications of PH practice including academic ethicists, health policy makers, health technology assessment bodies, and PH professionals. It will enable those who implement a PH intervention and those affected by it (i.e., the target population) to critically assess whether and how the required ethical considerations have been taken into account. Thereby, the framework can contribute to assuring the quality of ethical analysis in PH. Whether the presented framework will be able to achieve its goals has to be determined by evaluating its practical application. PMID:25705615

A Personal Memoir of Policy Failure: The Failed Merger of ANU and the Canberra CAE

ERIC Educational Resources Information Center

Scott, Roger

2004-01-01

The more immediate context of the events the author describes in this article is needed in order to identify the policy framework within which the Australian National University (ANU)-Canberra CAE (CCAE) merger was placed as a component of a wider public policy initiative undertaken by John Dawkins. There were four major components in that wider…

Community, Public Policy, and Recovery from Mental Illness: Emerging Research and Initiatives.

PubMed

Castillo, Enrico G; Chung, Bowen; Bromley, Elizabeth; Kataoka, Sheryl H; Braslow, Joel T; Essock, Susan M; Young, Alexander S; Greenberg, Jared M; Miranda, Jeanne; Dixon, Lisa B; Wells, Kenneth B

This commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital. Initiatives that address community contexts to improve mental health outcomes are currently under way. Common characteristics of such initiatives and select examples are discussed. This commentary concludes with a discussion of providers', consumers', and other stakeholders' roles in shaping policy reform and community change to facilitate recovery.

Health 2020--achieving health and development in today's Europe.

PubMed

Jakab, Zsuzsanna; Tsouros, Agis D

2014-06-01

The 21st-century health landscape is shaped by growing global, regional and local interdependence and an increasingly complex array of interlinking factors that influence health and well-being. Most of today's major public health challenges, including noncommunicable diseases, antimicrobial resistance, health inequalities and the health effects of austerity measures in some countries, cannot be addressed effectively without intersectoral and coordinated action at supranational, national and local levels. The 53 countries of the WHO European Region developed and adopted a European policy framework and strategy for the 21st century (Health 2020) as a common, evidence-informed policy framework to support and encourage coordinated action by policy-makers at all levels and in all sectors to improve population health and well-being. This article presents the development process of Health 2020 and its main strategic goals, objectives and content. Further, we describe what is needed to successfully implement Health 2020 in countries and how can WHO provide technical assistance to countries that embark on developing health policy aligned with the Health 2020 policy framework.

Child Safety Reference Frameworks: a Policy Tool for Child Injury Prevention at the Sub-national Level.

PubMed

Scholtes, Beatrice; Schröder-Bäck, Peter; Mackay, Morag; Vincenten, Joanne; Brand, Helmut

2017-06-01

The aim of this paper is to present the Child Safety Reference Frameworks (CSRF), a policy advice tool that places evidence-based child safety interventions, applicable at the sub-national level, into a framework resembling the Haddon Matrix. The CSRF is based on work done in previous EU funded projects, which we have adapted to the field of child safety. The CSRF were populated following a literature review. Four CSRF were developed for four domains of child safety: road, water and home safety, and intentional injury prevention. The CSRF can be used as a reference, assessment and comparative tool by child safety practitioners and policy makers working at the sub-national level. Copyright© by the National Institute of Public Health, Prague 2017

Mandating influenza vaccinations for health care workers: analysing opportunities for policy change using Kingdon's agenda setting framework.

PubMed

Jackson-Lee, Angela; Barr, Neil G; Randall, Glen E

2016-09-29

The consequences of annual influenza outbreaks are often underestimated by the general public. Influenza poses a serious public health threat around the world, particularly for the most vulnerable populations. Fortunately, vaccination can mitigate the negative effects of this common infectious disease. Although inoculating frontline health care workers (HCWs) helps minimize disease transmission, some HCWs continue to resist participating in voluntary immunization programs. A potential solution to this problem is government-mandated vaccination for HCWs; however, in practice, there are substantial barriers to the adoption of such policies. The purpose of this paper is to identify the likelihood of adopting a policy for mandatory immunization of HCWs in Ontario based on a historical review of barriers to the agenda setting process. Documents from secondary data sources were analysed using Kingdon's agenda setting framework of three converging streams leading to windows of opportunity for possible policy adoption. The problems, politics, and policies streams of Kingdon's framework have converged and diverged repeatedly over an extended period (policy windows have opened and closed several times). In each instance, a technically feasible solution was available. However, despite the evidence supporting the value of HCW immunization, alignment of the three agenda setting streams occurred for very short periods of time, during which, opposition lobby groups reacted, making the proposed solution less politically acceptable. Prior to the adoption of any new policies, issues must reach a government's decision agenda. Based on Kingdon's agenda setting framework, this only occurs when there is alignment of the problems, politics, and policies streams. Understanding this process makes it easier to predict the likelihood of a policy being adopted, and ultimately implemented. Such learning may be applied to policy issues in other jurisdictions. In the case of mandatory influenza vaccinations for HCWs in Ontario, it seems highly unlikely that a new policy will be adopted until perception of the problem's importance is sufficient to overcome the political opposition to implementing a solution and thus, create a window of opportunity that is open long enough to support change.

Strategies, Systems and Services: A Northern Ireland Early Years Policy Perspective

ERIC Educational Resources Information Center

McMillan, Dorothy J.; McConnell, Barbara

2015-01-01

Following a lengthy consultation process across Northern Ireland (NI), 2013 saw the publication of Learning to Learn: A Framework for Early Years Education and Learning [DE (Department of Education). 2013. "Learning to Learn: A Framework for Early Years Education and Learning." Accessed July 15, 2014.…

78 FR 64478 - Request for Comments on the Preliminary Cybersecurity Framework

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... February 26, 2013, and a series of open public workshops. The preliminary Framework was developed in..., methodologies, procedures and processes that align policy, business, and technological approaches to address....nist.gov/itl/cyberframework.cfm . DATES: Comments must be received by 5:00 p.m. Eastern Time December...

The Politics of Childhood and Asylum in the UK

ERIC Educational Resources Information Center

Giner, Clotilde

2007-01-01

This article considers the general treatment of asylum-seeking families with children in the UK, focusing on the government's practices and public reactions to these measures. It first describes both the exclusive asylum framework, based on institutionalised suspicion, welfare restrictions and detention, and the inclusive child policy framework,…

From theoretical concepts to policies and applied programmes: the landscape of integration of oral health in primary care.

PubMed

Harnagea, Hermina; Lamothe, Lise; Couturier, Yves; Esfandiari, Shahrokh; Voyer, René; Charbonneau, Anne; Emami, Elham

2018-02-15

Despite its importance, the integration of oral health into primary care is still an emerging practice in the field of health care services. This scoping review aims to map the literature and provide a summary on the conceptual frameworks, policies and programs related to this concept. Using the Levac et al. six-stage framework, we performed a systematic search of electronic databases, organizational websites and grey literature from 1978 to April 2016. All relevant original publications with a focus on the integration of oral health into primary care were retrieved. Content analyses were performed to synthesize the results. From a total of 1619 citations, 67 publications were included in the review. Two conceptual frameworks were identified. Policies regarding oral heath integration into primary care were mostly oriented toward common risk factors approach and care coordination processes. In general, oral health integrated care programs were designed in the public health sector and based on partnerships with various private and public health organizations, governmental bodies and academic institutions. These programmes used various strategies to empower oral health integrated care, including building interdisciplinary networks, training non-dental care providers, oral health champion modelling, enabling care linkages and care coordinated process, as well as the use of e-health technologies. The majority of studies on the programs outcomes were descriptive in nature without reporting long-term outcomes. This scoping review provided a comprehensive overview on the concept of integration of oral health in primary care. The findings identified major gaps in reported programs outcomes mainly because of the lack of related research. However, the results could be considered as a first step in the development of health care policies that support collaborative practices and patient-centred care in the field of primary care sector.

The project organization as a policy tool in implementing welfare reforms in the public sector.

PubMed

Jensen, Christian; Johansson, Staffan; Löfström, Mikael

2013-01-01

Organizational design is considered in policy literature as a forceful policy tool to put policy to action. However, previous research has not analyzed the project organization as a specific form of organizational design and, hence, has not given much attention to such organizations as a strategic choice when selecting policy tools. The purpose of the article is to investigate the project as a policy tool; how do such temporary organizations function as a specific form of organization when public policy is implemented? The article is based on a framework of policy implementation and is illustrated with two welfare reforms in the Swedish public sector, which were organized and implemented as project organizations. The case studies and the analysis show that it is crucial that a project organization fits into the overall governance structure when used as a policy tool. If not, the project will remain encapsulated and will not have sufficient impact on the permanent organizational structure. The concept of encapsulation indicates a need to protect the project from a potential hostile environment. The implication of this is that organizational design as a policy tool is a matter that deserves more attention in the strategic discussion on implementing public policies and on the suitability of using certain policy tools. Copyright © 2012 John Wiley & Sons, Ltd.

The Fairness Committee: Restorative Justice in a Small Urban Public High School

ERIC Educational Resources Information Center

Hantzopoulos, Maria

2013-01-01

Rather than creating safer schools, punitive policies--such as zero-tolerance discipline policies--appear only to have created hostile learning environments. In response, many advocacy organizations have urged schools to adopt a human rights framework, including restorative practices. Schools with restorative approaches have noted dramatic…

76 FR 9782 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access... policy framework for the development and adoption of a nationwide health information technology...

75 FR 51819 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-23

... Coordinator for Health Information Technology, HHS. ACTION: Notice of meeting. This notice announces a... Information Technology (ONC). The meeting will be open to the public. Name of Committee: HIT Policy Committee... framework for the development and adoption of a nationwide health [[Page 51820

75 FR 36658 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access... policy framework for the development and adoption of a nationwide health information technology...

76 FR 4352 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

... Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access... policy framework for the development and adoption of a nationwide health information technology...

The World report on ageing and health: a policy framework for healthy ageing

PubMed Central

Beard, John R; Officer, Alana; de Carvalho, Islene Araujo; Sadana, Ritu; Pot, Anne Margriet; Michel, Jean-Pierre; Lloyd-Sherlock, Peter; Epping-Jordan, JoAnne E; Peeters, G M E E (Geeske); Mahanani, Wahyu Retno; Thiyagarajan, Jotheeswaran Amuthavalli; Chatterji, Somnath

2015-01-01

Although populations around the world are rapidly ageing, evidence that increasing longevity is being accompanied by an extended period of good health is scarce. A coherent and focused public health response that spans multiple sectors and stakeholders is urgently needed. To guide this global response, WHO has released the first World report on ageing and health, reviewing current knowledge and gaps and providing a public health framework for action. The report is built around a redefinition of healthy ageing that centres on the notion of functional ability: the combination of the intrinsic capacity of the individual, relevant environmental characteristics, and the interactions between the individual and these characteristics. This Health Policy highlights key findings and recommendations from the report. PMID:26520231

A Framework to Evaluate Wildlife Feeding in Research, Wildlife Management, Tourism and Recreation.

PubMed

Dubois, Sara; Fraser, David

2013-10-11

Feeding of wildlife occurs in the context of research, wildlife management, tourism and in opportunistic ways. A review of examples shows that although feeding is often motivated by good intentions, it can lead to problems of public safety and conservation and be detrimental to the welfare of the animals. Examples from British Columbia illustrate the problems (nuisance animal activity, public safety risk) and consequences (culling, translocation) that often arise from uncontrolled feeding. Three features of wildlife feeding can be distinguished: the feasibility of control, the effects on conservation and the effects on animal welfare. An evaluative framework incorporating these three features was applied to examples of feeding from the literature. The cases of feeding for research and management purposes were generally found to be acceptable, while cases of feeding for tourism or opportunistic feeding were generally unacceptable. The framework should allow managers and policy-makers to distinguish acceptable from unacceptable forms of wildlife feeding as a basis for policy, public education and enforcement. Many harmful forms of wildlife feeding seem unlikely to change until they come to be seen as socially unacceptable.

Public preferences over efficiency, equity and autonomy in vaccination policy: an empirical study.

PubMed

Luyten, Jeroen; Dorgali, Veronica; Hens, Niel; Beutels, Philippe

2013-01-01

Vaccination programs increasingly have to comply with standards of evidence-based decision making. However, such a framework tends to ignore social and ethical sensitivities, risking policy choices that lack crucial public support. Research is needed under which circumstances and to which extent equity and autonomy should prevail over effectiveness and cost-effectiveness in matters of infectious disease prevention. We report on a study investigating public preferences over various vaccination policy options, based on a population survey held in Flanders, Belgium (N = 1049) between March and July 2011. We found (1) that public support varied considerably between policies that were equally efficient in preventing disease but differed according to target group or incentives to improve uptake and (2) that preferences over the use of legal compulsion, financial accountability or the offering of rewards appear to be driven by individuals' social orientation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Policies on pets for healthy cities: a conceptual framework.

PubMed

Rock, Melanie J; Adams, Cindy L; Degeling, Chris; Massolo, Alessandro; McCormack, Gavin R

2015-12-01

Drawing on the One Health concept, and integrating a dual focus on public policy and practices of caring from the Ottawa Charter for Health Promotion, we outline a conceptual framework to help guide the development and assessment of local governments' policies on pets. This framework emphasizes well-being in human populations, while recognizing that these outcomes relate to the well-being of non-human animals. Five intersecting spheres of activity, each associated with local governments' jurisdiction over pets, are presented: (i) preventing threats and nuisances from pets, (ii) meeting pets' emotional and physical needs, (iii) procuring pets ethically, (iv) providing pets with veterinary services and (v) licensing and identifying pets. This conceptual framework acknowledges the tenets of previous health promotion frameworks, including overlapping and intersecting influences. At the same time, this framework proposes to advance our understanding of health promotion and, more broadly, population health by underscoring interdependence between people and pets as well as the dynamism of urbanized ecologies. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The problem with the phrase women and minorities: intersectionality-an important theoretical framework for public health.

PubMed

Bowleg, Lisa

2012-07-01

Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). Public health's commitment to social justice makes it a natural fit with intersectionality's focus on multiple historically oppressed populations. Yet despite a plethora of research focused on these populations, public health studies that reflect intersectionality in their theoretical frameworks, designs, analyses, or interpretations are rare. Accordingly, I describe the history and central tenets of intersectionality, address some theoretical and methodological challenges, and highlight the benefits of intersectionality for public health theory, research, and policy.

The Problem With the Phrase Women and Minorities: Intersectionality—an Important Theoretical Framework for Public Health

PubMed Central

2012-01-01

Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). Public health’s commitment to social justice makes it a natural fit with intersectionality’s focus on multiple historically oppressed populations. Yet despite a plethora of research focused on these populations, public health studies that reflect intersectionality in their theoretical frameworks, designs, analyses, or interpretations are rare. Accordingly, I describe the history and central tenets of intersectionality, address some theoretical and methodological challenges, and highlight the benefits of intersectionality for public health theory, research, and policy. PMID:22594719

Interest Group Conflict Over Medicaid Expansion: The Surprising Impact of Public Advocates

PubMed Central

Callaghan, Timothy

2016-01-01

Objectives. We examined the potential economic, policy, and political influences on the decisions of the 50 US states to expand Medicaid under the Affordable Care Act. Methods. We related a measure of relative state progress toward Medicaid expansion updated to 2015 to each state’s economic circumstances, established policy frameworks in states, partisan control of state government, and lobbyists for businesses, medical professionals, unions, and public interest organizations. Results. The 9201 lobbyists working on health care reform in state capitols exerted a strong and significant impact on Medicaid expansion. Controlling for confounding factors (including partisanship and existing policy frameworks), we found that business and professional lobbyists exerted a negative effect on state Medicaid expansion and, unexpectedly, that public interest advocates exerted a positive effect. Conclusions. There are 3.1 million adults who lack coverage because they live in the 20 states that refused to expand Medicaid. Although political party and lobbyists for private interests present significant barriers in these states, legislative lobbying on behalf of the uninsured appears likely to be effective. PMID:26691109

Looking Back, Going Forward: The Carnegie Commission Tuition Policy. The New Millennium Project on Higher Education Costs, Pricing, and Productivity Working Paper.

ERIC Educational Resources Information Center

Wellman, Jane V.

In thinking about the design of public policy for higher education finance, it may be instructive to look back at the evolution of finance policy and how it has worked over the last three decades of U.S. higher education. The vehicle for this exploration is the tuition policy framework developed by the Carnegie Commission on Higher Education…

An evaluation framework for funding drugs for rare diseases.

PubMed

Winquist, Eric; Bell, Chaim M; Clarke, Joe T R; Evans, Gerald; Martin, Janet; Sabharwal, Mona; Gadhok, Anita; Stevenson, Helen; Coyle, Doug

2012-01-01

For rare diseases it may be difficult to generate data from randomized trials to support funding of a drug. Enzyme replacement therapies for diseases of inherited metabolic enzyme deficiency provide an example of this dilemma. The Ontario Public Drug Programs convened the Drugs for Rare Diseases Working Group to develop a policy for assessing these drugs. The Drugs for Rare Diseases Working Group developed terms of reference expecting that the ideal policy product would be transparent and consistent and address unique aspects of the treatment of a specific rare condition while being adaptable to other dissimilar conditions. The perspective was that of a public payer addressing requests for funding generated for a specific drug, and included respect for the principles of "accountability for reasonableness" of Daniels and Sabin. A seven-step framework was developed and tested by using the case study of idursulfase for mucopolysaccharidosis II (Hunter disease). Estimation of clinical effectiveness was done by using decision modeling. The model developed informed funding recommendations and ultimately led to an agreement with the manufacturer allowing funding of idursulfase in Ontario. This policy framework attempts to address the policy challenges of funding drugs for rare diseases. The framework will be used to assess other drugs in future and will inevitably require modification with experience. It is hoped that it may be of value to other policymakers. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

India's Proposed Universal Health Coverage Policy: Evidence for Age Structure Transition Effect and Fiscal Sustainability.

PubMed

Narayana, Muttur Ranganathan

2016-12-01

India's High Level Expert Group on Universal Health Coverage in 2011 recommended a universal, public-funded and national health coverage policy. As a plausible forward-looking macroeconomic reform in the health sector, this policy proposal on universal health coverage (UHC) needs to be evaluated for age structure transition effect and fiscal sustainability to strengthen its current design and future implementation. Macroeconomic analyses of the long-term implications of age structure transition and fiscal sustainability on India's proposed UHC policy. A new measure of age-specific UHC is developed by combining the age profile of public and private health consumption expenditure by using the National Transfer Accounts methodology. Different projections of age-specific public health expenditure are calculated over the period 2005-2100 to account for the age structure transition effect. The projections include changes in: (1) levels of the expenditure as gross domestic product grows, (2) levels and shape of the expenditure as gross domestic product grows and expenditure converges to that of developed countries (or convergence scenario) based on the Lee-Carter model of forecasting mortality rates, and (3) levels of the expenditure as India moves toward a UHC policy. Fiscal sustainability under each health expenditure projection is determined by using the measures of generational imbalance and sustainability gap in the Generational Accounting methodology. Public health expenditure is marked by age specificities and the elderly population is costlier to support for their healthcare needs in the future. Given the discount and productivity growth rates, the proposed UHC is not fiscally sustainable under India's current fiscal policies except for the convergence scenario. However, if the income elasticity of public expenditure on social welfare and health expenditure is less than one, fiscal sustainability of the UHC policy is attainable in all scenarios of projected public health expenditures. These new results strengthen the proposed UHC policy by accounting for age structure transition effect and justifying its sustainability within the framework of India's current fiscal policies. The age structure transition effect is important to incorporate the age-specific cost and benefit of the proposed UHC policy, especially as India moves toward an ageing society. Fiscal sustainability is essential to ensure that the proposed UHC is implementable on a long-term basis and within the framework of current fiscal policies.

Ethics in American health 1: ethical approaches to health policy.

PubMed

Ruger, Jennifer Prah

2008-10-01

I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy.

Legislator voting and behavioral science theory: a systematic review.

PubMed

Tung, Gregory J; Vernick, Jon S; Reiney, Erin V; Gielen, Andrea C

2012-11-01

To examine the application of behavioral science theories to explain the voting behavior of legislators for public health policies. We conducted a systematic review to identify studies that examined factors associated with legislator support, intention to vote, or actual votes on public health policies, emphasizing those grounded in behavior science theory. Twenty-one papers met our inclusion criteria, and 6 were explicitly grounded in a behavioral science theory. Behavioral science theories, and the theory of planned behavior in particular, provide a framework for understanding legislator voting behavior and can be used by advocates to advance pro-health policies.

Development of a framework to improve the utilisation of malaria research for policy development in Malawi.

PubMed

Mwendera, Chikondi; de Jager, Christiaan; Longwe, Herbert; Hongoro, Charles; Phiri, Kamija; Mutero, Clifford M

2017-11-21

The existing gap between research evidence and public health practice has attributed to the unmet Millennium Development Goals in Africa and consequently, has stimulated the development of frameworks to enhance knowledge translation. These efforts aim at maximising health research utilisation in policy and practice to address the world's disease burdens, including malaria. This study aimed at developing a contextual framework to improve the utilisation of malaria research for policy development in Malawi. The study used two approaches including: two case studies of policy analysis exploring the policy-making process in Malawi, utilisation of local malaria research, and the role of key stakeholders in policy formulation process; and the assessment of facilitating factors and barriers to malaria research utilisation for policy-making in Malawi. From the case studies' lessons and elements identified during the assessment of facilitating factors and barriers, a framework is developed to promote an integrated approach to knowledge translation. In this framework the Ministry of Health is considered as the main user of knowledge from research through the demand created by the research directorate and the National Malaria Control Programme. Key documents identified as being particularly relevant to the Ministry of Health for purposes of knowledge translation include the National Health Research Agenda, Guidelines for Policy Development and Analysis, and Guidelines for Evidence Use in Policy-making. Institutions conducting academic and policy-relevant malaria research in Malawi are identified and a consolidation of their linkages with the users of research is established through the Knowledge Translation Unit, the Evidence Informed decision-making Centre, and the African Institute for Development Policy. Equally, key players in this framework are the funding partners for both research and programmes that need to see accountability and impact of their support. Independent advisors, partners, and consultants also have their vital role in the process. The framework offers a practical basis for the factors identified and their linkages to promote a co-ordinated approach to malaria research utilisation in policy-making. Its applicability and success hinges on its wider dissemination and ownership by the government through the National Malaria Control Programme.

A Mixed Methods Approach to Code Stakeholder Beliefs in Urban Water Governance

NASA Astrophysics Data System (ADS)

Bell, E. V.; Henry, A.; Pivo, G.

2017-12-01

What is a reliable way to code policies to represent belief systems? The Advocacy Coalition Framework posits that public policy may be viewed as manifestations of belief systems. Belief systems include both ontological beliefs about cause-and-effect relationships and policy effectiveness, as well as normative beliefs about appropriate policy instruments and the relative value of different outcomes. The idea that belief systems are embodied in public policy is important for urban water governance because it trains our focus on belief conflict; this can help us understand why many water-scarce cities do not adopt innovative technology despite available scientific information. To date, there has been very little research on systematic, rigorous methods to measure the belief system content of public policies. We address this by testing the relationship between beliefs and policy participation to develop an innovative coding framework. With a focus on urban water governance in Tucson, Arizona, we analyze grey literature on local water management. Mentioned policies are coded into a typology of common approaches identified in urban water governance literature, which include regulation, education, price and non-price incentives, green infrastructure and other types of technology. We then survey local water stakeholders about their perceptions of these policies. Urban water governance requires coordination of organizations from multiple sectors, and we cannot assume that belief development and policy participation occur in a vacuum. Thus, we use a generalized exponential random graph model to test the relationship between perceptions and policy participation in the Tucson water governance network. We measure policy perceptions for organizations by averaging across their respective, affiliated respondents and generating a belief distance matrix of coordinating network participants. Similarly, we generate a distance matrix of these actors based on the frequency of their participation in each of the aforementioned policy types. By linking these perceptions and policies, we develop a coding frame that can supplement future content analysis when survey methods are not viable.

The Progressivity of Public Education in Greece: Empirical Findings and Policy Implications

ERIC Educational Resources Information Center

Koutsampelas, Christos; Tsakloglou, Panos

2015-01-01

This paper examines the short-run distributional effects of publicly provided education services in Greece using static incidence analysis. Public education is found to be inequality-reducing but the progressivity of the system withers away as we move up to higher educational levels. We employ a framework of both relative and absolute inequality…

Obesity Metaphors: How Beliefs about the Causes of Obesity Affect Support for Public Policy

PubMed Central

Barry, Colleen L; Brescoll, Victoria L; Brownell, Kelly D; Schlesinger, Mark

2009-01-01

Context: Relatively little is known about the factors shaping public attitudes toward obesity as a policy concern. This study examines whether individuals' beliefs about the causes of obesity affect their support for policies aimed at stemming obesity rates. This article identifies a unique role of metaphor-based beliefs, as distinct from conventional political attitudes, in explaining support for obesity policies. Methods: This article used the Yale Rudd Center Public Opinion on Obesity Survey, a nationally representative web sample surveyed from the Knowledge Networks panel in 2006/07 (N = 1,009). The study examines how respondents' demographic and health characteristics, political attitudes, and agreement with seven obesity metaphors affect support for sixteen policies to reduce obesity rates. Findings: Including obesity metaphors in regression models helps explain public support for policies to curb obesity beyond levels attributable solely to demographic, health, and political characteristics. The metaphors that people use to understand rising obesity rates are strong predictors of support for public policy, and their influence varies across different types of policy interventions. Conclusions: Over the last five years, the United States has begun to grapple with the implications of dramatically escalating rates of obesity. Individuals use metaphors to better understand increasing rates of obesity, and obesity metaphors are independent and powerful predictors of support for public policies to curb obesity. Metaphorical reasoning also offers a potential framework for using strategic issue framing to shift support for obesity policies. PMID:19298414

Media Coverage of Alcohol Issues: A Critical Political Economy Framework-A Case Study from Ireland.

PubMed

Mercille, Julien

2017-06-16

There is a growing literature on news media representations of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. This paper presents such a framework that conceives of news organisations as corporations that share the values and interests of political and economic elites. The media are thus expected to present viewpoints that are more aligned with the alcohol industry than the scientific consensus on public health policy would warrant. The media are also expected, but to a lesser extent, to present a certain amount of support for public health perspectives because these are supported by a few socioeconomic elite groups (the medical professions, progressive politicians). The case of Ireland from 2012 to 2017 illustrates the framework empirically. Four main newspapers' coverage of the Public Health (Alcohol) Bill and related policies is examined. Results show that, overall, 44.0% of articles support public health measures and 56.0% are opposed or remain neutral. It is argued that the media are not strong proponents of public health for multiple reasons: there are more articles opposed to or neutral toward public health measures than supporting them; the number of supportive articles remains relatively small and there are still many pieces presenting drinks industry views; there are virtually no calls in the media for stronger measures; supportive coverage is partially explained by the pub owners lobby's support for minimum unit pricing; the media often downplay or ignore the negative consequences of alcohol, such as its role in accidents; many news articles normalise drinking and promote events sponsored by the industry; there is not a single Irish journalist covering alcohol issues systematically; and other policy issues that are prioritised by elites receive multiple times more media coverage than public health measures. In short, the media reflect the views of the political and economic establishment on public health measures: there is some support from the medical professions and progressive politicians, but overall, there is a clear reluctance to support strong public health strategies. One main recommendation for public health advocates to promote their perspectives is to diversify the mass media and make them less commercial in nature, as well as to engage with non-corporate, so-called progressive "alternative media" outlets.

Toward a National Framework for the Secondary Use of Health Data: An American Medical Informatics Association White Paper

PubMed Central

Safran, Charles; Bloomrosen, Meryl; Hammond, W. Edward; Labkoff, Steven; Markel-Fox, Suzanne; Tang, Paul C.; Detmer, Don E.

2007-01-01

Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers’ needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard “good practices” for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use. PMID:17077452

Higher Education: Handbook of Theory and Research. Volume XI.

ERIC Educational Resources Information Center

Smart, John C., Ed.

This volume contains 10 papers on higher education theory and research. "Variation Among Academic Disciplines: Analytical Frameworks and Research" (John M. Braxton and Lowell L. Hargens) reviews work on disciplinary differences and proposed conceptual schemes for explaining these differences. "Public Policy and Public Trust: The Use…

Mapping public policy options responding to obesity: the case of Spain.

PubMed

González-Zapata, L I; Ortiz-Moncada, R; Alvarez-Dardet, C

2007-05-01

This study assesses the opinions of the main Spanish stakeholders from food and physical exercise policy networks on public policy options for responding to obesity. We followed the multi-criteria mapping methodology in the framework of the European project 'Policy options in responding to obesity' (PorGrow), through a structured interview to 21 stakeholders. A four-step approach was taken: options, criteria, scoring and weighting, obtaining in this way a measure of the performance of each option which integrates qualitative and quantitative information. In an overall analysis, the more popular policy options where those grouped as educational initiatives: include food and health in the school curriculum, improve health education to the general public, improve the training of health professionals in obesity care and prevention, incentives to caterers to provide healthier menus and improve community sports facilities. Fiscal measures as subsidies and taxes had the lowest support. The criteria assessed as priorities were grouped as efficacy and societal benefits. Obesity in Spain can be approached through public policies, although the process will not be easy or immediate. The feasibility of changes requires concerned public policymakers developing long-term actions taking into account the map of prioritized options by the stakeholders.

"We're not short of people telling us what the problems are. We're short of people telling us what to do": An appraisal of public policy and mental health

PubMed Central

Petticrew, Mark; Platt, Stephen; McCollam, Allyson; Wilson, Sarah; Thomas, Sian

2008-01-01

Background There is sustained interest in public health circles in assessing the effects of policies on health and health inequalities. We report on the theory, methods and findings of a project which involved an appraisal of current Scottish policy with respect to its potential impacts on mental health and wellbeing. Methods We developed a method of assessing the degree of alignment between Government policies and the 'evidence base', involving: reviewing theoretical frameworks; analysis of policy documents, and nineteen in-depth interviews with policymakers which explored influences on, and barriers to cross-cutting policymaking and the use of research evidence in decisionmaking. Results Most policy documents did not refer to mental health; however most referred indirectly to the determinants of mental health and well-being. Unsurprisingly research evidence was rarely cited; this was more common in health policy documents. The interviews highlighted the barriers to intersectoral policy making, and pointed to the relative value of qualitative and quantitative research, as well as to the imbalance of evidence between "what is known" and "what is to be done". Conclusion Healthy public policy depends on effective intersectoral working between government departments, along with better use of research evidence to identify policy impacts. This study identified barriers to both these. We also demonstrated an approach to rapidly appraising the mental health effects of mainly non-health sector policies, drawing on theoretical understandings of mental health and its determinants, research evidence and policy documents. In the case of the social determinants of health, we conclude that an evidence-based approach to policymaking and to policy appraisal requires drawing strongly upon existing theoretical frameworks, as well as upon research evidence, but that there are significant practical barriers and disincentives. PMID:18793414

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Educational Policy and Practice from the Perspective of Institutional Theory: Crafting a Wider Lens

ERIC Educational Resources Information Center

Burch, Patricia

2007-01-01

Institutional analyses of public education have increased in number in recent years. However, studies in education drawing on institutional analyses have not fully incorporated recent contributions from institutional theory, particularly relative to other domains such as law and health policy. The author sketches a framework that integrates recent…

Education for Rural Development towards New Policy Responses

ERIC Educational Resources Information Center

Atchoarena, David, Ed.; Gasperini, Lavinia, Ed.

2003-01-01

An international joint study by the Food and Agriculture Organization of the United Nations (FAO) and UNESCO's International Institute for Educational Planning (IIEP) was conducted on education and rural development to review the status of the topic from the standpoint of public policies and the conceptual frameworks on which they are based and…

Equity and the "B" Word: Budgeting and Professional Capacity in Student Affairs

ERIC Educational Resources Information Center

McCambly, Heather N.; Haley, Karen J.

2016-01-01

The dual pressures of the national college completion agenda and diminished public investment in higher education have led to a growing reliance on performance-based policies. Using a policy implementation framework, this qualitative study examines the implementation of a performance-based budgeting model at a broad-access urban research…

Hardwood supply in the Pacific Northwest-a policy perspective.

Treesearch

Terry L. Raettig; Kent P. Connaughton; Glenn R. Ahrens

1995-01-01

The policy framework for the hardwood resource and hardwood industry in western Oregon and Washington is examined. Harvesting trends, harvesting behavior of public and private landowners, and harvesting regulation are presented to complete the analysis of factors affecting short-run hardwood supply. In the short term, the supply of hardwoods is generally favorable, but...

Module 4: Work-Family Policy in the United States. Work-Family Curriculum Guide

ERIC Educational Resources Information Center

Kossek, Ellen Ernst; Leana, Carrie; MacDermid, Shelley; Pitt-Catsouphes, Marcie; Raskin, Patricia; Secret, Mary; Shulkin, Sandee; Sweet, Stephen

2006-01-01

Public policy affects the experiences of workers and their families, both directly and indirectly. For example, employment-focused statutes such as the Fair Labor Standards Act (FLSA), the Employment Retirement and Income Security Act, the Occupational Health and Safety Act, and the Age Discrimination in Employment Act establish frameworks for…

Smorgasbord or symphony? Assessing public health nutrition policies across 30 European countries using a novel framework.

PubMed

Lloyd-Williams, Ffion; Bromley, Helen; Orton, Lois; Hawkes, Corinna; Taylor-Robinson, David; O'Flaherty, Martin; McGill, Rory; Anwar, Elspeth; Hyseni, Lirije; Moonan, May; Rayner, Mike; Capewell, Simon

2014-11-21

Countries across Europe have introduced a wide variety of policies to improve nutrition. However, the sheer diversity of interventions represents a potentially bewildering smorgasbord. We aimed to map existing public health nutrition policies, and examine their perceived effectiveness, in order to inform future evidence-based diet strategies. We created a public health nutrition policy database for 30 European countries. National nutrition policies were classified and assigned using the marketing "4 Ps" approach Product (reformulation, elimination, new healthier products); Price (taxes, subsidies); Promotion (advertising, food labelling, health education) and Place (schools, workplaces, etc.). We interviewed 71 senior policy-makers, public health nutrition policy experts and academics from 14 of the 30 countries, eliciting their views on diverse current and possible nutrition strategies. Product Voluntary reformulation of foods is widespread but has variable and often modest impact. Twelve countries regulate maximum salt content in specific foods. Denmark, Austria, Iceland and Switzerland have effective trans fats bans. Price EU School Fruit Scheme subsidies are almost universal, but with variable implementation.Taxes are uncommon. However, Finland, France, Hungary and Latvia have implemented 'sugar taxes' on sugary foods and sugar-sweetened beverages. Finland, Hungary and Portugal also tax salty products. Promotion Dialogue, recommendations, nutrition guidelines, labelling, information and education campaigns are widespread. Restrictions on marketing to children are widespread but mostly voluntary. Place Interventions reducing the availability of unhealthy foods were most commonly found in schools and workplace canteens. Interviewees generally considered mandatory reformulation more effective than voluntary, and regulation and fiscal interventions much more effective than information strategies, but also politically more challenging. Public health nutrition policies in Europe appear diverse, dynamic, complex and bewildering. The "4 Ps" framework potentially offers a structured and comprehensive categorisation. Encouragingly, the majority of European countries are engaged in activities intended to increase consumption of healthy food and decrease the intake of "junk" food and sugary drinks. Leading countries include Finland, Norway, Iceland, Denmark, Hungary, Portugal and perhaps the UK. However, all countries fall short of optimal activities. More needs to be done across Europe to implement the most potentially powerful fiscal and regulatory nutrition policies.

Towards quality criteria for regional public health reporting: concept mapping with Dutch experts.

PubMed

van Bon-Martens, Marja J H; Achterberg, Peter W; van de Goor, Ien A M; van Oers, Hans A M

2012-06-01

In the Netherlands, municipal health assessments are carried out by 28 Regional Health Services, serving 418 municipalities. In the absence of guidelines, regional public health reports were developed in two pilot regions on the basis of the model and experience of national health reporting. Though they were well received and positively evaluated, it was not clear which specific characteristics determined 'good public health reporting'. Therefore, this study was set up to develop a theoretical framework for the quality of regional public health reporting in The Netherlands. Using concept mapping as a standardized tool for conceptualization, 35 relevant reporting experts formulated short statements in two different brainstorming sessions, describing specific quality criteria of regional public health reports. After the removal of duplicates, the list was supplemented with international criteria, and the statements were sent to each participant for rating and sorting. The results were processed statistically and represented graphically. The output was discussed and interpreted, leading to the final concept map. The final concept map consisted of 97 criteria, grouped into 13 clusters, and plotted in two dimensions: a 'product' dimension, ranging from 'production' to 'content', and a 'context' dimension, ranging from 'science' to 'policy'. The three most important clusters were: (i) 'solution orientation', (ii) 'policy relevance' and (iii) 'policy impact'. This study provided a theoretical framework for the quality of regional public health reporting, indicating relevant domains and criteria. Further work should translate domains and criteria into operational indicators for evaluating regional public health reports.

Mad cows, terrorism and junk food: should public policy reflect perceived or objective risks?

PubMed

Johansson-Stenman, Olof

2008-03-01

Empirical evidence suggests that people's risk-perceptions are often systematically biased. This paper develops a simple framework to analyse public policy when this is the case. Expected utility (well-being) is shown to depend on both objective and perceived risks (beliefs). The latter are important because of the fear associated with the risk and as a basis for corrective taxation and second-best adjustments. Optimality rules for public provision of risk-reducing investments, "internality-correcting" taxation (e.g. fat taxes) and provision of costly information to reduce people's risk-perception bias are presented.

Sustainability indicator system and policy processes in Malaysia: a framework for utilisation and learning.

PubMed

Hezri, A A

2004-12-01

Formulation of effective sustainability indicators for national assessment demands a comprehensive understanding of the utilisation, diffusion and dissemination of information in policy processes. To illustrate the dynamic of sustainability assessment within the context of policy processes, this paper uses a case study of national sustainability indicators development in Malaysia. Subsequently, this paper ascribes the limited achievement of national sustainability assessment in Malaysia to four types of constraints: meta-policy issues; technical capacities; communication concerns; and the inherent knowledge gaps within the indicator developer community vis-a-vis their theoretical limitations. It is proposed that such constraints will be encountered in many countries. Drawing from the literature on public policy, this paper outlines a framework for investigating indicator behaviour within policy processes based on well-established concepts such as knowledge utilisation and policy learning. I conclude this paper by elaborating on the corresponding future challenges that must be addressed before effective integration of sustainability indicators within policy systems can occur.

Air quality management: evolution of policy and practice in the UK as exemplified by the experience of English local government

NASA Astrophysics Data System (ADS)

Beattie, C. I.; Longhurst, J. W. S.; Woodfield, N. K.

The air quality management (AQM) framework in the UK is designed to be an effects-based solution to air pollutants currently affecting human health. The AQM process has been legislated through The Environment Act 1995, which required the National Air Quality Strategy (NAQS) to be published. AQM practice and capability within local authorities has flourished since the publication of the NAQS in March 1997. This paper outlines the policy framework within which the UK operates, both at a domestic and European level, and reviews the air quality management process relating to current UK policy and EU policy. Data from questionnaire surveys are used to indicate the involvement of various sectors of local government in the air quality management process. These data indicate an increasing use of monitoring, and use of air dispersion modelling by English local authorities. Data relating to the management of air quality, for example, the existence and work of air quality groups, dissemination of information to the public and policy measures in place on a local scale to improve air quality, have also been reported. The UK NAQS has been reviewed in 1999 to reflect developments in European legislation, technological and scientific advances, improved air pollution modelling techniques and an increasingly better understanding of the socio-economic issues involved. The AQM process, as implemented by UK local authorities, provides an effective model for other European member states with regards to the implementation of the Air Quality Framework Directive. The future direction of air quality policy in the UK is also discussed.

Towards health in all policies for childhood obesity prevention.

PubMed

Hendriks, Anna-Marie; Kremers, Stef P J; Gubbels, Jessica S; Raat, Hein; de Vries, Nanne K; Jansen, Maria W J

2013-01-01

The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established.

The policies-inequality feedback and health: the case of globalisation.

PubMed

De Vogli, R; Gimeno, D; Mistry, R

2009-09-01

Major research contributions aimed at explaining the association between economic inequality and health have concentrated on the plausibility of the material deprivation and psychosocial factors pathways. However, little work has analysed the reciprocal associations between public policies and inequality and their effect on health. A conceptual framework was first proposed explaining how the public policies-inequality feedback can influence health outcomes via material deprivation and psychosocial factors. Then, a critical review of the literature was conducted and an analysis of the health effects of the globalisation-inequality feedback as a case study. Different bodies of evidence seem to give support to the hypothesis of a public policies-inequality feedback influencing health-related outcomes. This seems to be particularly true when considering globalisation policies. Since the widespread adoption of the so-called "Washington Consensus", economic inequalities have sharply increased worldwide. The rise in inequality has, in turn, further consolidated the adoption of these policies through an increasing "democratic deficit". The reciprocal effects of globalisation and inequality have produced adverse health outcomes between and within societies through both material deprivation and psychosocial stress. Public policies and economic inequality are inextricably interrelated and can affect health through multiple, indirect, reciprocal pathways.

Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Simpson, Sarah; Mahoney, Mary; Harris, Elizabeth

2005-10-15

In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft frameworkmore » in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA.« less

Ethics in American Health 1: Ethical Approaches to Health Policy

PubMed Central

2008-01-01

I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy. PMID:18703449

Contrasting Intermediation Practices in Various Advisory Service Networks in the Case of the French Ecophyto Plan

ERIC Educational Resources Information Center

Cerf, M.; Bail, Le; Lusson, J. M.; Omon, B.

