Strength and Comprehensiveness of District School Wellness Policies Predict Policy Implementation at the School Level

ERIC Educational Resources Information Center

Schwartz, Marlene B.; Henderson, Kathryn E.; Falbe, Jennifer; Novak, Sarah A.; Wharton, Christopher M.; Long, Michael W.; O'Connell, Meghan L.; Fiore, Susan S.

2012-01-01

Background: In 2006, all local education agencies in the United States participating in federal school meal programs were required to establish school wellness policies. This study documented the strength and comprehensiveness of 1 state's written district policies using a coding tool, and tested whether these traits predicted school-level…

Getting It Right for Every Child: A National Policy Framework to Promote Children's Well-being in Scotland, United Kingdom.

PubMed

Coles, Emma; Cheyne, Helen; Rankin, Jean; Daniel, Brigid

2016-06-01

Getting It Right for Every Child (GIRFEC), a landmark policy framework for improving children's well-being in Scotland, United Kingdom, is a practice initiative signifying a distinct way of thinking, an agenda for change, and the future direction of child welfare policy. GIRFEC represents a unique case study of national transformative change within the contexts of children's well-being and universal services and is of relevance to other jurisdictions. Implementation is under way, with an understanding of well-being and the requirement for information sharing enshrined in law. Yet there is scope for interpretation within the legislation and associated guidance. Inherent tensions around intrusion, data gathering, professional roles, and balancing well-being against child protection threaten the effectiveness of the policy if not resolved. Despite persistent health inequalities and intergenerational deprivation, the Scottish government aspires for Scotland to be the best country for children to grow up in. Getting It Right for Every Child (GIRFEC) is a landmark children's policy framework to improve children's well-being via early intervention, universal service provision, and multiagency coordination across organizational boundaries. Placing the child and family "at the center," this approach marks a shift from welfare to well-being, yet there is still a general lack of consensus over how well-being is defined and measured. As an umbrella policy framework with broad reach, GIRFEC represents the current and future direction of children's/family policy in Scotland, yet large-scale practice change is required for successful implementation. This article explores the origins and emergence of GIRFEC and presents a critical analysis of its incremental design, development, and implementation. There is considerable scope for interpretation within the GIRFEC legislation and guidance, most notably around assessment of well-being and the role and remit of those charged with implementation. Tensions have arisen around issues such as professional roles; intrusion, data sharing, and confidentiality; and the balance between supporting well-being and protecting children. Despite the policy's intentions for integration, the service landscape for children and families still remains relatively fragmented. Although the policy has groundbreaking potential, inherent tensions must be resolved and the processes of change carefully managed in order for GIRFEC to be effective. It remains to be seen whether GIRFEC can fulfil the Scottish government's aspirations to reduce inequalities and improve lifelong outcomes for Scotland's children and young people. In terms of both a national children's well-being framework within a universal public service context and a distinct style of policymaking and implementation, the Scottish experience represents a unique case study of whole-country, transformational change and is of relevance to other jurisdictions. © 2016 Milbank Memorial Fund.

Implementing a Paid Leave Policy for Graduate Students at UW - Madison: The Student Perspective

NASA Astrophysics Data System (ADS)

Gosnell, Natalie M.

2013-01-01

In 2010 the University of Wisconsin - Madison Astronomy Department developed and implemented a departmental paid leave policy for our graduate students, even though the university lacks a campus-wide policy and cannot provide institutional funding for such programs. This policy includes 12 weeks of paid leave in event of a medical emergency or chronic medical condition, as well as paid parental leave for both male and female graduate research assistants. (The policy in its entirety can be found at http://www.astro.wisc.edu/grad-students/policies-procedures/medical-and-family-leave-policy.) This is the first of two presentations describing our policy implementation using a "bottom-up" approach, beginning with the graduate students. I will present the perspective of the graduate students who led the effort and will discuss the steps we took to put our policy in place, from the conception of the plan to the full implementation. These steps included identifying faculty allies, becoming knowledgeable about university policies and resources, involving department staff, and anticipating procedural and bureaucratic hurdles in order to come up with creative solutions in advance. Although each individual institution and department's path to implementing a similar plan will be unique, we hope the methods used to implement our policy at UW - Madison may serve as an example.