2017-01-01

Purpose: To highlight the way a public policy aiming to achieve a 50% decrease of pesticides use in France reframed advice provision in public and private networks. Design/methodology/approach: We developed a framework to analyze intermediation in a public funded network, a farmers' association, and a network of co-operatives. The framework…

Secure public cloud platform for medical images sharing.

PubMed

Pan, Wei; Coatrieux, Gouenou; Bouslimi, Dalel; Prigent, Nicolas

2015-01-01

Cloud computing promises medical imaging services offering large storage and computing capabilities for limited costs. In this data outsourcing framework, one of the greatest issues to deal with is data security. To do so, we propose to secure a public cloud platform devoted to medical image sharing by defining and deploying a security policy so as to control various security mechanisms. This policy stands on a risk assessment we conducted so as to identify security objectives with a special interest for digital content protection. These objectives are addressed by means of different security mechanisms like access and usage control policy, partial-encryption and watermarking.

Tobacco policies and vulnerable girls and women: toward a framework for gender sensitive policy development.

PubMed

Greaves, Lorraine; Jategaonkar, Natasha

2006-09-01

This article assesses the effects of comprehensive tobacco control policies on diverse subpopulations of girls and women who are at increased vulnerability to tobacco use because of disadvantage. The authors report on a recent assessment of experimental literature examining tobacco taxation; smoking location restrictions in public and private spaces; and sales restrictions. A comprehensive search was undertaken to identify relevant studies and evaluation reports. Gender based and diversity analyses were performed to identify pertinent sex differences and gender influences that would affect the application and impact of the policy. Finally, the results were contextualised within the wider literature on women's tobacco use and women's health. The authors consider not only the intended policy effects, but also explicitly examine the gendered and/or unintended consequences of these policies on other aspects of girls and women's health and wellbeing. A framework for developing gender sensitive tobacco programmes and policies for low income girls and women is provided.

Primary care in the UK: understanding the dynamics of devolution.

PubMed

Exworthy, M

2001-09-01

The United Kingdom is ostensibly one country and yet public policy often varies between its constituent territories - England, Scotland, Wales and Northern Ireland. Health policy illustrates the dilemmas inherent in an apparently unitary system that permits scope for territorial variation. Administrative devolution has now been accompanied by political devolution but their interaction has yet to produce policy outcomes. This paper describes recent health policy reform with regard to primary care in terms of the tension inherent in current policy between notions of a 'one nation NHS' and the territorial diversity wrought by devolution. The paper provides a framework for understanding the emergent outcomes by exploring various concepts. In particular, the existing character of territorial policy networks, the properties of policies in devolved territories and intergovernmental relations are considered from various disciplines to examine whether greater diversity or uniformity will result from the dual reform process. Whilst this evaluation can, at this stage, only be preliminary, the paper provides a framework to appraise the emerging impact of devolution upon primary care in the UK.

GLIMPSE: a rapid decision framework for energy and environmental policy.

PubMed

Akhtar, Farhan H; Pinder, Robert W; Loughlin, Daniel H; Henze, Daven K

2013-01-01

Over the coming decades, new energy production technologies and the policies that oversee them will affect human health, the vitality of our ecosystems, and the stability of the global climate. The GLIMPSE decision model framework provides insights about the implications of technology and policy decisions on these outcomes. Using GLIMPSE, decision makers can identify alternative techno-policy futures, examining their air quality, health, and short- and long-term climate impacts. Ultimately, GLIMPSE will support the identification of cost-effective strategies for simultaneously achieving performance goals for these metrics. Here, we demonstrate the utility of GLIMPSE by analyzing several future energy scenarios under existing air quality regulations and potential CO2 emission reduction policies. We find opportunities for substantial cobenefits in setting both climate change mitigation and health-benefit based air quality improvement targets. Though current policies which prioritize public health protection increase near-term warming, establishing policies that also reduce greenhouse gas emissions may offset warming in the near-term and lead to significant reductions in long-term warming.

Tobacco policies and vulnerable girls and women: toward a framework for gender sensitive policy development

PubMed Central

Greaves, Lorraine; Jategaonkar, Natasha

2006-01-01

This article assesses the effects of comprehensive tobacco control policies on diverse subpopulations of girls and women who are at increased vulnerability to tobacco use because of disadvantage. The authors report on a recent assessment of experimental literature examining tobacco taxation; smoking location restrictions in public and private spaces; and sales restrictions. A comprehensive search was undertaken to identify relevant studies and evaluation reports. Gender based and diversity analyses were performed to identify pertinent sex differences and gender influences that would affect the application and impact of the policy. Finally, the results were contextualised within the wider literature on women's tobacco use and women's health. The authors consider not only the intended policy effects, but also explicitly examine the gendered and/or unintended consequences of these policies on other aspects of girls and women's health and wellbeing. A framework for developing gender sensitive tobacco programmes and policies for low income girls and women is provided. PMID:17708012

An integrated framework for the geographic surveillance of chronic disease

PubMed Central

2009-01-01

Background Geographic public health surveillance is concerned with describing and disseminating geographic information about disease and other measures of health to policy makers and the public. While methodological developments in the geographical analysis of disease are numerous, few have been integrated into a framework that also considers the effects of case ascertainment bias on the effectiveness of chronic disease surveillance. Results We present a framework for the geographic surveillance of chronic disease that integrates methodological developments in the spatial statistical analysis and case ascertainment. The framework uses an hierarchical approach to organize and model health information derived from an administrative health data system, and importantly, supports the detection and analysis of case ascertainment bias in geographic data. We test the framework on asthmatic data from Alberta, Canada. We observe high prevalence in south-western Alberta, particularly among Aboriginal females. We also observe that persons likely mistaken for asthmatics tend to be distributed in a pattern similar to asthmatics, suggesting that there may be an underlying social vulnerability to a variety of respiratory illnesses, or the presence of a diagnostic practice style effect. Finally, we note that clustering of asthmatics tends to occur at small geographic scales, while clustering of persons mistaken for asthmatics tends to occur at larger geographic scales. Conclusion Routine and ongoing geographic surveillance of chronic diseases is critical to developing an understanding of underlying epidemiology, and is critical to informing policy makers and the public about the health of the population. PMID:19948046

Interventions to Promote an Integrated Approach to Public Health Problems: An Application to Childhood Obesity

PubMed Central

Hendriks, Anna-Marie; Gubbels, Jessica S.; De Vries, Nanne K.; Seidell, Jaap C.; Kremers, Stef P. J.; Jansen, Maria W. J.

2012-01-01

Experts stress the need to bring the childhood obesity epidemic under control by means of an integrated approach. The implementation of such an approach requires the development of integrated enabling policies on public health by local governments. A prerequisite for developing such integrated public health policies is intersectoral collaboration. Since the development of integrated policies is still in its early stages, this study aimed to answer the following research question: “What interventions can promote intersectoral collaboration and the development of integrated health policies for the prevention of childhood obesity?” Data were collected through a literature search and observations of and interviews with stakeholders. Based on a theoretical framework, we categorized potential interventions that could optimize an integrated approach regarding children's physical activity and diet. The intervention categories included education, persuasion, incentivization, coercion, training, restriction, environmental restructuring, modeling, and enablement. PMID:22792120

[Latin-American public policy regarding social determinants of health].

PubMed

García-Ramírez, Jorge A; Vélez-Álvarez, Consuelo

2013-01-01

The study was aimed at identifying Latin-American countries' public policy which has been related to the social determinants of health. A topic review was thus made of papers kept in the 22 Latin-American countries' databases and official documents issued by their multilateral organisations and ministries of health. The World Health Organization's concept of the social determinants of health has been summarised and a history given of the pertinent work developed worldwide in regions such as Europe and Latin-America. Public policy regarding the field of study in Argentina, Brazil, Bolivia, Chile, Colombia, Costa Rica, México and Venezuela has been described. It was concluded that Latin-America provides a panorama of inequality regarding the application of policy concerning the social determinants of health and that there was segmented intervention, mainly regarding intermediate determinants of health, without taking an integrated approach from different entrance points into account, according to the stated conceptual framework.

Developing a public health policy-research nexus: an evaluation of Nurse Practitioner models in aged care.

PubMed

Prosser, Brenton; Clark, Shannon; Davey, Rachel; Parker, Rhian

2013-10-01

A frustration often expressed by researchers and policy-makers in public health is an apparent mismatch between respective priorities and expectations for research. Academics bemoan an oversimplification of their work, a reticence for independent critique and the constant pressure to pursue evaluation funding. Meanwhile, policy-makers look for research reports written in plain language with clear application, which are attuned to current policy settings and produced quickly. In a context where there are calls in western nations for evidence based policy with stronger links to academic research, such a mismatch can present significant challenges to policy program evaluation. The purpose of this paper is to present one attempt to overcome these challenges. Specifically, the paper describes the development of a conceptual framework for a large-scale, multifaceted evaluation of an Australian Government health initiative to expand Nurse Practitioner models of practice in aged care service delivery. In doing so, the paper provides a brief review of key points for the facilitation of a strong research-policy nexus in public health evaluations, as well as describes how this particular evaluation embodies these key points. As such, the paper presents an evaluation approach which may be adopted and adapted by others undertaking public health policy program evaluations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Characterization of NEOs from the Policy Perspective: Implications from Problem and Solution Definitions

NASA Astrophysics Data System (ADS)

Lindquist, E.

2015-12-01

The characterization of near-Earth-objects (NEOs) in regard to physical attributes and potential risk and impact factors presents a complex and complicates scientific and engineering challenge. The societal and policy risks and impacts are no less complex, yet are rarely considered in the same context as material properties or related factors. The objective of this contribution is to position the characterization of NEOs within the public policy process domain as a means to reflect on the science-policy nexus in regard to risks associated with NEOs. This will be accomplished through, first, a brief overview of the science-policy nexus, followed by a discussion of several policy process frameworks, such as agenda setting and the multiple streams model, focusing events, and punctuated equilibrium, and their application and appropriateness to the problem of NEOs. How, too, for example, does NEO hazard and risk compare with other low probability, high risk, hazards in regard to public policy? Finally, we will reflect on the implications of alternative NEO "solutions" and the characterization of the NEO "problem," and the political and public acceptance of policy alternatives as a way to link NEO science and policy in the context of the overall NH004 panel.

The global context for public health nutrition taxation.

PubMed

Thow, Anne Marie; Heywood, Peter; Leeder, Stephen; Burns, Lee

2011-01-01

To assess critically the scope for public health nutrition taxation within the framework of the global tax reform agenda. Review of the tax policy literature for global policy priorities relevant to public health nutrition taxation; critical analysis of proposals for public health nutrition taxation judged against the global agenda for tax reform. The global tax reform agenda shapes decisions of tax policy makers in all countries. By understanding this agenda, public health nutritionists can make feasible taxation proposals and thus improve the development, uptake and implementation of recommendations for nutrition-related taxation. The priorities of the global tax reform agenda relevant to public health nutrition taxation are streamlining of taxes, adoption of value-added tax (VAT), minimisation of excise taxes (except to correct for externalities) and removal of import taxes in line with trade liberalisation policies. Proposals consistent with the global tax reform agenda have included excise taxes, extension of VAT to currently exempted (unhealthy) foods and tariff reductions for healthy foods. Proposals for public health nutrition taxation should (i) use existing types and rates of taxes where possible, (ii) use excise taxes that specifically address externalities, (iii) avoid differential VAT on foods and (iv) use import taxes in ways that comply with trade liberalisation priorities.

Music and dance make me feel alive: from Mandela's prison songs and dances to public policy.

PubMed

Buis, Johann S

2013-01-01

How is it possible for song and dance to exist in political incarceration and manifest itself later as public policy responding to apartheid atrocities? Examining the body of songs, oral history accounts, and eye-witness reports provided by fellow-prisoners of Mandela on Robben Island prison, I uncover a psychological environment mediated through music and dance--within the confines of a political prison. This source of prison music-making by political prisoners in detention, provide us with the artistic expressions of revolutionary songs, parody songs, praise songs, laments, etc. These music genres reflect ontologies embedded in Mandela's juristic imagination. My framework for explaining these ontologies is a theoretical framework I call an aesthetic of function: internal ontologies that speak to the African cultural ground against which external ontologies are expressed in the jurisprudential redress to apartheid atrocities. Examining his external (jurisprudential) ontologies through song and dance, one realizes that the best way for him to have solved the unprecedented public redress of apartheid atrocities is evident in the songs he sang in Robben Island prison. Retribution could have been a logical solution for him. Instead, he turned to truth-telling and reconciliation as public policy. The Truth and Reconciliation Commission's unprecedented breaking of social and jurisprudential boundaries, the claim of agency for both victims and perpetrators, and public policy of South Africa's first democratically elected black president, lie deeply embedded in cultural practices he testified to in his autobiography, "The Long Walk to Freedom". These cultural practices in prison were singing and dancing. This paper complements the music-as-torture trope: here music in detention carries ontological agency. Musical evidence of stylistic features, text, and contextual analyses, and related literary criticism devices, expose Mandela's embedded internal and external ontological cultural practices. Here, song and dance have agency to influence public policy despite the constraints of political detention.

Health and foreign policy in question: the case of humanitarian action.

PubMed

Thieren, Michel

2007-03-01

Health has gained recognition as a foreign policy concern in recent years. Political leaders increasingly address global health problems within their international relations agendas. The confluence of health and foreign policy has opened these issues to analysis that helps clarify the tenets and determinants of this linkage, offering a new framework for international health policy. Yet as health remains profoundly bound to altruistic values, caution is required before generalizing about the positive outcomes of merging international health and foreign policy principles. In particular, the possible side-effects of this framework deserve further consideration. This paper examines the interaction of health and foreign policy in humanitarian action, where public health and foreign policy are often in direct conflict. Using a case-based approach, this analysis shows that health and foreign policy need not be at odds in this context, although there are situations where altruistic and interest-based values compete. The hierarchy of foreign policy functions must be challenged to avoid misuse of national authority where health interventions do not coincide with national security and domestic interests.

Using Health Impact Assessment as an Interdisciplinary Teaching Tool.

PubMed

Chinchilla, Melissa; Arcaya, Mariana C

2017-07-08

Health Impact Assessment (HIA) courses are teaching public health and urban planning students how to assess the likely health effects of proposed policies, plans, and projects. We suggest that public health and urban planning have complimentary frameworks for training practitioners to address the living conditions that affect health. Planning perspectives emphasize practical skills for impacting community change, while public health stresses professional purpose and ethics. Frameworks from both disciplines can enhance the HIA learning experience by helping students tackle questions related to community impact, engagement, social justice, and ethics. We also propose that HIA community engagement processes can be enriched through an empathetic practice that focuses on greater personal introspection.

The economic impact of public resource supply constraints in northeast Oregon.

Treesearch

Edward C Waters; David W. Holland; Richard W. Haynes

1977-01-01

Traditional, fixed-price (input-output) economic models provide a useful framework for conceptualizing links in a regional economy. Apparent shortcomings in these models, however, can severely restrict our ability to deduce valid prescriptions for public policy and economic development. A more efficient approach using regional computable general equilibrium (CGE)...

Support and Training of Environmental Lawyers

ERIC Educational Resources Information Center

Cameron, Roderick A.

1971-01-01

The need for scientists to work with public interest lawyers in the field of environmental and consumer law is assessed. Scientists must become involved in public issues, educating lawyers to the problems, technical difficulties, and policy goals. From the lawyer, the scientist learns what the legal framework is into which his goals and supportive…

Understanding and Improving Multi-Sectoral Partnerships for Chronic Disease Prevention: Blending Conceptual and Practical Insights

ERIC Educational Resources Information Center

Willis, Cameron; Greene, Julie; Riley, Barbara

2017-01-01

Inter-organisational partnerships are widely used approaches in public health and chronic disease prevention (CDP), and may include organisations from different sectors, such as research-policy-practice sectors, inter-governmental sectors, or public and private sectors. While multiple conceptual frameworks related to multi-sectoral partnerships…

Epidemiological reflections of the contribution of anthropology to public health policy and practice.

PubMed

Porter, John D H

2006-01-01

Academic disciplines like anthropology and epidemiology provide a niche for researchers to speak the same language, and to interrogate the assumptions that they use to investigate problems. How anthropological and epidemiological methods communicate and relate to each other affects the way public health policy is created but the philosophical underpinnings of each discipline makes this difficult. Anthropology is reflective, subjective and investigates complexity and the individual; epidemiology, in contrast, is objective and studies populations. Within epidemiological methods there is the utilitarian concept of potentially sacrificing the interests of the individual for the benefits of maximizing population welfare, whereas in anthropology the individual is always included. Other strengths of anthropology in the creation of public health policy include: its attention to complexity, questioning the familiar; helping with language and translation; reconfiguring boundaries to create novel frameworks; and being reflective. Public health requires research that is multi-, inter- and trans-disciplinary. To do this, there is a need for each discipline to respect the 'dignity of difference' between disciplines in order to help create appropriate and effective public health policy.

Understanding public elderly care policy in Norway: A narrative analysis of governmental White papers.

PubMed

Jacobsen, Frode F

2015-08-01

How the general public in Norway conceives being an older adult and the meaning of chronological age has changed over the last few decades. As narratives of aging may be identified in the Norwegian mass media and in the population at large, dominant narratives may also be identified in policy documents, such as government health policy papers. This article explores a narrative analytical framework based on stories, subtexts, and counterstories; it argues that such narratives are characterized as much by what is unsaid as by what is said, and as much by choice of words and word combinations as by explicit messages. Culture strongly influences the conception of a likely future (what will be) and an envisioned future (what ought to be) regarding aging and geriatric care in Norway, as expressed in the public policy papers. The public policy story is discussed as both a story continuously developing, where later health policy papers relate to and comment on earlier documents, and as a story characterized by a measure of cultural incoherence. Some recent government documents dealing with professional geriatric care will serve as material for a narrative analysis. Copyright © 2015 Elsevier Inc. All rights reserved.

Incorporating Risk and Indicators into a Water Security Framework

NASA Astrophysics Data System (ADS)

Allen, D. M.; Bakker, K.; Simpson, M. W.; Norman, E.; Dunn, G.

2010-12-01

The concept of water security has received growing attention over the past five years in academic debates and policy circles, particularly with respect to cumulative impacts assessment and watershed management. We propose an integrative definition for water security; one that considers both stressors and impacts (or effects) on hydrological systems. We present a water security assessment framework that considers status and risk indicators for both water quality and quantity as measures of impacts. This assessment framework also integrates the social sciences with natural science, engineering, and public health, providing opportunities to address environmental challenges, including the relationship between water and land use dynamics, the integration of aquatic ecosystem and human health concerns, and the alignment of governance with water management imperatives. We argue that this framework has the potential to advance water science, the contributing disciplines, and water policy and management.

Analysis of newspaper coverage of active aging through the lens of the 2002 World Health Organization Active Ageing Report: A Policy Framework and the 2010 Toronto Charter for Physical Activity: A Global Call for Action.

PubMed

Abdullah, Boushra; Wolbring, Gregor

2013-12-05

As populations continue to grow older, efforts to support the process of aging well are important goals. Various synonyms are used to cover aging well, such as active aging. The World Health Organization published in 2002 the report Active Ageing: A Policy Framework that according to the call for papers, has brought active ageing to the forefront of international public health awareness. The 2010 Toronto Charter for Physical Activity: A Global Call for Action was singled out in the call for papers as a key document promoting physical activity one goal of the 2002 WHO active aging policy framework. Media are to report to the public topics of importance to them. We investigated the newspaper coverage of aging well and synonymous terms such as active aging through the lens of the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity. As sources we used the following newspapers: China Daily, The Star (Malaysia), two UK newspapers (The Guardian, The Times), a database of 300 Canadian newspapers (Canadian Newsstand) and a US newspaper (The New York Times). The study generated data answering the following four research questions: (1) how often are the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity mentioned; (2) how often is the topic of active aging and terms conveying similar content (aging well, healthy aging, natural aging and successful aging) discussed; (3) which of the issues flagged as important in the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity are covered in the newspaper coverage of active aging and synonymous terms; (4) which social groups were mentioned in the newspapers covered. The study found a total absence of mentioning of the two key documents and a low level of coverage of "active aging" and terms conveying similar content. It found further a lack of engagement with the issues raised in the two key documents and a low level of mentioning of socially disadvantages groups. We posit that reading the newspapers we covered will not expose the reader to the two key documents and the issues linked to aging well including the need to increase physical activity.

Analysis of Newspaper Coverage of Active Aging through the Lens of the 2002 World Health Organization Active Ageing Report: A Policy Framework and the 2010 Toronto Charter for Physical Activity: A Global Call for Action

PubMed Central

Abdullah, Boushra; Wolbring, Gregor

2013-01-01

As populations continue to grow older, efforts to support the process of aging well are important goals. Various synonyms are used to cover aging well, such as active aging. The World Health Organization published in 2002 the report Active Ageing: A Policy Framework that according to the call for papers, has brought active ageing to the forefront of international public health awareness. The 2010 Toronto Charter for Physical Activity: A Global Call for Action was singled out in the call for papers as a key document promoting physical activity one goal of the 2002 WHO active aging policy framework. Media are to report to the public topics of importance to them. We investigated the newspaper coverage of aging well and synonymous terms such as active aging through the lens of the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity. As sources we used the following newspapers: China Daily, The Star (Malaysia), two UK newspapers (The Guardian, The Times), a database of 300 Canadian newspapers (Canadian Newsstand) and a US newspaper (The New York Times). The study generated data answering the following four research questions: (1) how often are the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity mentioned; (2) how often is the topic of active aging and terms conveying similar content (aging well, healthy aging, natural aging and successful aging) discussed; (3) which of the issues flagged as important in the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity are covered in the newspaper coverage of active aging and synonymous terms; (4) which social groups were mentioned in the newspapers covered. The study found a total absence of mentioning of the two key documents and a low level of coverage of “active aging” and terms conveying similar content. It found further a lack of engagement with the issues raised in the two key documents and a low level of mentioning of socially disadvantages groups. We posit that reading the newspapers we covered will not expose the reader to the two key documents and the issues linked to aging well including the need to increase physical activity. PMID:24317386

Education Improves Public Health and Promotes Health Equity.

PubMed

Hahn, Robert A; Truman, Benedict I

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health - an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. © The Author(s) 2015.

Education Improves Public Health and Promotes Health Equity

PubMed Central

Hahn, Robert A.; Truman, Benedict I.

2015-01-01

This article describes a framework and empirical evidence to support the argument that educational programs and policies are crucial public health interventions. Concepts of education and health are developed and linked, and we review a wide range of empirical studies to clarify pathways of linkage and explore implications. Basic educational expertise and skills, including fundamental knowledge, reasoning ability, emotional self-regulation, and interactional abilities, are critical components of health. Moreover, education is a fundamental social determinant of health – an upstream cause of health. Programs that close gaps in educational outcomes between low-income or racial and ethnic minority populations and higher-income or majority populations are needed to promote health equity. Public health policy makers, health practitioners and educators, and departments of health and education can collaborate to implement educational programs and policies for which systematic evidence indicates clear public health benefits. PMID:25995305

Oregon's Senate Bill 560: practical policy lessons for nurse advocates.

PubMed

Gilson Sistrom, Maria

2010-02-01

In response to striking rates of childhood obesity in Oregon, advocates led by a nurse lobbyist proposed legislation in 2005 to regulate junk foods in public schools. Several theories propose to explain the policy-making process, yet Senate Bill 560 (SB 560) followed a twisted course through rule making, legislative and political processes that are not well articulated in policy theory. Three overlapping mechanisms were identified in content analysis of documents and interviews with participants in the SB 560 policy process. Strategically placed legislative "banana peels," proponents' amateur advocacy, and legislative outflanking by professional lobbyists more fully characterize this policy process and better account for the failure of SB 560. Subsequent passage of the Oregon Healthy School Foods bill in the more politically conducive 2007 legislature suggest that advocacy and incremental change frameworks are less predictive of successful passage than is the ability to take advantage of political opportunities to change public health policy.

Narrative review of frameworks for translating research evidence into policy and practice.

PubMed

Milat, Andrew J; Li, Ben

2017-02-15

A significant challenge in research translation is that interested parties interpret and apply the associated terms and conceptual frameworks in different ways. The purpose of this review was to: a) examine different research translation frameworks; b) examine the similarities and differences between the frameworks; and c) identify key strengths and weaknesses of the models when they are applied in practice. The review involved a keyword search of PubMed. The search string was (translational research OR knowledge translation OR evidence to practice) AND (framework OR model OR theory) AND (public health OR health promotion OR medicine). Included studies were published in English between January 1990 and December 2014, and described frameworks, models or theories associated with research translation. The final review included 98 papers, and 41 different frameworks and models were identified. The most frequently applied knowledge translation framework in the literature was RE-AIM, followed by the knowledge translation continuum or 'T' models, the Knowledge to Action framework, the PARiHS framework, evidence based public health models, and the stages of research and evaluation model. The models identified in this review stem from different fields, including implementation science, basic and medical sciences, health services research and public health, and propose different but related pathways to closing the research-practice gap.

Towards Health in All Policies for Childhood Obesity Prevention

PubMed Central

Hendriks, Anna-Marie; Kremers, Stef P. J.; Gubbels, Jessica S.; Raat, Hein; de Vries, Nanne K.; Jansen, Maria W. J.

2013-01-01

The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established. PMID:24490059

Building on the EGIPPS performance assessment: the multipolar framework as a heuristic to tackle the complexity of performance of public service oriented health care organisations.

PubMed

Marchal, Bruno; Hoerée, Tom; da Silveira, Valéria Campos; Van Belle, Sara; Prashanth, Nuggehalli S; Kegels, Guy

2014-04-17

Performance of health care systems is a key concern of policy makers and health service managers all over the world. It is also a major challenge, given its multidimensional nature that easily leads to conceptual and methodological confusion. This is reflected by a scarcity of models that comprehensively analyse health system performance. In health, one of the most comprehensive performance frameworks was developed by the team of Leggat and Sicotte. Their framework integrates 4 key organisational functions (goal attainment, production, adaptation to the environment, and values and culture) and the tensions between these functions.We modified this framework to better fit the assessment of the performance of health organisations in the public service domain and propose an analytical strategy that takes it into the social complexity of health organisations. The resulting multipolar performance framework (MPF) is a meta-framework that facilitates the analysis of the relations and interactions between the multiple actors that influence the performance of health organisations. Using the MPF in a dynamic reiterative mode not only helps managers to identify the bottlenecks that hamper performance, but also the unintended effects and feedback loops that emerge. Similarly, it helps policymakers and programme managers at central level to better anticipate the potential results and side effects of and required conditions for health policies and programmes and to steer their implementation accordingly.

Bridging the Gap Between Policy and Research Infrastructure: Risk and Vulnerability Case Study

NASA Astrophysics Data System (ADS)

Hugo, Wim; Rogers, Annabelle

2017-04-01

Linking sound scientific data and conclusions to decision and policy support is not a trivial task, and the difficulty in achieving this has been highlighted more than a decade ago (Reid, 2004). There are several reasons why this is the case, inter alia: 1. The language, (vocabularies, framework, and heuristics) adopted by the research community in a specific discipline may not translate into meaningful implementation language (Preston et al., 2015); 2. The researchers may not be in a position of influence (which includes aspects such as writing policy briefs, undertaking personal initiatives, and building up public or industry concern and interest) (Fox and Sitkin, 2015); 3. The frequency, timing, and/or certainty associated with research output is at odds with decision and policy-making cycles. Research typically progresses until there is a defensible level of certainty in statistical assessment of a result, while policy decisions are often made within a regular cycle; 4. Scientists are not trained for, or measured by, the typical work required for decision and policy support: synthesis of scenarios and cost-benefits of such scenarios given sometimes significant uncertainty in the input data, and cross-disciplinary concerns that need to be balanced. There is a significant expectation that research output, being increasingly open, standardised, and managed in formal research data infrastructure, will be useful to policy and decision makers without much additional intervention and modification. We believe that this is unlikely to be feasible in the majority of cases. For most instances, it will be necessary to provide a framework for the translation of scientific output into decision and policy support metrics or indicators at a frequency, with spatial and temporal resolution, and thematic coverage that suits the decision to be made. Such frameworks exist, since the need has been identified - sometimes formally - such as the very detailed framework developed by IPCC for translating climate science into policy - (IPCC, 2007), or less formally - such as the move to develop Essential Biodiversity Variables, loosely designed to support Aichi Targets (Pereira et al., 2013) or the UN Sustainable Development Goals (UN, 2016). In the paper, we examine a number of these frameworks, map them onto a generic framework for the translation of research output into policy and decision support, and discuss an example from the South African Risk and Vulnerability Atlas in detail. References Craig R. Fox & Sim B. Sitkin (2015). Bridging the divide between behavioral science & policy, Behavioral Science & Policy, Spring 2015, https://behavioralpolicy.org/wp-content/uploads/2016/1-1/Bridging-the-divide-between-behavioral-science-and-policy.pdf IPCC (2007). Conceptual framework for the identification and assessment of key vulnerabilities, https://www.ipcc.ch/publications_and_data/ar4/wg2/en/ch19s19-1-2.html Pereira et al. (2013). Essential Biodiversity Variables, Science 18 Jan 2013: Vol. 339, Issue 6117, pp. 277-278 DOI: 10.1126/science.1229931 Preston, B.L., Mustelin, J. & Maloney, M.C. Mitig Adapt Strateg Glob Change (2015) 20: 467. doi:10.1007/s11027-013-9503-x Reid WV (2004) Bridging the Science-Policy Divide. PLoS Biol 2(2): e27. doi:10.1371/journal.pbio.0020027 UN (2016). Sustainable Development Goals, http://www.un.org/sustainabledevelopment/sustainable-development-goals/

Using Ecological Frameworks to Advance a Field of Research, Practice, and Policy on Aging-in-Place Initiatives

ERIC Educational Resources Information Center

Greenfield, Emily A.

2012-01-01

Initiatives to promote aging in place have emerged rapidly in the United States across various health care settings (e.g., acute care hospitals, skilled nursing facilities) and broader community settings (e.g., public social service agencies). Moreover, recent federal policies include a growing number of provisions for local efforts to promote…

Public Schools and Political Ideas: Canadian Educational Policy in Historical Perspective.

ERIC Educational Resources Information Center

Manzer, Ronald A.

This book interprets the framework of political ideas and beliefs that structure individual and collective thinking about educational policies and give them meaning. The analysis begins with the state of education in the mid-19th century and brings up to date the prospective reforms of the early 1990s. The study argues that, from its foundation,…

Limiting the consumption of sugar sweetened beverages in Mexico's obesogenic environment: a qualitative policy review and stakeholder analysis.

PubMed

Moise, Nathalie; Cifuentes, Enrique; Orozco, Emanuel; Willett, Walter

2011-11-01

Mexico is building a legal framework to address its childhood obesity epidemic. Sugar sweetened beverages (SSB) in the school environment represent a major policy challenge. We addressed the following questions: What barriers inhibit political attention to SSB and childhood obesity? What political instruments, international and national, exist to guide agenda setting in Mexico? What opportunities exist for policy adoption? We conducted a systematic review of international and national legal instruments concerned with SSB consumption. We traced process, conducting interviews with key informants. Thematic analysis helped us identify barriers and opportunities for public health interventions. We found 11 national policy instruments, but detected implementation gaps and weak fiscal policies on SSB consumption in schools: limited drinking water infrastructure, SSB industry interests, and regulatory ambiguities addressing reduction of sugar in beverages. Public policy should target marketing practices and taxation. The school environment remains a promising target for policy. Access to safe drinking water must complement comprehensive and multi-sector policy approaches to reduce access to SSB.

Reproductive policy and the social construction of motherhood.

PubMed

Bonnie, Stabile

2016-01-01

Reproductive technologies allow women to embrace or forgo motherhood, but a woman's ability to make autonomous reproductive choices depends on access to these technologies. In the United States, public policies - laws, regulations, appropriations, and rulings - have either broadened or narrowed this access. Have U.S. public policies affecting reproductive choices conformed to attitudinal distinctions about motherhood itself? I identified policies covering infertility, contraception, and abortion and examined them contextually within the Ingram-Schneider social construction framework. Women's choices fell within social construction quadrants as being positively portrayed and powerful; negatively portrayed but powerful; positively portrayed but powerless; and negatively portrayed and powerless. Married heterosexual women embracing motherhood were likely to be viewed positively and to reap benefits. Women forgoing motherhood, poor women, and women seeking to form nontraditional families were likely to be viewed negatively and to bear burdens; critical among these burdens was restriction of access to technologies that could be used to support a decision to avoid motherhood or to achieve motherhood through nontraditional methods. Yes, U.S. public policies affecting reproductive choices have conformed to attitudinal distinctions about motherhood itself. These policies may also have altered those choices.

Public sector hospitals and organizational change: an agenda for policy analysis.

PubMed

Collins, C; Green, A

1999-01-01

An important feature of health care systems in recent years is the change in the organizational position and relations of public sector hospitals. Health sector reforms have led to increasing heterogeneity in the organizational location and status of public sector hospitals and new organizational forms of public-private relations are being developed by and for hospitals. These changes can have important implications for health and health care. They raise issues around equity, control, accountability and performance of health care. Yet the policy process in practice may be failing to develop and implement appropriate forms of policy formulation on health sector reform. This paper focuses on the organizational position and relations of hospitals within public sector health services. It firstly outlines key elements of health sector reform and relates these to two dimensions of organizational change for hospitals: increasing heterogeneity and forms of public-private relations. The paper provides a descriptive format for classifying forms of hospital organizational change and proposes a framework of six questions for analysing these organizational forms. This may be used to assess the appropriateness of specific policies to particular country situations and to develop more open debate around hospital organizational forms.

Urban Sprawl, Smart Growth, and Deliberative Democracy

PubMed Central

2010-01-01

Urban sprawl is an increasingly common feature of the built environment in the United States and other industrialized nations. Although there is considerable evidence that urban sprawl has adverse affects on public health and the environment, policy frameworks designed to combat sprawl—such as smart growth—have proven to be controversial, making implementation difficult. Smart growth has generated considerable controversy because stakeholders affected by urban planning policies have conflicting interests and divergent moral and political viewpoints. In some of these situations, deliberative democracy—an approach to resolving controversial public-policy questions that emphasizes open, deliberative debate among the affected parties as an alternative to voting—would be a fair and effective way to resolve urban-planning issues. PMID:20724685

Urban sprawl, smart growth, and deliberative democracy.

PubMed

Resnik, David B

2010-10-01

Urban sprawl is an increasingly common feature of the built environment in the United States and other industrialized nations. Although there is considerable evidence that urban sprawl has adverse affects on public health and the environment, policy frameworks designed to combat sprawl-such as smart growth-have proven to be controversial, making implementation difficult. Smart growth has generated considerable controversy because stakeholders affected by urban planning policies have conflicting interests and divergent moral and political viewpoints. In some of these situations, deliberative democracy-an approach to resolving controversial public-policy questions that emphasizes open, deliberative debate among the affected parties as an alternative to voting-would be a fair and effective way to resolve urban-planning issues.

Public health finance: a conceptual framework.

PubMed

Moulton, Anthony D; Halverson, Paul K; Honoré, Peggy A; Berkowitz, Bobbie

2004-01-01

In an attempt to stimulate development of public health finance as a field of practice, policy, and scholarship, this article proposes a working definition of the term "public health finance," embeds it in the context of the maturing literature on the public health system and its infrastructure, and proposes a four-part typology that spans both public-sector and private-sector contributions to the financing of prevention and health promotion. A developmental strategy for the field--in applied research, training and education, and performance standards--is outlined as well.

Public health, academic medicine, and the alcohol industry's corporate social responsibility activities.

PubMed

Babor, Thomas F; Robaina, Katherine

2013-02-01

We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry's economic interests.

Public Health, Academic Medicine, and the Alcohol Industry’s Corporate Social Responsibility Activities

PubMed Central

Robaina, Katherine

2013-01-01

We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry’s economic interests. PMID:23237151

For-Profit Colleges and Universities: Their Markets, Regulation, Performance, and Place in Higher Education

ERIC Educational Resources Information Center

Hentschke, Guilbert C., Ed.; Lechuga, Vicente M., Ed.; Tierney, William G., Ed.

2010-01-01

This book offers a clear-eyed and balanced analysis of for-profit colleges and universities (FPCUs), reviewing their history, business strategies, and management practices; setting them in the context of marketplace conditions, the framework of public policy and government regulations; and viewing them in the light of the public good. Individual…

Religion, Advocacy Coalitions, and the Politics of U.S. Public Schooling

ERIC Educational Resources Information Center

Lugg, Catherine A.; Robinson, Malila N.

2009-01-01

Employing the Advocacy Coalition Framework to ground the analysis, this article begins with an historical overview of the US Protestant Right and its involvement with the politics of public schooling. It then moves to a discussion of a few current legal and policy issues (intelligent design, evolution, the Kansas state board of education, school…

A framework to assess welfare mix and service provision models in health care and social welfare: case studies of two prominent Italian regions.

PubMed

Longo, Francesco; Notarnicola, Elisabetta; Tasselli, Stefano

2015-04-09

The mechanisms through which the relationships among public institutions, private providers and families affect care and service provision systems are puzzling. How can we understand the mechanisms in these contexts? Which elements should we explore to capture the complexity of care provision? The aim of our study is to provide a framework that can help read and reframe these puzzling care provision mechanisms in a welfare mix context. First, we develop a theoretical framework for understanding how service provision occurs in care systems that are characterised by a variety of relationships between multiple actors, using an evidence-based approach that looks at both public and private expenditures and the number of users relative to the level of needs coverage and compared with declared values and political rhetoric. Second, we test this framework in two case studies built on data from two prominent Italian regions, Lombardy and Emilia-Romagna. We argue that service provision models depend on the interplay among six conceptual elements: policy values, governance rules, resources, nature of the providers, service standards and eligibility criteria. Our empirical study shows that beneath the relevant differences in values and political rhetoric between the case studies of the two Italian regions, there is a surprising isomorphism in service standards and the levels of covering the population's needs. The suggested framework appears to be effective and feasible; it fosters interdisciplinary approaches and supports policy-making discussions. This study may contribute to deepening knowledge about public care service provision and institutional arrangements, which can be used to promote more effective reforms and may advance future research. Although the framework was tested on the Italian welfare system, it can be used to assess many different systems.

Revolution or evolution: the challenges of conceptualizing patient and public involvement in a consumerist world

PubMed Central

Tritter, Jonathan Q.

2009-01-01

Abstract Background  Changing the relationship between citizens and the state is at the heart of current policy reforms. Across England and the developed world, from Oslo to Ontario, Newcastle to Newquay, giving the public a more direct say in shaping the organization and delivery of healthcare services is central to the current health reform agenda. Realigning public services around those they serve, based on evidence from service user’s experiences, and designed with and by the people rather than simply on their behalf, is challenging the dominance of managerialism, marketization and bureaucratic expertise. Despite this attention there is limited conceptual and theoretical work to underpin policy and practice. Objective  This article proposes a conceptual framework for patient and public involvement (PPI) and goes on to explore the different justifications for involvement and the implications of a rights‐based rather than a regulatory approach. These issues are highlighted through exploring the particular evolution of English health policy in relation to PPI on the one hand and patient choice on the other before turning to similar patterns apparent in the United States and more broadly. Conclusions  A framework for conceptualizing PPI is presented that differentiates between the different types and aims of involvement and their potential impact. Approaches to involvement are different in those countries that adopt a rights‐based rather than a regulatory approach. I conclude with a discussion of the tension and interaction apparent in the globalization of both involvement and patient choice in both policy and practice. PMID:19754691

Understanding public perceptions of biotechnology through the "Integrative Worldview Framework".

PubMed

De Witt, Annick; Osseweijer, Patricia; Pierce, Robin

2015-07-03

Biotechnological innovations prompt a range of societal responses that demand understanding. Research has shown such responses are shaped by individuals' cultural worldviews. We aim to demonstrate how the Integrative Worldview Framework (IWF) can be used for analyzing perceptions of biotechnology, by reviewing (1) research on public perceptions of biotechnology and (2) analyses of the stakeholder-debate on the bio-based economy, using the Integrative Worldview Framework (IWF) as analytical lens. This framework operationalizes the concept of worldview and distinguishes between traditional, modern, and postmodern worldviews, among others. Applied to these literatures, this framework illuminates how these worldviews underlie major societal responses, thereby providing a unifying understanding of the literature on perceptions of biotechnology. We conclude the IWF has relevance for informing research on perceptions of socio-technical changes, generating insight into the paradigmatic gaps in social science, and facilitating reflexive and inclusive policy-making and debates on these timely issues. © The Author(s) 2015.

Discursive gaps in the implementation of public health policy guidelines in India: the case of HIV testing.

PubMed

Sheikh, Kabir; Porter, John

2010-12-01

The implementation of standardized policy guidelines for care of diseases of public health importance has emerged as a subject of concern in low and middle-income countries (LMIC) globally. We conducted an empirical research study using the interpretive policy analysis approach to diagnose reasons for gaps in the implementation of national guidelines for HIV testing in Indian hospitals. Forty-six in-depth interviews were conducted with actors involved in policy implementation processes in five states of India, including practitioners, health administrators, policy-planners and donors. We found that actors' divergences from their putative roles in implementation were underpinned by their inhabitation of discrete 'systems of meaning' - frameworks for perceiving policy problems, acting and making decisions. Key gaps in policy implementation included conflicts between different actors' ideals of performance of core tasks and conformance with policy, and problems in communicating policy ideas across systems of meaning. These 'discursive' gaps were compounded by the lack of avenues for intellectual intercourse and by unaccounted interrelationships of power between implementing actors. Our findings demonstrate the importance of thinking beyond short-sighted ideals of aligning frontline practices with global policymakers' intentions. Recognising the deliberative nature of implementation, and strengthening discourse and communications between involved actors may be critical to the success of public health policies in Indian and comparable LMIC settings. Effective policy implementation in the long term also necessitates enhancing practitioners' contributions to the policy process, and equipping country public health functionaries to actualize their policy leadership roles. Copyright © 2010 Elsevier Ltd. All rights reserved.

Conceptual framework for describing selected urban and community impacts of federal energy policies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morris, F.A,; Marcus, A.A.; Keller, D.

1980-06-01

A conceptual framework is presented for describing selected urban and community impacts of Federal energy policies. The framework depends on a simple causal model. The outputs of the model are impacts, changes in the state of the world of particular interest to policymakers. At any given time, a set of determinants account for the state of the world with respect to an impact category. Application of the model to a particular impact category requires: establishing a definition and measure for the impact category and identifying the determinants of these impacts. Analysis of the impact of a particular policy requires themore » following: identifying the policy and its effects (as estimated by others), isolating any effects that themselves constitute an urban and community impact, identifying any effects that change the value of determinants, and describing the impact with reference to the new values of determinants. This report provides a framework for these steps. Three impacts addressed are: neighborhood stability, housing availability, and quality and availability of public services. In each chapter, a definition and measure for the impact are specified; its principal determinants are identified; how the causal model can be used to estimate impacts by applying it to three illustrative Federal policies (domestic oil price decontrol, building energy performance standards, and increased Federal aid for mass transit) is demonstrated. (MCW)« less

Cost, Price and Public Policy: Peering into the Higher Education Black Box. New Agenda Series[TM], Volume 1, Number 3.

ERIC Educational Resources Information Center

Stringer, William L.; Cunningham, Alisa F.

This report contains a conceptual framework for analyzing costs and prices by evaluating the higher education production function and the determinants of both prices and costs. The framework can be used to strengthen understanding of costs and prices within individual institutions and to inform macro level investments at state and national levels.…

The potential of ecological theory for building an integrated framework to develop the public health contribution of health visiting.

PubMed

Bryans, Alison; Cornish, Flora; McIntosh, Jean

2009-11-01

In line with recent UK and Scottish policy imperatives, there is increasing pressure for the health visiting service to assume an enhanced role in improving public health. Although health visiting has so far maintained its unique position as a primarily preventive service within the UK health service, its distinctive contribution now appears under threat. The continuing absence of a comprehensive and integrated conceptual basis for practice has a negative impact on the profession's ability to respond to current challenges. Establishing an integrative framework to conceptualise health visiting practice would enable more sensitive, focused and appropriate research, education and evaluation in relation to practice. Work in this area could thus usefully contribute to the future development of the service at a difficult time. Our paper aims to make such a contribution. In support of our conceptual aims, we draw on a study of health visiting practice undertaken within a large conurbation in central Scotland. The study used a mixed method, collaborative approach involving 12 audio-recorded and observed health visitor-client interactions, semi-structured interviews with the 12 HVs and 12 clients, examination of related documentation and workshops with the HV participants. We critically consider prevalent models of health visiting practice and describe the more integrative conceptual approach provided by Bronfenbrenner's ecological, 'person-in-context' framework. The paper subsequently explores relationships between this framework and understandings of need demonstrated by health visitors who participated in our study. Current policy emphasises the need to focus on public health and social inclusion in order to improve health. However, if this policy is to be translated into practice, we must develop a more adequate understanding of how practitioners work effectively with families and individuals in a sensitive and context-specific manner. Bronfenbrenner's framework appears to offer a promising means of building on the current strengths of the health visiting service to further develop a 'person-in-context' approach to health improvement that is mindful of and responsive to multiple, inter-related influences on health. We therefore recommend further research to directly test the utility of this framework.

Health policies in Brazil in times of contradiction: paths and pitfalls in the construction of a universal system.

PubMed

Machado, Cristiani Vieira; Lima, Luciana Dias de; Baptista, Tatiana Wargas de Faria

2017-10-02

This article analyzes the trajectory of national health policy in Brazil from 1990 to 2016 and explores the policy's contradictions and conditioning factors during the same period. Continuities and changes were seen in the policy's context, process, and content in five distinct moments. The analysis of the policy's conditioning factors showed that the Constitutional framework, institutional arrangements, and action by health sector stakeholders were central to the expansion of public programs and services, providing the material foundations and expanding the basis of support for the Brazilian Unified National Health System at the health sector level. However, historical and structural limitations, institutional legacies, and the dispute between projects for the sector have influenced national health policy. Interaction between these conditioning factors explains the policy's contradictions during the period, for example with regard to health's position in the national development model and social security system and the financing and public-private relations in health. Expansion of public services occurred simultaneously with the strengthening of private segments. Dynamic health markets that compete for resources from government and families, limit the possibility of consolidating a universal health system, and reiterate social stratification and inequalities in health.

Constructing public and political discourse on alcohol issues: towards a framework for analysis.

PubMed

Hansen, Anders; Gunter, Barrie

2007-01-01

To examine the possibilities for research into news reporting and its role in reflecting and informing public and political beliefs and action in relation to alcohol and drinking practices. Studies on media and alcohol, focusing on the role of media in relation to alcohol consumption and drinking-related practices, policies and beliefs. Most research on alcohol and media has focused on either advertising or entertainment media content, rather than on news reporting and its wider social implications. The role of news reporting could usefully be widened. We offer a framework for analysing the role of news media in relation to public debate and practice with regard to alcohol and drinking.

Global Tobacco Control: An integrated approach to global health policy

PubMed Central

RUGER, JENNIFER PRAH

2014-01-01

Following the development discussion in the last volume on the ‘politics of health’, Jennifer Prah Ruger argues that the Framework Convention on Tobacco Control (FCTC) represents a shift in global health policy that recognizes the importance of addressing health needs on multiple fronts and integrating public policies into a comprehensive set of health improvement strategies. She argues that the FCTC provides a model for multifaceted approaches to health improvement that require simultaneous progress on various dimensions. PMID:25598648

Searching for sustainability within public health policy: insights from an injury prevention perspective.

PubMed

Errington, Gail; Evans, Catrin; Watson, Michael C

2017-04-01

Sustaining public health programmes in the long-term is key to ensuring full manifestation of their intended benefits. Although an increasing interest in sustainability is apparent within the global literature, empirical studies from within the European setting are few. The factors that influence sustainability are generally conceptualized at three levels: programme level, the immediate context and the wider environment. To-date attention has focused primarily on the former two. Using a community-based child injury prevention programme in England as an exemplar, this paper explores the concept of sustainability within the wider policy environment, and considers the impact of this on local programmes. A content review of global and UK national public health policies (1981-2014) relevant to child safety was undertaken. Interviews were held with senior representatives of global and UK agencies involved in developing child safety policy. Forty-nine policies were reviewed. The term 'sustain', or its derivatives, featured in 36 (73%) of these. Its' use however, related primarily to conservation of resources rather than continued programme operation. Potential mechanisms for supporting programme sustainability featured within some documents; however, the approach to sustainability was inconsistent between policies and over time. Policy stakeholders identified programme sustainability as relevant to their core business, but its' conceptualization varied according to individual interpretation. Programme sustainability is poorly addressed within global and UK-based public health policy. Strengthening a national and international policy focus on sustainability and incorporating sustainability into public health planning frameworks may create a more supportive environment for local programmes. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Reprising the Home Language Survey: Summary of a National Working Session on Policies, Practices, and Tools for Identifying Potential English Learners

ERIC Educational Resources Information Center

Linquanti, Robert; Bailey, Alison L.

2014-01-01

This document is the first in a series of working papers that elaborate on a framework of four key stages in moving toward a common definition of English learner (EL), as described in the Council of Chief State School Officers (CCSSO) publication, "Toward a "Common Definition of English Learner": A Brief Defining Policy and…

Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework

PubMed Central

Gushulak, BD; Weekers, J; MacPherson, DW

2010-01-01

International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced by global health events. PMID:22460280

Migrants and emerging public health issues in a globalized world: threats, risks and challenges, an evidence-based framework.

PubMed

Gushulak, Bd; Weekers, J; Macpherson, Dw

2009-01-01

International population mobility is an underlying factor in the emergence of public health threats and risks that must be managed globally. These risks are often related, but not limited, to transmissible pathogens. Mobile populations can link zones of disease emergence to lowprevalence or nonendemic areas through rapid or high-volume international movements, or both. Against this background of human movement, other global processes such as economics, trade, transportation, environment and climate change, as well as civil security influence the health impacts of disease emergence. Concurrently, global information systems, together with regulatory frameworks for disease surveillance and reporting, affect organizational and public awareness of events of potential public health significance. International regulations directed at disease mitigation and control have not kept pace with the growing challenges associated with the volume, speed, diversity, and disparity of modern patterns of human movement. The thesis that human population mobility is itself a major determinant of global public health is supported in this article by review of the published literature from the perspective of determinants of health (such as genetics/biology, behavior, environment, and socioeconomics), population-based disease prevalence differences, existing national and international health policies and regulations, as well as inter-regional shifts in population demographics and health outcomes. This paper highlights some of the emerging threats and risks to public health, identifies gaps in existing frameworks to manage health issues associated with migration, and suggests changes in approach to population mobility, globalization, and public health. The proposed integrated approach includes a broad spectrum of stakeholders ranging from individual health-care providers to policy makers and international organizations that are primarily involved in global health management, or are influenced by global health events.

Learning in the zone: toward workforce development of evidence-based public policy communication.

PubMed

Meyerson, Beth E; Haderxhanaj, Laura T; Comer, Karen; Zimet, Gregory D

2018-06-05

Evidence-based policy communication (EBPC) is an important, emerging focus in public health research. However, we have yet to understand public health workforce ability to develop and/or use it. The study objective was to characterize capacity to develop and use EBPC and identify cooperative learning and development opportunities using the case of Human papillomavirus (HPV). Vygotsky's Zone of Proximal Development (ZPD) informed guided interviews with 27 advocates in Indiana from government, industry, research, state associations and individuals. Participants focused on HPV, cancer, women's health, school health and minority health. Capacity to develop and use EBPC was reported to develop through cooperative learning opportunities on the job or in advocacy focused coalitions. Coalition learning appeared to translate across health topics. Notably, policy experience did not assure understanding or use of EBPC. The ZPD framework can inform workforce EBPC interventions by focusing on actual development, potential development and factors for learning and development in the ZPD. Future studies should further clarify and evaluate emerging indicators in additional public health policy areas with a larger sample.

Impact of environmental discourses on public health policy arrangements: a comparative study in the UK and Flanders, (Belgium).

PubMed

Stassen, K R; Gislason, M; Leroy, P

2010-10-01

Theoretically inspired by discursive institutionalism and multi-level governance, this paper assesses the extent to which 'environmental health' has emerged as a new discourse at European level, the effects it has had on national public health governance in two European countries, and what mechanisms have triggered or hindered these effects. Comparison of the dynamics in public health policy arrangements in Flanders (Belgium) and the UK, nations influenced by both international and European environmental health discourses. The Policy Arrangement Approach was the analytical framework used to structure the results of this textual analysis. Despite their shared focus on environmental health, Belgium and the UK display quite different approaches to environmental health governance. While Belgium works on environmental health in a predominantly top-down approach, the UK has developed a more inward-facing approach to environmental health policies. The cases of the UK and Belgium show that, although these countries respond similarly to internationally agreed charters and both are members of the European Union, national differences in environmental health policies persist, mainly due to pre-existing national policy arrangements and the activities of national institutions. This leads to a divergent interplay between national and international institutions. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The DECIDE evidence to recommendation framework adapted to the public health field in Sweden.

PubMed

Guldbrandsson, Karin; Stenström, Nils; Winzer, Regina

2016-12-01

Organizations worldwide compile results from scientific studies, and grade the evidence of interventions, in order to assist policy makers. However, quality of evidence alone is seldom sufficient to make a recommendation. The Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence (DECIDE) framework aims to facilitate decision making and to improve dissemination and implementation of recommendations in the healthcare and public health sector. The aim of this study was to investigate whether the DECIDE framework is applicable in the public health field in Sweden. The DECIDE framework was presented and discussed in interviews with stakeholders and governmental organizations and tested in panels. Content analyses were performed. In general, the informants were positive to the DECIDE framework. However, two questions, the first regarding individual autonomy and the second regarding method sustainability, were by the stakeholders felt to be missing in the framework. The importance of the composition of the DECIDE stakeholder panel was lifted by the informants, as was the significant role of the chair. Further, the informants raised concerns about the general lack of research evidence based on RCT design regarding universal methods in the public health sector. Finally, the local, regional and national levels' responsibility for dissemination and implementation of recommendations were lifted by the informants. The DECIDE framework might be useful as a tool for dissemination and implementation of recommendations in the public health field in Sweden. Important questions for further research are whether these findings are suitable for other public health topics and in other public health settings. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Attitudes toward nonsmoking policies and tobacco tax increases: a cross-sectional study among Vietnamese adults.

PubMed

Dao, Thi Minh An; Hoang, Van Minh; Le, Thi Huong; Kim, Bao Giang; Le, Thi Thanh Xuan; Pham, Thi Quynh Nga; Hsia, Jason

2015-03-01

Following the 2009 update of the 2005 Framework Convention on Tobacco Control, Vietnam issued a new policy to ban smoking at workplaces and public places. This cross-sectional survey explored public attitudes toward this new regulation and provides evidence to inform future laws. Using stratified cluster sampling, 10 383 Vietnamese people older than 15 years were drawn from 11 142 selected households. Policies mandating "no smoking at workplaces" were supported by 88.7% of Vietnamese adults, whereas "no smoking in public places" and "increasing the tobacco tax" received less support. Educational level, knowledge of health effects, access to information on quitting and smoking health risks, smoking status, ethnicity, and region had significant associations with positive attitudes toward all 3 tobacco control policies. Adults belonging to the non-Kinh ethnic group, those who do not live in the Red river delta, people with lower educational levels, and current smokers should be targeted in tobacco control communication programs. © 2012 APJPH.

[Discrimination and homophobia associated to the human immunodeficiency virus epidemic].

PubMed

Orozco-Núñez, Emanuel; Alcalde-Rabanal, Jacqueline Elizabeth; Ruiz-Larios, José Arturo; Sucilla-Pérez, Héctor; García-Cerde, Rodrigo

2015-01-01

To describe a political mapping on discrimination and homophobia associated to human immunodeficiency virus (HIV) in the context of public institutions in Mexico. The political mapping was conducted in six Mexican states. Stakeholders who were involved in HIV actions from public and private sectors were included. Semistructured interviews were applied to explore homophobia and discrimination associated with HIV. Information was systematized using the Policy Maker software, which is a good support for analyzing health policies. Discriminatory and homophobic practices in the public domain occurred, damaging people´s integrity via insults, derision and hate crimes. Most stakeholders expressed a supportive position to prevent discrimination and homophobia and some of them had great influence on policy-making decisions. It was found that state policy frameworks are less specific in addressing these issues. Homophobia and discrimination associated to HIV are still considered problematic in Mexico. Homophobia is a very sensitive issue that requires further attention. Also, an actual execution of governmental authority requires greater enforcement of laws against discrimination and homophobia.

Media Coverage of Alcohol Issues: A Critical Political Economy Framework—A Case Study from Ireland

PubMed Central

Mercille, Julien

2017-01-01

There is a growing literature on news media representations of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. This paper presents such a framework that conceives of news organisations as corporations that share the values and interests of political and economic elites. The media are thus expected to present viewpoints that are more aligned with the alcohol industry than the scientific consensus on public health policy would warrant. The media are also expected, but to a lesser extent, to present a certain amount of support for public health perspectives because these are supported by a few socioeconomic elite groups (the medical professions, progressive politicians). The case of Ireland from 2012 to 2017 illustrates the framework empirically. Four main newspapers’ coverage of the Public Health (Alcohol) Bill and related policies is examined. Results show that, overall, 44.0% of articles support public health measures and 56.0% are opposed or remain neutral. It is argued that the media are not strong proponents of public health for multiple reasons: there are more articles opposed to or neutral toward public health measures than supporting them; the number of supportive articles remains relatively small and there are still many pieces presenting drinks industry views; there are virtually no calls in the media for stronger measures; supportive coverage is partially explained by the pub owners lobby’s support for minimum unit pricing; the media often downplay or ignore the negative consequences of alcohol, such as its role in accidents; many news articles normalise drinking and promote events sponsored by the industry; there is not a single Irish journalist covering alcohol issues systematically; and other policy issues that are prioritised by elites receive multiple times more media coverage than public health measures. In short, the media reflect the views of the political and economic establishment on public health measures: there is some support from the medical professions and progressive politicians, but overall, there is a clear reluctance to support strong public health strategies. One main recommendation for public health advocates to promote their perspectives is to diversify the mass media and make them less commercial in nature, as well as to engage with non-corporate, so-called progressive “alternative media” outlets. PMID:28621753

How stakeholder roles, power, and negotiation impact natural resource policy: A political economy view

USGS Publications Warehouse

Caughlan, L.

2002-01-01

Natural resource management decisions are complicated by multiple property rights, management objectives, and stakeholders with varying degrees of influence over the decision making process. In order to make efficient decisions, managers must incorporate the opinions and values of the involved stakeholders as well as understand the complex institutional constraints and opportunities that influence the decision-making process. Often this type of information is not understood until after a decision has been made, which can result in wasted time and effort.The purpose of my dissertation was to show how institutional frameworks and stakeholder involvement influence the various phases of the resource management decision-making process in a public choice framework. The intent was to assist decision makers and stakeholders by developing a methodology for formally incorporating stakeholders'' objectives and influence into the resource management planning process and to predict the potential success of rent-seeking activity based on stakeholder preferences and level of influence. Concepts from decision analysis, institutional analysis, and public choice economics were used in designing this interdisciplinary framework. The framework was then applied to an actual case study concerning elk and bison management on the National Elk Refuge and Grand Teton National Park near Jackson, Wyoming. The framework allowed for the prediction of the level of support and conflict for all relevant policy decisions, and the identification of each stakeholder''s level of support or opposition for each management decision.

The implications of fundamental cause theory for priority setting.

PubMed

Goldberg, Daniel S

2014-10-01

Application of fundamental cause theory to Powers and Faden's model of social justice highlights the ethical superiority of upstream public health interventions. In this article, I assess the ramifications of fundamental cause theory specifically in context of public health priority setting. Ethically optimal public health policy simultaneously maximizes overall population health and compresses health inequalities. The fundamental cause theory is an important framework in helping to identify which categories of public health interventions are most likely to advance these twin goals.

"Table Top Theory" as a Policy Framework for Gauging the Confluence of Teaching and Private Sector Interests

ERIC Educational Resources Information Center

Jones, Bruce A.

2007-01-01

Without question, the role of business, philanthropy, and other private sector interests in the day-to-day operation of public education has increased significantly over the past 25 years. Pundits of this phenomenon contend that a number of factors have contributed to the increase, such as (1) public dissatisfaction with the performance of school…

Spiral Development: A Perspective

DTIC Science & Technology

2005-06-30

GRADUATE SCHOOL OF BUSINESS AND PUBLIC POLICY 555 DYER ROAD MONTEREY, CA 93943-5103 8. PERFORMING ORGANIZATION REPORT NUMBER NPS-GSBPP-05-009...Framework from 1987-2003." BPP Research Colloquium. 25 November 2003. Copies of the Acquisition Sponsored Research Reports may be printed from...Perspective 30 June 2005 by Dr. Aruna Apte, Assistant Professor raduate School of Business & Public Polic THIS PAGE INTENTIONALLY LEFT

Building on the EGIPPS performance assessment: the multipolar framework as a heuristic to tackle the complexity of performance of public service oriented health care organisations

PubMed Central

2014-01-01

Background Performance of health care systems is a key concern of policy makers and health service managers all over the world. It is also a major challenge, given its multidimensional nature that easily leads to conceptual and methodological confusion. This is reflected by a scarcity of models that comprehensively analyse health system performance. Discussion In health, one of the most comprehensive performance frameworks was developed by the team of Leggat and Sicotte. Their framework integrates 4 key organisational functions (goal attainment, production, adaptation to the environment, and values and culture) and the tensions between these functions. We modified this framework to better fit the assessment of the performance of health organisations in the public service domain and propose an analytical strategy that takes it into the social complexity of health organisations. The resulting multipolar performance framework (MPF) is a meta-framework that facilitates the analysis of the relations and interactions between the multiple actors that influence the performance of health organisations. Summary Using the MPF in a dynamic reiterative mode not only helps managers to identify the bottlenecks that hamper performance, but also the unintended effects and feedback loops that emerge. Similarly, it helps policymakers and programme managers at central level to better anticipate the potential results and side effects of and required conditions for health policies and programmes and to steer their implementation accordingly. PMID:24742181

The Role of Policy and Institutions on Health Spending.

PubMed

de la Maisonneuve, Christine; Moreno-Serra, Rodrigo; Murtin, Fabrice; Oliveira Martins, Joaquim

2017-07-01

This paper investigates the impact of policies and institutions on health expenditures for a large panel of Organisation for Economic Co-operation and Development countries for the period of 2000-2010. A set of 20 policy and institutional indicators developed by the Organisation for Economic Co-operation and Development are integrated into a theoretically motivated econometric framework, alongside control variables related to demographic (dependency ratio) and non-demographic (income, prices and technology) drivers of health expenditures per capita. Although a large share of cross-country differences in public health expenditures can be explained by demographic and economic factors (around 71%), cross-country variations in policies and institutions also have a significant influence, explaining most of the remaining difference in public health spending (23%). Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

What makes public health studies ethical? Dissolving the boundary between research and practice.

PubMed

Willison, Donald J; Ondrusek, Nancy; Dawson, Angus; Emerson, Claudia; Ferris, Lorraine E; Saginur, Raphael; Sampson, Heather; Upshur, Ross

2014-08-08

The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary - whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants - have been unsatisfactory.Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle - from initial planning through to knowledge exchange. The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives.The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services organizations, and beyond. Public Health Ontario has developed an ethics framework that is applicable to any evidence-generating activity, regardless of whether it is labelled research. While developed in a public health context, it is readily adaptable to other health services organizations and beyond.

[Implementation of Italian guidelines on public health genomics in Italy: a challenging policy of the NHS].

PubMed

Boccia, Stefania; Federici, Antonio; Colotto, Marco; Villari, Paolo

2014-01-01

Genomics and related fields are becoming increasingly relevant in health care practice. Italy is the first European country that has a structured policy of Public Health Genomics. Nevertheless, what should be the role of genomics in a public health perspective and how public health professionals should engage with advances in genomics' knowledge and technology, is still not entirely clear. A description of the regulatory framework made-up by the Italian government in the last years is provided. In order to implement the national guidelines on Public Health Genomics published in 2013, key issues including the ethical, legal and social aspects within an evidence-based framework should be warranted and are herewith discussed. Genomics and predictive medicine are considered one of the main intervention areas by the National Prevention Plan 2010-2012, and dedicated guidelines were published in 2013. In order to implement such guidelines, we envisage a coordinated effort between stakeholders to guide development in genomic medicine, towards an impact on population health. There is also room to implement knowledge on how genomics can be integrated into health systems in an appropriate and sustainable way. Learning programs are needed to spread knowledge and awareness of genomics technology, in particular on genomic testing for complex diseases.

Immigration as a social determinant of health.

PubMed

Castañeda, Heide; Holmes, Seth M; Madrigal, Daniel S; Young, Maria-Elena DeTrinidad; Beyeler, Naomi; Quesada, James

2015-03-18

Although immigration and immigrant populations have become increasingly important foci in public health research and practice, a social determinants of health approach has seldom been applied in this area. Global patterns of morbidity and mortality follow inequities rooted in societal, political, and economic conditions produced and reproduced by social structures, policies, and institutions. The lack of dialogue between these two profoundly related phenomena-social determinants of health and immigration-has resulted in missed opportunities for public health research, practice, and policy work. In this article, we discuss primary frameworks used in recent public health literature on the health of immigrant populations, note gaps in this literature, and argue for a broader examination of immigration as both socially determined and a social determinant of health. We discuss priorities for future research and policy to understand more fully and respond appropriately to the health of the populations affected by this global phenomenon.

[Public sector and social and health policy reforms. An inventory on the eve of the new millennium].

PubMed

Gerschman, S

1999-01-01

This study reflects on reforms in health systems and social policies within the framework of the so-called public sector reforms. The point of departure is a review of various explanations for the crisis in the Welfare State, present in the literature from the 1990s. Social policies, at the heart of the crisis, are heavily challenged. What we intend to demonstrate is that this argument plays a specific role, that of introducing neoliberal changes into economic policy, in which the economic tools used generate abstention by the state from the social sphere, deregulation of national economies in favor of the free market, and the fundamentally oversized role of the international financial market. Within this context we analyze the social security and health system reforms. The final part of the article deals with current difficulties in social policies, focusing the debate on a mapping of possible alternatives for developing social and health policies.

Public health ethics. Public justification and public trust.

PubMed

Childress, J F; Bernheim, R Gaare

2008-02-01

Viewing public health as a political and social undertaking as well as a goal of this activity, the authors develop some key elements in a framework for public health ethics, with particular attention to the formation of public health policies and to decisions by public health officials that are not fully determined by established public policies. They concentrate on ways to approach ethical conflicts about public health interventions. These conflicts arise because, in addition to the value of public health, societies have a wide range of other values that sometimes constrain the selection of means to achieve public health goals. The authors analyze three approaches for resolving these conflicts (absolutist, contextualist, and presumptivist), argue for the superiority of the presumptivist approach, and briefly explicate five conditions for rebutting presumptions in a process of public justification. In a liberal, pluralistic, democratic society, a presumptivist approach that engages the public in the context of a variety of relationships can provide a foundation for public trust, which is essential to public health as a political and social practice as well as to achieving public health goals.

Chronic disease prevention policy in British Columbia and Ontario in light of public health renewal: a comparative policy analysis

PubMed Central

2013-01-01

Background Public health strategies that focus on legislative and policy change involving chronic disease risk factors such as unhealthy diet and physical inactivity have the potential to prevent chronic diseases and improve quality of life as a whole. However, many public health policies introduced as part of public health reform have not yet been analyzed, such as in British Columbia and Ontario. The purpose of this paper is to present the results of a descriptive, comparative analysis of public health policies related to the Healthy Living Core Program in British Columbia and Chronic Disease Prevention Standard in Ontario that are intended to prevent a range of chronic diseases by promoting healthy eating and physical activity, among other things. Methods Policy documents were found through Internet search engines and Ministry websites, at the guidance of policy experts. These included government documents as well as documents from non-governmental organizations that were implementing policies and programs at a provincial level. Documents (n = 31) were then analysed using thematic content analysis to classify, describe and compare policies in a systematic fashion, using the software NVivo. Results Three main categories emerged from the analysis of documents: 1) goals for chronic disease prevention in British Columbia and Ontario, 2) components of chronic disease prevention policies, and 3) expected outputs of chronic disease prevention interventions. Although there were many similarities between the two provinces, they differed somewhat in terms of their approach to issues such as evidence, equity, and policy components. Some expected outputs were adoption of healthy behaviours, use of information, healthy environments and increased public awareness. Conclusions The two provincial policies present different approaches to support the implementation of related programs. Differences may be related to contextual factors such as program delivery structures and different philosophical approaches underlying the two frameworks. These differences and possible explanations for them are important to understand because they serve to contextualize the differences in health outcomes across the two provinces that might eventually be observed. This analysis informs future public health policy directions as the two provinces can learn from each other. PMID:24099140

Chronic disease prevention policy in British Columbia and Ontario in light of public health renewal: a comparative policy analysis.

PubMed

Kothari, Anita; Gore, Dana; MacDonald, Marjorie; Bursey, Gayle; Allan, Diane; Scarr, Jennifer

2013-10-08

Public health strategies that focus on legislative and policy change involving chronic disease risk factors such as unhealthy diet and physical inactivity have the potential to prevent chronic diseases and improve quality of life as a whole. However, many public health policies introduced as part of public health reform have not yet been analyzed, such as in British Columbia and Ontario. The purpose of this paper is to present the results of a descriptive, comparative analysis of public health policies related to the Healthy Living Core Program in British Columbia and Chronic Disease Prevention Standard in Ontario that are intended to prevent a range of chronic diseases by promoting healthy eating and physical activity, among other things. Policy documents were found through Internet search engines and Ministry websites, at the guidance of policy experts. These included government documents as well as documents from non-governmental organizations that were implementing policies and programs at a provincial level. Documents (n = 31) were then analysed using thematic content analysis to classify, describe and compare policies in a systematic fashion, using the software NVivo. Three main categories emerged from the analysis of documents: 1) goals for chronic disease prevention in British Columbia and Ontario, 2) components of chronic disease prevention policies, and 3) expected outputs of chronic disease prevention interventions. Although there were many similarities between the two provinces, they differed somewhat in terms of their approach to issues such as evidence, equity, and policy components. Some expected outputs were adoption of healthy behaviours, use of information, healthy environments and increased public awareness. The two provincial policies present different approaches to support the implementation of related programs. Differences may be related to contextual factors such as program delivery structures and different philosophical approaches underlying the two frameworks. These differences and possible explanations for them are important to understand because they serve to contextualize the differences in health outcomes across the two provinces that might eventually be observed. This analysis informs future public health policy directions as the two provinces can learn from each other.

The Road Weather Bulletin : Road Weather Management Publications and Training Materials

DOT National Transportation Integrated Search

2011-01-01

This document summarizes results from the Road Weather Policy Forum held November 8-9, 2010 in Washington, D.C. The agenda outlines a research framework, broad research needs, and the various roles and responsibilities of several stakeholder sectors.

Human trafficking and exploitation: A global health concern.

PubMed

Zimmerman, Cathy; Kiss, Ligia

2017-11-01

In this collection review, Cathy Zimmerman and colleague introduce the PLOS Medicine Collection on Human Trafficking, Exploitation and Health, laying out the magnitude of the global trafficking problem and offering a public health policy framework to guide responses to trafficking.

What shapes research impact on policy? Understanding research uptake in sexual and reproductive health policy processes in resource poor contexts

PubMed Central

2011-01-01

Assessing the impact that research evidence has on policy is complex. It involves consideration of conceptual issues of what determines research impact and policy change. There are also a range of methodological issues relating to the question of attribution and the counter-factual. The dynamics of SRH, HIV and AIDS, like many policy arenas, are partly generic and partly issue- and context-specific. Against this background, this article reviews some of the main conceptualisations of research impact on policy, including generic determinants of research impact identified across a range of settings, as well as the specificities of SRH in particular. We find that there is scope for greater cross-fertilisation of concepts, models and experiences between public health researchers and political scientists working in international development and research impact evaluation. We identify aspects of the policy landscape and drivers of policy change commonly occurring across multiple sectors and studies to create a framework that researchers can use to examine the influences on research uptake in specific settings, in order to guide attempts to ensure uptake of their findings. This framework has the advantage that distinguishes between pre-existing factors influencing uptake and the ways in which researchers can actively influence the policy landscape and promote research uptake through their policy engagement actions and strategies. We apply this framework to examples from the case study papers in this supplement, with specific discussion about the dynamics of SRH policy processes in resource poor contexts. We conclude by highlighting the need for continued multi-sectoral work on understanding and measuring research uptake and for prospective approaches to receive greater attention from policy analysts. PMID:21679384

Rethinking the evaluation and measurement of Health in all policies.

PubMed

Bauman, Adrian E; King, Lesley; Nutbeam, Don

2014-06-01

Current international attention to Health in all policies (HiAP) has its origins in a more sophisticated understanding of the impact of public policies on health, and a recognition that policies across government have an impact on the social and environmental determinants of health and related inequalities in health. As an emerging field, there has been limited attention focused on comprehensive approaches to the evaluation of HiAP to date, and the research focus around HiAP has mainly examined the processes of cross-sectoral policy development, rather than their health-related impacts or outcomes. The purpose of this paper is to explore issues in assessing the implementation of HiAP and describe an expanded evaluation framework for assessing the potential intermediate and end-point effects of HiAP actions, using a planning logic model for 'complex programs'. This meets the needs of public sector policy-makers who express an interest in understanding the relationship between HiAP and health-related and social outcomes. The paper proposes applying a contribution analysis method to estimate and model the anticipated impacts of HiAP policies on intermediate and longer term outcomes, in advance of empirical studies of these outcomes, and as an innovative input into HiAP and evaluation planning. A broader long-term evaluation framework will enhance the political saliency of HiAP initiatives, especially from governments considering HiAP approaches in financially constrained environments. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Conceptual Framework for Planning Systemic Human Adaptation to Global Warming.

PubMed

Tait, Peter W; Hanna, Elizabeth G

2015-08-31

Human activity is having multiple, inter-related effects on ecosystems. Greenhouse gas emissions persisting along current trajectories threaten to significantly alter human society. At 0.85 °C of anthropogenic warming, deleterious human impacts are acutely evident. Additional warming of 0.5 °C-1.0 °C from already emitted CO₂ will further intensify extreme heat and damaging storm events. Failing to sufficiently address this trend will have a heavy human toll directly and indirectly on health. Along with mitigation efforts, societal adaptation to a warmer world is imperative. Adaptation efforts need to be significantly upscaled to prepare society to lessen the public health effects of rising temperatures. Modifying societal behaviour is inherently complex and presents a major policy challenge. We propose a social systems framework for conceptualizing adaptation that maps out three domains within the adaptation policy landscape: acclimatisation, behavioural adaptation and technological adaptation, which operate at societal and personal levels. We propose that overlaying this framework on a systems approach to societal change planning methods will enhance governments' capacity and efficacy in strategic planning for adaptation. This conceptual framework provides a policy oriented planning assessment tool that will help planners match interventions to the behaviours being targeted for change. We provide illustrative examples to demonstrate the framework's application as a planning tool.

Many-Objective Reservoir Policy Identification and Refinement to Reduce Institutional Myopia in Water Management

NASA Astrophysics Data System (ADS)

Giuliani, M.; Herman, J. D.; Castelletti, A.; Reed, P. M.

2013-12-01

Institutional inertia strongly limits our ability to adapt water reservoir operations to better manage growing water demands as well as their associated uncertainties in a changing climate. Although it has long been recognized that these systems are generally framed in heterogeneous socio-economic contexts involving a myriad of conflicting, non-commensurable operating objectives, our broader understanding of the multiobjective consequences of current operating rules as well as their vulnerability to hydroclimatic uncertainties is severely limited. This study proposes a decision analytic framework to overcome policy inertia and myopia in complex river basin management contexts. The framework combines reservoir policy identification and many-objective optimization under uncertainty to characterize current operations and discover key tradeoffs between alternative policies for balancing evolving demands and system uncertainties. The approach is demonstrated on the Conowingo Dam, located within the Lower Susquehanna River, USA. The Lower Susquehanna River is an interstate water body that has been subject to intensive water management efforts due to the system's competing demands from urban water supply, atomic power plant cooling, hydropower production, and federally regulated environmental flows. Initially our proposed framework uses available streamflow observations to implicitly identify the Conowingo Dam's current but unknown operating policy. This baseline policy is identified by fitting radial basis functions to existing system dynamics. Our assumption in the baseline policy is that the dam operator is represented as a rational agent seeking to maximize primary operational objectives (i.e., guaranteeing the public water supply and maximizing the hydropower revenue). The quality of the identified baseline policy is evaluated by its ability to replicate historical release dynamics. Once identified, the historical baseline policy then provides a means of representing the decision preferences guiding current operations. Our results show that the estimated policy closely captures the dynamics of current releases and flows for the Lower Susquehanna. After identifying the historical baseline policy, our proposed decision analytic framework then combines evolutionary many-objective optimization with visual analytics to discover improved operating policies. Our Lower Susquehanna results confirm that the system's current history-based operations are negatively biased to overestimate the reliability of the reservoir's multi-sector services. Moreover, our proposed framework has successfully identified alternative reservoir policies that are more robust to hydroclimatic uncertainties while being capable of better addressing the tradeoffs across the Conowingo Dam's multi-sector services.

Incorporating consideration of health impacts into land use development approval processes: Development of a Health Background Study Framework.

PubMed

Moloughney, Brent W; Bursey, Gayle E; Neumann, Jana; Leeming, Daniel H; Gutmann, Christine E; Sivanand, Bhavna; Mowat, David L

2014-09-12

This project involved development of a Health Background Study (HBS) Framework to support consideration of health impacts within municipalities' approval process for land use development. Peel Public Health and Toronto Public Health led the project with the participation of planners, urban designers, engineers, public health staff and development industry representatives. Historical growth in the Region of Peel and suburban Toronto has resulted in extensive low-density development, creating car-dependent communities with disconnected streets and segregated land uses. The inclusion of an HBS in developers' applications to municipalities is one approach by which health-related expectations for the built environment can be established within the approval process. Development of the HBS Framework used the six core elements of the built environment with the strongest evidence for impact on health and was informed by analysis of the provincial and local policy contexts, practices of other municipalities and stakeholder interviews. The Framework's contents were refined according to feedback from multidisciplinary stakeholder workshops. The HBS Framework identifies minimum standards for built environment core elements that developers need to address in their applications. The Framework was created to be simple and instructive with applicability to a range of development locations and scales, and to various stages of the development approval process. Peel Public Health is leading several initiatives to support the use of the HBS as a part of the development application process. The HBS Framework is a tool that public health and planning can use to support the consideration of health impacts within municipalities' land use development processes.

Canaries in the coal mine: Interpersonal violence, gang violence, and violent extremism through a public health prevention lens.

PubMed

Eisenman, David P; Flavahan, Louise

2017-08-01

This paper asks what programmes and policies for preventing violent extremism (also called 'countering violent extremism', or CVE) can learn from the public health violence prevention field. The general answer is that addressing violent extremism within the wider domain of public health violence prevention connects the effort to a relevant field of research, evidence-based policy and programming, and a broader population reach. This answer is reached by examining conceptual alignments between the two fields at both the case-level and the theoretical level. To address extremist violence within the wider reach of violence prevention, having a shared model is seen as a first step. The World Health Organization uses the social-ecological framework for assessing the risk and protective factors for violence and developing effective public-health based programmes. This study illustrates how this model has been used for gang violence prevention and explores overlaps between gang violence prevention and preventing violent extremism. Finally, it provides policy and programme recommendations to align CVE with public health violence prevention.

Manifestations of integrated public health policy in Dutch municipalities.

PubMed

Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

2016-06-01

Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

From built environment to health inequalities: An explanatory framework based on evidence

PubMed Central

Gelormino, Elena; Melis, Giulia; Marietta, Cristina; Costa, Giuseppe

2015-01-01

Objective: The Health in All Policies strategy aims to engage every policy domain in health promotion. The more socially disadvantaged groups are usually more affected by potential negative impacts of policies if they are not health oriented. The built environment represents an important policy domain and, apart from its housing component, its impact on health inequalities is seldom assessed. Methods: A scoping review of evidence on the built environment and its health equity impact was carried out, searching both urban and medical literature since 2000 analysing socio-economic inequalities in relation to different components of the built environment. Results: The proposed explanatory framework assumes that key features of built environment (identified as density, functional mix and public spaces and services), may influence individual health through their impact on both natural environment and social context, as well as behaviours, and that these effects may be unequally distributed according to the social position of individuals. Conclusion: In general, the expected links proposed by the framework are well documented in the literature; however, evidence of their impact on health inequalities remains uncertain due to confounding factors, heterogeneity in study design, and difficulty to generalize evidence that is still very embedded to local contexts. PMID:26844145

41 CFR 102-3.5 - What does this subpart cover and how does it apply?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What does this subpart cover and how does it apply? 102-3.5 Section 102-3.5 Public Contracts and Property Management Federal...? § 102-3.5 What does this subpart cover and how does it apply? This subpart provides the policy framework...

Near Earth Objects and Cascading Effects from the Policy Perspective: Implications from Problem and Solution Definition

NASA Astrophysics Data System (ADS)

Lindquist, Eric

2016-04-01

The characterization of near-Earth-objects (NEOs) in regard to physical attributes and potential risk and impact factors presents a complex and complicates scientific and engineering challenge. The societal and policy risks and impacts are no less complex, yet are rarely considered in the same context as material properties or related factors. Further, NEO impacts are typically considered as discrete events, not as initial events in a dynamic cascading system. The objective of this contribution is to position the characterization of NEOs within the public policy process domain as a means to reflect on the science-policy nexus in regard to risks and multi-hazard impacts associated with these hazards. This will be accomplished through, first, a brief overview of the science-policy nexus, followed by a discussion of policy process frameworks, such as agenda setting and the multiple streams model, focusing events, and punctuated equilibrium, and their application and appropriateness to the problem of NEOs. How, too, for example, does NEO hazard and risk compare with other low probability, high risk, hazards in regard to public policy? Finally, we will reflect on the implications of alternative NEO "solutions" and the characterization of the NEO "problem," and the political and public acceptance of policy alternatives as a way to link NEO science and policy in the context of the overall NH9.12 panel.

Addressing barriers to the prevention, diagnosis and treatment of hepatitis B and C in the face of persisting fiscal constraints in Europe: report from a high level conference.