Health and wellness policy ethics.

PubMed

Cavico, Frank J; Mujtaba, Bahaudin G

2013-08-01

This perspective is an ethical brief overview and examination of "wellness" policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a "healthy" lifestyle. The authors address how these policies could adversely affect "non-healthy" employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace.

School Wellness Policies: Opportunities for Change

ERIC Educational Resources Information Center

Hoxie-Setterstrom, Gail; Hoglund, Barbara

2011-01-01

School districts are required to comply with a 2004 federal mandate to guide nutrition and physical activity environments of schools by developing and implementing wellness policies. The purposes of this article are to (a) discuss the implications of the federal mandate and (b) analyze policies from nine school districts in one large suburban…

The spirit of democracy in the implementation of public information policy at the provincial government of West Java

NASA Astrophysics Data System (ADS)

Sjoraida, D. F.; Asmawi, A.; Anwar, R. K.

2018-03-01

This article analyses the implementation of Law Number 14/2008 on Public Information Disclosure on the Provincial Government of West Java. This descriptive-qualitative study presents a discussion of the spirit of democracy in the implementation of the abovem-entioned policy in West Java Province. With the theory of policy implementation and democratization, data obtains that the element of democratic spirit in the implementation of public information policy in the government of West Java is quite thick. Therefore, there must be a massification of the implementation of the law in West Java, especially its socialization to districts/cities and society in general. It was found that the democratization of the West Java Provincial Government in implementing the Act has been well received in the community. However, the lack of publicity about this Law can reduce the strength of moral messages that exist in the law to the public.

Implementing Educational Policies in Sub-Saharan Africa--Review Essay.

ERIC Educational Resources Information Center

Thakur, Dan S.

1991-01-01

Reviews a series of 10 World Bank documents examining policy implementation activity in Ethiopia, Kenya, Tanzania, Lesotho, Swaziland, Uganda, Zambia, and Zimbabwe. The reports are concise and well documented and show a great conceptualization of education issues (such as deteriorating enrollments contracting educational finances) and policy…

Views of policy makers and health promotion professionals on factors facilitating implementation and maintenance of interventions and policies promoting physical activity and healthy eating: results of the DEDIPAC project.

PubMed

Muellmann, Saskia; Steenbock, Berit; De Cocker, Katrien; De Craemer, Marieke; Hayes, Catherine; O'Shea, Miriam P; Horodyska, Karolina; Bell, Justyna; Luszczynska, Aleksandra; Roos, Gun; Langøien, Lars Jørun; Rugseth, Gro; Terragni, Laura; De Bourdeaudhuij, Ilse; Brug, Johannes; Pischke, Claudia R

2017-12-06

The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. We aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors facilitating adoption, implementation, and maintenance of multi-level interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland. Six interventions and six policies were identified based on pre-defined criteria. Forty semi-structured interviews were conducted with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies. All interview transcripts were coded in NVivo, using a common categorization matrix. Coding in the respective countries was done by one researcher and validated by a second researcher. Active involvement of relevant stakeholders and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementation of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured. Despite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identify similar factors facilitating adoption, implementation, and maintenance of these interventions and policies.

School District Wellness Policies: Evaluating Progress and Potential for Improving Children's Health Five Years after the Federal Mandate. Brief Report. Volume 3

ERIC Educational Resources Information Center

Chriqui, Jamie; Resnick, Elissa; Schneider, Linda; Schermbeck, Rebecca; Adcock, Tessa; Carrion, Violeta; Chaloupka, Frank

2013-01-01

This brief report updates data published in August 2010 from the most comprehensive, ongoing nationwide analysis of written wellness policies. It includes data from the 2006-07 through the 2010-11 school years, which were the first five years following the required implementation date for wellness policies. The major findings and trends presented…

Assessing School Wellness Policies and Identifying Priorities for Action: Results of a Bi-State Evaluation.