PubMed

Papatheodoridis, G; Thomas, H C; Golna, C; Bernardi, M; Carballo, M; Cornberg, M; Dalekos, G; Degertekin, B; Dourakis, S; Flisiak, R; Goldberg, D; Gore, C; Goulis, I; Hadziyannis, S; Kalamitsis, G; Kanavos, P; Kautz, A; Koskinas, I; Leite, B R; Malliori, M; Manolakopoulos, S; Matičič, M; Papaevangelou, V; Pirona, A; Prati, D; Raptopoulou-Gigi, M; Reic, T; Robaeys, G; Schatz, E; Souliotis, K; Tountas, Y; Wiktor, S; Wilson, D; Yfantopoulos, J; Hatzakis, A

2016-02-01

In the WHO-EURO region, around 28 million people are currently living with chronic viral hepatitis, and 120,000 people die every year because of it. Lack of awareness and understanding combined with the social stigma and discrimination exacerbate barriers related to access to prevention, diagnosis and treatment services for those most in need. In addition, the persisting economic crisis has impacted on public health spending, thus posing challenges on the sustainable investment in promotion, primary and secondary prevention, diagnosis and treatment of viral hepatitis across European countries. The Hepatitis B and C Public Policy Association in cooperation with the Hellenic Center for Disease Prevention and Control together with 10 partner organizations discussed at the Athens High Level Meeting held in June 2014 recent policy developments, persisting and emerging challenges related to the prevention and management of viral hepatitis and the need for a de minimis framework of urgent priorities for action, reflected in a Call to Action (Appendix S1). The discussion confirmed that persisting barriers do not allow the full realisation of the public health potential of diagnosing and preventing hepatitis B and C, treating hepatitis B and curing hepatitis C. Such barriers are related to (a) lack of evidence-based knowledge of hepatitis B and C, (b) limited access to prevention, diagnosis and treatment services with poor patient pathways, (c) declining resources and (d) the presence of social stigma and discrimination. The discussion also confirmed the emerging importance of fiscal constraints on the ability of policymakers to adequately address viral hepatitis challenges, particularly through increasing coverage of newer therapies. In Europe, it is critical that public policy bodies urgently agree on a conceptual framework for addressing the existing and emerging barriers to managing viral hepatitis. Such a framework would ensure all health systems share a common understanding of definitions and indicators and look to integrate their responses to manage policy spillovers in the most cost-effective manner, while forging wide partnerships to sustainably and successfully address viral hepatitis. © 2016 John Wiley & Sons Ltd.

Defining a Communications Satellite Policy System for the 21st Century: A Model for a International Legal Framework and A New _Code of Conduct_

NASA Astrophysics Data System (ADS)

Pelton, Joseph N.

1996-02-01

This paper addresses the changing international communications environment and explores the key elements of a new policy framework for the 21st Century. It addresses the issues related to changing markets, trade considerations, standards, regulatory changes and international institutions and law. The most important aspects will related to new international policy and regulatory frameworks and in particular to a new international code of ethics and behavior in the field of satellite communications. A new communications satellite policy framework requires systematically addressing the following points: • Multi-lateral agreements at the nation state and the operating entity level • Systematic means to access both private and public capital • Meshing ITU regulations with regional and national policy guidelines including • landing rights" and national allocation procedures. • Systematic approach to local partnerships • Resolving the issue of the relative standing of various satellite systems (i.e. GEO, MEO, and LEO systems) • Resolving the rights, duties, and priorities of satellite facility providers versus types of service prviders. Beyond this policy framework and generalized legal infrastructure there is also another need. This is a need that arises from both increased globalism and competitive international markets. This is what might quite simply be called a "code of reasonable conduct:" To provide global and international communications services effectively and well in the 21st Century will require more than meeting minimum international legal requirements. A new "code of conduct" for global satellite communications will thus likely need to address: • Privacy and surveillance • Ethics of transborder data flow • Censorship and moral values • Cultural and linguistic sensitivity • Freedom of the press and respect for journalistic standards As expanding global information and telecommunications systems grow and impact every aspect of modern life, the need for new international policy and especially new suitable standards of conduct in the field of satellite communications become ever more apparent and necessary.

[Framework for the strengthening of health information systems in Peru].

PubMed

Curioso, Walter H; Espinoza-Portilla, Elizabeth

2015-01-01

In this article we present the essential components and policies that are most relevant regarding the conceptual framework to strengthen the health information systems in Peru. The article also presents the main policies, actions and strategies made in the field of electronic health in Peru that are most significant. The health information systems in Peru play a key role and are expected to achieve an integrated and interoperable information system. This will allow health information to be complete, efficient, of good quality and available in a timely manner to achieve better quality of life for people and allow meaningful modernization of public health in the context of health reform in Peru.

Public health law and disaster medicine: understanding the legal environment.

PubMed

Gionis, Thomas A; Wecht, Cyril; Marshall, Lewis W

2007-01-01

Disaster medicine specialists, policy makers, and the public often feel frustrated when they encounter the complex legal framework that surrounds public health emergencies and disasters. Such a framework is particularly difficult to understand when one considers that the federal government has no express powers over public health or disaster management. In fact, under the US Constitution, the states, rather than the federal government, possess public health governance. Although public health sovereignty formally resides within the states, and notwithstanding the federal government's lack of express constitutional powers over public health crises and disaster management, the federal government has gradually taken on a greater leadership role in managing public health emergencies. In order to clarify the state and federal responsibilities surrounding public health emergencies and disasters, this article explores necessary and pertinent legal topics. These topics include public health duties, public health disasters, state sovereignty, governmental coercion, de facto constitutional empowerment, separation of powers, limited powers, federalism, state police powers, general and federal declarations of emergencies, the Model State Emergency Health Powers Act (MSEHPA), and public health and national security.

Civil Society-Driven Drug Policy Reform for Health and Human Welfare-India.

PubMed

Vallath, Nandini; Tandon, Tripti; Pastrana, Tania; Lohman, Diederik; Husain, S Asra; Cleary, James; Ramanath, Ganpati; Rajagopal, M R

2017-03-01

The lack of adequate access to opioids in India as analgesics and for agonist therapies, forces millions to live with severe unalleviated pain, or languish with suffering associated with drug dependence. Although India is a major opium exporter, the excessively prohibitive 1985 narcotics law formulated to control harmful use of drugs, impeded the availability and access to opioids for medical and scientific purposes. Amendment of this law in 2014 established a new national regulatory framework for improved access to essential opioid analgesics. This article reflects on key elements and processes that led to this landmark achievement. Unlike quick timelines associated with effecting policy reforms for law enforcement, realizing the 2014 drug policy change primarily to mitigate human suffering, was a 22-year-long process. The most exacting challenges included recognizing the multilayered complexities of the prior policy framework and understanding their adverse impact on field practices to chart an appropriate and viable path for reform. The evolution of an informal civil society movement involving health care professionals, lawyers, media, policy analysts, government officials, and the public was pivotal in addressing these challenges and garnering momentum for reform. The success of the effort for improving access to opioid medications was underpinned by a three-pronged strategy of 1) persuading the executive arm of the government to take interim enabling measures; 2) leveraging judicial intervention through public interest litigation; and 3) crafting a viable policy document for legislative approval and implementation. We hope our findings are useful for realizing drug policy reforms, given the current transformed global policy mandates emphasizing humanitarian, healthcare, and quality-of-life considerations. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

AN EIGHT-STEP FRAMEWORK FOR EFFECTIVE AGRICULTURAL WATERSHED MANAGEMENT. (R825290)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

A BIOLOGICAL FRAMEWORK OF URBAN STREAM ASSESSMENT, RESTORATION, AND CONSERVATION. (R825284)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

SYNOPSIS OF EMERGING PATHOGEN WORKSHOP PUBLICATION

EPA Science Inventory

This presentation will highlight the core principles and findings from the 2001 workshop, the proceedings of which were recently published in a special edition of Compost Science. It will also provide a historical, policy and regulatory framework to shed light on, and be...

Lessons from HeLa Cells: The Ethics and Policy of Biospecimens.

PubMed

Beskow, Laura M

2016-08-31

Human biospecimens have played a crucial role in scientific and medical advances. Although the ethical and policy issues associated with biospecimen research have long been the subject of scholarly debate, the story of Henrietta Lacks, her family, and the creation of HeLa cells captured the attention of a much broader audience. The story has been a catalyst for policy change, including major regulatory changes proposed in the United States surrounding informed consent. These proposals are premised in part on public opinion data, necessitating a closer look at what such data tell us. The development of biospecimen policy should be informed by many considerations-one of which is public input, robustly gathered, on acceptable approaches that optimize shared interests, including access for all to the benefits of research. There is a need for consent approaches that are guided by realistic aspirations and a balanced view of autonomy within an expanded ethical framework.

Lessons from HeLa Cells: The Ethics and Policy of Biospecimens

PubMed Central

Beskow, Laura M.

2016-01-01

Human biospecimens have played a crucial role in scientific and medical advances. Although the ethical and policy issues associated with biospecimen research have long been the subject of scholarly debate, the story of attention of a much broader audience. The story has been a catalyst for policy change, including major regulatory changes proposed in the United States surrounding informed consent. These proposals are premised in part on public opinion data, necessitating a closer look at what such data tell us. The development of biospecimen policy should be informed by many considerations—one of which is public input, robustly gathered, on acceptable approaches that optimize shared interests, including access for all to the benefits of research. There is a need for consent approaches that are guided by realistic aspirations and a balanced view of autonomy within an expanded ethical framework. PMID:26979405

Integrated Science Assessment (ISA) for Carbon Monoxide ...

EPA Pesticide Factsheets

EPA announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes was made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA's decision regarding whether the current standards for CO sufficiently protect public health and the environment. The Integrated Plan for Review of the NAAQS for CO {U.S. EPA, 2008 #8615} identifies key policy-relevant questions that provide a framework for this review of the scientific evidence. These questions frame the entire review of the NAAQS, and thus are informed by both science and policy considerations. The ISA organizes and presents the scientific evidence such that it, when considered along with findings from risk analyses and policy considerations, will help the EPA address these questions during the NAAQS review:

Designing the framework for competency-based master of public health programs in India.

PubMed

Sharma, Kavya; Zodpey, Sanjay; Morgan, Alison; Gaidhane, Abhay; Syed, Zahiruddin Quazi; Kumar, Rajeev

2013-01-01

Competency in the practice of public health is the implicit goal of education institutions that offer master of public health (MPH) programs. With the expanding number of institutions offering courses in public health in India, it is timely to develop a common framework to ensure that graduates are proficient in critical public health. Steps such as situation assessment, survey of public health care professionals in India, and national consultation were undertaken to develop a proposed competency-based framework for MPH programs in India. The existing curricula of all 23 Indian MPH courses vary significantly in content with regard to core, concentration, and crosscutting discipline areas and course durations. The competency or learning outcome is not well defined. The findings of the survey suggest that MPH graduates in India should have competencies ranging from monitoring of health problems and epidemics in the community, applying biostatistics in public health, conducting action research, understanding social and community influence on public health developing indicators and instruments to monitor and evaluate community health programs, developing proposals, and involving community in planning, delivery, and monitoring of health programs. Competency statements were framed and mapped with domains including epidemiology, biostatistics, social and behavioral sciences, health care system, policy, planning, and financing, and environmental health sciences and a crosscutting domain that include health communication and informatics, health management and leadership, professionalism, systems thinking, and public health biology. The proposed competency-based framework for Indian MPH programs can be adapted to meet the needs of diverse, unique programs. The framework ensures the uniqueness and diversity of individual MPH programs in India while contributing to measures of overall program success.

Career cartography: a conceptualization of career development to advance health and policy.

PubMed

Feetham, Suzanne; Doering, Jennifer J

2015-01-01

The purpose of this article is to propose a conceptualization of career development that emphasizes the interdependence between research, practice, and policy. Career cartography applies three decades of career development experience to lay out a systematic, comprehensive, and iterative approach for planning and communicating the outcomes of science at any career stage. To inform practice and policy, nurse researchers must be clear on the intended destination and trajectory of the science, and be skilled in communicating that science and vision to diverse stakeholders. Career cartography builds on the science of cartography, is developed within the context of public and health policy, and is composed of several components, including a destination statement, career mapping, a supportive career cartography team, and use of communication and dissemination strategies. The successful utilization of career cartography may accelerate advancement of individual careers, scientific impact, and the discipline as a whole by guiding nurse researchers to be deliberative in career planning and to communicate successfully the outcomes of research across a wide variety of stakeholders. Career cartography provides a framework for planning a nurse researcher's program of research and scholarship to advance science, policy, and health of the public. Career cartography guides nurse researchers to realize their full potential to advance the health of the public and inform public and health policy in academic and practice environments. © 2014 Sigma Theta Tau International.

Questions about environmental ethics: toward a research agenda with a focus on public policy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Deknatel, C.Y.

Despite common elements and antecedents of environmental ethics, their implied application to related policy or action is not always clear. An attempt is made to develop a set of questions and a preliminary framework for considering some of the issues raised by environmental ethics as they might appear in public policy. These examples are merely meant to illustrate the questions which surround environmental ethics and to suggest the beginnings of an approach. The goal of this approach is to clarify the properties of environmental ethics and those of specific situations to which ethics might be applied. It may then bemore » easier to say what the meaning, role, and effect of environmental ethics can be. 42 references, 2 figures.« less

Empirical science meets moral panic: an analysis of the politics of needle exchange.

PubMed

Buchanan, David; Shaw, Susan; Ford, Amy; Singer, Merrill

2003-01-01

The paper presents an analysis of the policy advocacy strategies used by both proponents and opponents of needle exchange programs in the US, drawing on the analytic framework developed by Stone. Based on a case study of the politics of needle exchange in Massachusetts, we argue that proponents of needle exchange have relied almost exclusively on empirical scientific arguments to build their case, while opponents have generally resorted to normative ethical arguments. Since the frames of argument are unrelated, the two sides talk past one another, bypassing progress towards resolution or consensus. By failing to address the ethical concerns raised by opponents, public health advocates of needle exchange are losing the larger public debate. The paper concludes with specific recommendations for how public health advocates should respond to the normative dimensions of this public policy issue.

A narrative review of research impact assessment models and methods.

PubMed

Milat, Andrew J; Bauman, Adrian E; Redman, Sally

2015-03-18

Research funding agencies continue to grapple with assessing research impact. Theoretical frameworks are useful tools for describing and understanding research impact. The purpose of this narrative literature review was to synthesize evidence that describes processes and conceptual models for assessing policy and practice impacts of public health research. The review involved keyword searches of electronic databases, including MEDLINE, CINAHL, PsycINFO, EBM Reviews, and Google Scholar in July/August 2013. Review search terms included 'research impact', 'policy and practice', 'intervention research', 'translational research', 'health promotion', and 'public health'. The review included theoretical and opinion pieces, case studies, descriptive studies, frameworks and systematic reviews describing processes, and conceptual models for assessing research impact. The review was conducted in two phases: initially, abstracts were retrieved and assessed against the review criteria followed by the retrieval and assessment of full papers against review criteria. Thirty one primary studies and one systematic review met the review criteria, with 88% of studies published since 2006. Studies comprised assessments of the impacts of a wide range of health-related research, including basic and biomedical research, clinical trials, health service research, as well as public health research. Six studies had an explicit focus on assessing impacts of health promotion or public health research and one had a specific focus on intervention research impact assessment. A total of 16 different impact assessment models were identified, with the 'payback model' the most frequently used conceptual framework. Typically, impacts were assessed across multiple dimensions using mixed methodologies, including publication and citation analysis, interviews with principal investigators, peer assessment, case studies, and document analysis. The vast majority of studies relied on principal investigator interviews and/or peer review to assess impacts, instead of interviewing policymakers and end-users of research. Research impact assessment is a new field of scientific endeavour and there are a growing number of conceptual frameworks applied to assess the impacts of research.

Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas

PubMed Central

Liu, Nancy H.; Daumit, Gail L.; Dua, Tarun; Aquila, Ralph; Charlson, Fiona; Cuijpers, Pim; Druss, Benjamin; Dudek, Kenn; Freeman, Melvyn; Fujii, Chiyo; Gaebel, Wolfgang; Hegerl, Ulrich; Levav, Itzhak; Munk Laursen, Thomas; Ma, Hong; Maj, Mario; Elena Medina‐Mora, Maria; Nordentoft, Merete; Prabhakaran, Dorairaj; Pratt, Karen; Prince, Martin; Rangaswamy, Thara; Shiers, David; Susser, Ezra; Thornicroft, Graham; Wahlbeck, Kristian; Fekadu Wassie, Abe; Whiteford, Harvey; Saxena, Shekhar

2017-01-01

Excess mortality in persons with severe mental disorders (SMD) is a major public health challenge that warrants action. The number and scope of truly tested interventions in this area remain limited, and strategies for implementation and scaling up of programmes with a strong evidence base are scarce. Furthermore, the majority of available interventions focus on a single or an otherwise limited number of risk factors. Here we present a multilevel model highlighting risk factors for excess mortality in persons with SMD at the individual, health system and socio‐environmental levels. Informed by that model, we describe a comprehensive framework that may be useful for designing, implementing and evaluating interventions and programmes to reduce excess mortality in persons with SMD. This framework includes individual‐focused, health system‐focused, and community level and policy‐focused interventions. Incorporating lessons learned from the multilevel model of risk and the comprehensive intervention framework, we identify priorities for clinical practice, policy and research agendas. PMID:28127922

Policy evaluation for a bus-based transit system: the case study of Busan, Korea

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lew, K.S.

This study considers a quite specific set of dimensions of transit evaluation as a comprehensive management-strategy approach for addressing the ongoing problems of urban public transit systems and apply them in a case study. With increasing difficulties in providing effective public transportation, attention in this study was placed on providing for the movement of people in an efficient and equitable manner. This study was therefore concerned with just identifying and evaluating policy options that are feasible within the socio-economic and political context of the Busan metropolitan area and, in particular, how the criteria of efficiency and equity can best bemore » achieved by implementing transit policy alternatives. In the absence of long-run major public investment in urban transportation, the criteria of both efficiency and equity can only be furthered through managerial strategies applied within a systematic evaluative framework. By emphasizing the planning, operational, and managerial considerations of fixed-route bus transit in Busan, it has been acknowledged that efficient and equitable public transportation can be provided through a variety of social, economic, political, and institutional arrangements that are possible to apply from a policy viewpoint in the immediate future.« less

Resistance and change: a multiple streams approach to understanding health policy making in Ghana.

PubMed

Kusi-Ampofo, Owuraku; Church, John; Conteh, Charles; Heinmiller, B Timothy

2015-02-01

Although much has been written on health policy making in developed countries, the same cannot be said of less developed countries, especially in Africa. Drawing largely on available historical and government records, newspaper publications, parliamentary Hansards, and published books and articles, this article uses John W. Kingdon's multiple streams framework to explain how the problem, politics, and policy streams converged for Ghana's National Health Insurance Scheme (NHIS) to be passed into law in 2003. The article contends that a change in government in the 2000 general election opened a "policy window" for eventual policy change from "cash-and-carry" to the NHIS. Copyright © 2015 by Duke University Press.

Selecting interventions to promote fruit and vegetable consumption: from policy to action, a planning framework case study in Western Australia.

PubMed

Pollard, Christina M; Lewis, Janette M; Binns, Colin W

2008-12-24

The Department of Health in Western Australia identified access to, and daily consumption of recommended amounts of fruit and vegetables, as priority health determinants. The numerous factors that influence supply and consumption of fruit and vegetables indicated that a comprehensive approach would be required.A government and non-government sector steering group was set up to select priority interventions using the National Public Health Partnership's Framework for Implementing Public Health Strategies. This structured framework was used for developing strategies to improve fruit and vegetable consumption and supply, and to identify implementation priorities.After one year a desktop audit of progress on framework interventions was undertaken. The structured framework led to a plan for defined actions, partners, costs, and performance indicators for strategies to improve fruit and vegetable consumption and supply. Lead agency custodians for management of the selected interventions were identified.After one year there was significant progress in the implementation of a number of the high-ranking interventions. The exception was interventions that provide the infrastructure support such as research and development capacity, information systems. A structured framework and stakeholder participation assisted in developing a fruit and vegetable implementation strategy. Engagement and commitment of influential and diverse stakeholders is needed, not just for program support, but particularly in the areas of food and nutrition policy development and providing the infrastructure support required. Further work is required to develop performance outcomes and cost effectiveness measures for many of the strategies that have been proposed to address portfolio objectives.

"What is meant by public?": Stakeholder views on strengthening impacts of public reporting of hospital performance data.

PubMed

Canaway, Rachel; Bismark, Marie; Dunt, David; Prang, Khic-Houy; Kelaher, Margaret

2018-04-01

Public reporting of hospital performance data is a developing area that is gaining increased attention. This is the first study to explore a range of stakeholder opinions on how such public reporting could be strengthened in Australia. Thirty-four semi-structured interviews were conducted with a purposive sample of expert healthcare consumer, provider and purchaser informants who worked in a variety of senior roles and had knowledge of or involvement in public reporting of hospital data within the public or private healthcare sectors. Informants from all Australian states, territory and national jurisdictions participated. Thematic analysis was used to gain an overview of experts' opinions to inform policy and systems-development for strengthening foundational frameworks for public reporting of health services performance. Themes arising were synthesised to generate explanatory figures to highlight key areas for strengthening public reporting. Our findings suggest that in Australia there is a lack of agreement on what the objectives and who the audience are for public reporting of hospital performance data. Without this shared understanding it is difficult to strengthen frameworks and impacts of public reporting. When developing frameworks for public reporting of hospital data in Australia, more explicit definition of what or who are the 'public' is needed along with identification of barriers, desired impacts, data needs, and data collection/reporting/feedback mechanisms. All relevant stakeholders should be involved in design of public reporting frameworks. Offering multiple systems of public reporting, each tailored to particular audiences, might enable greater impact of reporting towards improved hospital quality and safety, and consumer knowledge to inform treatment decisions. This study provides an overview of perspectives, but further research is warranted to develop PR frameworks that can generate greatest impacts for the needs of various audiences. Copyright © 2018 Elsevier Ltd. All rights reserved.

Policy Choice for Urban Low-carbon transportation in Beijing: Scenario Analysis Based on LEAP model

NASA Astrophysics Data System (ADS)

Zhang, Yu

2016-04-01

Beijing is a fast developing megacity with serious traffic problems, such as high energy consumption, high CO2 emission and traffic congestion. The coming 13th Five-Year Plan for Beijing economic and social development will focus on the low-carbon transportation policy to achieve the urban traffic sustainable development. In order to improve the feasibility of urban low-carbon transportation policies, this paper analyzes the future trends of CO2 emissions from transportation of Beijing. Firstly, five policies scenarios are developed according to the coming Beijing 13th Five-Year Plan, including the "Business As Usual (BAU)", the "Public Transportation Priority(PTP)", the "New Energy Vehicle(NEV)", the "Active Transportation(AT)", the "Private Car Regulation(PCR)" and the "Hybrid Policy(HP)". Then the Long-range Energy Alternatives Planning System(LEAP model) framework is adopted to estimate CO2 emission under given policies scenarios up to year 2020 and analyze the implications. The results demonstrate that the low-carbon transportation policies can reduce CO2 emission effectively. Specifically, the "Hybrid Policy(HP)" has the best performance. In terms of single policy effect, the "Private Car Regulation(PCR)" comes first followed by the "Public Transportation Priority(PTP)".

Tobacco litter costs and public policy: a framework and methodology for considering the use of fees to offset abatement costs.

PubMed

Schneider, John E; Peterson, N Andrew; Kiss, Noemi; Ebeid, Omar; Doyle, Alexis S

2011-05-01

Growing concern over the costs, environmental impact and safety of tobacco product litter (TPL) has prompted states and cities to undertake a variety of policy initiatives, of which litter abatement fees are part. The present work describes a framework and methodology for calculating TPL costs and abatement fees. Abatement is associated with four categories of costs: (1) mechanical and manual abatement from streets, sidewalks and public places, (2) mechanical and manual abatement from storm water and sewer treatment systems, (3) the costs associated with harm to the ecosystem and harm to industries dependent on clean and healthy ecosystems, and (4) the costs associated with direct harm to human health. The experiences of the City of San Francisco's recently proposed tobacco litter abatement fee serve as a case study. City and municipal TPL costs are incurred through manual and mechanical clean-up of surfaces and catchment areas. According to some studies, public litter abatement costs to US cities range from US$3 million to US$16 million. TPL typically comprises between 22% and 36% of all visible litter, implying that total public TPL direct abatement costs range from about US$0.5 million to US$6 million for a city the size of San Francisco. The costs of mitigating the negative externalities of TPL in a city the size of San Francisco can be offset by implementing a fee of approximately US$0.20 per pack. Tobacco litter abatement costs to cities can be substantial, even when the costs of potential environmental pollution and tourism effects are excluded. One public policy option to address tobacco litter is levying of fees on cigarettes sold. The methodology described here for calculating TPL costs and abatement fees may be useful to state and local authorities who are considering adoption of this policy initiative.

Tobacco litter costs and public policy: a framework and methodology for considering the use of fees to offset abatement costs

PubMed Central

Peterson, N Andrew; Kiss, Noemi; Ebeid, Omar; Doyle, Alexis S

2011-01-01

Objectives Growing concern over the costs, environmental impact and safety of tobacco product litter (TPL) has prompted states and cities to undertake a variety of policy initiatives, of which litter abatement fees are part. The present work describes a framework and methodology for calculating TPL costs and abatement fees. Methods Abatement is associated with four categories of costs: (1) mechanical and manual abatement from streets, sidewalks and public places, (2) mechanical and manual abatement from storm water and sewer treatment systems, (3) the costs associated with harm to the ecosystem and harm to industries dependent on clean and healthy ecosystems, and (4) the costs associated with direct harm to human health. The experiences of the City of San Francisco's recently proposed tobacco litter abatement fee serve as a case study. Results City and municipal TPL costs are incurred through manual and mechanical clean-up of surfaces and catchment areas. According to some studies, public litter abatement costs to US cities range from US$3 million to US$16 million. TPL typically comprises between 22% and 36% of all visible litter, implying that total public TPL direct abatement costs range from about US$0.5 million to US$6 million for a city the size of San Francisco. The costs of mitigating the negative externalities of TPL in a city the size of San Francisco can be offset by implementing a fee of approximately US$0.20 per pack. Conclusions Tobacco litter abatement costs to cities can be substantial, even when the costs of potential environmental pollution and tourism effects are excluded. One public policy option to address tobacco litter is levying of fees on cigarettes sold. The methodology described here for calculating TPL costs and abatement fees may be useful to state and local authorities who are considering adoption of this policy initiative. PMID:21504923

Inclusive Livable Communities for People with Psychiatric Disabilities

ERIC Educational Resources Information Center

National Council on Disability, 2008

2008-01-01

Two reports of the National Council on Disability (NCD), Livable Communities for Adults with Disabilities and Creating Livable Communities, set forth a livable community framework. These reports propose necessary changes in public policies regarding housing; transportation that is reliable and accessible; environments that are physically…

The Documentation Centre for Education in Europe

ERIC Educational Resources Information Center

Educational Documentation and Information, 1971

1971-01-01

This account of the Centre, prepared by the Secretariat of the Council of Europe, is in three parts: the first, Background, explains its origins and policy framework; the sections headed Operations and Publications respectively describe its functions as a library" and as a publishing house." (Author)

A CONCEPTUAL FRAMEWORK FOR INCORPORATING COGNITIVE PRINCIPLES INTO GEOGRAPHICAL DATABASE REPRESENTATION. (R825195)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Insights into the government's role in food system policy making: improving access to healthy, local food alongside other priorities.

PubMed

Wegener, Jessica; Raine, Kim D; Hanning, Rhona M

2012-11-12

Government actors have an important role to play in creating healthy public policies and supportive environments to facilitate access to safe, affordable, nutritious food. The purpose of this research was to examine Waterloo Region (Ontario, Canada) as a case study for "what works" with respect to facilitating access to healthy, local food through regional food system policy making. Policy and planning approaches were explored through multi-sectoral perspectives of: (a) the development and adoption of food policies as part of the comprehensive planning process; (b) barriers to food system planning; and (c) the role and motivation of the Region's public health and planning departments in food system policy making. Forty-seven in-depth interviews with decision makers, experts in public health and planning, and local food system stakeholders provided rich insight into strategic government actions, as well as the local and historical context within which food system policies were developed. Grounded theory methods were used to identify key overarching themes including: "strategic positioning", "partnerships" and "knowledge transfer" and related sub-themes ("aligned agendas", "issue framing", "visioning" and "legitimacy"). A conceptual framework to illustrate the process and features of food system policy making is presented and can be used as a starting point to  engage multi-sectoral stakeholders in plans and actions to facilitate access to healthy food.

Tobacco control and trade policy: proactive strategies for integrating policy norms.

PubMed

Drope, Jeffrey; Lencucha, Raphael

2013-01-01

Palpable tension continues at the intersection of tobacco control and trade policy. Through consideration of four major tobacco control-related trade disputes, we suggest how to empower public health proponents in the face of entrenched economic policymaking norms. We argue that a more effective pro-tobacco control message should: (a) seek to be broadly consistent with core principles of the world trading system, (b) boldly assert countries' international commitments to the Framework Convention on Tobacco Control, (c) marshal deep scientific evidence, and (d) come from a broad range of actors, including from low- and middle-income countries as well as from other trade policy community members.

Reducing violent injuries: priorities for pediatrician advocacy.

PubMed

Dolins, J C; Christoffel, K K

1994-10-01

A basic framework for developing an advocacy plan must systematically break down the large task of policy development implementation into manageable components. The basic framework described in detail in this paper includes three steps: Setting policy objectives by narrowing the scope of policy, by reviewing policy options, and by examining options against selected criteria. Developing strategies for educating the public and for approaching legislative/regulatory bodies. Evaluating the effectiveness of the advocacy action plan as a process and as an agent for change. To illustrate the variety of ways in which pediatricians can be involved in the policy process to reduce violent injuries among children and adolescents, we apply this systematic approach to three priority areas. Prohibiting the use of corporal punishment in schools is intended to curb the institutionalized legitimacy of violence that has been associated with future use of violence. Efforts to remove handguns from the environments of children and adolescents are aimed at reducing the numbers of firearm injuries inflicted upon and by minors. Comprehensive treatment of adolescent victims of assault is intended to decrease the reoccurrence of violent injuries.

Street-level bureaucracy and policy implementation in community public health nursing: a qualitative study of the experiences of student and novice health visitors.

PubMed

Hughes, Alison; Condon, Louise

2016-11-01

Aim To explore the experiences of student and novice health visitors in implementing health visiting policy reform pre- and post-qualification. In England, public health nursing has been subject to major policy reform. The Health Visitor Implementation Plan (2011) set out a plan to recruit increasing numbers of nurses and midwives to the profession to deliver an expanded and refocussed health visiting service. Exploring this policy change from the viewpoint of those new to health visiting offers a unique perspective into how a specific policy vision is translated into nursing practice. A descriptive qualitative study in which participants were enrolled on a one-year post-graduate health visiting course at a University in South West of England. Qualitative data were collected pre- and post-qualification. A total of 16 interviews and a focus group were conducted with nine participants between September 2012 and March 2013. Findings Descriptive data were interpreted using Lipsky's theoretical framework of street-level bureaucracy. Three themes emerged which relate to this 'bottom-up' perspective on policy implementation; readiness to operationalise policy, challenges in delivering the service vision; and using discretion in delivering the vision. Community public health nurses operate as street-level bureaucrats in negotiating the demands of policy and practice, and by this means, attempt to reconcile professional values with institutional constraints. Barriers to policy implementation at a local level mediate the effects of policy reform, ultimately impacting upon outcomes for children and families.

Why media representations of corporations matter for public health policy: a scoping review.

PubMed

Weishaar, Heide; Dorfman, Lori; Freudenberg, Nicholas; Hawkins, Benjamin; Smith, Katherine; Razum, Oliver; Hilton, Shona

2016-08-30

Media representations play a crucial role in informing public and policy opinions about the causes of, and solutions to, ill-health. This paper reviews studies analysing media coverage of non-communicable disease (NCD) debates, focusing on how the industries marketing commodities that increase NCD risk are represented. A scoping review identified 61 studies providing information on media representations of NCD risks, NCD policies and tobacco, alcohol, processed food and soft drinks industries. The data were narratively synthesized to describe the sample, media depictions of industries, and corporate and public health attempts to frame the media debates. The findings indicate that: (i) the limited research that has been undertaken is dominated by a focus on tobacco; (ii) comparative research across industries/risk-factors is particularly lacking; and (iii) coverage tends to be dominated by two contrasting frames and focuses either on individual responsibilities ('market justice' frames, often promoted by commercial stakeholders) or on the need for population-level interventions ('social justice' frames, frequently advanced by public health advocates). Establishing the underlying frameworks is crucial for the analysis of media representation of corporations, as they reflect the strategies that respective actors use to influence public health debates and decision making. The potential utility of media research lies in the insights that it can provide for public health policy advocates about successful framing of public health messages and strategies to counter frames that undermine public health goals. A better understanding of current media debates is of paramount importance to improving global health.

Finding the loopholes: a cross-sectional qualitative study of systemic barriers to treatment access for women drug court participants.

PubMed

Morse, Diane S; Silverstein, Jennifer; Thomas, Katherine; Bedel, Precious; Cerulli, Catherine

2015-12-01

Therapeutic diversion courts seek to address justice-involved participants' underlying problems leading to their legal system involvement, including substance use disorder, psychiatric illness, and intimate partner violence. The courts have not addressed systemic hurdles, which can contribute to a cycle of substance use disorder and recidivism, which in turn hinder health and wellness. The study purpose is to explore the systemic issues faced by women participants in drug treatment court from multiple perspectives to understand how these issues may relate to health and wellness in their lives. Qualitative thematic framework analysis of five separate focus groups consisting of female drug treatment court participants, community providers, and court staff ( n = 25). Themes were mapped across the socio-ecological framework and contextualized according to social determinants of health. Numerous systemic factors impacted women's access to treatment. Laws and legal policies (governance) excluded those who could potentially have benefitted from therapeutic court and did not allow consideration of parenting issues. Macroeconomic policies limit housing options for those with convictions. Social policies limited transportation, education, and employment options. Public policies limited healthcare and social protection and ability to access available resources. Culture and societal values, including stigma, limited treatment options. By understanding the social determinant of health for women in drug treatment court and stakeholder's perceptions, the legal system can implement public policy to better address the health needs of women drug court participants.

Financial Reporting: Framework for Analyzing Federal Agency Financial Statements

DTIC Science & Technology

1991-03-01

the only source that would be used to pay current liabilities. 6;Loyd C. Heath, Financial Reporting and the Evaluation of Solvency (New York: AICPA...when assessing department programs and deter- mining public policy. With improved financial reporting as an objective, we plan to continue working...Golembiewski, Robert T. and Jack Rabin, ed. Public Budgeting and Finance. New York- Marcel Dekker, Inc., 1983. Heath, Loyd C., Financial Reporting and the

Dimensionality and R4P: A Health Equity Framework for Research Planning and Evaluation in African American Populations.

PubMed

Hogan, Vijaya; Rowley, Diane L; White, Stephanie Baker; Faustin, Yanica

2018-02-01

Introduction Existing health disparities frameworks do not adequately incorporate unique interacting contributing factors leading to health inequities among African Americans, resulting in public health stakeholders' inability to translate these frameworks into practice. Methods We developed dimensionality and R4P to integrate multiple theoretical perspectives into a framework of action to eliminate health inequities experienced by African Americans. Results The dimensional framework incorporates Critical Race Theory and intersectionality, and includes dimensions of time-past, present and future. Dimensionality captures the complex linear and non-linear array of influences that cause health inequities, but these pathways do not lend themselves to approaches to developing empirically derived programs, policies and interventions to promote health equity. R4P provides a framework for addressing the scope of actions needed. The five components of R4P are (1) Remove, (2) Repair, (3) Remediate, (4) Restructure and (5) Provide. Conclusion R4P is designed to translate complex causality into a public health equity planning, assessment, evaluation and research tool.

Thoughts About Health Policy Content in Baccalaureate Nursing Programs.

PubMed

Waddell, Ashley; Adams, Jeffrey M; Fawcett, Jacqueline

2016-10-01

We describe a framework used to analyze health policy content in baccalaureate nursing program courses that combines the conceptual model for nursing and health policy and the Adams influence model to account for knowledge and skills needed for health policy work. Our analysis of health policy content in courses in one baccalaureate nursing program focused on what policies were emphasized and how educational content supported the development of personal influence. The analysis revealed course content focused on public sources of health policies and lack of overt course content about policies from organizational and professional sources. Additionally, we identified little course content about the development of personal influence skills except for communication and message articulation components. As the nursing profession continues to build influence in the policy arena, educators must continue to prepare future nurses for such work. © The Author(s) 2016.

The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

PubMed

Lee, K

2000-09-01

There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

Public health workforce: challenges and policy issues

PubMed Central

Beaglehole, Robert; Dal Poz, Mario R

2003-01-01

This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce. PMID:12904251

Chronic disease management and the home-care alternative in Ontario, Canada.

PubMed

Tsasis, Peter

2009-08-01

The pressure on our health-care system to deliver efficient, quality and cost-effective care is increasing. The debate on its sustainability is also expanding. These challenges can be managed with revisions to our health-care policy frameworks governing how and what public health-care services are delivered. Chronic disease management and home care can together ease many of the present and future pressures facing the health-care system. However, the current level of investment and the present policy are not effectively supporting movement in this direction. Updating the Canada Health Act to reflect the realities of our health-care system, and developing policies to support the areas of interdisciplinary teamwork and system integration are needed to facilitate chronic disease management and home care in Canada. This article lays out the challenges, highlights the impending issues and suggests a framework for moving forward.

A case study of the New York City trans-fat story for international application.

PubMed

Tan, Andy S L

2009-04-01

Heart disease is the leading cause of death in New York City and contributes to significant burden of disease in the United States and internationally. Excessive intake of artificial trans-fatty acids has been causally associated with increased risk of heart disease. This article describes New York City's 2007 trans-fatty acids regulation, which was aimed at lowering the prevalence of heart disease among the city's residents by prohibiting the use of trans-fatty acids in the preparation of food in the city's food outlets. The author describes sequentially: (1) formulation, (2) public consultation, (3) implementation and (4) evaluation of the policy. He proposes a strategic framework for food policy development for international policymakers who are considering similar regulations. The framework includes four domains: (1) background research, (2) stakeholder support, (3) effective policy implementation and (4) evaluation and dissemination.

Assessing and forecasting population health: integrating knowledge and beliefs in a comprehensive framework.

PubMed

Van Meijgaard, Jeroen; Fielding, Jonathan E; Kominski, Gerald F

2009-01-01

A comprehensive population health-forecasting model has the potential to interject new and valuable information about the future health status of the population based on current conditions, socioeconomic and demographic trends, and potential changes in policies and programs. Our Health Forecasting Model uses a continuous-time microsimulation framework to simulate individuals' lifetime histories by using birth, risk exposures, disease incidence, and death rates to mark changes in the state of the individual. The model generates a reference forecast of future health in California, including details on physical activity, obesity, coronary heart disease, all-cause mortality, and medical expenditures. We use the model to answer specific research questions, inform debate on important policy issues in public health, support community advocacy, and provide analysis on the long-term impact of proposed changes in policies and programs, thus informing stakeholders at all levels and supporting decisions that can improve the health of populations.

Corporate political activity of the dairy industry in France: an analysis of publicly available information.

PubMed

Mialon, Melissa; Mialon, Jonathan

2017-09-01

In the present study, we used a structured approach based on publicly available information to identify the corporate political activity (CPA) strategies of three major actors in the dairy industry in France. We collected publicly available information from the industry, government and other sources over a 6-month period, from March to August 2015. Data collection and analysis were informed by an existing framework for classifying the CPA of the food industry. Setting/Subjects Our study included three major actors in the dairy industry in France: Danone, Lactalis and the Centre National Interprofessionnel de l'Economie Laitière (CNIEL), a trade association. During the period of data collection, the dairy industry employed CPA practices on numerous occasions by using three strategies: the 'information and messaging', the 'constituency building' and the 'policy substitution' strategies. The most common practice was the shaping of evidence in ways that suited the industry. The industry also sought involvement in the community, establishing relationships with public health professionals, academics and the government. Our study shows that the dairy industry used several CPA practices, even during periods when there was no specific policy debate on the role of dairy products in dietary guidelines. The information provided here could inform public health advocates and policy makers and help them ensure that commercial interests of industry do not impede public health policies and programmes.

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review.

PubMed

Hurlimann, Thierry; Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo; Godard, Béatrice

2017-01-01

The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. The goal of this scoping review is to delineate and "map" the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O'Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues cannot be managed without a careful consideration for the complexity of contexts in which nutrition-related interventions are expected to be implemented. These interventions engage a variety of actors with diverse perspectives and interests. We discuss these challenges and also comment on the importance of considering ethical impacts in the monitoring and evaluation of such interventions. General ethical frameworks or recommendations-although useful-cannot be expected to provide policy makers, implementators and other public health personnel with sufficient practical ethical guidance as they cannot consider and anticipate the particularities of all specific nutrition-related public health interventions and the complexity of the contexts in which they are implemented. Further research is needed in order to develop more targeted ethical frameworks.

The politics of HPV vaccination policy formation in the United States.

PubMed

Abiola, Sara E; Colgrove, James; Mello, Michelle M

2013-08-01

This article explores the political dimensions of policy formation for the human papillomavirus (HPV) vaccine through case studies of six states: California, Indiana, New Hampshire, New York, Texas, and Virginia. Using thematic content analysis of semistructured key informant interviews with policy stakeholders, newspaper articles, and archival materials, we describe the trajectory of public health policy developments for HPV immunization and analyze key influences on policy outcomes through the theoretical lens of the Multiple Streams framework. Specifically, we examine factors influencing the extent to which HPV was perceived as a problem meriting policy action; political forces that facilitated and impeded policy adoption, including interest-group opposition and structural and ideological features of the states' political environments; and factors affecting which policy alternatives received consideration. We find that effective policy entrepreneurship played a critical role in determining policy outcomes. We conclude by discussing lessons from the case of HPV vaccination for future efforts to craft vaccination policies.

Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

PubMed

Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

2017-02-01

The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

Controlling hepatitis C in Rwanda: a framework for a national response.