PubMed

Harvey, Susan P; Markenson, Deborah; Gibson, Cheryl A

2018-05-01

Obesity is a complex health problem affecting more than one-third of school-aged youth. The increasing obesity rates in Kansas and Missouri has been particularly concerning, with efforts being made to improve student health through the implementation of school wellness policies (SWPs). The primary purpose of this study was to conduct a rigorous assessment of SWPs in the bi-state region. SWPs were collected from 46 school districts. The Wellness School Assessment Tool (WellSAT) was used to assess comprehensiveness and strength. Additionally, focus group discussions and an online survey were conducted with school personnel to identify barriers and supports needed. Assessment of the SWPs indicated that most school districts failed to provide strong and specific language. Due to these deficiencies, districts reported lack of enforcement of policies. Several barriers to implementing the policies were reported by school personnel; supports needed for effective implementation were identified. To promote a healthful school environment, significant improvements are warranted in the strength and comprehensiveness of the SWPs. The focus group discussions provided insight as to where we need to bridge the gap between the current state of policies and the desired beneficial practices to support a healthy school environment. © 2018, American School Health Association.

Little Association Between Wellness Policies and School-Reported Nutrition Practices

PubMed Central

Lucarelli, Jennifer F.; Alaimo, Katherine; Belansky, Elaine S.; Mang, Ellen; Miles, Richard; Kelleher, Deanne K.; Bailey, Deborah; Drzal, Nicholas B.; Liu, Hui

2017-01-01

Background The Child Nutrition and WIC Reauthorization Act of 2004 mandated written school wellness policies. Little evidence exists to evaluate the impact of such policies. This study assessed the quality (comprehensiveness of topics addressed and strength of wording) of wellness policies and the agreement between written district-level policies and school-reported nutrition policies and practices in 48 low-income Michigan school districts participating in the School Nutrition Advances Kids study. Method Written wellness policy quality was assessed using the School Wellness Policy Evaluation Tool. School nutrition policies and practices were assessed using the School Environment and Policy Survey. Analysis of variance determined differences in policy quality, and Fisher’s exact test examined agreement between written policies and school-reported practices. Results Written wellness policies contained ambiguous language and addressed few practices, indicating low comprehensiveness and strength. Most districts adopted model wellness policy templates without modification, and the template used was the primary determinant of policy quality. Written wellness policies often did not reflect school-reported nutrition policies and practices. Conclusions School health advocates should avoid assumptions that written wellness policies accurately reflect school practices. Encouraging policy template customization and stronger, more specific language may enhance wellness policy quality, ensure consistency between policy and practice, and enhance implementation of school nutrition initiatives. PMID:25249567

An Examination of Critical Problems Associated with the Implementation of the Universal Basic Education (UBE) Programme in Nigeria

ERIC Educational Resources Information Center

Ejere, Emmanuel Iriemi

2011-01-01

It is hardly debatable that implementation is the bane of public policies and programmes in Nigeria. A well formulated policy or programme is useless if not properly implemented as its stated objectives will not be realized. The Universal Basic Education (UBE) programme was introduced in Nigeria in September 1999 by the Obasanjo's administration.…

Evaluating School Wellness Policy in Curbing Childhood Obesity in Anchorage, Alaska

ERIC Educational Resources Information Center

Parsons, Wendy G.; Garcia, Gabriel M.; Hoffman, Pamela K.

2014-01-01

In 2006, the Anchorage School District implemented a school wellness policy to address the problem of obesity among its elementary-aged students. We assessed whether the addition of this policy is effective in protecting or preventing students from becoming overweight/obese over time. The methods involved following two cohorts of students for 5…

The position of the targets of the public health policy of maternal and child in Bandung

NASA Astrophysics Data System (ADS)

Sugyati, C.; Mariana, D.; Sjoraida, D. F.