PubMed

Mbituyumuremyi, Aimable; Van Nuil, Jennifer Ilo; Umuhire, Jeanne; Mugabo, Jules; Mwumvaneza, Mutagoma; Makuza, Jean Damascene; Umutesi, Justine; Nsanzimana, Sabin; Gupta, Neil

2018-01-01

With the introduction of direct-acting antiviral drugs, treatment of hepatitis C is both highly effective and tolerable. Access to treatment for patients, however, remains limited in low- and middle-income countries due to the lack of supportive health infrastructure and the high cost of treatment. Poorer countries are being encouraged by international bodies to organize public health responses that would facilitate the roll-out of care and treatment on a national scale. Yet few countries have documented formal plans and policies. Here, we outline the approach taken in Rwanda to a public health framework for hepatitis C control and care within the World Health Organization hepatitis health sector strategy. This includes the development and implementation of policies and programmes, prevention efforts, screening capacity, treatment services and strategic information systems. We highlight key successes by the national programme for the control and management of hepatitis C: establishment of national governance and planning; development of diagnostic capacity; approval and introduction of direct-acting antiviral treatments; training of key personnel; generation of political will and leadership; and fostering of key strategic partnerships. Existing challenges and next steps for the programme include developing a detailed monitoring and evaluation framework and tools for monitoring of viral hepatitis. The government needs to further decentralize care and integrate hepatitis C management into routine clinical services to provide better access to diagnosis and treatment for patients. Introducing rapid diagnostic tests to public health-care facilities would help to increase case-finding. Increased public and private financing is essential to support care and treatment services.

Health Effects of Environmental Exposures, Occupational Hazards and Climate Change in Ethiopia: Synthesis of Situational Analysis, Needs Assessment and the Way Forward.

PubMed

Berhane, Kiros; Kumie, Abera; Samet, Jonathan

2016-01-01

The burden of diseases caused by environmental and occupational health hazards and the effects of global climate change are of growing concerns in Ethiopia. However, no adequate information seems to be available on the current situation. This means there is a critical gap in research, policy framework and implementation in the country. The purpose of this paper was to synthesize evidence from a systematic situational analysis and needs assessment to help establish a hub for research and training on three major themes and their related policy frameworks: air pollution and health, occupational health and safety and climate change and health. The methods used in this work include a systematic review of secondary data from peer-reviewed literature, thesis reports from academia, government and national statistical reports. Limited primary data based on key informant interviews held with major stakeholders were also used as sources of data. Exposures to high levels of indoor and outdoor air pollutants were found to be major sources of public health challenges. Lack of occupational safety and health due to agricultural activities and exposure to industries was found to be substantial. Worse is the growing fear that climate change will pose increasingly significant multidimensional challenges to the environment and public health. Across all three areas of focus, there was a paucity of information on local scientific evidence. There is also very limited trained skilled manpower and physical infrastructure to monitor the environment and enforce regulatory guidelines. Research, policy frameworks and regulatory mechanisms were among the cross-cutting issues that needed urgent attention. Critical gaps were observed in research and training across the three themes. Also, there is a limitation in implementing the link between policy and related regulations in the environment and health.

Peter Bourne's drug policy and the perils of a public health ethic, 1976-1978.

PubMed

Clark, Claire D; Dufton, Emily

2015-02-01

As President Jimmy Carter's advisor for health issues, Peter Bourne promoted a rational and comprehensive drug strategy that combined new supply-side efforts to prevent drug use with previously established demand-side addiction treatment programs. Using a public health ethic that allowed the impact of substances on overall population health to guide drug control, Bourne advocated for marijuana decriminalization as well as increased regulations for barbiturates. A hostile political climate, a series of rumors, and pressure from both drug legalizers and prohibitionists caused Bourne to resign in disgrace in 1978. We argue that Bourne's critics used his own public health framework to challenge him, describe the health critiques that contributed to Bourne's resignation, and present the story of his departure as a cautionary tale for today's drug policy reformers.

Engaging the public on climate change issues

NASA Astrophysics Data System (ADS)

Bean, Alice

2016-03-01

As a Jefferson Science Fellow from August 2014-August 2015, Alice Bean worked with the Office of Religion and Global Affairs at the U.S. Department of State on climate change and environmental issues. The Office of Religion and Global Affairs works to implement the National Strategy on Religious Leader and Faith Community Engagement which includes building partnerships on environmental issues. With the United Nations Framework Convention on Climate Change Conference of the Parties meeting 21 in December, 2015 in Paris, there were and continue to be great opportunities for physicists to interact with policy makers and the general public. As an experimental particle physicist, much was learned about climate change science, how the public views scientists, how science can influence policy, but most especially how to communicate about science.

State Policies to Transform Struggling Schools: How Various State Policies Can Be Used to Enable School & District Turnaround. Meeting the Turnaround Challenge: Strategies, Resources & Tools to Transform a Framework into Practice

ERIC Educational Resources Information Center

Mass Insight Education (NJ1), 2009

2009-01-01

State governments wield significant authority in the management of public schools. As a nexus for federal funding, state funding, and regulatory authority, states have both the legal and financial power to help drive school change. The "No Child Left Behind Act" has required each state to create a system of standards-based assessment and…

What makes public health studies ethical? Dissolving the boundary between research and practice

PubMed Central

2014-01-01

Background The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary – whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants – have been unsatisfactory. Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle – from initial planning through to knowledge exchange. Discussion The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives. The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services organizations, and beyond. Summary Public Health Ontario has developed an ethics framework that is applicable to any evidence-generating activity, regardless of whether it is labelled research. While developed in a public health context, it is readily adaptable to other health services organizations and beyond. PMID:25104180

2002 Industry Studies: Energy

DTIC Science & Technology

2002-01-01

the Public Utility Regulatory Policy Act ( PURPA ), one of five statutes aimed at reducing U.S. dependence on foreign oil.77 This law required utilities...restructuring was in the area of pricing. Under the framework established by PURPA and the FERC orders, a wholesale power market between utilities and IPPs

75 FR 2488 - Mid-Atlantic Fishery Management Council; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... Mid-Atlantic Fishery Management Council's (MAFMC) Scientific and Statistical Committee (SSC) will hold... include new member orientation (overview of Council process and role of the SSC), review and adoption of SSC Standard Operating Practices and Procedures, ABC Control Rule Framework and Council Risk Policy...

A CBO Study: The Economics of Climate Change: A Primer

DTIC Science & Technology

2003-04-01

issues related to climate change , focusing primarily on its economic aspects. The study draws from numerous published sources to summarize the current...state of climate science and provide a conceptual framework for addressing climate change as an economic problem. It also examines public policy

32 CFR 185.4 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... non-reimbursable basis only if required by law or if both authorized by law and approved by the... perform its primary mission). (f) DSCA plans shall be compatible with the National Response Framework; the... necessary to restore governmental function and public order, or, (2) When duly constituted Federal, State...

From policy to practice: implementation of physical activity and food policies in schools

PubMed Central

2013-01-01

Purpose Public policies targeting the school setting are increasingly being used to address childhood obesity; however, their effectiveness depends on their implementation. This study explores the factors which impeded or facilitated the implementation of publicly mandated school-based physical activity and nutrition guidelines in the province of British Columbia (BC), Canada. Methods Semi-structured interviews were conducted with 50 school informants (17 principals - 33 teacher/school informants) to examine the factors associated with the implementation of the mandated Daily Physical Activity (DPA) and Food and Beverage Sales in Schools (FBSS) guidelines. Coding used a constructivist grounded theory approach. The first five transcripts and every fifth transcript thereafter were coded by two independent coders with discrepancies reconciled by a third coder. Data was coded and analysed in the NVivo 9 software. Concept maps were developed and current theoretical perspectives were integrated in the later stages of analysis. Results The Diffusion of Innovations Model provided an organizing framework to present emergent themes. With the exception of triability (not relevant in the context of mandated guidelines/policies), the key attributes of the Diffusion of Innovations Model (relative advantage, compatibility, complexity, and observability) provided a robust framework for understanding themes associated with implementation of mandated guidelines. Specifically, implementation of the DPA and FBSS guidelines was facilitated by perceptions that they: were relatively advantageous compared to status quo; were compatible with school mandates and teaching philosophies; had observable positive impacts and impeded when perceived as complex to understand and implement. In addition, a number of contextual factors including availability of resources facilitated implementation. Conclusions The enactment of mandated policies/guidelines for schools is considered an essential step in improving physical activity and healthy eating. However, policy makers need to: monitor whether schools are able to implement the guidelines, support schools struggling with implementation, and document the impact of the guidelines on students’ behaviors. To facilitate the implementation of mandated guidelines/policies, the Diffusion of Innovations Model provides an organizational framework for planning interventions. Changing the school environment is a process which cannot be undertaken solely by passive means as we know that such approaches have not resulted in adequate implementation. PMID:23731803

From policy to practice: implementation of physical activity and food policies in schools.

PubMed

Mâsse, Louise C; Naiman, Daniel; Naylor, Patti-Jean

2013-06-03

Public policies targeting the school setting are increasingly being used to address childhood obesity; however, their effectiveness depends on their implementation. This study explores the factors which impeded or facilitated the implementation of publicly mandated school-based physical activity and nutrition guidelines in the province of British Columbia (BC), Canada. Semi-structured interviews were conducted with 50 school informants (17 principals - 33 teacher/school informants) to examine the factors associated with the implementation of the mandated Daily Physical Activity (DPA) and Food and Beverage Sales in Schools (FBSS) guidelines. Coding used a constructivist grounded theory approach. The first five transcripts and every fifth transcript thereafter were coded by two independent coders with discrepancies reconciled by a third coder. Data was coded and analysed in the NVivo 9 software. Concept maps were developed and current theoretical perspectives were integrated in the later stages of analysis. The Diffusion of Innovations Model provided an organizing framework to present emergent themes. With the exception of triability (not relevant in the context of mandated guidelines/policies), the key attributes of the Diffusion of Innovations Model (relative advantage, compatibility, complexity, and observability) provided a robust framework for understanding themes associated with implementation of mandated guidelines. Specifically, implementation of the DPA and FBSS guidelines was facilitated by perceptions that they: were relatively advantageous compared to status quo; were compatible with school mandates and teaching philosophies; had observable positive impacts and impeded when perceived as complex to understand and implement. In addition, a number of contextual factors including availability of resources facilitated implementation. The enactment of mandated policies/guidelines for schools is considered an essential step in improving physical activity and healthy eating. However, policy makers need to: monitor whether schools are able to implement the guidelines, support schools struggling with implementation, and document the impact of the guidelines on students' behaviors. To facilitate the implementation of mandated guidelines/policies, the Diffusion of Innovations Model provides an organizational framework for planning interventions. Changing the school environment is a process which cannot be undertaken solely by passive means as we know that such approaches have not resulted in adequate implementation.

Is Aboriginal nutrition a priority for local government? A policy analysis.

PubMed

Helson, Catherine; Walker, Ruth; Palermo, Claire; Rounsefell, Kim; Aron, Yudit; MacDonald, Catherine; Atkinson, Petah; Browne, Jennifer

2017-11-01

The present study aimed to explore how Australian local governments prioritise the health and well-being of Aboriginal populations and the extent to which nutrition is addressed by local government health policy. In the state of Victoria, Australia, all seventy-nine local governments' public health policy documents were retrieved. Inclusion of Aboriginal health and nutrition in policy documents was analysed using quantitative content analysis. Representation of Aboriginal nutrition 'problems' and 'solutions' was examined using qualitative framing analysis. The socio-ecological framework was used to classify the types of Aboriginal nutrition issues and strategies within policy documents. Victoria, Australia. Local governments' public health policy documents (n 79). A small proportion (14 %, n 11) of local governments addressed Aboriginal health and well-being in terms of nutrition. Where strategies aimed at nutrition existed, they mostly focused on individual factors rather than the broader macroenvironment. A limited number of Victorian local governments address nutrition as a health issue for their Aboriginal populations in policy documents. Nutrition needs to be addressed as a community and social responsibility rather than merely an individual 'behaviour'. Partnerships are required to ensure Aboriginal people lead government policy development.

A knowledge translation project on community-centred approaches in public health.

PubMed

Stansfield, J; South, J

2018-03-01

This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

Civil society and the negotiation of the Framework Convention on Tobacco Control

PubMed Central

MAMUDU, H. M.

2008-01-01

Tobacco control civil society organisations mobilised to influence countries during the negotiation of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) between 1999 and 2003. Tobacco control civil society organisations and coalitions around the world embraced the idea of an international tobacco control treaty and came together as the Framework Convention Alliance (FCA), becoming an important non-state actor within the international system of tobacco control. Archival documents and interviews demonstrate that the FCA successfully used strategies including publication of a newsletter, shaming, symbolism and media advocacy to influence policy positions of countries during the FCTC negotiation. The FCA became influential in the negotiation process by mobilising tobacco control civil society organisations and resources with the help of the Internet and framing the tobacco control discussion around global public health. PMID:19333806

Protecting children from toxic chemicals: putting it on Australia's public health agenda.

PubMed

Lantz, Sarah

2013-11-01

The high volume and widespread use of industrial chemicals, the backlog of internationally untested chemicals, the uptake of synthetic chemicals found in babies in utero, cord blood, and in breast milk, and the lack of a unified and comprehensive regulatory framework all necessitate developing policies that protect the most vulnerable in our society - our children. Australia's failure to do so raises profound intergenerational ethical issues. This article tells a story of international policy, and where Australia is falling down. It demonstrates that we can learn from countries already taking critical steps to reduce the toxic chemical exposure, and that the development of a comprehensive, child-centered chemical regulation framework is central to turning around Australia's failure.

K-12 students with concussions: a legal perspective.

PubMed

Zirkel, Perry A; Brown, Brenda Eagan

2015-04-01

This article provides a multipart analysis of the public schools' responsibility for students with concussions. The first part provides the prevailing diagnostic definitions of concussions and postconcussive syndrome. The second and central part provides (a) the legal framework of the two overlapping federal laws--the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act and the varying state laws or local policies for individual health plans and (b) a summary of the developing body of hearing officer decisions, court decisions, and Office for Civil Rights rulings that have applied this framework to K-12 students with concussions. The final part offers recommendations for proactive return to school policies, with the school nurse playing a central supporting role. © The Author(s) 2014.

Including policy and management in socio-hydrology models: initial conceptualizations

NASA Astrophysics Data System (ADS)

Hermans, Leon; Korbee, Dorien

2017-04-01

Socio-hydrology studies the interactions in coupled human-water systems. So far, the use of dynamic models that capture the direct feedback between societal and hydrological systems has been dominant. What has not yet been included with any particular emphasis, is the policy or management layer, which is a central element in for instance integrated water resources management (IWRM) or adaptive delta management (ADM). Studying the direct interactions between human-water systems generates knowledges that eventually helps influence these interactions in ways that may ensure better outcomes - for society and for the health and sustainability of water systems. This influence sometimes occurs through spontaneous emergence, uncoordinated by societal agents - private sector, citizens, consumers, water users. However, the term 'management' in IWRM and ADM also implies an additional coordinated attempt through various public actors. This contribution is a call to include the policy and management dimension more prominently into the research focus of the socio-hydrology field, and offers first conceptual variables that should be considered in attempts to include this policy or management layer in socio-hydrology models. This is done by drawing on existing frameworks to study policy processes throughout both planning and implementation phases. These include frameworks such as the advocacy coalition framework, collective learning and policy arrangements, which all emphasis longer-term dynamics and feedbacks between actor coalitions in strategic planning and implementation processes. A case about longter-term dynamics in the management of the Haringvliet in the Netherlands is used to illustrate the paper.

A critical analysis of UK public health policies in relation to diet and nutrition in low-income households.

PubMed

Attree, Pamela

2006-04-01

Diet and nutrition, particularly among low-income groups, is a key public health concern in the UK. Low levels of fruit and vegetable consumption, and obesity, especially among children, have potentially severe consequences for the future health of the nation. From a public health perspective, the UK government's role is to help poorer families make informed choices within healthy frameworks for living. However, the question is - to what extent are such policies in accordance with lay experiences of managing diet and nutrition on a low-income? This paper critically examines contemporary public health policies aimed at improving diet and nutrition, identifying the underlying theories about the influences on healthy eating in poor families, and exploring the extent to which these assumptions are based on experiential accounts. It draws on two qualitative systematic reviews - one prioritizing low-income mothers' accounts of 'managing' in poverty; and the other focusing on children's perspectives. The paper finds some common ground between policies and lay experiences, but also key divergencies. Arguably, the emphasis of public health policy on individual behaviour, coupled with an ethos of empowered consumerism, underplays material limitations on 'healthy eating' for low-income mothers and children. Health policies fail to take into account the full impact of structural influences on food choices, or recognize the social and emotional factors that influence diet and nutrition. In conclusion, it is argued that while health promotion campaigns to improve low-income families' diets do have advantages, these are insufficient to outweigh the negative effects of poverty on nutrition.

The sideshow or the circus? The role for public interest organisations at inquests.

PubMed

Prictor, Megan

2012-12-01

Recent changes in coronial law in Australian jurisdictions have enabled inquests to adopt an expanded scope and have facilitated the participation of family members and other interested parties. Public interest bodies have increasingly sought to have input to coronial policy and practice. This article examines the involvement by public interest organisations in Australian inquests over recent years. These organisations adopt various roles in inquests, including the representation and support of family members of the deceased, and the pursuit of policy and legislative changes. A further role is that of participation in specific inquests as an "interested party", in order to provide relevant expertise, shape the scope of the inquiry, and illuminate systemic issues which may have contributed to a death. This article considers the legal framework for the involvement of public interest organisations, and critically reflects upon the main purposes and effects of such intervention.

Conflict of interest and FCTC implementation in China.

PubMed

Wan, Xia; Ma, Shaojun; Hoek, Janet; Yang, Jie; Wu, Lanyan; Zhou, Jiushun; Yang, Gonghuan

2012-07-01

To critically review the structure of tobacco control policy making in China, examine conflicts of interest within this structure, and consider how these affected the introduction of on-pack warnings. Government policy documents and warning labels were obtained and critically reviewed. Few differences exist between the on-pack warnings formerly used in China and those introduced ostensibly to meet Framework Convention on Tobacco Control (FCTC) obligations. Comparison with tobacco manufactured for export or overseas consumption shows the new Chinese domestic on-pack warnings are demonstrably inferior to those required internationally. The inherent conflict of interest in the Chinese tobacco control agency structure, which must meet commercial and public health objectives, undermined the introduction of new health warnings. To promote more effective tobacco control policies, the conflict of interest inhibiting the public health function of the State Tobacco Monopoly Administration (STMA) must be removed. Specifically, the public health function must be separated from oversight of commercial production, and packaging must be redesigned with pictorial warnings and messages compliant with Article 11 of the FCTC.

Empowered: Renewable energy, western states and the Bureau of Land Management

NASA Astrophysics Data System (ADS)

Buthman, James Douglas

Renewable Energy (RE) increasingly influences electrical markets throughout the United States. The public lands, those lands managed by the Bureau of Land Management (BLM), are being used for the placement of utility-scale (20+ Megawatts) RE facilities, particularly solar, wind, and geothermal power plants. This dissertation uses Kingdon's (1984) multiple streams theory (MS) as a framework to examine state influence on the implementation phase of the federal policy process. This is a comparative case study of four western states (Arizona, California, Nevada, and Utah). Three theories guide the examination of the three streams of governmental action: problems = new institutionalism; policies = cooperative federalism; and politics = networks. The research question asks: How do state governments affect the implementation phase of the federal policy process concerning the use of the public lands for utility-scale RE?

A Conceptual Framework for Planning Systemic Human Adaptation to Global Warming

PubMed Central

Tait, Peter W.; Hanna, Elizabeth G.

2015-01-01

Human activity is having multiple, inter-related effects on ecosystems. Greenhouse gas emissions persisting along current trajectories threaten to significantly alter human society. At 0.85 °C of anthropogenic warming, deleterious human impacts are acutely evident. Additional warming of 0.5 °C–1.0 °C from already emitted CO2 will further intensify extreme heat and damaging storm events. Failing to sufficiently address this trend will have a heavy human toll directly and indirectly on health. Along with mitigation efforts, societal adaptation to a warmer world is imperative. Adaptation efforts need to be significantly upscaled to prepare society to lessen the public health effects of rising temperatures. Modifying societal behaviour is inherently complex and presents a major policy challenge. We propose a social systems framework for conceptualizing adaptation that maps out three domains within the adaptation policy landscape: acclimatisation, behavioural adaptation and technological adaptation, which operate at societal and personal levels. We propose that overlaying this framework on a systems approach to societal change planning methods will enhance governments’ capacity and efficacy in strategic planning for adaptation. This conceptual framework provides a policy oriented planning assessment tool that will help planners match interventions to the behaviours being targeted for change. We provide illustrative examples to demonstrate the framework’s application as a planning tool. PMID:26334285

Transfer of Health for All policy – What, how and in which direction? A two-case study

PubMed Central

Tervonen-Gonçalves, Leena; Lehto, Juhani

2004-01-01

Background This article explores the transfer of World Health Organization's (WHO) policy initiative Health for All by the Year 2000 (HFA2000) into national contexts by using the changes in the public health policies of Finland and Portugal from the 1970's onward and the relationship of these changes to WHO policy development as test cases. Finland and Portugal were chosen to be compared as they represent different welfare state types and as the paradigmatic transition from the old to new public health is assumed to be related to the wider welfare state development. Methods The policy transfer approach is used as a conceptual tool to analyze the possible policy changes related to the adaptation of HFA into the national context. To be able to analyze not only the content but also the contextual conditions of policy transfer Kingdon's analytical framework of policy analysis is applied. Conclusions Our analysis suggests that no significant change of health promotion policy resulted from the launch of HFA program neither in Finland nor in Portugal. Instead the changes that occurred in both countries were of incremental nature, in accordance with the earlier policy choices, and the adaptation of HFA program was mainly applied to the areas where there were national traditions. PMID:15585064

Scientific Autonomy and Public Oversight

PubMed Central

Resnik, David B.

2009-01-01

When scientific research collides with social values, science’s right to self-governance becomes an issue of paramount concern. In this article, I develop an account of scientific autonomy within a framework of public oversight. I argue that scientific autonomy is justified because it promotes the progress of science, which benefits society, but that restrictions on autonomy can also be justified to prevent harm to people, society, or the environment, and to encourage beneficial research. I also distinguish between different ways of limiting scientific autonomy, and I argue that government involvement in scientific decision-making should usually occur through policies that control the process of science, rather than policies that control the content of science. PMID:19777124

New Beginnings: Ensuring Quality Bilingual/ESL Instruction in New York City Public Schools. Executive Summary [and] Report of the Chancellor's Bilingual/ESL Education Practitioners' Workgroup and Policy/Research Panels.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Office of Bilingual Education.

The report presents a conceptual framework and related strategies designed to help policymakers and practitioners re-examine, and when necessary, rework the basic assumptions and practices defining the educational experiences of bilingual/English-as-a-Second-Language (ESL) learners in New York City (New York) public schools. The report consists of…

75 FR 67149 - Request for Public Comment on the Draft 2010 National Nanotechnology Initiative Strategic Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-01

... Nanotechnology Initiative Strategic Plan AGENCY: White House Office of Science and Technology Policy. ACTION... Nanotechnology Initiative (NNI) Strategic Plan. The draft plan is posted at http://strategy.nano.gov . Comments... information. Overview: The National Nanotechnology Initiative (NNI) Strategic Plan is the framework that...

A social-ecological impact assessment for public land management: application of a conceptual and methodological framework

USDA-ARS?s Scientific Manuscript database

According to the U.S. National Environmental Policy Act of 1969 (NEPA), federal action to manipulate habitat for species conservation requires an environmental impact statement (EIS), which should integrate natural and social sciences in planning and decision-making. Nonetheless, most impact assessm...

A Scandinavian Perspective on Educational Leadership

ERIC Educational Resources Information Center

Moos, Lejf; Moller, Jorunn; Johansson, Olof

2004-01-01

The objective of this article is to examine the rhetoric of educational leadership within a Scandinavian context, as it occurs within the framework of New Public Management. The study asks questions about new demands on leadership expressed in policy documents. Local culture and distinctive aspects of national life tend to modify external…

75 FR 3906 - Office of the National Coordinator for Health Information Technology; HIT Policy Committee's...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-25

... Coordinator for Health Information Technology, HHS. ACTION: Notice of meetings. This notice announces... for Health Information Technology (ONC). The meetings will be open to the public via dial-in access... framework for the development and adoption of a nationwide health information technology infrastructure that...

Social Dominance Theory and Medical Specialty Choice

ERIC Educational Resources Information Center

Lepièce, Brice; Reynaert, Christine; van Meerbeeck, Philippe; Dory, Valérie

2016-01-01

Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social…

Wildland economics: theory and practice

Treesearch

Pete Morton

2000-01-01

Since passage of the Wilderness Act, economists have derived the total economic valuation framework for estimating wildland benefits. Over the same time period, policies adopted by public land management agencies have been slow to internalize wilderness economics into management decisions. The lack of spatial resolution and modeler bias associated with the FORPLAN...

School Psychology: A Public Health Framework: I. From Evidence-Based Practices to Evidence-Based Policies.

ERIC Educational Resources Information Center

Hoagwood, Kimberly; Johnson, Jacqueline

2003-01-01

Describes current perspectives on evidence-based practices in psychology, medicine, and education; discusses challenges in the implementation and dissemination of research-based findings into schools; describes differences between current models of organizational behavior as studied in children's mental health services and in education; and…

Career Development and Public Policy: A Framework Document.

ERIC Educational Resources Information Center

2000

This paper sets a context for career development services, including their importance and where they are typically delivered. Career development services are being delivered in many sectors: career education is delivered in schools and post-secondary institutions; career counseling is available from community agencies and private practitioners;…

Change, Continuity and Path-Dependency in Hungarian Public Education

ERIC Educational Resources Information Center

Szolár, Éva

2015-01-01

In this descriptive study the aim is to analyze the Hungarian educational policy history and event-chain of the comprehensive and post-comprehensive project. As a structuring framework this paper used the historical landmarks and the different institutional arrangement models (governance types and power distribution models). Accordingly, three…

Government-Microsoft Partnerships: Supranational Formulation in Private and Public Policy

ERIC Educational Resources Information Center

Cardoso, Clementina Marques

2008-01-01

This article argues that the framework for the governance of technological knowledge and skills that is formulated for national consumption emerges from a supranational terrain of politics outside the jurisdiction of national and European parliamentary activity and scrutiny. Traditionally understood as a space where ideas circulate and initiatives…

A Framework for Organizing Current and Future Electric Utility Regulatory and Business Models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Satchwell, Andrew; Cappers, Peter; Schwartz, Lisa

In this report, we will present a descriptive and organizational framework for incremental and fundamental changes to regulatory and utility business models in the context of clean energy public policy goals. We will also discuss the regulated utility's role in providing value-added services that relate to distributed energy resources, identify the "openness" of customer information and utility networks necessary to facilitate change, and discuss the relative risks, and the shifting of risks, for utilities and customers.

Fading vision: knowledge translation in the implementation of a public health policy intervention

PubMed Central

2013-01-01

Background In response to several high profile public health crises, public health renewal is underway in Canada. In the province of British Columbia, the Ministry of Health initiated a collaborative evidence-informed process involving a steering committee of representatives from the six health authorities. A Core Functions (CF) Framework was developed, identifying 21 core public health programs. For each core program, an evidence review was conducted and a model core program paper developed. These documents were distributed to health authorities to guide development of their own renewed public health services. The CF implementation was conceptualized as an embedded knowledge translation process. A CF coordinator in each health authority was to facilitate a gap analysis and development of a performance improvement plan for each core program, and post these publically on the health authority website. Methods Interviews (n = 19) and focus groups (n = 8) were conducted with a total of 56 managers and front line staff from five health authorities working in the Healthy Living and Sexually Transmitted Infection Prevention core programs. All interviews and focus groups were digitally recorded, transcribed and verified by the project coordinator. Five members of the research team used NVivo 9 to manage data and conducted a thematic analysis. Results Four main themes emerged concerning implementation of the CF Framework generally, and the two programs specifically. The themes were: ‘you’ve told me what, now tell me how’; ‘the double bind’; ‘but we already do that’; and the ‘selling game.’ Findings demonstrate the original vision of the CF process was lost in the implementation process and many participants were unaware of the CF framework or process. Conclusions Results are discussed with respect to a well-known framework on the adoption, assimilation, and implementation of innovations in health services organizations. Despite attempts of the Ministry of Health and the Steering Committee to develop and implement a collaborative, evidence-informed policy intervention, there were several barriers to the realization of the vision for core public health functions implementation, at least in the early stages. In neglecting the implementation process, it seems unlikely that the expected benefits of the public health renewal process will be realized. PMID:23734672

Factors shaping political priorities for violence against women-mitigation policies in Sri Lanka.

PubMed

Colombini, Manuela; Mayhew, Susannah H; Lund, Ragnhild; Singh, Navpreet; Swahnberg, Katarina; Infanti, Jennifer; Schei, Berit; Wijewardene, Kumudu

2018-05-25

Although violence against women (VAW) is a global public health issue, its importance as a health issue is often unrecognized in legal and health policy documents. This paper uses Sri Lanka as a case study to explore the factors influencing the national policy response to VAW, particularly by the health sector. A document based health policy analysis was conducted to examine current policy responses to VAW in Sri Lanka using the Shiffman and Smith (2007) policy analysis framework. The findings suggest that the networks and influences of various actors in Sri Lanka, and their ideas used to frame the issue of VAW, have been particularly important in shaping the nature of the policy response to date. The Ministry of Women and Child Affairs led the national response on VAW, but suffered from limited financial and political support. Results also suggest that there was low engagement by the health sector in the initial policy response to VAW in Sri Lanka, which focused primarily on criminal legislation, following global influences. Furthermore, a lack of empirical data on VAW has impeded its promotion as a health policy issue, despite financial support from international organisations enabling an initial health systems response by the Ministry of Health. Until a legal framework was established (2005), the political context provided limited opportunities for VAW to also be construed as a health issue. It was only then that the Ministry of Health got legitimacy to institutionalise VAW services. Nearly a decade later, a change in government has led to a new national plan on VAW, giving a clear role to the health sector in the fight against VAW. High-level political will, criminalisation of violence, coalesced women's groups advocating for legislative change, prevalence data, and financial support from influential institutions are all critical elements helping frame violence as a national public health issue.

An Analysis of Hospital Accreditation Policy in Iran

PubMed Central

YOUSEFINEZHADI, Taraneh; MOSADEGHRAD, Ali Mohammad; ARAB, Mohammad; RAMEZANI, Mozhdeh; SARI, Ali AKBARI

2017-01-01

Background: Public policymaking is complex and lacks research evidences, particularly in the Eastern Mediterranean Region (EMR). This policy analysis aims to generate insights about the process of hospital accreditation policy making in Iran, to identify factors influencing policymaking and to evaluate utilization of evidence in policy making process. Methods: The study examined the policymaking process using Walt and Gilson framework. A qualitative research design was employed. Thirty key informant interviews with policymakers and stakeholders were conducted. In addition hundred and five related documents were reviewed. Data was analyzed using framework analysis. Results: The accreditation program was a decision made at Ministry of Health and Medical Education in Iran. Many healthcare stakeholders were involved and evidence from leading countries was used to guide policy development. Poor hospital managers’ commitment, lack of physicians’ involvement and inadequate resources were the main barriers in policy implementation. Furthermore, there were too many accreditations standards and criteria, surveyors were not well-trained, had little motivation for their work and there was low consistency among them. Conclusion: This study highlighted the complex nature of policymaking cycle and highlighted various factors influencing policy development, implementation and evaluation. An effective accreditation program requires a robust well-governed accreditation body, various stakeholders’ involvement, sufficient resources and sustainable funds, enough human resources, hospital managers’ commitment, and technical assistance to hospitals. PMID:29308378

NASA agenda for tomorrow

NASA Technical Reports Server (NTRS)

1988-01-01

Key elements of national policy, NASA goals and objectives, and other materials that comprise the framework for NASA planning are included. The contents are expressed as they existed through much of 1988; thus they describe the strategic context employed by NASA in planning both the FY 1989 program just underway and the proposed FY 1990 program. NASA planning will continue to evolve in response to national policy requirements, a changing environment, and new opportunities. Agenda for Tomorrow provides a status report as of the time of its publication.

Managing health worker migration: a qualitative study of the Philippine response to nurse brain drain

PubMed Central

2012-01-01

Background The emigration of skilled nurses from the Philippines is an ongoing phenomenon that has impacted the quality and quantity of the nursing workforce, while strengthening the domestic economy through remittances. This study examines how the development of brain drain-responsive policies is driven by the effects of nurse migration and how such efforts aim to achieve mind-shifts among nurses, governing and regulatory bodies, and public and private institutions in the Philippines and worldwide. Methods Interviews and focus group discussions were conducted to elicit exploratory perspectives on the policy response to nurse brain drain. Interviews with key informants from the nursing, labour and immigration sectors explored key themes behind the development of policies and programmes that respond to nurse migration. Focus group discussions were held with practising nurses to understand policy recipients’ perspectives on nurse migration and policy. Results Using the qualitative data, a thematic framework was created to conceptualize participants’ perceptions of how nurse migration has driven the policy development process. The framework demonstrates that policymakers have recognised the complexity of the brain drain phenomenon and are crafting dynamic policies and programmes that work to shift domestic and global mindsets on nurse training, employment and recruitment. Conclusions Development of responsive policy to Filipino nurse brain drain offers a glimpse into a domestic response to an increasingly prominent global issue. As a major source of professionals migrating abroad for employment, the Philippines has formalised efforts to manage nurse migration. Accordingly, the Philippine paradigm, summarised by the thematic framework presented in this paper, may act as an example for other countries that are experiencing similar shifts in healthcare worker employment due to migration. PMID:23249411

["Health 2020" - the New European Framework Strategy of WHO].

PubMed

Michelsen, K; Brand, H

2012-12-01

The WHO Regional Committee for Europe agreed in September 2012 on the new framework strategy "Health 2020". The framework has the strategic objectives of improving health for all and reducing health inequalities as well as improving leadership and participatory governance for health. The present article introduces the basic points of "Health 2020". Central elements (European Action Plan for Strengthening Public Health and Public Health Services, health and well-being, reducing health inequalities, whole-of-governance and whole-of-society approaches) are described in more detail, taking background materials into account. Critical remarks address the implementation, reporting and governance issues. They are discussed by taking into account the context of the development of "Health 2020". Even if some critical aspects exist, it can be stated that "Health 2020" delivers a framework and orientation for health policies - as well as for the heterogeneous situation in WHO Europe as well as for Germany. © Georg Thieme Verlag KG Stuttgart · New York.

Building policy capacities: an interactive approach for linking knowledge to action in health promotion.

PubMed

Rütten, Alfred; Gelius, Peter

2014-09-01

This article outlines a theoretical framework for an interactive, research-driven approach to building policy capacities in health promotion. First, it illustrates how two important issues in the recent public health debate, capacity building and linking scientific knowledge to policy action, are connected to each other theoretically. It then introduces an international study on an interactive approach to capacity building in health promotion policy. The approach combines the ADEPT model of policy capacities with a co-operative planning process to foster the exchange of knowledge between policy-makers and researchers, thus improving intra- and inter-organizational capacities. A regional-level physical activity promotion project involving governmental and public-law institutions, NGOs and university researchers serves as a case study to illustrate the potential of the approach for capacity building. Analysis and comparison with a similar local-level project indicate that the approach provides an effective means of linking scientific knowledge to policy action and to planning concrete measures for capacity building in health promotion, but that it requires sufficiently long timelines and adequate resources to achieve adequate implementation and sustainability. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Forecasting future tobacco control policy: where to next?

PubMed

Freeman, Becky; Gartner, Coral; Hall, Wayne; Chapman, Simon

2010-10-01

Effective tobacco control policies include price increases through taxes, restrictions on smoking in public and work places, adequately funded mass media campaigns, bans on advertising, health warnings on packages and cessation assistance. As these policies have been largely implemented in Australia, what next should the country do in tobacco control? Ninety-one Australian tobacco control stakeholders took part in a web-based survey about the future of tobacco control policies. The policy deemed most important in decreasing smoking was to increase excise and customs duty by 30%. Other policies receiving high support included: funding mass media campaigns through tax hypothecation; introducing retail display bans; plain packaging of tobacco products; and banning smoking in outdoor dining areas. Reintroducing the sale of smokeless tobacco products received the least support. Countries that have largely implemented the provisions of the Framework Convention on Tobacco Control must maintain commitments to proven tobacco control measures, but also provide global leadership through the adoption of innovative policies. The release of the Australian 2009 National Preventative Health Taskforce's report presents an opportunity to translate these ideas into action. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Technology-based innovation for independent living: policy and innovation in the United Kingdom, Scandinavia, and the United States.

PubMed

Berridge, Clara; Furseth, Peder Inge; Cuthbertson, Richard; Demello, Steven

2014-01-01

Interest in utilizing technology to help older adults remain living at home is growing; however, uptake remains low. We present a conceptual framework for understanding independent living technology innovation within health and social services. Public policy and innovation in the United States, the United Kingdom, and Scandinavia are profiled as case studies. In all profiled countries, independent living technology is more rapidly advancing than associated state policy, regulation, and payment systems. The findings from this comparative analysis reveal areas for further exploration, including policy subsystem environments in which technologies and services are regulated, as well as trends and desires of older adults and their caregivers within particular cultural contexts.

Essays on Energy Technology Innovation Policy

NASA Astrophysics Data System (ADS)

Chan, Gabriel Angelo Sherak

Motivated by global climate change, enhancing innovation systems for energy technologies is seen as one of the largest public policy challenges of the near future. The role of policy in enhancing energy innovation systems takes several forms: public provision of research and develop funding, facilitating the private sector's capability to develop new technologies, and creating incentives for private actors to adopt innovative and appropriate technologies. This dissertation explores research questions that span this range of policies to develop insights in how energy technology innovation policy can be reformed in the face of climate change. The first chapter of this dissertation explores how decision making to allocate public research and development funding could be improved through the integration of expert technology forecasts. I present a framework to evaluate and optimize the U.S. Department of Energy's research and development portfolio of applied energy projects, accounting for spillovers from technical complimentary and competition for the same market share. This project integrates one of the largest and most comprehensive sets of expert elicitations on energy technologies (Anadon et al., 2014b) in a benefit evaluation framework. This work entailed developing a new method for probability distribution sampling that accommodates the information that can be provided by expert elicitations. The results of this project show that public research and development in energy storage and solar photovoltaic technologies has the greatest marginal returns to economic surplus, but the methodology developed in this chapter is broadly applicable to other public and private R&D-sponsoring organizations. The second chapter of this dissertation explores how policies to transfer technologies from federally funded research laboratories to commercialization partners, largely private firms, create knowledge spillovers that lead to further innovation. In this chapter, I study the U.S. Department of Energy's National Laboratories, and provide the first quantitative evidence that technology transfer agreements at the Labs lead to greatly increased rates of innovation spillovers. This chapter also makes a key methodological contribution by introducing a technique to utilize automated text analysis in an empirical matching design that is broadly applicable to other types of social science studies. This work has important implications for how policies should be designed to maximize the social benefits of the $125 billion in annual federal funding allocated to research and development and the extent to which private firms can benefit from technology partnerships with the government. The final chapter of this dissertation explores the effectiveness of international policy to facilitate the deployment of low-emitting energy technologies in developing countries. Together with Joern Huenteler, I examine wind energy deployment in China supported through international climate finance flows under the Kyoto Protocol's Clean Development Mechanism. Utilizing a project-level financial model of wind energy projects parameterized with high-resolution observations of Chinese wind speeds, we find that the environmental benefits of projects financed under the Clean Development Mechanism are substantially lower than reported, as many Chinese wind projects would have been built without the Mechanism's support, and thus do not represent additional clean energy generation. Together, the essays in this dissertation suggest several limitations of energy technology innovation policy and areas for reform. Public funds for energy research and development could be made more effective if decision making approaches were better grounded in available technical expertise and developed in framework that captures the important interactions of technologies in a research and development portfolio. The first chapter of this dissertation suggests a politically feasible path towards this type of reform. Policies to "unlock" publicly sponsored inventions from the organizations that develop them have broad impact on private sector innovation. These policies multiply the effect of public research and development funds, but should be strengthened to more rapidly advance the scientific frontier. The second chapter of this dissertation provides some of the first quantitative evidence to support reform in this area. Finally, international policies to facilitate the deployment of climate-friendly technologies in developing countries face serious implementation challenges. The current paradigm of utilizing carbon markets to fund individual projects that would not have otherwise occurred has failed to encourage energy technology deployment in one of the sectors with the greatest experience with such policies. The third chapter of this dissertation suggests that this failure has been largely due to poorly designed procedural rules, but options for reform are available. Mitigation of global climate change will require broad policy response across the full range of scales, sectors, and policy spheres. Undoubtedly, climate mitigation will result in widespread transformation of energy systems. This dissertation focuses on the role of innovation policy in accelerating the transformation of these systems. The range of policies studied in this dissertation can make climate change mitigation more politically feasible and more cost effective by expanding the set of technological choices available to public and private actors faced with incentives and requirements to lower their greenhouse gas emissions to collectively safe levels.

Stakeholder influence in public sector information systems strategy implementation-The case of public hospitals in South Africa.

PubMed

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

Recent literature on organisational strategy has called for greater emphasis on individuals (stakeholders) and what they do in the process of strategizing. Public sector organisations have to engage with an array of heterogeneous stakeholders in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations on the implementation of Information Systems (IS) strategy in public hospitals in South Africa. An interpretive approach using two provinces was employed. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis, physical artefacts and observation. The collected data was analysed using thematic analysis. Findings reveal that IS strategy implementation in public hospitals involves a large and complex network of stakeholder groups at different levels, and over different time periods. These stakeholder groups act in accordance with formal and informal roles, rules and modalities. Various contextual conditions together with the actions of, and interactions between stakeholder groups give rise to the situationality of stakeholder relations dynamics and strategy implementation. The multiple actions and interactions over time lead to the realisation of some aspects of the IS strategy in public hospitals. Given the complexity and dynamism of the context there are also certain unplanned implementations as well. These relationships are captured in a Stakeholder Relations Influence (SRI) framework. The SRI framework can be assistive in the assessment and mapping of stakeholders and stakeholder relations, and the assessment of the implications of these relations for effective IS strategy implementation in public hospitals. The framework can also provide the basis for the development of appropriate corrective measures in the implementation of strategies and policies in public institutions such as public hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

The Socio-Exposome: Advancing Exposure Science and Environmental Justice in a Post-Genomic Era

PubMed Central

Senier, Laura; Brown, Phil; Shostak, Sara; Hanna, Bridget

2017-01-01

We propose the socio-exposome as a conceptual framework for integrative environmental health research. Environmental scientists coined the term “exposome” with the goal of inventorying and quantifying environmental exposures as precisely as scientists measure genes and gene expression. To date, the exposome’s proponents have not thoroughly engaged social scientific theoretical and methodological expertise, although the exclusion of sociological expertise risks molecularizing complex social phenomena and limiting the possibility of collective action to improve environmental conditions. As a corrective, and to demonstrate how “omic” technologies could be made more relevant to public health, our socio-exposome framework blends insights from sociological and public health research with insights from environmental justice scholarship and activism. We argue that environmental health science requires more comprehensive data on more and different kinds of environmental exposures, but also must consider the socio-political conditions and inequalities that allow hazards to continue unchecked. We propose a multidimensional framework oriented around three axes: individual, local, and global, and suggest some sociomarkers and data sources that could identify exposures at each level. This framework could also guide policy, by creating a predictive framework that helps communities understand the repercussions of corporate and regulatory practices for public health and social justice. PMID:28944245

[A framework to support action in population mental health].

PubMed

Mantoura, Pascale; Roberge, Marie-Claude; Fournier, Louise

In Quebec, like elsewhere in the world, we are witnessing a growing concern for the population's mental health and for the importance of concentrating efforts on prevention and promotion. In this context, public health actors are invited to adopt a leadership role in advancing mental health promotion and mental disorder prevention goals, and establish the required partnerships with actors from the health and social services and from other sectors who are indispensable to the population mental health agenda. In Canada, public heath actors are not yet sufficiently supported in this role. They express the need to access structuring frameworks which can clarify their action in mental health. This article first presents the momentum for change at the policy level within the field of mental health. A framework to support population mental health action is then presented. The framework identifies the various dimensions underlying the promotion of population mental health as well as the reduction of mental health inequalities. The article finally illustrates how the application of a populational (the application of a populational responsibility perspective) responsibility perspective, as it is defined in the context of Quebec, facilitates the implementation of the various elements of this framework. In the end, public health actors are better equipped to situate their practice in favour of the population's mental health.

Insights into the Government’s Role in Food System Policy Making: Improving Access to Healthy, Local Food Alongside Other Priorities

PubMed Central

Wegener, Jessica; Raine, Kim D.; Hanning, Rhona M.

2012-01-01

Government actors have an important role to play in creating healthy public policies and supportive environments to facilitate access to safe, affordable, nutritious food. The purpose of this research was to examine Waterloo Region (Ontario, Canada) as a case study for “what works” with respect to facilitating access to healthy, local food through regional food system policy making. Policy and planning approaches were explored through multi-sectoral perspectives of: (a) the development and adoption of food policies as part of the comprehensive planning process; (b) barriers to food system planning; and (c) the role and motivation of the Region’s public health and planning departments in food system policy making. Forty-seven in-depth interviews with decision makers, experts in public health and planning, and local food system stakeholders provided rich insight into strategic government actions, as well as the local and historical context within which food system policies were developed. Grounded theory methods were used to identify key overarching themes including: “strategic positioning”, “partnerships” and “knowledge transfer” and related sub-themes (“aligned agendas”, “issue framing”, “visioning” and “legitimacy”). A conceptual framework to illustrate the process and features of food system policy making is presented and can be used as a starting point to engage multi-sectoral stakeholders in plans and actions to facilitate access to healthy food. PMID:23202834

UK policy on social networking sites and online health: From informed patient to informed consumer?

PubMed Central

Hunt, Daniel; Koteyko, Nelya; Gunter, Barrie

2015-01-01

Background Social networking sites offer new opportunities for communication between and amongst health care professionals, patients and members of the public. In doing so, they have the potential to facilitate public access to health care information, peer-support networks, health policy fora and online consultations. Government policies and guidance from professional organisations have begun to address the potential of these technologies in the domain of health care and the responsibilities they entail for their users. Objective Adapting a discourse analytic framework for the analysis of policy documents, this review paper critically examines discussions of social networking sites in recent government and professional policy documents. It focuses particularly on who these organisations claim should use social media, for what purposes, and what the anticipated outcomes of use will be for patients and the organisations themselves. Conclusion Recent policy documents have configured social media as a new means with which to harvest patient feedback on health care encounters and communicate health care service information with which patients and the general public can be ‘empowered’ to make responsible decisions. In orienting to social media as a vehicle for enabling consumer choice, these policies encourage the marketization of health information through a greater role for non-profit and commercial organisations in the eHealth domain. At the same time, current policy largely overlooks the role of social media in mediating ongoing support and self-management for patients with long-term conditions. PMID:29942541

Concussions and youth football: using a public health law framework to head off a potential public health crisis.

PubMed

Baugh, Christine M; Shapiro, Zachary E

2015-07-01

Concussion from sport is increasingly recognized as a public health priority. In response, all states and the District of Columbia have enacted youth concussion legislation. This paper first examines key developments in concussion-related policy and legislation and then uses the findings from recent scientific studies to highlight the need to incorporate evolving scientific evidence into concussion legislation in order to better protect youth and adolescent athletes. Next, the paper discusses the framework of empirical health law research and why it should be applied in the case of concussion legislation. Finally, this paper argues that empirical health law research should be considered in any decision about whether legislation can help improve the health and safety of young players, a particularly vulnerable population whose unique needs have not yet been adequately addressed.

Modified Policy-Delphi study for exploring obesity prevention priorities

PubMed Central

Haynes, Emily; Palermo, Claire; Reidlinger, Dianne P

2016-01-01

Introduction Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of ‘intrusiveness’ has been applied to policy decisions in the UK, whereby ethical implications are considered through level of intrusiveness to choice; however, the concept has also been used to avert government regulation to address obesity. The concept of intrusiveness has not been explored from a stakeholder's perspective. The aim is to investigate the relevance of intrusiveness and autonomy to health policy development, and to explore consensus on obesity policy priorities of under-represented stakeholders. Methods and analysis The Policy-Delphi technique will be modified using the James Lind Alliance approach to collaborative priority setting. A total of 60 participants will be recruited to represent three stakeholder groups in the Australian context: consumers, public health practitioners and policymakers. A three-round online Policy-Delphi survey will be undertaken. Participants will prioritise options informed by submissions to the 2009 Australian Government Inquiry into Obesity, and rate the intrusiveness of those proposed. An additional round will use qualitative methods in a face-to-face discussion group to explore stakeholder perceptions of the intrusiveness of options. The novelty of this methodology will redress the balance by bringing the consumer voice forward to identify ethically acceptable obesity policy options. Ethics and dissemination Ethical approval was granted by the Bond University Health Research Ethics Committee. The findings will inform development of a conceptual framework for analysing and prioritising obesity policy options, which will be relevant internationally and to ethical considerations of wider public health issues. The findings will be disseminated through peer-reviewed publications, conference presentations and collaborative platforms of policy and science. PMID:27601495

Modified Policy-Delphi study for exploring obesity prevention priorities.

PubMed

Haynes, Emily; Palermo, Claire; Reidlinger, Dianne P

2016-09-06

Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of 'intrusiveness' has been applied to policy decisions in the UK, whereby ethical implications are considered through level of intrusiveness to choice; however, the concept has also been used to avert government regulation to address obesity. The concept of intrusiveness has not been explored from a stakeholder's perspective. The aim is to investigate the relevance of intrusiveness and autonomy to health policy development, and to explore consensus on obesity policy priorities of under-represented stakeholders. The Policy-Delphi technique will be modified using the James Lind Alliance approach to collaborative priority setting. A total of 60 participants will be recruited to represent three stakeholder groups in the Australian context: consumers, public health practitioners and policymakers. A three-round online Policy-Delphi survey will be undertaken. Participants will prioritise options informed by submissions to the 2009 Australian Government Inquiry into Obesity, and rate the intrusiveness of those proposed. An additional round will use qualitative methods in a face-to-face discussion group to explore stakeholder perceptions of the intrusiveness of options. The novelty of this methodology will redress the balance by bringing the consumer voice forward to identify ethically acceptable obesity policy options. Ethical approval was granted by the Bond University Health Research Ethics Committee. The findings will inform development of a conceptual framework for analysing and prioritising obesity policy options, which will be relevant internationally and to ethical considerations of wider public health issues. The findings will be disseminated through peer-reviewed publications, conference presentations and collaborative platforms of policy and science. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Structural factors in HIV prevention: concepts, examples, and implications for research.

PubMed

Sumartojo, E

2000-06-01

HIV-prevention behavior is affected by the environment as well as by characteristics of individuals at risk. HIV-related structural factors are defined as barriers to, or facilitators of, an individual's HIV prevention behaviors; they may relate to economic, social, policy, organizational or other aspects of the environment. A relatively small number of intervention studies demonstrates the potential of structural interventions to increase HIV prevention in the United States and internationally. The promise of structural interventions has also been shown in studies of interventions to prevent disease or promote public health in areas other than HIV. Frameworks help define and exemplify structural barriers and facilitators for HIV prevention. One framework developed at Centers for Disease Control and Prevention gives examples of structural facilitators in terms of the economic resources, policy supports, societal attitudes, and organizational structures and functions associated with governments, service organizations, businesses, workforce organizations, faith communities, justice systems, media organizations, educational systems, and healthcare systems. Frameworks should assist researchers and health officials to identify important areas for structural research and programming. A structural approach is timely and innovative. Despite limitations, including the challenge of a new perspective on prevention and the difficulty of evaluating their effects, researchers and public health officials are urged to pursue structural interventions to prevent HIV.

CRISPR, Patents, and the Public Health



PubMed Central

Sherkow, Jacob S.

2017-01-01

Patent issues surrounding CRISPR, the revolutionary genetic editing technology, may have important implications for the public health. Patents maintain high prices for novel therapies, limiting patient access. Relatedly, insurance coverage for expensive therapies is waning. Patents also misallocate research and development resources to profitable disease indications rather than those that necessarily impinge on the public health. And it is unclear how CRISPR therapies will figure into the current regulatory framework for biosimilars. Policy makers and physicians should consider these issues now, before CRISPR therapies become widely adopted—and entrenched—in the marketplace. PMID:29259531

CRISPR, Patents, and the Public Health.

PubMed

Sherkow, Jacob S

2017-12-01

Patent issues surrounding CRISPR, the revolutionary genetic editing technology, may have important implications for the public health. Patents maintain high prices for novel therapies, limiting patient access. Relatedly, insurance coverage for expensive therapies is waning. Patents also misallocate research and development resources to profitable disease indications rather than those that necessarily impinge on the public health. And it is unclear how CRISPR therapies will figure into the current regulatory framework for biosimilars. Policy makers and physicians should consider these issues now, before CRISPR therapies become widely adopted-and entrenched-in the marketplace.

Using the Consolidated Framework for Implementation Research to implement and evaluate national surgical planning

PubMed Central

Saluja, Saurabh; Silverstein, Allison; Mukhopadhyay, Swagoto; Lin, Yihan; Raykar, Nakul; Keshavjee, Salmaan; Samad, Lubna; Meara, John G

2017-01-01

The Lancet Commission on Global Surgery defined six surgical indicators and a framework for a national surgical plan that aimed to incorporate surgical care as a part of global public health. Multiple countries have since begun national surgical planning; each faces unique challenges in doing so. Implementation science can be used to more systematically explain this heterogeneous process, guide implementation efforts and ultimately evaluate progress. We describe our intervention using the Consolidated Framework for Implementation Research. This framework requires identifying characteristics of the intervention, the individuals involved, the inner and outer setting of the intervention, and finally describing implementation processes. By hosting a consultative symposium with clinicians and policy makers from around the world, we are able to specify key aspects of each element of this framework. We define our intervention as the incorporation of surgical care into public health planning, identify local champions as the key individuals involved, and describe elements of the inner and outer settings. Ultimately we describe top-down and bottom-up models that are distinct implementation processes. With the Consolidated Framework for Implementation Research, we are able to identify specific strategic models that can be used by implementers in various settings. While the integration of surgical care into public health throughout the world may seem like an insurmountable challenge, this work adds to a growing effort that seeks to find a way forward. PMID:29225930

The role for public funding of faith-based organizations delivering behavioral health services: guideposts for monitoring and evaluation.

PubMed

Kramer, Fredrica D

2010-12-01

The paper reviews policies promoting faith-based organizations' (FBO) participation in publicly-funded programs since the Charitable Choice statute was enacted during the Clinton administration and then additional faith-based initiatives were implemented by the Bush administration. The paper focuses on research findings on FBO participation in publicly-funded human service programs under these policies. It then proposes a framework for evaluation to assess the appropriateness of public funding for behavioral health services delivered by FBOs, in order to address: (1) the programmatic and systemic effects resulting from the infusion of new players from the faith community, and the consequences to the profile of services and who gets served; and (2) the content and effectiveness of faith-infused services as a basis for identifying interventions appropriate for public funding. The analysis considers classification issues, theoretical bases of measured effects of faith-infused services, and the transferability of faith-based interventions across religious and secular applications in order to satisfy constitutional issues and client choice.

Framing Public Policy and Prevention of Chronic Violence in American Youths

PubMed Central

Dodge, Kenneth A.

2009-01-01

Metaphors can both inspire and mislead the public. Current metaphors for youth violence are inconsistent with scientific evidence about how chronic violence develops and evoke inaccurate or harmful reactions. Popular, problematic metaphors include superpredator, quarantining the contagious, corrective surgery, man as computer, vaccine, and chronic disease. Four new metaphors that more accurately reflect the science of child development are proposed to shape the field. Preventive dentistry offers a lifelong system of universal, selected, and indicated intervention policies. Cardiovascular disease offers concepts of distal risk factors, proximal processes, equifinality and multifinality, and long-term prevention. The Centers for Disease Control and Prevention's public health model focuses on injury and the victim to elicit popular support. Public education for illiteracy offers concepts of long-term universal education coupled with specialized help for high-risk youths and goes beyond metaphor to represent a truly applicable framework. Research is proposed to test the scientific merit for and public receptivity to these metaphors. PMID:18855489

Intelligent policy making? Key actors' perspectives on the development and implementation of an early years' initiative in Scotland's public health arena.

PubMed

Deas, L; Mattu, L; Gnich, W

2013-11-01

Increased political enthusiasm for evidence-based policy and action has re-ignited interest in the use of evidence within political and practitioner networks. Theories of evidence-based policy making and practice are being re-considered in an attempt to better understand the processes through which knowledge translation occurs. Understanding how policy develops, and practice results, has the potential to facilitate effective evidence use. Further knowledge of the factors which shape healthcare delivery and their influence in different contexts is needed. This paper explores the processes involved in the development of a complex intervention in Scotland's National Health Service (NHS). It uses a national oral health programme for children (Childsmile) as a case study, drawing upon key actors' perceptions of the influence of different drivers (research evidence, practitioner knowledge and values, policy, and political and local context) to programme development. Framework analysis is used to analyse stakeholder accounts from in-depth interviews. Documentary review is also undertaken. Findings suggest that Childsmile can be described as an 'evidence-informed' intervention, blending available research evidence with knowledge from practitioner experience and continual learning through evaluation, to plan delivery. The importance of context was underscored, in terms of the need to align with prevailing political ideology and in the facilitative strength of networks within the relatively small public health community in Scotland. Respondents' perceptions support several existing theoretical models of translation, however no single theory offered a comprehensive framework covering all aspects of the complex processes reported. Childsmile's use of best available evidence and on-going contribution to knowledge suggest that the programme is an example of intelligent policy making with international relevance. Copyright © 2013 Elsevier Ltd. All rights reserved.

Regulatory Framework for Conducting Clinical Research in Canada.

PubMed

Alas, Josmar K; Godlovitch, Glenys; Mohan, Connie M; Jelinski, Shelly A; Khan, Aneal A

2017-09-01

Research in human subjects is at the core of achieving improvements in health outcomes. For clinical trials, in addition to the peer review of the results before publication, it is equally important to consider whether the trial will be conducted in a manner that generates data of the highest quality and provides a measure of safety for the participating subjects. In Canada, there is no definitive legislation that governs the conduct of research involving human subjects, but a network of regulations at different levels does provide a framework for both principal investigators and sponsors. In this paper, we provide an overview of the federal, provincial and institutional legislation, guidelines and policies that will inform readers about the requirements for clinical trial research. This includes a review of the role of the Food and Drug Regulations under the Food and Drugs Act and the Tri-Council Policy Statement (TCPS2), an overview of provincial legislation across the country, and a focus on selected policies from institutional research ethics boards and public health agencies. Many researchers may find navigation through regulations frustrating, and there is a paucity of information that explains the interrelationship between the different regulatory agencies in Canada. Better understanding the process, we feel, will facilitate investigators interested in clinical trials and also enhance the long-term health of Canadians.

Peter Bourne’s Drug Policy and the Perils of a Public Health Ethic, 1976–1978

PubMed Central

Dufton, Emily

2015-01-01

As President Jimmy Carter’s advisor for health issues, Peter Bourne promoted a rational and comprehensive drug strategy that combined new supply-side efforts to prevent drug use with previously established demand-side addiction treatment programs. Using a public health ethic that allowed the impact of substances on overall population health to guide drug control, Bourne advocated for marijuana decriminalization as well as increased regulations for barbiturates. A hostile political climate, a series of rumors, and pressure from both drug legalizers and prohibitionists caused Bourne to resign in disgrace in 1978. We argue that Bourne’s critics used his own public health framework to challenge him, describe the health critiques that contributed to Bourne’s resignation, and present the story of his departure as a cautionary tale for today’s drug policy reformers. PMID:25521893

Converging technologies: a critical analysis of cognitive enhancement for public policy application.

PubMed

Makridis, Christos

2013-09-01

This paper investigates cognitive enhancement, specifically biological cognitive enhancement (BCE), as a converging technology, and its implications for public policy. With an increasing rate of technological advancements, the legal, social, and economic frameworks lag behind the scientific advancements that they support. This lag poses significant challenges for policymakers if it is not dealt with sufficiently within the right analytical context. Therefore, the driving question behind this paper is, "What contingencies inform the advancement of biological cognitive enhancement, and what would society look like under this set of assumptions?" The paper is divided into five components: (1) defining the current policy context for BCEs, (2) analyzing the current social and economic outcomes to BCEs, (3) investigating the context of cost-benefit arguments in relation to BCEs, (4) proposing an analytical model for evaluating contingencies for BCE development, and (5) evaluating a simulated policy, social, technological, and economic context given the contingencies. In order to manage the risk and uncertainty inherent in technological change, BCEs' drivers must be scrutinized and evaluated.

Accounting for reasonableness: Exploring the personal internal framework affecting decisions about cancer drug funding.

PubMed

Sinclair, Shane; Hagen, Neil A; Chambers, Carole; Manns, Braden; Simon, Anita; Browman, George P

2008-05-01

Drug decision-makers are involved in developing and implementing policy, procedure and processes to support health resource allocation regarding drug treatment formularies. A variety of approaches to decision-making, including formal decision-making frameworks, have been developed to support transparent and fair priority setting. Recently, a decision tool, 'The 6-STEPPPs Tool', was developed to assist in making decisions about new cancer drugs within the public health care system. We conducted a qualitative study, utilizing focus groups and participant observation, in order to investigate the internal frameworks that supported and challenged individual participants as they applied this decision tool within a multi-stakeholder decision process. We discovered that health care resource allocation engaged not only the minds of decision-makers but profoundly called on the often conflicting values of the heart. Objective decision-making frameworks for new drug therapies need to consider the subjective internal frameworks of decision-makers that affect decisions. Understanding the very human, internal turmoil experienced by individuals involved in health care resource allocation, sheds additional insight into how to account for reasonableness and how to better support difficult decisions through transparent, values-based resource allocation policy, procedures and processes.

Gender equity and socioeconomic inequality: a framework for the patterning of women's health.

PubMed

Moss, Nancy E

2002-03-01

This paper explores the interrelationship of gender equity and socioeconomic inequality and how they affect women's health at the macro- (country) and micro- (household and individual) levels. An integrated framework draws theoretical perspectives from both approaches and from public health. Determinants of women's health in the geopolitical environment include country-specific history and geography, policies and services, legal rights, organizations and institutions, and structures that shape gender and economic inequality. Culture, norms and sanctions at the country and community level, and sociodemographic characteristics at the individual level, influence women's productive and reproductive roles in the household and workplace. Social capital, roles, psychosocial stresses and resources. health services, and behaviors mediate social, economic and cultural effects on health outcomes. Inequality between and within households contributes to the patterning of women's health. Within the framework, relationships may vary depending upon women's lifestage and cohort experience. Examples of other relevant theoretical frameworks are discussed. The conclusion suggests strategies to improve data, influence policy, and extend research to better understand the effect of gender and socioeconomic inequality on women's health.

A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics

PubMed Central

Renwick, Matthew J; Brogan, David M; Mossialos, Elias

2016-01-01

Despite the growing threat of antimicrobial resistance, pharmaceutical and biotechnology firms are reluctant to develop novel antibiotics because of a host of market failures. This problem is complicated by public health goals that demand antibiotic conservation and equitable patient access. Thus, an innovative incentive strategy is needed to encourage sustainable investment in antibiotics. This systematic review consolidates, classifies and critically assesses a total of 47 proposed incentives. Given the large number of possible strategies, a decision framework is presented to assist with the selection of incentives. This framework focuses on addressing market failures that result in limited investment, public health priorities regarding antibiotic stewardship and patient access, and implementation constraints and operational realities. The flexible nature of this framework allows policy makers to tailor an antibiotic incentive package that suits a country's health system structure and needs. PMID:26464014

'A preferred consultant and partner to the Royal Government, NGOs, and the community': British American Tobacco's access to policy-makers in Cambodia.

PubMed

MacKenzie, Ross; Collin, Jeff

2017-04-01

British American Tobacco Cambodia (BATC) has dominated the country's tobacco market since its launch in 1996. Aggressive marketing in a weak regulatory environment and strategies to influence tobacco control policy have contributed to an emerging tobacco-related public health crisis. Analysis of internal tobacco industry documents, issues of BATC's in-house newsletter, civil society reports and media demonstrate that BATC officials have successfully sought to align the company with Cambodia's increasingly controversial political and business leadership that is centred around the Cambodian People's Party with the aim of gaining access to policy-makers and influencing the policy process. Connections to the political elite have resulted in official recognition of the company's ostensible contribution to Cambodia's economic and social development and, more significantly, provided BATC with opportunities to petition policy-makers and to dilute tobacco control regulation. Corporate promotion of its contribution to Cambodia's economic and social development is at odds with its determined efforts to thwart public health regulation and Cambodia's compliance with the Framework Convention on Tobacco Control.

Ethical considerations for planetary protection in space exploration: a workshop.

PubMed

Rummel, J D; Race, M S; Horneck, G

2012-11-01

With the recognition of an increasing potential for discovery of extraterrestrial life, a diverse set of researchers have noted a need to examine the foundational ethical principles that should frame our collective space activities as we explore outer space. A COSPAR Workshop on Ethical Considerations for Planetary Protection in Space Exploration was convened at Princeton University on June 8-10, 2010, to examine whether planetary protection measures and practices should be extended to protect planetary environments within an ethical framework that goes beyond "science protection" per se. The workshop had been in development prior to a 2006 NRC report on preventing the forward contamination of Mars, although it responded directly to one of the recommendations of that report and to several peer-reviewed papers as well. The workshop focused on the implications and responsibilities engendered when exploring outer space while avoiding harmful impacts on planetary bodies. Over 3 days, workshop participants developed a set of recommendations addressing the need for a revised policy framework to address "harmful contamination" beyond biological contamination, noting that it is important to maintain the current COSPAR planetary protection policy for scientific exploration and activities. The attendees agreed that there is need for further study of the ethical considerations used on Earth and the examination of management options and governmental mechanisms useful for establishing an environmental stewardship framework that incorporates both scientific input and enforcement. Scientists need to undertake public dialogue to communicate widely about these future policy deliberations and to ensure public involvement in decision making. A number of incremental steps have been taken since the workshop to implement some of these recommendations.

Public Health Systems Research: Setting a National Agenda

PubMed Central

Lenaway, Dennis; Halverson, Paul; Sotnikov, Sergey; Tilson, Hugh; Corso, Liza; Millington, Wayne

2006-01-01

The Institute of Medicine has recommended that policy decisions about improvement of national public health systems be guided by sound scientific evidence. However, to date there is no national research agenda to help guide public health systems. The Centers for Disease Control and Prevention was called upon to lead a collaborative consensus-based process to define key research questions and establish a framework to create opportunities to better coordinate, leverage, and identify public health resources, which are increasingly scarce. The public health systems research agenda that emerged from this process has 14 overarching priority research themes. This national agenda should stimulate and guide research to meet the urgent need to improve the nation’s public health systems. PMID:16449601

Sustainability of knowledge translation interventions in healthcare decision-making: protocol for a scoping review.

PubMed

Tricco, Andrea C; Cogo, Elise; Ashoor, Huda; Perrier, Laure; McKibbon, K Ann; Grimshaw, Jeremy M; Straus, Sharon E

2013-05-14

Knowledge translation (KT also known as research utilisation, translational medicine and implementation science) is a dynamic and iterative process that includes the synthesis, dissemination, exchange and ethically sound application of knowledge to improve health. After the implementation of KT interventions, their impact on relevant outcomes should be monitored. The objectives of this scoping review are to: (1) conduct a systematic search of the literature to identify the impact on healthcare outcomes beyond 1 year, or beyond the termination of funding of the initiative of KT interventions targeting chronic disease management for end-users including patients, clinicians, public health officials, health services managers and policy-makers; (2) identify factors that influence sustainability of effective KT interventions; (3) identify how sustained change from KT interventions should be measured; and (4) develop a framework for assessing sustainability of KT interventions. Comprehensive searches of relevant electronic databases (eg, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials), websites of funding agencies and websites of healthcare provider organisations will be conducted to identify relevant material. We will include experimental, quasi-experimental and observational studies providing information on the sustainability of KT interventions targeting chronic disease management in adults and focusing on end-users including patients, clinicians, public health officials, health services managers and policy-makers. Two reviewers will pilot-test the screening criteria and data abstraction form. They will then screen all citations, full articles and abstract data in duplicate independently. The results of the scoping review will be synthesised descriptively and used to develop a framework to assess the sustainability of KT interventions. Our results will help inform end-users (ie, patients, clinicians, public health officials, health services managers and policy-makers) regarding the sustainability of KT interventions. Our dissemination plan includes publications, presentations, website posting and a stakeholder meeting.

Gambling and the Health of the Public: Adopting a Public Health Perspective.

PubMed

Korn, David A.; Shaffer, Howard J.

1999-01-01

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

The Policy Framework for Online Charter Schools

ERIC Educational Resources Information Center

Pazhouh, Rosa; Lake, Robin; Miller, Larry

2015-01-01

Online charter schools, charter schools that primarily utilize remote online instruction, have been both popular and controversial. As of October 2015, fully online charter schools operate in 26 (soon to be 27) states and enrolled approximately 200,000 students in the 2013-14 school year, comprising over 8 percent of all public charter school…

Education and Development: Dynamics of Access, Equity, and Social Justice in Nigeria

ERIC Educational Resources Information Center

Oghenekohwo, Jonathan E.; Torunarigha, Young D.

2018-01-01

Widening access to education as social justice is basic in any discourse on educational investment, growth and development in developing country such as Nigeria. Presently, there is disconnect between educational development expectations and public policy frameworks designed to drive the united nations sustainable development goals (SDGs) in 2030…

Leading the Way: Access. 2013-18 Master Plan

ERIC Educational Resources Information Center

West Virginia Higher Education Policy Commission, 2013

2013-01-01

The 2013-18 West Virginia Higher Education Policy Commission master plan, "Leading the Way: Access. Success. Impact" was developed to provide a programmatic framework and goals to enable the state's system of public four-year institutions to meet the educational needs of West Virginians. A state economy in flux with declining revenues…

Real Women, Real Lives. Marriage, Divorce, Widowhood.

ERIC Educational Resources Information Center

Governor's Commission on the Status of Women, Madison, WI.

The booklet describes economic handicaps faced by women who become divorced or widowed. The purpose of the document is to increase the general public's understanding of how customs, old laws, and government policies support the framework of the family when things go wrong. The document is presented in four major sections. Section I focuses on…

On the Assessment of Income Distribution: A Comment on the Secretariat Papers.

ERIC Educational Resources Information Center

Kravis, Irving B.

An assessment of three other conference papers summarizing knowledge of the inequalities in the distribution of personal income, education, and educational opportunities leads to fundamental questions about the appropriate framework and goals of public policy in the field of education, inequality, and life chances. Without a clear perception of…

Child Welfare Strategy in the Coming Years.

ERIC Educational Resources Information Center

Kadushin, Alfred; And Others

This collection of policy papers by a dozen national experts in subject areas related to child welfare is designed to assist public and voluntary agency program directors in their efforts to update current programs or to design new ones. Sequentially the chapters: (1) set a framework for the following papers, (2) examine the provision of foster…

Delivering Electronic Information in a Knowledge-Based Democracy. Summary of Proceedings (Washington, DC, July 14, 1993).

ERIC Educational Resources Information Center

Library of Congress, Washington, DC.

The Library of Congress hosted a 1-day conference, "Delivering Electronic Information in a Knowledge-Based Democracy" to explore the public policy framework essential to creating electronic information resources and making them broadly available. Participants from a variety of sectors contributed to wide-ranging discussions on issues…

Excellence, Accessibility, Responsibility. Report of the Advisory Panel on Future Directions for Postsecondary Education.

ERIC Educational Resources Information Center

Ontario Ministry of Education and Training, Toronto.

This advisory report presents 18 recommendations for cost sharing, cooperation among institutions, and meeting future demands for higher education in Ontario. A framework for public policy is offered which stresses the themes of excellence, accessibility, and responsibility and urges differentiation in strengths among colleges and universities, a…

Transforming Power Systems Through Global Collaboration

DOE Office of Scientific and Technical Information (OSTI.GOV)

2017-06-01

Ambitious and integrated policy and regulatory frameworks are crucial to achieve power system transformation. The 21st Century Power Partnership -- a multilateral initiative of the Clean Energy Ministerial -- serves as a platform for public-private collaboration to advance integrated solutions for the large-scale deployment of renewable energy in combination with energy efficiency and grid modernization.

Assessment-Based Curriculum: Globalising and Enterprising Culture, Human Capital and Teacher-Technicians in Aotearoa New Zealand

ERIC Educational Resources Information Center

O'Neill, Anne-Marie

2016-01-01

This policy chronology traces the institution of globalised school curriculum and assessment discourses, as a vernacular and specific form of public rationalisation and educational governmentality in Aotearoa New Zealand. Without functional national standards or national testing, official discourses constructed an assessment-driven framework as a…

Human Development and Violence Prevention: A Focus on Youth. Center Paper 011.

ERIC Educational Resources Information Center

Williams, Kirk R.; Guerra, Nancy G.; Elliott, Delbert S.

This publication outlines a theoretical framework to guide research, policy, and action plans to combat youth violence. Research findings suggest that analyzing violence in connection with human development will provide a greater understanding of the problem. Such an analysis should trace pathways to violence in order to infuse prevention…

45 CFR 1307.3 - Basis for determining whether a Head Start agency will be subject to an open competition.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Align with the Head Start Child Development and Early Learning Framework, State early learning... Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM POLICIES AND PROCEDURES FOR...

45 CFR 1307.3 - Basis for determining whether a Head Start agency will be subject to an open competition.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Align with the Head Start Child Development and Early Learning Framework, State early learning... Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM POLICIES AND PROCEDURES FOR...

45 CFR 1307.3 - Basis for determining whether a Head Start agency will be subject to an open competition.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Align with the Head Start Child Development and Early Learning Framework, State early learning... Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START PROGRAM POLICIES AND PROCEDURES FOR...

Exploring Higher Education Governance in Poland and Romania: Re-Convergence after Divergence?

ERIC Educational Resources Information Center

Dobbins, Michael

2017-01-01

This analysis focuses on changes in higher education governance in Poland and Romania in the post-communist era. The author applies a theoretical framework based on institutional isomorphism and historical institutionalism and maps the policy trajectories of both systems on the basis of three governance ideal-types. The public higher education…

Evaluating Interactive Policy Making on Biotechnology: The Case of the Dutch Ministry of Health, Welfare and Sport

ERIC Educational Resources Information Center

Broerse, Jacqueline E. W.; de Cock Buning, Tjard; Roelofsen, Anneloes; Bunders, Joske F. G.

2009-01-01

Public engagement is increasingly advocated and applied in the development and implementation of technological innovations. However, initiatives so far are rarely considered effective. There is a need for more methodological rigor and insight into conducive conditions. The authors developed an evaluative framework and assessed accordingly the…

Schools in the Nexus of Neoliberal Urban Transformation and Education Policy Change

ERIC Educational Resources Information Center

Bayhan, Sezen; Caner, Ayse

2017-01-01

Drawing on field research carried out on Istanbul school geography, this paper analyzes the co-constitutive relationship between school spaces and urban transformation in Istanbul, the largest city in Turkey. Following a brief discussion of its theoretical framework, the paper describes how relocation of Istanbul inner-city public schools has…

INFORMATION ASYMMETRIES, IMITATION, AND STRATEGIC FORESIGHT: A SIGNALING FRAMEWORK TO ANALYZE THE ADOPTION PROCESS OF AN INDUSTRY MANAGEMENT STANDARD. (R827918)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

The health financing transition: a conceptual framework and empirical evidence.

PubMed

Fan, Victoria Y; Savedoff, William D

2014-03-01

Almost every country exhibits two important health financing trends: health spending per person rises and the share of out-of-pocket spending on health services declines. We describe these trends as a "health financing transition" to provide a conceptual framework for understanding health markets and public policy. Using data over 1995-2009 from 126 countries, we examine the various explanations for changes in health spending and its composition with regressions in levels and first differences. We estimate that the income elasticity of health spending is about 0.7, consistent with recent comparable studies. Our analysis also shows a significant trend in health spending - rising about 1 per cent annually - which is associated with a combination of changing technology and medical practices, cost pressures and institutions that finance and manage healthcare. The out-of-pocket share of total health spending is not related to income, but is influenced by a country's capacity to raise general revenues. These results support the existence of a health financing transition and characterize how public policy influences these trends. Copyright © 2014 Elsevier Ltd. All rights reserved.

Welfare implications of energy and environmental policies: A general equilibrium approach

NASA Astrophysics Data System (ADS)

Iqbal, Mohammad Qamar

Government intervention and implementation of policies can impose a financial and social cost. To achieve a desired goal there could be several different alternative policies or routes, and government would like to choose the one which imposes the least social costs or/and generates greater social benefits. Therefore, applied welfare economics plays a vital role in public decision making. This paper recasts welfare measure such as equivalent variation, in terms of the prices of factors of production rather than product prices. This is made possible by using duality theory within a general equilibrium framework and by deriving alternative forms of indirect utility functions and expenditure functions in factor prices. Not only we are able to recast existing welfare measures in factor prices, we are able to perform a true cost-benefit analysis of government policies using comparative static analysis of different equilibria and breaking up monetary measure of welfare change such as equivalent variation into its components. A further advantage of our research is demonstrated by incorporating externalities and public goods in the utility function. It is interesting that under a general equilibrium framework optimal income tax tends to reduce inequalities. Results show that imposition of taxes at socially optimal rates brings a net gain to the society. It was also seen that even though a pollution tax may reduce GDP, it leads to an increase in the welfare of the society if it is imposed at an optimal rate.

Claims in vapour device (e-cigarette) regulation: A Narrative Policy Framework analysis.

PubMed

O'Leary, Renée; Borland, Ron; Stockwell, Tim; MacDonald, Marjorie

2017-06-01

The electronic cigarette or e-cigarette (vapour device) is a consumer product undergoing rapid growth, and governments have been adopting regulations on the sale of the devices and their nicotine liquids. Competing claims about vapour devices have ignited a contentious debate in the public health community. What claims have been taken up in the state arena, and how have they possibly influenced regulatory outcomes? This study utilized Narrative Policy Framework to analyze the claims made about vapour devices in legislation recommendation reports from Queensland Australia, Canada, and the European Union, and the 2016 deeming rule legislation from the United States, and examined the claims and the regulatory outcomes in these jurisdictions. The vast majority of claims in the policy documents represented vapour devices as a threat: an unsafe product harming the health of vapour device users, a gateway product promoting youth tobacco uptake, and a quasi-tobacco product impeding tobacco control. The opportunity for vapour devices to promote cessation or reduce exposure to toxins was very rarely presented, and these positive claims were not discussed at all in two of the four documents studied. The dominant claims of vapour devices as a public health threat have supported regulations that have limited their potential as a harm reduction strategy. Future policy debates should evaluate the opportunities for vapour devices to decrease the health and social burdens of the tobacco epidemic. Copyright © 2017 Elsevier B.V. All rights reserved.

Global-to-local policy transfer in the introduction of new molecular tuberculosis diagnostics in South Africa.

PubMed

Colvin, C J; Leon, N; Wills, C; van Niekerk, M; Bissell, K; Naidoo, P

2015-11-01

Lack of innovation in diagnostics has contributed to tuberculosis (TB) remaining a global health challenge. It is critical to understand how new diagnostic technologies are translated into policies and how these are implemented. To examine policy transfer for two rapid molecular diagnostic tests, GenoType(®) MDRTBplus and Xpert(®) MTB/RIF, to understand policy development, uptake and implementation in South Africa. A policy transfer analysis framework integrating the key dimensions of policy transfer into one coherent model was used. Two phases of key informant interviews were undertaken with a wide range of stakeholders. Both tests were developed through innovative partnerships and responded to urgent public health needs. GenoType was introduced through a process that was more inclusive than that for Xpert. National policy and planning processes were opaque for both tests. Their implementation, maintenance and expansion suffered from poor communication and coordination, insufficient attention to resource implications, technical challenges and a lack of broader health systems thinking. Our analysis identified the risks and benefits of partnerships for technological innovation, the complex intersections between global and national actors and the impact of health systems on policy transfer, and the risks of rescue- and technology-focused thinking in addressing public health challenges.

A framework to expand public services to children with biomedical healthcare needs related to HIV in the Free State, South Africa.

PubMed

Reid, Marianne; Botma, Yvonne

2012-06-01

The study undertook the development of a framework for expanding the public services available to children with biomedical healthcare needs related to HIV in South Africa. The study consisted of various component projects which were depicted as phases. The first phase was a descriptive quantitative analysis of healthcare services for children exposed to or infected by HIV, as rendered by the public health sector in the Free State Province. The second stage was informed by health policy research: a nominal group technique with stakeholders was used to identify strategies for expanding the healthcare services available to these children. The third phase consisted of workshops with stakeholders in order to devise and validate a framework for the expansion. The theory of change logic model served as the theoretical underpinning of the draft framework. Triangulated data from the literature and the preceding two phases of the study provided the empirical foundation. The problem identified was that of fragmented care delivered to children exposed to or infected with HIV, due to the 'over-verticalization' of programmes. A workshop was held during which the desired results, the possible factors that could influence the results, as well as the suggested strategies to expand and integrate the public services available to HIV-affected children were confirmed. Thus the framework was finalised during the validation workshop by the researchers in collaboration with the stakeholders.

Adolescent Maturity and the Brain: The Promise and Pitfalls of Neuroscience Research in Adolescent Health Policy

PubMed Central

Johnson, Sara B.; Blum, Robert W.; Giedd, Jay N.

2010-01-01

Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well into the 20s. This has prompted intense interest in linking neuromaturation to maturity of judgment. Public policy is struggling to keep up with burgeoning interest in cognitive neuroscience and neuroimaging. However, empirical evidence linking neurodevelopmental processes and adolescent real-world behavior remains sparse. Nonetheless, adolescent brain development research is already shaping public policy debates about when individuals should be considered mature for policy purposes. With this in mind, in this article we summarize what is known about adolescent brain development and what remains unknown, as well as what neuroscience can and cannot tell us about the adolescent brain and behavior. We suggest that a conceptual framework that situates brain science in the broader context of adolescent developmental research would help to facilitate research-to-policy translation. Furthermore, although contemporary discussions of adolescent maturity and the brain often use a deficit-based approach, there is enormous opportunity for brain science to illuminate the great strengths and potentialities of the adolescent brain. So, too, can this information inform policies that promote adolescent health and well-being. PMID:19699416

Public-policy issues associated with the SAFRR Tsunami Scenario: Chapter M in The SAFRR (Science Application for Risk Reduction) Tsunami Scenario

USGS Publications Warehouse

Johnson, Laurie; Real, Chuck

2013-01-01

The SAFRR (Science Application for Risk Reduction) tsunami scenario simulates a tsunami generated by a hypothetical magnitude 9.1 earthquake that occurs offshore of the Alaska Peninsula (Kirby and others, 2013). In addition to the work performed by the authors on public-policy issues associated with the SAFRR tsunami scenario, this section of the scenario also reflects the policy discussions of the State of California’s Tsunami Policy Work Group, a voluntary advisory body formed in October 2011, which operates under the California Natural Resources Agency (CNRA), Department of Conservation, and is charged with identifying, evaluating, and making recommendations to resolve issues that are preventing full and effective implementation of tsunami hazard mitigation and risk reduction throughout California’s coastal communities. It also presents the analyses of plans and hazard policies of California’s coastal counties, incorporated cities, and major ports performed by the staff of the California Geological Survey (CGS) and Lauren Prehoda, Office of Environmental and Government Affairs, California Department of Conservation. It also draws on the policy framework and assessment prepared for the ARkStorm Pacific Coast winter storm and catastrophic flooding (Topping and others, 2010).