2018-03-01

This study seeks to make a deep, systematic analysis of the urgency of implementing elements in the implementation of public health policies, especially in the field of mother and child in Bandung City, West Java. This study is important to evaluate whether the government services on maternal and child health is sufficient or not. With the descriptive-qualitative method, this study presents a discussion of how the implementers interact with the community as their targets in implementing public health programs in Bandung City so that their presence is indispensable. With theories of implementation of policies and health campaign, the data was obtained and showed that (a) the unity of the coordination and uniformity of information services, and a network of cooperation in public health institutions, in the Government of Bandung City, have been performed well; (b) in getting their rights the targets are highly motivated for the services of public health and some of them function to be the volunteers to assist local health policy implementers. However, the lack of health care workers who were directly addressing maternal and child health was perceived by the public so well that this study recommends the convening of additional formal health workers in the community.

Implementation challenges of free maternity services policy in Kenya: the health workers' perspective.

PubMed

Wamalwa, Emmanuel Wekesa

2015-01-01

Kenya implemented the policy of free maternity services to reduce maternal mortality and morbidity. For successful implementation of this policy, there is need to monitor the implementation progress, identify the challenges and mitigate them and determine better strategies for implementation based on emerging implementation issues. This study was carried out to determine the challenges facing policy implementation and strategies for better implementation. This was a cross-sectional descriptive study carried at the Rift Valley Provincial General Hospital (RVPGH) and Bondeni maternity. All the staff who work at Bondeni Maternity (including nursing officer in-charge) were included in the study. All the staff who work at the Maternity Unit of the RVPGH were included in the study, as well as the Medical Superintendent of the facility. A total of 110 respondents were sampled. A questionnaire and interview guide were used to collect data. Data was analyzed using SPSS software. A response rate of 91% (n=100) was achieved. Major implementation challenges include inadequate supplies (86%), inadequate funding (38%), staff shortage (92%), lack of motivation among health workers (62%), overwhelming workload (89%) and abuse of services by clients (32%). Strategies for better implementation include employment of more staff, motivation of health workers, improvement in policy financing, training of health workers and provision of adequate supplies. Implementation of free maternity services policy in Kenya is facing challenges but there exists strategies, which, if implemented, will help address these challenges.

Using policy and workforce development to address Aboriginal mental health and wellbeing.

PubMed

Jones, Carmel; Brideson, Tom

2009-08-01

The aim of this paper is to discuss the New South Wales (NSW) Aboriginal Mental Health and Well Being Policy and its key workforce initiative, the NSW Aboriginal Mental Health Workforce Training Program. The Policy provides a strong framework guiding the development of Aboriginal mental health and wellbeing programs throughout NSW Mental Health Services. However, the effectiveness of the Policy will be determined by the success of its implementation. The NSW Aboriginal Mental Health Workforce Training Program will support implementation of the Policy by growing an Aboriginal mental health workforce in NSW.

EPA's Quality Policy and Procedure CIO Policy Transmittal 09-001

EPA Pesticide Factsheets

The purpose of this memo is to (1) issue the final versions of the Quality Policy and Procedure documents (with a Q&A document for your reference as well) and (2) call for members of a new advisory group to guide Policy implementation activities.

[The Pan American Health Organization's gender equality policy].

PubMed

2006-02-01

The 46th Directing Council of the Pan American Health Organization (PAHO) approved this past September a document entitled " Proposed PAHO gender equality policy" and urged Member States to implement specific policies accordingly, in collaboration with other government sectors, international organizations, and interested parties from civil society. The approved policy is rooted in principles of gender equality and gender equity, the empowerment of men and women, respect for diversity, and gender mainstreaming. PAHO will integrate and support among its Member States the perspective of gender equality in planning, implementing, monitoring, and evaluating policies, programs, projects, and research. The aim is among other things, to attain the highest possible health and well-being for men and women during their whole life cycle, as well as in all population groups. Hopefully these measures will help propel the Region toward the attainment of true gender equality.

Health and Wellness Policy Ethics

PubMed Central

Cavico, Frank J.; Mujtaba, Bahaudin G.

2013-01-01

This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace. PMID:24596847

Effects of a Tobacco-Free Work Site Policy on Employee Tobacco Attitudes and Behaviors, Travis County, Texas, 2010-2012.