Seeking Legitimacy for DSM-5: The Bereavement Exception as an Example of Failed Process.

PubMed

Sabin, James E; Daniels, Norman

2017-02-01

In 2013 the American Psychiatric Association (APA) published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Even before publication, DSM-5 received a torrent of criticism, most prominently over removal of the "bereavement exclusion" for the diagnosis of major depression. We argue that while the APA can claim legitimate authority for deciding scientific questions, it does not have legitimacy for resolving what is ultimately a question of ethics and public policy. We show how the "accountability for reasonableness" framework for seeking legitimacy in health policy could have been used to achieve a better resolution of the conflict than actually occurred. © 2017 American Medical Association. All Rights Reserved.

Ethical issues in the development and implementation of nutrition-related public health policies and interventions: A scoping review

PubMed Central

Peña-Rosas, Juan Pablo; Saxena, Abha; Zamora, Gerardo

2017-01-01

Background The limited integration of ethics in nutrition-related public health policies and interventions is one major concern for those who have the task of implementing them. Ethical challenges that are overlooked during the development of such interventions could raise serious ethical issues during their implementation and even after. As a result, these decision makers need technical support and ethical guidance for adaptation of interventions to local (cultural, social, economic, etc.) contexts. Aim The goal of this scoping review is to delineate and “map” the range of ethical issues in nutrition-related public health interventions, as well as the range of the various fields in which they may arise. Methods A scoping review of empirical research and conceptual literature was conducted following the framework of Arksey and O’Malley. Searches using PubMed with Medical Subject Headings (MeSH) categories and Advanced Search Builder as well as in the Global Health Library were performed. The final sample consists of 169 publications. Results The ethics of public health prevention or treatment of obesity and non-communicable diseases is the most explicitly and frequently discussed subject. In comparison, ethical issues raised by public health interventions in the fields of undernutrition, breastfeeding, vitamin/mineral supplementation and food fortification, food security, food sustainability and food safety are addressed in a lower proportion of the sample. The results illustrate the various natures, types, and scopes of existing public health nutrition-related interventions, and the various ethical issues that may be raised by these interventions, in addition to the numerous and different contexts in which they may be implemented. Discussion The ethical issues faced in the development and implementation of nutrition-related public health interventions are varied and cannot be equated with, nor generalized about, when dealing with specific activities in this field. More importantly, these ethical issues cannot be managed without a careful consideration for the complexity of contexts in which nutrition-related interventions are expected to be implemented. These interventions engage a variety of actors with diverse perspectives and interests. We discuss these challenges and also comment on the importance of considering ethical impacts in the monitoring and evaluation of such interventions. Conclusion General ethical frameworks or recommendations–although useful–cannot be expected to provide policy makers, implementators and other public health personnel with sufficient practical ethical guidance as they cannot consider and anticipate the particularities of all specific nutrition-related public health interventions and the complexity of the contexts in which they are implemented. Further research is needed in order to develop more targeted ethical frameworks. PMID:29073186

An International Framework for Data Sharing: Moving Forward with the Global Alliance for Genomics and Health.

PubMed

Rahimzadeh, Vasiliki; Dyke, Stephanie O M; Knoppers, Bartha M

2016-06-01

The Global Alliance for Genomics and Health is marshaling expertise in biomedical research and data sharing policy to propel bench-to-bedside translation of genomics in parallel with many of the BioSHaRE-EU initiatives described at length in this Issue. Worldwide representation of institutions, funders, researchers, and patient advocacy groups at the Global Alliance is testament to a shared ideal that sees maximizing the public good as a chief priority of genomic innovation in health. The Global Alliance has made a critical stride in this regard with the development of its Framework for Responsible Sharing of Genomic and Health-related Data.(1) This article first discusses the human rights pillars that underlie the Framework and mission of the Global Alliance. Second, it outlines the Global Alliance's use of data governance policies through a number of demonstration projects. Finally, the authors describe how the Global Alliance envisions international data sharing moving forward in the postgenomic era.

Reflexive governance in biobanking: on the value of policy led approaches and the need to recognise the limits of law.

PubMed

Laurie, Graeme

2011-09-01

Although a few jurisdictions around the world have legislated in response to the phenomenon of biobanking, the far more common response has been policy led with funders and other stakeholders initiating multi-level policy initiatives to guide biobanking practice. An example of this is UK Biobank which has developed and operates according to an Ethics and Governance Framework. Such an instrument has no basis in law and yet it has played a crucial role in the set up and ongoing management of the resource. It will continue to do so, as related policies emerge, such as access and intellectual property policies. Numerous biobanking initiatives have similar high-level policy documents that guide decisions and practice. These are often framed as a commitment to participants, researchers and society more broadly and invoke notions such as the public good and the public interest. As such, they serve as a benchmark against which to measure a biobank's performance. Moreover, policies become an important means by which biobankers are held accountable. This article critically analyses this policy-driven phenomenon asking how effectively policy--often as an alternative to law--serves to police and to promote biobanking. It argues that a policy of reflexive governance--defined and developed herein--can best meet the challenges faced by many biobanks and without the need for recourse to law.

Sociohydrology of an Arid City: Development of a Coupled Model of Water Management in Las Vegas

NASA Astrophysics Data System (ADS)

Garcia, M. E.; Islam, S.; Portney, K. E.

2014-12-01

Rapidly growing cities in arid regions present a significant water management challenge. Key to tackling this challenge is understanding how and why some cities transition to more sustainable water management; acknowledging that urban water resources decisions are both responding to and precipitating hydrologic change, this question is best tackled through a sociohydrology approach. While coupling of natural and societal systems is in it's infancy in the field of hydrology, there is a strong tradition of studying coupled systems in the field of Socio-Ecological Systems. We build on Ostrom's Socio-Ecological Systems framework to develop a system dynamics model of water management for the Las Vegas metropolitan area using Vensim. A key objective our proposed modeling framework is to illuminate the dynamic interactions of the sociohydrologic system components and enable testing of various assumptions and strategies. The model of Las Vegas water management consists of five sub-modules: water supply, water demand, finances, public perception and policy making process. The development of the first three modules were based on clearly defined system structure. The public perception sub-module tracks the level public risk perception of a water supply shortage and represents the hypothesis that public risk perception is updated periodically when shortage events are experienced. The policy making process module uses an algorithm capturing the hypothesized decision making process to select policy actions (or in-action) from a set of feasible actions in response to the system states tracked by the model and observable to decision makers. The model was tested and parameterized using mix of quantitative data on water demands, supplies and costs and qualitative data from document analysis and interview data covering 1990 to 2010 period. Given that not only the parameters but also the structure of the public perception and the policy making process sub-systems is contested, a different approach must be taken to assess the robustness of these modules. Presented here is the development of the model, results of model testing against the historic reference modes using Las Vegas as an example, and future work planned to improve the robustness of the model.

"Health for All" in England and Brazil?

PubMed

Duncan, Peter; Bertolozzi, Maria Rita; Cowley, Sarah; Egry, Emiko Yoshikawa; Chiesa, Anna Maria; de Siqueira França, Francisco Oscar

2015-01-01

This article discusses the achievements and challenges that England and Brazil face in relation to their capacity to address inequalities in health through health promotion and public health policies. Using secondary data (policy texts and related documents), this article contextualizes, explains, and critically appraises health promotion and public health efforts for the reduction of inequalities in health in the 2 countries. A historic documentary analysis was undertaken, with hermeneutics as the methodological framework. The global economic crisis has prompted the so-called developed economies of Europe to reconsider their economic and social priorities. England represents a state facing this kind of challenge. Equally, Brazil is assuming new positions not only on the world stage but also in terms of the relationship it has with its citizens and the priorities it has for state welfare. The United Kingdom continues to finance a health care system allowing universal access in the form of the National Health Service, and state concern about the public health task of reducing inequalities has recently been underlined in policy. For Brazil, although there have been recent achievements related to population access to healthcare, challenges continue, especially with regard to the quality of care. © SAGE Publications 2015.

HIV, drugs and the legal environment

PubMed Central

Strathdee, Steffanie A.; Beletsky, Leo; Kerr, Thomas

2014-01-01

A large body of scientific evidence indicates that policies based solely on law enforcement without taking into account public health and human rights considerations increase the health risks of people who inject drugs (PWIDs) and their communities. Although formal laws are an important component of the legal environment supporting harm reduction, it is the enforcement of the law that affects PWIDs' behavior and attitudes most acutely. This commentary focuses primarily on drug policies and policing practices that increase PWIDs' risk of acquiring HIV and viral hepatitis, and avenues for intervention. Policy and legal reforms that promote public health over the criminalization of drug use and PWID are urgently needed. This should include alternative regulatory frameworks for illicit drug possession and use. Changing legal norms and improving law enforcement responses to drug-related harms requires partnerships that are broader than the necessary bridges between criminal justice and public health sectors. HIV prevention efforts must partner with wider initiatives that seek to improve police professionalism, accountability, and transparency and boost the rule of law. Public health and criminal justice professionals can work synergistically to shift the legal environment away from one that exacerbates HIV risks to one that promotes safe and healthy communities. PMID:25265900

Democracy and the governance of uncertainty. The case of agricultural gene technologies.

PubMed

Pellizzoni, L

2001-09-14

The use of genetically modified organisms (GMOs) in agriculture and food production is the object of an intense and divisive debate. Drawing on a study on the public perception of agricultural gene technologies carried out in five European countries, the article deals with the policy aspects of the issue, and more precisely on the relation between institutions, experts and the public in a context of deep uncertainty. A theoretical framework is developed and compared with the study findings, suggesting that issues like the GMOs one represent a strong case for a more participatory policy-making. My conclusions suggest a style of governance based on the principles of deliberative democracy, as a suitable approach to the confrontation of different viewpoints and forms of knowledge. This appears to be the best way to improve the overall quality of policy-making: in this I include its legitimacy, the degree of public trust, and also the actual quality of its products. Strengthening the role of the public sphere seems more effective than simply increasing direct decision-making by the populace, and it offers an alternative to the 'elitist' solutions to the crisis of representative democracy.

Building intentions with the Theory of Planned Behaviour: the mediating role of knowledge and expectations in implementing new pharmaceutical services in Malaysia.

PubMed

Tan, Christine L; Gan, Vincent B; Saleem, Fahad; Hassali, Mohamed A

2016-01-01

Pharmacy value added services (PVAS) was introduced as a matter of public health policy by Malaysia's Ministry of Health to improve health outcomes through public healthcare services. For example, drive through pharmacy services is a major policy implementation of the Ministry. However, adoption rates are low and therefore hampering the achievement of national health policy goals. Our objective is to explore the key determinants and mediators of successful implementation of new public pharmaceutical services by investigating the cognitive perspectives of patients' intentions to adopt with the Theory of Planned Behavior as the theoretical framework. A two phase mixed methodology involving first a qualitative exploration and the second a quantitative phase was conducted in public health facilities in Negeri Sembilan, Malaysia. Multiple regression and mediation analysis were performed. Subjective norms, perceived behavioural control, knowledge and expectations are found to be significant predictors of intentions to adopt PVAS. Knowledge and expectations are found to exert significant indirect effects on intentions. Overall, we suggest that patient knowledge be enhanced through appropriate channels and expectations of service quality be met to increase intentions.

Developing a framework for assessment of the environmental determinants of walking and cycling.

PubMed

Pikora, Terri; Giles-Corti, Billie; Bull, Fiona; Jamrozik, Konrad; Donovan, Rob

2003-04-01

The focus for interventions and research on physical activity has moved away from vigorous activity to moderate-intensity activities, such as walking. In addition, a social ecological approach to physical activity research and practice is recommended. This approach considers the influence of the environment and policies on physical activity. Although there is limited empirical published evidence related to the features of the physical environment that influence physical activity, urban planning and transport agencies have developed policies and strategies that have the potential to influence whether people walk or cycle in their neighbourhood. This paper presents the development of a framework of the potential environmental influences on walking and cycling based on published evidence and policy literature, interviews with experts and a Delphi study. The framework includes four features: functional, safety, aesthetic and destination; as well as the hypothesised factors that contribute to each of these features of the environment. In addition, the Delphi experts determined the perceived relative importance of these factors. Based on these factors, a data collection tool will be developed and the frameworks will be tested through the collection of environmental information on neighbourhoods, where data on the walking and cycling patterns have been collected previously. Identifying the environmental factors that influence walking and cycling will allow the inclusion of a public health perspective as well as those of urban planning and transport in the design of built environments.

Just-in-Time Training of the Evidence-Based Public Health Framework, Oklahoma, 2016-2017.

PubMed

Douglas, Malinda R; Lowry, Jon P; Morgan, Latricia A

2018-03-07

Training of practitioners on evidence-based public health has shown to be beneficial, yet overwhelming. Chunking information and proximate practical application are effective techniques to increase retention in adult learning. Evidence-based public health training for practitioners from African American and Hispanic/Latino community agencies and tribes/tribal nations incorporated these 2 techniques. The community-level practitioners alternated attending training and implementing the steps of the evidence-based public health framework as they planned state-funded programs. One year later, survey results showed that participants reported increased confidence in skills that were reinforced by practical and practiced application as compared with posttraining survey results. In addition, at 1 year, reported confidence in skills that were not fortified by proximate application decreased when compared with posttraining confidence levels. All 7 community programs successfully created individualized evidence-based action plans that included evidence-based practices and policies across socioecological levels that fit with the unique culture and climate of their own community.

Childbearing, stress and obesity disparities in women: a public health perspective

PubMed Central

Davis, Esa M; Stange, Kurt C; Horwitz, Ralph I

2011-01-01

The perinatal period, from early in the first trimester to 1 year postpartum, provides opportunities for novel public health interventions to reduce obesity disparities. We present a unifying socio-biological framework to suggest opportunities for multidisciplinary research and public health approaches to elucidate and target the mechanisms for the development of maternal obesity and related disparities. The framework illustrates the interplay of the social, cultural and physical environment; stress appraisal and response; and coping behaviors on short-term outcomes (e.g. allostatic load and gestational weight gain), the intermediate outcomes of persistent insulin resistance and post-partum weight retention, and longer term outcomes of obesity and its disease consequences. Testing the proposed relationships may provide insights into how childbearing risk factors such as gestational weight gain, postpartum weight retention and parity contribute to obesity, which are needed to inform public health policies and clinical care guidelines aimed at reducing obesity and improving the health of women. PMID:21088987

A Review of Literature to Understand the Complexity of Equity, Ethics and Management for Achieving Public Health Goals in India

PubMed Central

Garg, Pankaj; Nagpal, Jitender

2014-01-01

In the context of inadequate public spending on health care in India (0.9% of the GDP); government liberalized its policies in the form of subsidized lands and tax incentives, resulting in the mushrooming of private hospitals and clinics in India. Paradoxically, a robust framework was not developed for the regulation of these health care providers, resulting in disorganized health sector, inadequate financing models, and lack of prioritization of services, as well as a sub-optimal achievement of the Millennium Development Goals (MDG). We systematically reviewed the evidence base regarding regulation of private hospitals, applicability of private-public mix, state of health insurance and effective policy development for India, while seeking lessons on regulation of private health systems, from South African (a developing country) and Australian (a developed country) health care systems. PMID:24701465

Human rights, public health and medicinal cannabis use

PubMed Central

Bone, Melissa; Seddon, Toby

2016-01-01

This paper explores the interplay between the human rights and drug control frameworks and critiques case law on medicinal cannabis use to demonstrate that a bona fide human rights perspective allows for a broader conception of ‘health’. This broad conception, encompassing both medicalised and social constructionist definitions, can inform public health policies relating to medicinal cannabis use. The paper also demonstrates how a human rights lens can alleviate a core tension between the State and the individual within the drug policy field. The leading medicinal cannabis case in the UK highlights the judiciary’s failure to engage with an individual’s human right to health as they adopt an arbitrary, externalist view, focussing on the legality of cannabis to the exclusion of other concerns. Drawing on some international comparisons, the paper considers how a human rights perspective can lead to an approach to medicinal cannabis use which facilitates a holistic understanding of public health. PMID:26692654

Human rights, public health and medicinal cannabis use.

PubMed

Bone, Melissa; Seddon, Toby

2016-01-01

This paper explores the interplay between the human rights and drug control frameworks and critiques case law on medicinal cannabis use to demonstrate that a bona fide human rights perspective allows for a broader conception of 'health'. This broad conception, encompassing both medicalised and social constructionist definitions, can inform public health policies relating to medicinal cannabis use. The paper also demonstrates how a human rights lens can alleviate a core tension between the State and the individual within the drug policy field. The leading medicinal cannabis case in the UK highlights the judiciary's failure to engage with an individual's human right to health as they adopt an arbitrary, externalist view, focussing on the legality of cannabis to the exclusion of other concerns. Drawing on some international comparisons, the paper considers how a human rights perspective can lead to an approach to medicinal cannabis use which facilitates a holistic understanding of public health.

Evaluation and mechanism for outcomes exploration of providing public health care in contract service in rural China: a multiple-case study with complex adaptive systems design.

PubMed

Zhou, Huixuan; Zhang, Shengfa; Zhang, Weijun; Wang, Fugang; Zhong, You; Gu, Linni; Qu, Zhiyong; Tian, Donghua

2015-02-27

The Chinese government has increased the funding for public health in 2009 and experimentally applied a contract service policy (could be seen as a counterpart to family medicine) in 15 counties to promote public health services in the rural areas in 2013. The contract service aimed to convert village doctors, who had privately practiced for decades, into general practitioners under the government management, and better control the rampant chronic diseases. This study made a rare attempt to assess the effectiveness of public health services delivered under the contract service policy, explore the influencing mechanism and draw the implications for the policy extension in the future. Three pilot counties and a non-pilot one with heterogeneity in economic and health development from east to west of China were selected by a purposive sampling method. The case study methods by document collection, non-participant observation and interviews (including key informant interview and focus group interview) with 84 health providers and 20 demanders in multiple level were applied in this study. A thematic approach was used to compare diverse outcomes and analyze mechanism in the complex adaptive systems framework. Without sufficient incentives, the public health services were not conducted effectively, regardless of the implementation of the contract policy. To appropriately increase the funding for public health by local finance and properly allocate subsidy to village doctors was one of the most effective approaches to stimulate health providers and demanders' positivity and promote the policy implementation. County health bureaus acted as the most crucial agents among the complex public health systems. Their mental models influenced by the compound and various environments around them led to the diverse outcomes. If they could provide extra incentives and make the contexts of the systems ripe enough for change, the health providers and demanders would be receptive to the transition of the policy. The innovative fund raising measures could be taken by relatively developed counties of China to conduct public health services. Policymakers could take systems thinking as a useful tool to design plans and predict the unintended outcomes during the process of public health reforms.

The political implications of epigenetics.

PubMed

Robison, Shea K

2016-01-01

Epigenetics, which is just beginning to attract public attention and policy discussion, challenges conventional understanding of gene-environment interaction and intergenerational inheritance and perhaps much more besides. Does epigenetics challenge modern political ideologies? I analyzed the narratives of obesity and epigenetics recently published in the more liberal New York Times and the more conservative Wall Street Journal. For the years 2010 through 2014, 50 articles on obesity and 29 articles on epigenetics were identified, and elements in their causal narratives were quantitatively analyzed using a well described narrative policy framework. The narratives on obesity aligned with the two newspapers' reputed ideologies. However, the narratives on epigenetics aligned with neither ideology but freely mixed liberal and conservative elements. This small study may serve as a starting point for broader studies of epigenetics as it comes to affect political ideologies and, in turn, public policies. The narrative mix reported here could yet prove vulnerable to ideological capture, or, more optimistically, could portend the emergence of a "third-way" narrative using epigenetics to question atomistic individualism and allowing for less divisiveness in public-health domains such as obesity.

The political implications of epigenetics Emerging narratives and ideologies.

PubMed

Robison, Shea K

2016-01-01

Epigenetics, which is just beginning to attract public attention and policy discussion, challenges conventional understanding of gene-environment interaction and intergenerational inheritance and perhaps much more besides. Does epigenetics challenge modern political ideologies? I analyzed the narratives of obesity and epigenetics recently published in the more liberal New York Times and the more conservative Wall Street Journal. For the years 2010 through 2014, 50 articles on obesity and 29 articles on epigenetics were identified, and elements in their causal narratives were quantitatively analyzed using a well described narrative policy framework. The narratives on obesity aligned with the two newspapers' reputed ideologies. However, the narratives on epigenetics aligned with neither ideology but freely mixed liberal and conservative elements. This small study may serve as a starting point for broader studies of epigenetics as it comes to affect political ideologies and, in turn, public policies. The narrative mix reported here could yet prove vulnerable to ideological capture, or, more optimistically, could portend the emergence of a "third-way" narrative using epigenetics to question atomistic individualism and allowing for less divisiveness in public-health domains such as obesity.

Theoretical reflections on governance in health regions.

PubMed

Bretas, Nilo; Shimizu, Helena Eri

2017-04-01

This article analyzes governance in health regions, through the contributions of two studies: one on a governance model and the other on duties in the management of public policies networks. The former conducted a meta-analysis of 137 case studies in the literature on collaborative governance aimed at preparing an explanatory and analytical model. Authors identified critical variables that will influence the results: a previous history of conflict or cooperation, incentives for participation, power imbalances, leadership and institutional design. They also identified key factors: face-to-face dialogue, trust building and development of commitment and shared vision. The latter study examined networks of public policies in the analytic tradition and the perspective of governance, incorporating concepts from the field of political science, economics and interorganizational relations, in order to support the management of public policies networks. The study identified network management as equivalent to a strategic game involving functions: network activation, framework of relations, intermediation, facilitation and consensus building and mediation and arbitration. The combination of the two reflections provides a conceptual reference for better understanding of governance in health regions.

Policy for Research and Innovation in Latin America

NASA Astrophysics Data System (ADS)

Aguirre-Bastos, Carlos

2010-02-01

Latin America (LAC) is renewing efforts to build-up research and innovation (R&I) capacities, guided by policies that consider the need to transform the traditional science system into a more dynamic entity. Policies permitted the generation of new spaces to develop science, strengthen scientific communities, improve university-enterprise linkages, establish common agendas between public and private sectors, earmark special budgets, build new infrastructure, and improve the number and quality of scientific publications. In spite of much progress, LAC lags much behind developed countries, their universities rank lower than their international counterparts, the number of researchers is small and funding is below an appropriate threshold. Some countries have innovated in few economic sectors, while others remain technologically underdeveloped and much of the countries' innovative capacities remain untapped. It is believed that policies still have little influence on social and economic development and there exists dissatisfaction in the academic and entrepreneurial sectors with their quality and relevance or with the political will of governments to execute them. On the other hand, in the past decades, the complexity of innovation systems has increased considerably, and has yet to be taken fully into account in LAC policy definitions. The situation calls for decision makers to shape new framework conditions for R&I in a way that both processes co-evolve and are stimulated and guided on solutions to the major problems of society. Considering the main features of complex systems, self- organization, emergence and non-linearity, R&I policy measures need to be seen as interventions in such a system, as the use of traditional leverage effects used in the past for policy decisions are more and more obsolete. Policies must now use ``weak coordination mechanisms,'' foresight, mission statements, and visions. It is obvious that due to nonlinearities in the system, adaptive political requirements and governance have to replace master plans and long term fixed targets. Policies must include incentives for networking, pilot projects, simulation models, etc. International cooperation is absolutely necessary to generate the new policy framework needed by LAC. )

Menu-labeling policy in King County, Washington.

PubMed

Johnson, Donna B; Payne, Elizabeth C; McNeese, Molly A; Allen, Deborah

2012-09-01

Food eaten away from home now accounts for about one third of total calories consumed in the U.S. Policy change could lead to sustainable improvements in restaurant and other nutrition environments. Broadly described, policy development is one of the three core functions of public health, and there is a need to more fully understand and evaluate this function. Policy process research has developed frameworks and models that can be used to understand the policy development process. To describe policy processes associated with the passage of restaurant menu-labeling regulations in order to inform nutrition policy development in other settings. Document reviews and interviews with 12 key players in the policy process were conducted and analyzed between June 2009 and October 2010. Policy process actors primarily belonged to two advocacy coalitions: a public health coalition and an industry coalition. Within the coalitions there were shared values and beliefs about the appropriate role of governmental regulation in protecting the health of the population and the need for environmental change. The process was adversarial at times, but "policy learning" built the trust needed for collaboration to negotiate agreements. Expert technical assistance moved the process forward. Elements that contributed to the success of a menu-labeling policy initiative in a large, urban health department have been identified. The King County case study can inform the work of others who seek to build healthier nutrition environments through policy change. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Biotechnology regulation: is policy transfer an appropriate answer?

PubMed

Cárdenas-Gómez, Olga Carolina; Létourneau, Lyne

2010-01-01

In the world of biotechnology regulation, one often encounters the suggestion that the legislation of other countries should be consulted. Known as "policy transfer" in the field of public policy analysis, the purpose of such a recommendation is for policymakers to use the experiences of other States as a basis for developing appropriate regulatory frameworks in a timely manner. This paper examines whether policy transfer is relevant as an instrument for biotechnology regulation, and if it is, to what extent. Our analysis uses the example of Assisted Reproductive Technologies (ART), and unfolds according to the following argumentative steps. We will begin by discussing policy transfer as a recognized feature of policymaking in the literature pertaining to public policy analysis. We will then introduce a distinction between the technical dimension of policymaking and its political component. We will refer to "morality policy" as an illustration of policymaking directed toward its political component. We will show that, in the case of morality policy, States have moved away from a policy transfer approach. We will then establish that ART qualifies as morality policy, suggesting that policy transfer is most likely not the optimal policymaking tool for dealing with biotechnology regulation. Moving beyond the issue of ART in order to expand our reasoning to biotechnology regulation as a whole, we will conclude that, although the experiences of other States may be useful, policy transfer does not suffice in terms of informing policymaking in the case of biotechnology advances.

Beyond America's War on Drugs: Developing Public Policy to Navigate the Prevailing Pharmacological Revolution.

PubMed

Golub, Andrew; Bennett, Alex S; Elliott, Luther

2015-03-30

This paper places America's "war on drugs" in perspective in order to develop a new metaphor for control of drug misuse. A brief and focused history of America's experience with substance use and substance use policy over the past several hundred years provides background and a framework to compare the current Pharmacological Revolution with America's Nineteenth Century Industrial Revolution. The paper concludes with cautions about growing challenges and provides suggestions for navigating this revolution and reducing its negative impact on individuals and society.

Beyond America's War on Drugs: Developing Public Policy to Navigate the Prevailing Pharmacological Revolution

PubMed Central

Golub, Andrew; Bennett, Alex S.; Elliott, Luther

2015-01-01

This paper places America's “war on drugs” in perspective in order to develop a new metaphor for control of drug misuse. A brief and focused history of America's experience with substance use and substance use policy over the past several hundred years provides background and a framework to compare the current Pharmacological Revolution with America's Nineteenth Century Industrial Revolution. The paper concludes with cautions about growing challenges and provides suggestions for navigating this revolution and reducing its negative impact on individuals and society. PMID:25893215

PATENTS AND RESEARCH INVESTMENTS: ASSESSING THE EMPIRICAL EVIDENCE.

PubMed

Budish, Eric; Roin, Benjamin N; Williams, Heidi L

2016-05-01

A well-developed theoretical literature - dating back at least to Nordhaus (1969) - has analyzed optimal patent policy design. We re-present the core trade-off of the Nordhaus model and highlight an empirical question which emerges from the Nordhaus framework as a key input into optimal patent policy design: namely, what is the elasticity of R&D investment with respect to the patent term? We then review the - surprisingly small - body of empirical evidence that has been developed on this question over the nearly half century since the publication of Nordhaus's book.

Policy Making to Build Relationships: A Grounded Theory Analysis of Interviews and Documents Relating to H1N1, Ebola, and the U.S. Public Health Preparedness Network.

PubMed

Myers, Nathan

2016-01-01

In the last five years, the American public health emergency preparedness and response system has been tested by two significant threats, H1N1 and Ebola. While neither proved as dangerous as initially feared, these viruses highlighted on-going issues with collaborations in the field of public health and health care. Strengths were identified within the network, but also challenges that must be resolved before the U.S. faces a major pandemic. Employing interview data from public health emergency response practitioners and documentary evidence from the H1N1 and Ebola responses, this qualitative analysis uses the grounded theory approach to identify key areas for collaborative improvement. The grounded theory developed calls for a stronger policy framework at the federal level to facilitate more collaboration between U.S. agencies and facilitate more collaboration at the state and local level.

An environmental scan of policies in support of chronic disease self-management in Canada.

PubMed

Liddy, C; Mill, K

2014-02-01

The evidence supporting chronic disease self-management warrants further attention. Our aim was to identify existing policies, strategies and frameworks that support self-management initiatives. This descriptive study was conducted as an environmental scan, consisting of an Internet search of government and other publicly available websites, and interviews with jurisdictional representatives identified through the Health Council of Canada and academic networking. We interviewed 16 representatives from all provinces and territories in Canada and found 30 publicly available and relevant provincial and national documents. Most provinces and territories have policies that incorporate aspects of chronic disease self-management. Alberta and British Columbia have the most detailed policies. Both feature primary care prominently and are not disease specific. Both also have provincial level implementation of chronic disease self-management programming. Canada's northern territories all lacked specific policies supporting chronic disease self-management despite a significant burden of disease. Engaging patients in self-management of their chronic diseases is important and effective. Although most provinces and territories have policies that incorporate aspects of chronic disease self-management, they were often embedded within other initiatives and/or policy documents framed around specific diseases or populations. This approach could limit the potential reach and effect of self-management.

Global health interdependence and the international physicians' movement.

PubMed

Gellert, G A

1990-08-01

International Physicians for the Prevention of Nuclear War has had an impressive public impact in the 1980s, helping to shatter the myths of surviving and medically responding to a nuclear attack. The 1990s present a new challenge for the medical community in a different social and international context characterized by increasing global interdependence. Another view of physician activism is presented to complement advocacy for nuclear disarmament in the promotion of peace. A framework for analysis is provided by "fateful visions"--accepted policy views of prospective superpower relations--drawn from practitioners of foreign policy, international relations, and security affairs. A perceptual gap may exist between physicians who wish to address underlying ethical and public health concerns on security issues and policy practitioners who are accustomed to discussion within existing policy frames of reference that can be pragmatically used. A strategy is proposed for physicians to use their specialized training and skills to evaluate trends in global health interdependence. The international physicians' movement may contribute substantively to the formulation of policy by expanding and interpreting an increasingly complex database on interdependence, and by creating a dialogue with policy formulators based on mutual recognition of the value and legitimacy of each professions' expertise and complementary contributions to international security policy.

What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?

PubMed

Singh, Kavita; Reddy, K Srinath; Prabhakaran, Dorairaj

2011-12-01

The accelerating epidemics of noncommunicable diseases (NCDs) in India call for a comprehensive public health response which can effectively combat and control them before they peak and inflict severe damage in terms of unaffordable health, economic, and social costs. To synthesize and present recent evidences regarding the effectiveness of several types of public health interventions to reduce NCD burden. Interventions influencing behavioral risk factors (like unhealthy diet, physical inactivity, tobacco and alcohol consumption) through policy, public education, or a combination of both have been demonstrated to be effective in reducing the NCD risk in populations as well as in individuals. Policy interventions are also effective in reducing the levels of several major biological risk factors linked to NCDs (high blood pressure; overweight and obesity; diabetes and abnormal blood cholesterol). Secondary prevention along the lines of combination pills and ensuring evidenced based clinical care are also critical. Though the evidence for health promotion and primary prevention are weaker, policy interventions and secondary prevention when combined with these are likely to have a greater impact on reducing national NCD burden. A comprehensive and integrated response to NCDs control and prevention needs a "life course approach." Proven cost-effective interventions need to be integrated in a NCD prevention and control policy framework and implemented through coordinated mechanisms of regulation, environment modification, education, and health care responses.

What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?

PubMed Central

Singh, Kavita; Reddy, K Srinath; Prabhakaran, Dorairaj

2011-01-01

The accelerating epidemics of noncommunicable diseases (NCDs) in India call for a comprehensive public health response which can effectively combat and control them before they peak and inflict severe damage in terms of unaffordable health, economic, and social costs. To synthesize and present recent evidences regarding the effectiveness of several types of public health interventions to reduce NCD burden. Interventions influencing behavioral risk factors (like unhealthy diet, physical inactivity, tobacco and alcohol consumption) through policy, public education, or a combination of both have been demonstrated to be effective in reducing the NCD risk in populations as well as in individuals. Policy interventions are also effective in reducing the levels of several major biological risk factors linked to NCDs (high blood pressure; overweight and obesity; diabetes and abnormal blood cholesterol). Secondary prevention along the lines of combination pills and ensuring evidenced based clinical care are also critical. Though the evidence for health promotion and primary prevention are weaker, policy interventions and secondary prevention when combined with these are likely to have a greater impact on reducing national NCD burden. A comprehensive and integrated response to NCDs control and prevention needs a “life course approach.” Proven cost-effective interventions need to be integrated in a NCD prevention and control policy framework and implemented through coordinated mechanisms of regulation, environment modification, education, and health care responses. PMID:22628907

Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government.

PubMed

Martineau, F P; Graff, H; Mitchell, C; Lock, K

2014-09-01

The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives-for example, minimum unit pricing licensing conditions-can serve as test cases for wider national implementation. By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

The Value of "Dialogue Events" as Sites of Learning: An Exploration of Research and Evaluation Frameworks

ERIC Educational Resources Information Center

Lehr, Jane L.; McCallie, Ellen; Davies, Sarah R.; Caron, Brandiff R.; Gammon, Benjamin; Duensing, Sally

2007-01-01

In the past five years, informal science institutions (ISIs), science communication, advocacy and citizen action groups, funding organizations, and policy-makers in the UK and the USA have become increasingly involved in efforts to promote increased public engagement with science and technology (PEST). Such engagement is described as taking place…

"Children of the Street": Sexual Citizenship and the Unprotected Lives of Ghanaian Street Youth

ERIC Educational Resources Information Center

Oduro, Georgina Yaa

2012-01-01

Youth-sensitive policies are gradually gaining recognition in Africa. The release of the recent publication "Children in Ghana" by the Ministry of Women and Children's Affairs (MOWAC) and UNICEF-Ghana attests to the value the country places on young people's perspectives. Guided by Richardson's conceptual framework on sexual citizenship,…

"Streams of Influence" in Student Affairs: A Renewed Emphasis on Leadership Education

ERIC Educational Resources Information Center

Gigliotti, Ralph A.

2015-01-01

This case study presents an overview of the development of a new Office for Leadership Programs at Villanova University, housed under the Office of Student Development. Adapting Kingdon's (1984) public policy model to the creation of new initiatives in student affairs, this article offers a conceptual framework for the design of new student…

75 FR 59657 - Energy Efficiency Program for Certain Commercial and Industrial Equipment: Public Meeting and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... industrial electric motors under section 342(b) of the Energy Policy and Conservation Act (EPCA). DOE will.../electric_motors.html . For information on obtaining a copy of the framework document, see the supplementary... Electric Motors, Docket No. EERE-2010-BT-STD-0027 and/or RIN 1904-AC28, 1000 Independence Avenue, SW...

The Psychology of Working: A New Framework for Counseling Practice and Public Policy

ERIC Educational Resources Information Center

Blustein, David L.; Kenna, Alexandra C.; Gill, Nadia; DeVoy, Julia E.

2008-01-01

The authors present the "psychology-of-working perspective" (D. L. Blustein, 2006; N. Peterson & R. C. Gonzalez, 2005; M. S. Richardson, 1993) as an alternative to traditional career development theories, which have primarily explored the lives of those with choice and volition in their working lives. The major historical and conceptual features…

A Conceptual Development Framework for Management and Leadership Learning in the UK Incubator Sector

ERIC Educational Resources Information Center

D. Hannon, Paul

2003-01-01

Focuses attention upon a recent phenomenon promoted by public sector policy and government funding and adopted within the private sector as a vehicle for wealth creation, where wealth can mean the development of different forms of capital such as financial, intellectual and social. Incubators and incubation programmes have established themselves…

Analyzing Crime and Crime Control: A Resource Guide. Economics-Political Science Series.

ERIC Educational Resources Information Center

Butterfield, Ruth I.; And Others

This document, the fourth in a series of resource guides emphasizing economic-political analysis of contemporary public policies and issues, focuses on crime control. Designed as a three-week unit for secondary school students, the guide is presented in three sections. The introduction presents an economic and a political science framework for…

The Contribution of Virtual Education to Social Inclusion with the Consolidation of a New Conviviality

ERIC Educational Resources Information Center

Fainholc, Beatriz

2011-01-01

This article discusses some of the approaches implemented as socio-educational public policies--which have failed--aimed at strengthening social inclusion to encourage a substantive conviviality, an alternative to the existing one, which is included under the new comprehensive framework of Social Studies of Science and Technology in their…

Attitudes of Business Students on the TARP Program: A Semantic Differential Analysis

ERIC Educational Resources Information Center

Piotrowski, Chris; Guyette, Roger W., Jr.

2011-01-01

The TARP program, a federal response to the 2008 financial crisis, has generated much debate both inside and outside of academia. Since business ethics, corporate responsibility, and public policy form the basic educational framework of the undergraduate business school curriculum, we investigated attitudes toward the TARP in the Spring of 2009.…

Queer Youth in Heterosexist Schools: Isolation, Prejudice and No Clear Supportive Policy Frameworks

ERIC Educational Resources Information Center

Murray, Olivia

2011-01-01

In the wake of institutionalized homophobia afflicting public schools, the nation faces a unique opportunity to acknowledge and transform the assumption that all people are or should be heterosexual and gender-conforming. In this article, the author examines how people, as a nation, can reform schools to be more inclusive of diverse student…

Libya: Transition and U.S. Policy

DTIC Science & Technology

2016-04-20

the country’s public finances , or create a viable framework for post-conflict justice and reconciliation. Elections for legislative bodies and a...revenue earned from each barrel sold, putting significant pressure on government finances . The Central Intelligence Agency World Factbook estimates...FY2015 Request Complex Crises Fund (CCF-OCO) 15,000 - - Foreign Military Financing (FMF) 150 - 150 949 - - International Military Education

The Evaluation Turn in the Higher Education System: Lessons from Italy

ERIC Educational Resources Information Center

Lumino, Rosaria; Gambardella, Dora; Grimaldi, Emiliano

2017-01-01

This article explores how new public management policy ideas and technologies circulating in the globalised education space have been re-contextualised in the re-design of the Italian Higher Education System. In doing so, it uses the governmentality studies as a sensitising framework to problematise what we term here as the "calculative and…

Gathering Evidence on an After-School Supplemental Instruction Program: Design Challenges and Early Findings in Light of NCLB

ERIC Educational Resources Information Center

Chatterji, Madhabi; Kwon, Young Ae; Sng, Clarice

2006-01-01

The No Child Left Behind (NCLB) Act of 2001 requires that public schools adopt research-supported programs and practices, with a strong recommendation for randomized controlled trials (RCTs) as the "gold standard" for scientific rigor in empirical research. Within that policy framework, this paper compares the relative utility of…

Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research

PubMed Central

Collin, Jeff; Hill, Sarah E.; Kandlik Eltanani, Mor; Plotnikova, Evgeniya; Ralston, Rob; Smith, Katherine E.

2017-01-01

Background Public health’s terms of engagement with unhealthy commodity industries (alcohol, tobacco and ultra-processed food and drinks) have become increasingly contested in policy and research. We sought to identify approaches that could attract consensus support within and across policy domains. Methods Using snowball sampling, we undertook an online survey of 335 health researchers, advocates and policymakers, in 40 countries, assessing responses to stated principles, claims and recommendations for engaging with unhealthy commodity industries in relation to key policy and research initiatives. Results Most respondents identified a fundamental conflict between industry interests and public health objectives for all three industries, with agreement greatest in relation to tobacco and weakest for food. This pattern was replicated across diverse questions regarding potential forms of engagement, including in rejecting voluntarism and partnership approaches to health policy. While awareness of tobacco industry tactics to influence policy and research was higher than for alcohol and food, most respondents rejected the view that the influence of the latter was less significant for public health. Proposals that health and research organisations should divest their funds attracted less support with respect to food, while restricting publication of industry-funded research in academic journals was the issue that most divided opinion. Respondents reported most difficulty in answering questions about the food industry. Conclusions The strong consensus around restricting interactions with the tobacco industry supports increased implementation of the WHO Framework Convention on Tobacco Control’s conflict of interest provisions. There is strong support for the extension of such practices to the alcohol industry, challenging current norms. More mixed responses indicate a need for greater clarity in defining the food industry, and for research analyzing links, similarities and differences across different types of unhealthy commodity producers. Partnership approaches to addressing non-communicable diseases seem incapable of attracting widespread support across public health, challenging practice in many contexts. PMID:28886049

Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research.

PubMed

Collin, Jeff; Hill, Sarah E; Kandlik Eltanani, Mor; Plotnikova, Evgeniya; Ralston, Rob; Smith, Katherine E

2017-01-01

Public health's terms of engagement with unhealthy commodity industries (alcohol, tobacco and ultra-processed food and drinks) have become increasingly contested in policy and research. We sought to identify approaches that could attract consensus support within and across policy domains. Using snowball sampling, we undertook an online survey of 335 health researchers, advocates and policymakers, in 40 countries, assessing responses to stated principles, claims and recommendations for engaging with unhealthy commodity industries in relation to key policy and research initiatives. Most respondents identified a fundamental conflict between industry interests and public health objectives for all three industries, with agreement greatest in relation to tobacco and weakest for food. This pattern was replicated across diverse questions regarding potential forms of engagement, including in rejecting voluntarism and partnership approaches to health policy. While awareness of tobacco industry tactics to influence policy and research was higher than for alcohol and food, most respondents rejected the view that the influence of the latter was less significant for public health. Proposals that health and research organisations should divest their funds attracted less support with respect to food, while restricting publication of industry-funded research in academic journals was the issue that most divided opinion. Respondents reported most difficulty in answering questions about the food industry. The strong consensus around restricting interactions with the tobacco industry supports increased implementation of the WHO Framework Convention on Tobacco Control's conflict of interest provisions. There is strong support for the extension of such practices to the alcohol industry, challenging current norms. More mixed responses indicate a need for greater clarity in defining the food industry, and for research analyzing links, similarities and differences across different types of unhealthy commodity producers. Partnership approaches to addressing non-communicable diseases seem incapable of attracting widespread support across public health, challenging practice in many contexts.

"The law was actually drafted by us but the Government is to be congratulated on its wise actions": British American Tobacco and public policy in Kenya.

PubMed

Patel, Preeti; Collin, Jeff; Gilmore, Anna B

2007-02-01

British American Tobacco (BAT) has historically enjoyed a monopoly position in Kenya. Analysis of recent tobacco control debates and a case study of BAT's response to the emergence of competition in Kenya are used to explore the company's ability to shape public policy and its treatment of tobacco farmers. Analysis of internal industry documents from BAT's Guildford depository, other relevant data and interviews with key informants. BAT enjoys extensive high-level political connections in Kenya, including close relationships with successive Kenyan presidents. Such links seems to have been used to influence public policy. Health legislation has been diluted and delayed, and when a competitor emerged in the market, BAT used its contacts to have the government pass legislation drafted by BAT that compelled farmers to sell tobacco to BAT rather than to its competitor. BAT was already paying farmers less than any other African leaf-growing company, and the legislation entrenched poor pay and a quasi-feudal relationship. BAT's public relation's response to the threat of competition and the ministers' public statements extolling the economic importance of tobacco growing suggest that BAT has manipulated tobacco farming as a political issue. The extent of BAT's influence over public policy is consistent with the observations that, despite ratifying the Framework Convention on Tobacco Control, progress in implementing tobacco control measures in Kenya has been limited. The benefits of tobacco farming seem to be deliberately exaggerated, and an analysis of its true cost benefits is urgently needed. Tobacco farmers must be protected against BAT's predatory practices and fully informed about its activities to help them have an informed role in policy debates. As image, particularly around the importance of tobacco farming, seems key to BAT's ability to influence policy, the truth about its treatment of farmers must be publicised.

“The law was actually drafted by us but the Government is to be congratulated on its wise actions”: British American Tobacco and public policy in Kenya

PubMed Central

Patel, Preeti; Collin, Jeff; Gilmore, Anna B

2007-01-01

Background and objective British American Tobacco (BAT) has historically enjoyed a monopoly position in Kenya. Analysis of recent tobacco control debates and a case study of BAT's response to the emergence of competition in Kenya are used to explore the company's ability to shape public policy and its treatment of tobacco farmers. Design Analysis of internal industry documents from BAT's Guildford depository, other relevant data and interviews with key informants. Results BAT enjoys extensive high‐level political connections in Kenya, including close relationships with successive Kenyan presidents. Such links seems to have been used to influence public policy. Health legislation has been diluted and delayed, and when a competitor emerged in the market, BAT used its contacts to have the government pass legislation drafted by BAT that compelled farmers to sell tobacco to BAT rather than to its competitor. BAT was already paying farmers less than any other African leaf‐growing company, and the legislation entrenched poor pay and a quasi‐feudal relationship. BAT's public relation's response to the threat of competition and the ministers' public statements extolling the economic importance of tobacco growing suggest that BAT has manipulated tobacco farming as a political issue. Conclusions The extent of BAT's influence over public policy is consistent with the observations that, despite ratifying the Framework Convention on Tobacco Control, progress in implementing tobacco control measures in Kenya has been limited. The benefits of tobacco farming seem to be deliberately exaggerated, and an analysis of its true cost benefits is urgently needed. Tobacco farmers must be protected against BAT's predatory practices and fully informed about its activities to help them have an informed role in policy debates. As image, particularly around the importance of tobacco farming, seems key to BAT's ability to influence policy, the truth about its treatment of farmers must be publicised. PMID:17297056

Analysis of public policies in favor of the elderly people in Senegal: state of legal protection.

PubMed

Ka, Ousseynou; Seck, Ibrahima; Coumé, Mamadou; Thiongane, Bassirou; Mbaye, El Hadji; Dia, Anta Tal

2018-03-01

Senegal will be spared by phenomenon of population ageing, which will surely have socioeconomic and cultural consequences that will not be easy to tackle, as all sectors will be affected. In regard to legal protection, there are not any special legal acts for the elderly as is the case for children and women. They are treated just as responsible adults whose legal status is the same as everyone else. As far as the framework of legal protection of elderly people is concerned, Senegal has ratified all international and regional means and mecanisms for the protection of the rights of the elderly. In addition, the authorities have adopted policies and programs that favor taking charge of old people's interests. At the present, Senegal possesses a legal framework for the protection of its elderly people. So the matter is about creating new rights, because even the existing rights are not known to their beneficiaries. What is important is to ensure that the elderly fully enjoy their rights in the same way as the other members of society. It is wise, therefore, to put in place plan for information, public awareness and communication concerning the legal regulating framework. Thus, Senegal could be regarded as a pioneer in terms of the protection the elderly, and these leading programs can represent models for the countries of the region, whose social, sanitary and economic contexts are similar.

Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms.

PubMed

Langham, Erika; Thorne, Hannah; Browne, Matthew; Donaldson, Phillip; Rose, Judy; Rockloff, Matthew

2016-01-27

Harm from gambling is known to impact individuals, families, and communities; and these harms are not restricted to people with a gambling disorder. Currently, there is no robust and inclusive internationally agreed upon definition of gambling harm. In addition, the current landscape of gambling policy and research uses inadequate proxy measures of harm, such as problem gambling symptomology, that contribute to a limited understanding of gambling harms. These issues impede efforts to address gambling from a public health perspective. Data regarding harms from gambling was gathered using four separate methodologies, a literature review, focus groups and interviews with professionals involved in the support and treatment of gambling problems, interviews with people who gamble and their affected others, and an analysis of public forum posts for people experiencing problems with gambling and their affected others. The experience of harm related to gambling was examined to generate a conceptual framework. The catalogue of harms experienced were organised as a taxonomy. The current paper proposes a definition and conceptual framework of gambling related harm that captures the full breadth of harms that gambling can contribute to; as well as a taxonomy of harms to facilitate the development of more appropriate measures of harm. Our aim is to create a dialogue that will lead to a more coherent interpretation of gambling harm across treatment providers, policy makers and researchers.

A framework for evaluating the public health impact of e-cigarettes and other vaporized nicotine products.

PubMed

Levy, David T; Cummings, K Michael; Villanti, Andrea C; Niaura, Ray; Abrams, David B; Fong, Geoffrey T; Borland, Ron

2017-01-01

The use of vaporized nicotine products (VNPs), especially e-cigarettes and, to a lesser extent, pressurized aerosol nicotine products and heat-not-burn tobacco products, are being adopted increasingly as an alternative to smoking combusted products, primarily cigarettes. Considerable controversy has accompanied their marketing and use. We propose a framework that describes and incorporates patterns of VNP and combustible cigarette use in determining the total amount of toxic exposure effects on population health. We begin by considering toxicity and the outcomes relevant to population health. We then present the framework and define different measures of VNP use; namely, trial and long-term use for exclusive cigarette smokers, exclusive VNP and dual (cigarette and VNP) use. Using a systems thinking framework and decision theory we considered potential pathways for current, former and never users of VNPs. We then consider the evidence to date and the probable impacts of VNP use on public health, the potential effects of different policy approaches and the possible influence of the tobacco industry on VNP and cigarette use. © 2016 Society for the Study of Addiction.

A Framework for Evaluating the Public Health Impact of E-cigarettes and Other Vaporized Nicotine Products

PubMed Central

Levy, David T.; Cummings, K. Michael; Villanti, Andrea C.; Niaura, Ray; Abrams, David B.; Fong, Geoffrey T.; Borland, Ron

2016-01-01

The use of vaporized nicotine products (VNPs), especially e-cigarettes and to a lesser extent pressurized aerosol nicotine products and heat-not-burn tobacco products, are increasingly being adopted as an alternative to smoking combusted products, primarily cigarettes. Considerable controversy has accompanied their marketing and use. We propose a framework that describes and incorporates patterns of VNP and combustible cigarette use in determining the total amount of toxic exposure effects on population health. We begin by considering toxicity and the outcomes relevant to population health. We then present the framework and define different measures of VNP use, namely, trial and long-term use for exclusive cigarette smokers, exclusive VNP and dual (cigarette and VNP) use. Using a systems thinking framework and decision theory we considered potential pathways for current, former and never users of VNPs. We then consider the evidence to-date and the likely impacts of VNP use on public health, the potential effects of different policy approaches, and the possible influence of the tobacco industry on VNP and cigarette use. PMID:27109256

Biodiversity and human well-being: an essential link for sustainable development

PubMed Central

Chazdon, Robin; Duffy, J. Emmett; Prager, Case; Worm, Boris

2016-01-01

As society strives to transition towards more sustainable development pathways, it is important to properly conceptualize the link between biodiversity (i.e. genes, traits, species and other dimensions) and human well-being (HWB; i.e. health, wealth, security and other dimensions). Here, we explore how published conceptual frameworks consider the extent to which the biodiversity–HWB links are being integrated into public discourse and scientific research and the implications of our findings for sustainable development. We find that our understanding has gradually evolved from seeing the value of biodiversity as an external commodity that may influence HWB to biodiversity as fundamental to HWB. Analysis of the literature trends indicates increasing engagement with the terms biodiversity, HWB and sustainable development in the public, science and policy spheres, but largely as independent rather than linked terms. We suggest that a consensus framework for sustainable development should include biodiversity explicitly as a suite of internal variables that both influence and are influenced by HWB. Doing so will enhance clarity and help shape coherent research and policy priorities. We further suggest that the absence of this link in development can inadvertently lead to a ratcheting down of biodiversity by otherwise well-meaning policies. Such biotic impoverishment could lock HWB at minimum levels or lead to its decline and halt or reverse progress in achieving sustainable development. PMID:27928039

Biodiversity and human well-being: an essential link for sustainable development.

PubMed

Naeem, Shahid; Chazdon, Robin; Duffy, J Emmett; Prager, Case; Worm, Boris

2016-12-14

As society strives to transition towards more sustainable development pathways, it is important to properly conceptualize the link between biodiversity (i.e. genes, traits, species and other dimensions) and human well-being (HWB; i.e. health, wealth, security and other dimensions). Here, we explore how published conceptual frameworks consider the extent to which the biodiversity-HWB links are being integrated into public discourse and scientific research and the implications of our findings for sustainable development. We find that our understanding has gradually evolved from seeing the value of biodiversity as an external commodity that may influence HWB to biodiversity as fundamental to HWB. Analysis of the literature trends indicates increasing engagement with the terms biodiversity, HWB and sustainable development in the public, science and policy spheres, but largely as independent rather than linked terms. We suggest that a consensus framework for sustainable development should include biodiversity explicitly as a suite of internal variables that both influence and are influenced by HWB. Doing so will enhance clarity and help shape coherent research and policy priorities. We further suggest that the absence of this link in development can inadvertently lead to a ratcheting down of biodiversity by otherwise well-meaning policies. Such biotic impoverishment could lock HWB at minimum levels or lead to its decline and halt or reverse progress in achieving sustainable development. © 2016 The Authors.

Predictors of women's attitudes toward world health organization framework convention on tobacco control policies in urban China.

PubMed

Abdullah, Abu Saleh; Yang, Tingzhong; Beard, Jennifer

2010-05-01

In 2005 China ratified the WHO Framework Convention on Tobacco Control (FCTC) and committed to implement tobacco control legislation and policies. Wide variation in smoking prevalence between men and women in China and the high exposure of women to secondhand smoke suggest that each component of the FCTC should be analyzed from a gender perspective. This study describes women's attitudes toward and predictors of support for four key FCTC measures in China. Cross-sectional data were collected from 1,408 women in two urban cities on demographics, smoking behavior, and attitudes toward key tobacco control measures. Seventy percent of the study women (n = 1,408) were exposed to secondhand smoke at home, work, or other public places. Support for the four FCTC measures of interest was as follows: 92.5% supported banning smoking in public places, 79.2% supported increasing the cigarette tax, 92% supported stronger health warnings on cigarette packages, and 87.1% favored banning tobacco advertising. The predictors for supporting each of these measures included socioeconomic, attitudinal, and behavioral factors. Urban Chinese women appear to support implementation of key WHO FCTC measures. Predictors of women's attitudes toward the key FCTC measures varied. The formulation process resulting from the tobacco control policy should consider these women-specific predictors in order to facilitate successful implementation of FCTC.

Debates—Perspectives on socio-hydrology: Modeling flood risk as a public policy problem

NASA Astrophysics Data System (ADS)

Gober, Patricia; Wheater, Howard S.

2015-06-01

Socio-hydrology views human activities as endogenous to water system dynamics; it is the interaction between human and biophysical processes that threatens the viability of current water systems through positive feedbacks and unintended consequences. Di Baldassarre et al. implement socio-hydrology as a flood risk problem using the concept of social memory as a vehicle to link human perceptions to flood damage. Their mathematical model has heuristic value in comparing potential flood damages in green versus technological societies. It can also support communities in exploring the potential consequences of policy decisions and evaluating critical policy tradeoffs, for example, between flood protection and economic development. The concept of social memory does not, however, adequately capture the social processes whereby public perceptions are translated into policy action, including the pivotal role played by the media in intensifying or attenuating perceived flood risk, the success of policy entrepreneurs in keeping flood hazard on the public agenda during short windows of opportunity for policy action, and different societal approaches to managing flood risk that derive from cultural values and economic interests. We endorse the value of seeking to capture these dynamics in a simplified conceptual framework, but favor a broader conceptualization of socio-hydrology that includes a knowledge exchange component, including the way modeling insights and scientific results are communicated to floodplain managers. The social processes used to disseminate the products of socio-hydrological research are as important as the research results themselves in determining whether modeling is used for real-world decision making.

Ethical Considerations for Planetary Protection in Space Exploration: A Workshop

PubMed Central

Rummel, J.D.; Horneck, G.

2012-01-01

Abstract With the recognition of an increasing potential for discovery of extraterrestrial life, a diverse set of researchers have noted a need to examine the foundational ethical principles that should frame our collective space activities as we explore outer space. A COSPAR Workshop on Ethical Considerations for Planetary Protection in Space Exploration was convened at Princeton University on June 8–10, 2010, to examine whether planetary protection measures and practices should be extended to protect planetary environments within an ethical framework that goes beyond “science protection” per se. The workshop had been in development prior to a 2006 NRC report on preventing the forward contamination of Mars, although it responded directly to one of the recommendations of that report and to several peer-reviewed papers as well. The workshop focused on the implications and responsibilities engendered when exploring outer space while avoiding harmful impacts on planetary bodies. Over 3 days, workshop participants developed a set of recommendations addressing the need for a revised policy framework to address “harmful contamination” beyond biological contamination, noting that it is important to maintain the current COSPAR planetary protection policy for scientific exploration and activities. The attendees agreed that there is need for further study of the ethical considerations used on Earth and the examination of management options and governmental mechanisms useful for establishing an environmental stewardship framework that incorporates both scientific input and enforcement. Scientists need to undertake public dialogue to communicate widely about these future policy deliberations and to ensure public involvement in decision making. A number of incremental steps have been taken since the workshop to implement some of these recommendations. Key Words: Planetary protection—Extraterrestrial life—Life in extreme environments—Environment—Habitability. Astrobiology 12, 1017–1023. PMID:23095097

TB in Vulnerable Populations

PubMed Central

Ugarte-Gil, César; Caro, Godofredo; Aylas, Rula; Castro, César; Lema, Claudia

2016-01-01

Abstract This article analyzes the factors associated with vulnerability of the Ashaninka, the most populous indigenous Peruvian Amazonian people, to tuberculosis (TB). By applying a human rights-based analytical framework that assesses public policy against human rights standards and principles, and by offering a step-by-step framework for a full assessment of compliance, it provides evidence of the relationship between the incidence of TB among the Ashaninka and Peru’s poor level of compliance with its human rights obligations. The article argues that one of the main reasons for the historical vulnerability of the Ashaninka to diseases such as TB is a lack of political will on the part of the national government to increase public health spending, ensure that resources reach the most vulnerable population, and adopt and invest in a culturally appropriate health system. PMID:27780999

[Policies and mental health action plans in OECD: lessons for Quebec?].

PubMed

Thiebaut, Georges-Charles; Farand, Lambert; Fleury, Marie-Josée

2014-01-01

The objectives of this research are: 1) to provide a conceptual framework for analyzing mental health policies; 2) to compare mental health policies across a sample of OECD jurisdictions; 3) to describe configurations of mental health policies; 4) to identify practical implications for the Province of Quebec. This research is a comparative synthetic study of mental health policies. The web sites of the Ministries of health of the thirty-four OECD countries and ten Canadian Provinces were searched for mental health policies proposed within the last fifteen years. Twenty one such policies (with an English or French version) were retrieved, covering thirteen OECD countries, six Canadian Provinces and the WHO. Content analysis was performed based on the categories (differentiation, integration, governance) and sub-categories of the aforementioned conceptual framework. Eight policies that together cover the variations encountered between all policies were used to identify typical configurations. A conceptual framework derived from Parsons' Theory of Social Action posits that social action systems must exhibit a level of internal differentiation that corresponds to the heterogeneity of their external environment and also a level of integration that allows them to remain coherent despite the complexity of their environment. Governance mechanisms help them maintain an equilibrium between differentiation and integration.In terms of differentiation, mental health policies exhibit much variation between the needs and the groups that are prioritized (age, gender, ethnicity, culture, etc.), the types of interventions that are proposed (promotion, prevention, treatment, rehabilitation, etc.), the systemic levels at which interventions take place (society, government as a whole, health care system, organizations, programs, individuals), and the level of specification and scientific basis of proposed interventions. In terms of integration, policies promote various mechanisms belonging to four general categories of increasing effectiveness from hierarchical separation of mandates, to exchange of information, to collaborative planning, and to complete structural integration and co-localisation of certain components (ex. dependence and mental health services). In terms of governance, policies present program theories of varying explicitness and scientific bases, and with different emphases on structures, processes or outcomes. Management models also vary in terms of precision, accountability, financing mechanisms, information systems, and the importance of clinical governance and quality improvement.Five configurations of mental health policies are identified (the public health, the professional, the structural technocratic, the functional technocratic, and the political), each comprising typical combinations of the preceding ingredients. The current Quebec mental health policy belongs to the structural technocratic configuration. It specifies fragmented mental health structures with mild integration mechanisms. In the future, it should consider improving its public health aspects (inter-sector work on the determinants of mental health), professional aspects (emphasis on scientific evidence, clinical governance and quality), and functional aspects (integrated specialized community mental health and addiction services). But political factors may prevent it from doing so.

Designing a model for trauma system management using public health approach: the case of Iran.

PubMed

Tarighi, Payam; Tabibi, Seyed Jamaledin; Motevalian, Seyed Abbas; Tofighi, Shahram; Maleki, Mohammad Reza; Delgoshaei, Bahram; Panahi, Farzad; Masoomi, Gholam Reza

2012-01-01

Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS) to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.

INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): overview and key principles.

PubMed

Swinburn, B; Sacks, G; Vandevijvere, S; Kumanyika, S; Lobstein, T; Neal, B; Barquera, S; Friel, S; Hawkes, C; Kelly, B; L'abbé, M; Lee, A; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Rayner, M; Sanders, D; Snowdon, W; Walker, C

2013-10-01

Non-communicable diseases (NCDs) dominate disease burdens globally and poor nutrition increasingly contributes to this global burden. Comprehensive monitoring of food environments, and evaluation of the impact of public and private sector policies on food environments is needed to strengthen accountability systems to reduce NCDs. The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) is a global network of public-interest organizations and researchers that aims to monitor, benchmark and support public and private sector actions to create healthy food environments and reduce obesity, NCDs and their related inequalities. The INFORMAS framework includes two 'process' modules, that monitor the policies and actions of the public and private sectors, seven 'impact' modules that monitor the key characteristics of food environments and three 'outcome' modules that monitor dietary quality, risk factors and NCD morbidity and mortality. Monitoring frameworks and indicators have been developed for 10 modules to provide consistency, but allowing for stepwise approaches ('minimal', 'expanded', 'optimal') to data collection and analysis. INFORMAS data will enable benchmarking of food environments between countries, and monitoring of progress over time within countries. Through monitoring and benchmarking, INFORMAS will strengthen the accountability systems needed to help reduce the burden of obesity, NCDs and their related inequalities. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

An evidence-based public health approach to climate change adaptation.

PubMed

Hess, Jeremy J; Eidson, Millicent; Tlumak, Jennifer E; Raab, Kristin K; Luber, George

2014-11-01

Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.

Expediting contaminated site cleanup in California

DOE Office of Scientific and Technical Information (OSTI.GOV)

Newman, B.S.; Conlan, J.T.

California generally has been considered a leader in the advocacy of policies for the cleanup and abatement of environmental pollution. Many of the more innovative programs and policies were developed within the broad framework of California`s Brownfields Initiative. Because both the public and private sectors recognize that environmental cleanup and reuse of California`s industrial properties are major components of economic revitalization, the state has used administrative and legislative tools to provide incentives for redeveloping brownfields contaminated by leaking underground storage tanks (USTs) and other industrial operations. However, it is the broader reach of various state and local policies, programs, agreementsmore » and management communication that provide benefits to the majority of the regulated community.« less

Health policy in Denmark: leaving the decentralized welfare path?

PubMed

Vrangbaek, Karsten; Christiansen, Terkel

2005-01-01

In this article, we investigate developments in Danish health care policy. After a short presentation of its historical roots, we focus on the decades after the administrative reform of 1970, which shaped the current decentralized public health care system. Theories of path dependency and institutional inertia are used to explain the relative stability in the overall structure, and theories of policy process and reform are used to discuss gradual changes within the overall framework. Although comprehensive reforms have not taken place in Denmark, many gradual changes may pave the way for more radical changes in the future. The political climate currently seems to be more favorable toward structural reform than in the past.

A Review of Studies on the System-Wide Implementation of Evidence-Based Psychotherapies for Posttraumatic Stress Disorder in the Veterans Health Administration.

PubMed

Rosen, C S; Matthieu, M M; Wiltsey Stirman, S; Cook, J M; Landes, S; Bernardy, N C; Chard, K M; Crowley, J; Eftekhari, A; Finley, E P; Hamblen, J L; Harik, J M; Kehle-Forbes, S M; Meis, L A; Osei-Bonsu, P E; Rodriguez, A L; Ruggiero, K J; Ruzek, J I; Smith, B N; Trent, L; Watts, B V

2016-11-01

Since 2006, the Veterans Health Administration (VHA) has instituted policy changes and training programs to support system-wide implementation of two evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD). To assess lessons learned from this unprecedented effort, we used PubMed and the PILOTS databases and networking with researchers to identify 32 reports on contextual influences on implementation or sustainment of EBPs for PTSD in VHA settings. Findings were initially organized using the exploration, planning, implementation, and sustainment framework (EPIS; Aarons et al. in Adm Policy Ment Health Health Serv Res 38:4-23, 2011). Results that could not be adequately captured within the EPIS framework, such as implementation outcomes and adopter beliefs about the innovation, were coded using constructs from the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework (Glasgow et al. in Am J Public Health 89:1322-1327, 1999) and Consolidated Framework for Implementation Research (CFIR; Damschroder et al. in Implement Sci 4(1):50, 2009). We highlight key areas of progress in implementation, identify continuing challenges and research questions, and discuss implications for future efforts to promote EBPs in large health care systems.

Bridging the gap between regulatory acceptance and industry use of non-animal methods.

PubMed

Clippinger, Amy J; Hill, Erin; Curren, Rodger; Bishop, Patricia

2016-01-01

Collaboration between industry and regulators resulted in the development of a decision tree approach using in vitro or ex vivo assays to replace animal tests when determining the eye irritation potential of antimicrobial cleaning products (AMCPs) under the United States Environmental Protection Agency (EPA) Office of Pesticide Programs' hazard classification and labeling system. A policy document issued by the EPA in 2013 and updated in 2015 describes the alternate testing framework that industry could apply to new registrations of AMCPs and, on a case-by-case basis, to conventional pesticide products. Despite the collaborative effort, the availability of relevant non-animal methods, and the EPA's change in policy, only a limited number of AMCPs have been registered using the framework. Companies continue to conduct animal tests when registering AMCPs due to various challenges surrounding adoption of the new testing framework; however, recent discussions between industry, regulators, and other interested parties have identified ways these challenges may be overcome. In this article we explore how use of the alternate framework could be expanded through efforts such as increasing international harmonization, more proactively publicizing the framework, and enhancing the training of regulatory reviewers. Not only can these strategies help to increase use of the EPA alternate eye irritation framework, they can also be applied to facilitate the uptake of other alternative approaches to animal testing in the future.

Data for development in health: a case study and monitoring framework from Kazakhstan

PubMed Central

Obermann, Konrad; Chanturidze, Tata; Richardson, Erica; Tanirbergenov, Serik; Shoranov, Marat; Nurgozhaev, Ali

2016-01-01

Healthcare reforms are often not coupled with a relevant and appropriate monitoring framework, leaving policymakers and the public without evidence about the implications of such reforms. Kazakhstan has embarked on a large-scale reform of its healthcare system in order to achieve Universal Health Coverage. The health-related 2020 Strategic Development Goals reflect this political ambition. In a case-study approach and on the basis of published and unpublished evidence as well as personal involvement and experience (A) the indicators in the 2020 Strategic Development Goals were assessed and (B) a ‘data-mapping’ exercise was conducted, where the WHO health system framework was used to describe the data available at present in Kazakhstan and comment on the different indicators regarding their usefulness for monitoring the current health-related 2020 Strategic Development Goals in Kazakhstan. It was concluded that the country’s current monitoring framework needs further development to track the progress and outcomes of policy implementation. The application of a modified WHO/World Bank/Global Fund health system monitoring framework was suggested to examine the implications of recent health sector reforms. Lessons drawn from the Kazakhstan experience on tailoring the suggested framework, collecting the data, and using the generated intelligence in policy development and decision-making can serve as a useful example for other middle-income countries, potentially enabling them to fast-track developments in the health sector. PMID:28588905

Workplace exposure to engineered nanomaterials: the Italian path for the definition of occupational health and safety policies.

PubMed

Mirabile, Marco; Boccuni, Fabio; Gagliardi, Diana; Rondinone, Bruna Maria; Iavicoli, Sergio

2014-07-01

This study explores the way the publication of a National White Book on health and safety risks that affect workers in jobs involving Nanotechnologies and Nanomaterials influenced the key Italian stakeholders attitude toward this issue and identifies the standpoints and priorities shared among researchers and stakeholders to develop a policy framework to address this issue. The study not only highlights some important assumptions (i.e. the acknowledgment by the key stakeholders of the need for actions and the identification of objectives which can gain a wide consensus) for the establishment of a policy community that sustains the development of a policymaking process on the issue but, through the interaction between stakeholders and OSH researchers, it also identifies some in nuce proposals that represent the starting point for policy interventions aimed at meeting the needs of both stakeholders and scientific community. Results obtained in terms of clarification of interests at stake, identification of potential areas of consensus and level of key national actors' engagement achieved, show the potentialities of adopting a knowledge based and inclusive approach to policy-making to address the issue of prevention and management of health and safety risks related to technological innovation within a framework of scientific uncertainty. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Obesity and climate change mitigation in Australia: overview and analysis of policies with co-benefits.

PubMed

Lowe, Melanie

2014-02-01

To provide an overview of the shared structural causes of obesity and climate change, and analyse policies that could be implemented in Australia to both equitably reduce obesity rates and contribute to mitigating climate change. Informed by the political economy of health theoretical framework, a review was conducted of the literature on the shared causes of, and solutions to, obesity and climate change. Policies with potential co-benefits for climate change and obesity were then analysed based upon their feasibility and capacity to reduce greenhouse gas emissions and equitably reduce obesity rates in Australia. Policies with potential co-benefits fit within three broad categories: those to replace car use with low-emissions, active modes of transport; those to improve diets and reduce emissions from the food system; and macro-level economic policies to reduce the over-consumption of food and fossil fuel energy. Given the complex causes of both problems, it is argued that a full spectrum of complementary strategies across different sectors should be utilised. Such an approach would have significant public health, social and environmental benefits. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

The Interconnectedness of Water and Health: Translating Science Into Public Health-driven Policy

NASA Astrophysics Data System (ADS)

Lichtveld, M.

2017-12-01

Louisiana and other U.S. Gulf Coast communities' unique vulnerability stems from three interconnected stressors they face: historic health disparities, persistent environmental stressors, and a geography prone to both natural and technological disasters. The health of the ecosystem is inextricably linked to that of humans. Specifically, water presents both a central asset and an intransigent environmental health threat. Waterborne illnesses associated with infectious organisms, chemical contaminants, coastal erosion, natural and technological disasters such as hurricanes and oil spills, as well as climate change-associated sea level rise and dead zones, all can negatively impact human health. Existing water-related policies at the federal, state, and local levels have failed to effectively protect the health of communities and their environment to date. For example, despite the existence of the Clean Water Act and the Safe Drinking Water Act, oil spills and drinking water contamination continue to pose significant threats to communities' health and wellbeing. This presentation will examine water-related threats to Gulf Coast communities and their ecosystem. Emphasis will be placed on key examples of policy failure and the impact such failures. A public health-driven framework will demonstrate how science can inform evidence- based policy and in turn prevention-driven public health practice.

Choice vs. voice? PPI policies and the re-positioning of the state in England and Wales.

PubMed

Hughes, David; Mullen, Caroline; Vincent-Jones, Peter

2009-09-01

CONTEXT AND THESIS: Changing patient and public involvement (PPI) policies in England and Wales are analysed against the background of wider National Health Service (NHS) reforms and regulatory frameworks. We argue that the growing divergence of health policies is accompanied by a re-positioning of the state vis-à-vis PPI, characterized by different mixes of centralized and decentralized regulatory instruments. Analysis of legislation and official documents, and interviews with policy makers. In England, continued hierarchical control is combined with the delegation of responsibilities for the oversight and organization of PPI to external institutions such as the Care Quality Commission and local involvement networks, in support of the government's policy agenda of increasing marketization. In Wales, which has rejected market reforms and economic regulation, decentralization is occurring through the use of mixed regulatory approaches and networks suited to the small-country governance model, and seeks to benefit from the close proximity of central and local actors by creating new forms of engagement while maintaining central steering of service planning. Whereas English PPI policies have emerged in tandem with a pluralistic supply-side market and combine new institutional arrangements for patient 'choice' with other forms of involvement, the Welsh policies focus on 'voice' within a largely publicly-delivered service. While the English reforms draw on theories of economic regulation and the experience of independent regulation in the utilities sector, the Welsh model of local service integration has been more influenced by reforms in local government. Such transfers of governance instruments from other public service sectors to the NHS may be problematic.

Challenges for the formulation, implantation and implementation of a National Health Surveillance Policy in Brazil.

PubMed

Guimarães, Raphael Mendonça; Meira, Karina Cardoso; Paz, Elisabete Pimenta Araújo; Dutra, Viviane Gomes Parreira; Campos, Carlos Eduardo Aguilera

2017-05-01

This article examines the evolution of health surveillance policies as actions, models and systems, as well as contributing to the debate about the constitution of the National Health Surveillance Policy (PNVS). The article discusses conceptual elements regarding the notion of health surveillance and its evolution in Brazil and a trajectory is provided in relation to the construction of care models, particularly after the creation of the Unified Health System (SUS). The possibility of using the framework of public policies based on evidence, and methods for analyzing health situations, such as spatial analysis and time series, are highlighted. To conclude, questions are raised regarding the effective creation of the PNVS, and the challenges that the federal executive faces in driving this process.

Catching Fire: An Analysis of Maine's Combined Heat and Power Energy Incentive Policies

NASA Astrophysics Data System (ADS)

Laufer, Joshua A.

This study qualitatively reviews and analyzes Maine's state-level incentive policies and regulations to catalyze the development of renewably fueled Combined Heat and Power (CHP) facilities by utilizing a framework developed by Janet Sawin. The results of the analysis indicate that additional opportunities exist to promote additional renewable CHP plant development through both strengthening existing state policies and passing new legislation. Maine's Renewable Portfolio Standard and Production-Based Incentive pilot program could be expanded in scope and in their level of support for renewable CHP. New policies could be enacted to further accelerate renewable CHP development in the state, such as a Production Tax Credit (PTC) and the creation of a grant program for level 2 feasibility studies within the existing Public Benefits Fund (PBF), Efficiency Maine Trust.

Allocation of authority in European health policy.

PubMed

Adolph, Christopher; Greer, Scott L; Massard da Fonseca, Elize

2012-11-01

Although many study the effects of different allocations of health policy authority, few ask why countries assign responsibility over different policies as they do. We test two broad theories: fiscal federalism, which predicts rational governments will concentrate information-intensive operations at lower levels, and redistributive and regulatory functions at higher levels; and "politicized federalism", which suggests a combination of systematic and historically idiosyncratic political variables interfere with efficient allocation of authority. Drawing on the WHO Health in Transition country profiles, we present new data on the allocation of responsibility for key health care policy tasks (implementation, provision, finance, regulation, and framework legislation) and policy areas (primary, secondary and tertiary care, public health and pharmaceuticals) in the 27 EU member states and Switzerland. We use a Bayesian multinomial mixed logit model to analyze how different countries arrive at different allocations of authority over each task and area of health policy, and find the allocation of powers broadly follows fiscal federalism. Responsibility for pharmaceuticals, framework legislation, and most finance lodges at the highest levels of government, acute and primary care in the regions, and provision at the local and regional levels. Where allocation does not follow fiscal federalism, it appears to reflect ethnic divisions, the population of states and regions, the presence of mountainous terrain, and the timing of region creation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of the England Wildlife Health Strategy--a framework for decision makers.

PubMed

Hartley, M; Lysons, R

2011-02-12

Diseases in wildlife have been recognised as having the potential to affect human health, livestock health and species conservation. In order to assess and respond to these potential risks in an effective and a proportionate way, the UK Government initiated development of the Wildlife Health Strategy to provide a framework for decision making. The England Wildlife Health Strategy (EWHS) has been developed through extensive consultation. Discussions and negotiations with government departments, agencies, non-governmental public bodies and wildlife organisations were held to obtain advice and input on specific and specialised aspects of wildlife health. A series of workshops to investigate the application of innovative science to wildlife health policy contributed further. A formal public consultation was held that proposed a range of actions to implement the strategy. A summary of responses to this consultation was published in October 2007. The EWHS was published in June 2009 and provides a framework for a generic four-stage approach to wildlife health that can be adopted by decision makers both within and outside government.

Equity and efficiency in health status and health services utilization: a household perspective.

PubMed

Sirageldin, I; Diop, F

1991-01-01

Health economists examine the existing pattern of disease, the initial distributional structure of public policies, and the behavioral response of households in allocating resources towards health promoting activities to understand the health consequences of public fiscal and income policies. They hope that this analysis will guide health policymakers to minimize differentials in health service utilization and health outcomes. The household production of health serves as the general framework. The analysis reveals that the demand for health and the demand for health services depend on the organization of government fiscal and distribution policies. Further the demand for health services hinges on its own price as well as on the prices of other inputs including nutrition and environmental sanitation. The government basically subsidizes these inputs, but it does not equally distribute the subsidies. For people with the lower subsidy on other health inputs, the health benefit from using health services tend to be lower. Thus the fact that these households have a low demand for health and low use of health services may indicate a rational decision which reveals low perceived productivity of these inputs. Therefore policymakers should include the effect of public subsidies when examining the effect of public policies on health status. These policies may include structural adjustment or cost recovery schemes. In fact, as evidenced in a case study in the Ivory Coast, structural adjustments did not affect the rural poor and urban poor, but instead adversely affected middle class urban households. Hence policymakers should not limit their examinations to traditional income groups.

Tobacco control in the Russian Federation--a policy analysis.

PubMed

Lunze, Karsten; Migliorini, Luigi

2013-01-23

The Russian Federation (Russia) has one of the highest smoking rates in the world. The purpose of this study is to analyze past and current trends of the tobacco epidemic in the Russian Federation, review current tobacco control policy responses, and identify areas of opportunity for policy priorities. We used a policy triangle as analytical framework to examine content, context, and processes of Russian tobacco control policy. The analysis was based on secondary data on supply and demand sides of the Russian tobacco epidemic, tobacco-related economic and health effects during Russia's economic transition, and compliance of Russian tobacco policy with international standards and regulations. Tobacco-promoting strategies have specifically targeted women and youth. Russia's approval of a "National Tobacco Control Concept" and draft for a comprehensive tobacco control bill increasingly align national legislature with the WHO Framework Convention on Tobacco Control (FCTC). However, several structural and cultural factors represent substantial barriers to the policy process. The influence of transnational tobacco companies on policy processes in Russia has so far impeded a full implementation of the FCTC mandates. Several strategies have been identified as having the potential to reduce the prevalence of tobacco use in Russia and decrease tobacco-related national health and economic burden: adjusting national tobacco policy by raising tobacco tax from the current lowest level in Europe to at least 70%; consequent enforcement of a complete smoking ban in public places; marketing restrictions; and smoking cessation interventions integrated into primary care. Russia's tobacco control efforts need to target women and youths specifically to efficiently counter industry efforts.

Tobacco control in the Russian Federation- a policy analysis

PubMed Central

2013-01-01

Background The Russian Federation (Russia) has one of the highest smoking rates in the world. The purpose of this study is to analyze past and current trends of the tobacco epidemic in the Russian Federation, review current tobacco control policy responses, and identify areas of opportunity for policy priorities. Methods We used a policy triangle as analytical framework to examine content, context, and processes of Russian tobacco control policy. The analysis was based on secondary data on supply and demand sides of the Russian tobacco epidemic, tobacco-related economic and health effects during Russia’s economic transition, and compliance of Russian tobacco policy with international standards and regulations. Results Tobacco-promoting strategies have specifically targeted women and youth. Russia’s approval of a “National Tobacco Control Concept” and draft for a comprehensive tobacco control bill increasingly align national legislature with the WHO Framework Convention on Tobacco Control (FCTC). However, several structural and cultural factors represent substantial barriers to the policy process. The influence of transnational tobacco companies on policy processes in Russia has so far impeded a full implementation of the FCTC mandates. Conclusions Several strategies have been identified as having the potential to reduce the prevalence of tobacco use in Russia and decrease tobacco-related national health and economic burden: adjusting national tobacco policy by raising tobacco tax from the current lowest level in Europe to at least 70%; consequent enforcement of a complete smoking ban in public places; marketing restrictions; and smoking cessation interventions integrated into primary care. Russia’s tobacco control efforts need to target women and youths specifically to efficiently counter industry efforts. PMID:23339756

A framework on the emergence and effectiveness of global health networks

PubMed Central

Shiffman, Jeremy; Quissell, Kathryn; Schmitz, Hans Peter; Pelletier, David L; Smith, Stephanie L; Berlan, David; Gneiting, Uwe; Van Slyke, David; Mergel, Ines; Rodriguez, Mariela; Walt, Gill

2016-01-01

Since 1990 mortality and morbidity decline has been more extensive for some conditions prevalent in low- and middle-income countries than for others. One reason may be differences in the effectiveness of global health networks, which have proliferated in recent years. Some may be more capable than others in attracting attention to a condition, in generating funding, in developing interventions and in convincing national governments to adopt policies. This article introduces a supplement on the emergence and effectiveness of global health networks. The supplement examines networks concerned with six global health problems: tuberculosis (TB), pneumonia, tobacco use, alcohol harm, maternal mortality and newborn deaths. This article presents a conceptual framework delineating factors that may shape why networks crystallize more easily surrounding some issues than others, and once formed, why some are better able than others to shape policy and public health outcomes. All supplement papers draw on this framework. The framework consists of 10 factors in three categories: (1) features of the networks and actors that comprise them, including leadership, governance arrangements, network composition and framing strategies; (2) conditions in the global policy environment, including potential allies and opponents, funding availability and global expectations concerning which issues should be prioritized; (3) and characteristics of the issue, including severity, tractability and affected groups. The article also explains the design of the project, which is grounded in comparison of networks surrounding three matched issues: TB and pneumonia, tobacco use and alcohol harm, and maternal and newborn survival. Despite similar burden and issue characteristics, there has been considerably greater policy traction for the first in each pair. The supplement articles aim to explain the role of networks in shaping these differences, and collectively represent the first comparative effort to understand the emergence and effectiveness of global health networks. PMID:26318679

A Step-by-Step Guide to Publishing Journal Articles and Strategies for Securing Impactful Publications

ERIC Educational Resources Information Center

Onwuegbuzie, Anthony J.

2016-01-01

In the last few years, I have been presenting workshops on publishing (among other topics) in many countries across 6 continents. And presenting these workshops in various countries has allowed me to learn the policies and practices of editors of journals representing numerous countries, thereby helping me to broaden the framework for writing…

Public Spending Efficiency: Institutional Indicators in Primary and Secondary Education. OECD Economics Department Working Papers, No. 543

ERIC Educational Resources Information Center

Gonand, Frederic; Joumard, Isabelle; Price, Robert

2007-01-01

This paper presents composite indicators of the institutional and policy characteristics of educational systems, collated from the questionnaire responses of 26 Member countries. These indicators provide an overview of the institutional framework in the primary and secondary education sector and are constructed so as to be used for the analysis of…