PubMed

Seidel, Sarah E; Metzger, Kristi; Guerra, Andrea; Patton-Levine, Jessie; Singh, Sandeepkumar; Wilson, William T; Huang, Philip

2017-12-14

The adoption of tobacco-free policies in behavioral health settings is an important step in reducing staff tobacco use as well as the high rates of tobacco use among people with mental illness and behavioral disorders. Studies have demonstrated the importance of staff support when implementing tobacco-free workplace policies, but there is limited research examining tobacco use prevalence among staff and staff attitude before and after policy adoption. Integral Care, a local authority for behavioral health and developmental disabilities in Austin, Texas, and Austin Public Health embarked on a comprehensive planning process before implementing a 100% tobacco-free campus policy. The objectives were 1) assess staff tobacco use and attitudes toward a tobacco-free policy, 2) communicate policy to staff, 3) provide staff education and training, and 4) provide cessation resources. Integral Care and Austin Public Health conducted a web-based employee survey 6 months before and 6 and 12 months after implementation of the policy to measure tobacco use prevalence and attitudes among employees. Employees had significant improvements in tobacco use prevalence and attitudes toward the tobacco-free policy from pre-implementation to post-implementation. Tobacco use prevalence among staff decreased from 27.6% to 13.8%, and support for the policy increased from 60.6% to 80.3% at 12 months post-implementation. Adoption of 100% tobacco-free campus policies in behavioral health settings can result in significant reductions in staff tobacco use. Leadership should provide staff with education, training, and cessation support before adoption of tobacco-free work site policies to ensure success.

Implementing nationally determined contributions: building energy policies in India’s mitigation strategy

NASA Astrophysics Data System (ADS)

Yu, Sha; Evans, Meredydd; Kyle, Page; Vu, Linh; Tan, Qing; Gupta, Ashu; Patel, Pralit

2018-03-01

The Nationally Determined Contributions are allowing countries to examine options for reducing emissions through a range of domestic policies. India, like many developing countries, has committed to reducing emissions through specific policies, including building energy codes. Here we assess the potential of these sectoral policies to help in achieving mitigation targets. Collectively, it is critically important to see the potential impact of such policies across developing countries in meeting national and global emission goals. Buildings accounted for around one third of global final energy use in 2010, and building energy consumption is expected to increase as income grows in developing countries. Using the Global Change Assessment Model, this study finds that implementing a range of energy efficiency policies robustly can reduce total Indian building energy use by 22% and lower total Indian carbon dioxide emissions by 9% in 2050 compared to the business-as-usual scenario. Among various policies, energy codes for new buildings can result in the most significant savings. For all building energy policies, well-coordinated, consistent implementation is critical, which requires coordination across different departments and agencies, improving capacity of stakeholders, and developing appropriate institutions to facilitate policy implementation.

The role of tobacco control policies in reducing smoking and deaths in a middle income nation: results from the Thailand SimSmoke simulation model.

PubMed

Levy, D T; Benjakul, S; Ross, H; Ritthiphakdee, B

2008-02-01

With the male smoking prevalence near 60% in 1991, Thailand was one of the first Asian nations to implement strict tobacco control policies. However, the success of their efforts has not been well documented. The role of tobacco control policies are examined using the "SimSmoke" tobacco control model. We first validated the model against survey data on smoking prevalence. We then distinguished the effect of policies implemented between 1991 and 2006 from long-term trends in smoking rates. We also estimated smoking attributable deaths and lives saved as a result of the policies. The model validates well against survey data. The model shows that by the year 2006, policies implemented between 1991 and 2006 had already decreased smoking prevalence by 25% compared to what it would have been in the absence of the policies. Tax increases on cigarettes and advertising bans had the largest impact, followed by media anti-smoking campaigns, clean air laws and health warnings. The model estimates that the policies saved 31 867 lives by 2006 and will have saved 319,456 lives by 2026. The results document the success of Thailand in reducing smoking prevalence and reducing the number of lives lost to smoking, thereby showing the potential of tobacco control policies specifically in a middle-income country. Additional improvements can be realised through higher taxes, stronger clean air policies, comprehensive cessation treatment policies, and targeted media campaigns.

The SAZA study: implementing health financing reform in South Africa and Zambia.

PubMed

Gilson, Lucy; Doherty, Jane; Lake, Sally; McIntyre, Di; Mwikisa, Chris; Thomas, Stephen

2003-03-01

This paper explores the policy-making process in the 1990s in two countries, South Africa and Zambia, in relation to health care financing reforms. While much of the analysis of health reform programmes has looked at design issues, assuming that a technically sound design is the primary requirement of effective policy change, this paper explores the political and bureaucratic realities shaping the pattern of policy change and its impacts. Through a case study approach, it provides a picture of the policy environment and processes in the two countries, specifically considering the extent to which technical analysts and technical knowledge were able to shape policy change. The two countries' experiences indicate the strong influence of political factors and actors over which health care financing policies were implemented, and which not, as well as over the details of policy design. Moments of political transition in both countries provided political leaders, specifically Ministers of Health, with windows of opportunity in which to introduce new policies. However, these transitions, and the changes in administrative structures introduced with them, also created environments that constrained the processes of reform design and implementation and limited the equity and sustainability gains achieved by the policies. Technical analysts, working either inside or outside government, had varying and often limited influence. In part, this reflected the limits of their own capacity as well as weaknesses in the way they were used in policy development. In addition, the analysts were constrained by the fact that their preferred policies often received only weak political support. Focusing almost exclusively on designing policy reforms, these analysts gave little attention to generating adequate support for the policy options they proposed. Finally, the country experiences showed that front-line health workers, middle level managers and the public had important influences over policy implementation and its impacts. The limited attention given to communicating policy changes to, or consulting with, these actors only heightened the potential for reforms to result in unanticipated and unwanted impacts. The strength of the paper lies in its 'thick description' of the policy process in each country, an empirical case study approach to policy that is under-represented in the literature. While such an approach allows only a cautious drawing of general conclusions, it suggests a number of ways in which to strengthen the implementation of financing policies in each country.

The policy context of patient centered medical homes: perspectives of primary care providers.

PubMed

Alexander, Jeffrey A; Cohen, Genna R; Wise, Christopher G; Green, Lee A

2013-01-01

Interest in the patient centered medical home (PCMH) model has increased significantly in recent years. Despite this attention, information is limited regarding the influence of policy context on implementation of the PCMH model. Using comparative, qualitative data, we identify several key policy impediments to PCMH implementation, and propose practical guidelines for addressing these issues. Qualitative, semi-structured in-person interviews with representatives of physician organizations and primary care practices pursuing PCMH. Practitioners and staff at 16 physician practices in Michigan, as well as key leaders of physician organizations. We identified five primary policy issues cited by physicians and physician organization leaders as most impactful on their efforts to adopt PCMH: misalignment of current reimbursement schemes, administrative burden, conflicting criteria for PCMH designation, workforce policy issues, and uncertainty of health care reform. These policies were largely seen as barriers to their ability to implement PCMH. Providers' motivation to embrace PCMH, and their level of confidence regarding the results of such change, are greatly influenced by their perception of the external environment and the control they believe they have over this environment. Having policies in place that shape the path to PCMH in a manner that makes it as easy as possible for providers to accomplish the desired changes could well make the difference in whether successful transformation is achieved.

32 CFR 589.2 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... AND COMMAND SPONSORED FAMILY MEMBERS § 589.2 Policy. (a) This part (chapter) implements procedural... well as to their command sponsored family members. (b) DODD 5525.9 requires DoD cooperation with courts... DoD employees serving outside the United States, as well as their command sponsored family members...

32 CFR 589.2 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... AND COMMAND SPONSORED FAMILY MEMBERS § 589.2 Policy. (a) This part (chapter) implements procedural... well as to their command sponsored family members. (b) DODD 5525.9 requires DoD cooperation with courts... DoD employees serving outside the United States, as well as their command sponsored family members...

32 CFR 589.2 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... AND COMMAND SPONSORED FAMILY MEMBERS § 589.2 Policy. (a) This part (chapter) implements procedural... well as to their command sponsored family members. (b) DODD 5525.9 requires DoD cooperation with courts... DoD employees serving outside the United States, as well as their command sponsored family members...

Policy implementation of methadone maintenance treatment and HIV infection: evidence from Hubei province, China

PubMed Central

2013-01-01

To view methadone maintenance treatment (MMT) globally, it is necessary to accumulate data on MMT policy implementation under different health service systems. The aim of the current study is to provide empirical evidence about policy implementation of MMT and HIV infection control, as well as recommendations for improvement of MMT in the future. Based on China’s national policy framework of MMT, policy implementation of MMT in Hubei province has two objectives: 1) to create linkages between health and public security, and 2) to provide integrated services for management of drug abusers. From 2007 to 2011, following the establishment of MMT clinics that provide methadone as well as HIV prevention services, the proportion of HIV infection among drug abusers decreased relatively quickly (12.12% → 5.77% → 5.19% → 2.39% → 2.04%). However, high drop-out rate and poor information management have been identified as particular problems which now need to be addressed. Furthermore, client drop-out from MMT programs may reflect social issues the clients encounter, and consequently, sustainable MMT development requires incorporation of social measures that help MMT clients return to society without discrimination, especially through family cooperation and employment opportunities. PMID:24188659

Evaluating the Wellness School Assessment Tool for Use in Public Health Practice to Improve School Nutrition and Physical Education Policies in New York

ERIC Educational Resources Information Center

Brissette, Ian; Wales, Kathleen; O'Connell, Meghan

2013-01-01

Background: Addressing the limitations of existing Local Wellness Policies (LWPs) and promoting their implementation remain priorities for health and education agencies. One gap has been the absence of a standard assessment to support LWP revision. During planning for an initiative to improve school nutrition and physical education policy, the…

A Seat at the Table: How the Work of Teaching Impacts Teachers as Policy Agents

ERIC Educational Resources Information Center

Good, Annalee G.; Fox Barocas, Sadie; Chávez-Moreno, Laura C.; Feldman, Rachel; Canela, Carlos

2017-01-01

Policy reflects and shapes society's beliefs about schools, teachers, children, learning, and society, as well as the power structures embedded in our communities and decision-making processes. Although teachers may be central to the "implementation" of education policy, they are marginal to the "design" of policy agendas and…

Supporting High School Teachers' College and Career Readiness Efforts: Bridging California's Vision with Local Implementation Needs. Policy Brief

ERIC Educational Resources Information Center

Lewis, Jodi; Nodine, Thad; Venezia, Andrea

2016-01-01

This brief shares the perspectives and concerns of high school teachers in two districts regarding implementing the Common Core State Standards, specifically as the Common Core pertains to preparing more students for college and well-paying careers. The brief also makes state policy recommendations for ways to support teachers in their efforts to…

Determinants in implementing a public policy for an essential volume of free water in Bogotá and Medellín, Colombia.

PubMed

Vargas, Laura; Heller, Léo

2016-03-01

Within the framework for the realization of the human right to water and sanitation, States have the obligation to implement programs and public policies that satisfy the basic needs of their population, especially its most vulnerable demographics. In Colombia, this challenge has been addressed through policies that provide a determined essential amount of free water to people whose access to water and sanitation services are limited due to low income. Through a review of legal and technical documents as well as relevant literature, this article presents an analysis of the particular determinants involved in implementing this program in Bogotá and Medellín, as well as some related concerns. Among such factors, we discuss the evolution and changes of the tariff model used in service provision, estimates of basic consumption, the role of social movements and collective action, and user disconnection due to non-payment. The main particularities and differences of each case highlighted the inconveniences related to the method of identifying eligible users and applying assistance to beneficiary user groups, and the need for national guidelines in implementing this policy.

New Zealand Freshwater Management: Changing Policy for a Changing World

NASA Astrophysics Data System (ADS)

Rouse, H. L.; Norton, N.

2014-12-01

Fresh water is essential to New Zealand's economic, environmental, cultural and social well-being. In line with global trends, New Zealand's freshwater resources are under pressure from increased abstraction and changes in land-use which contribute contaminants to our freshwater systems. Recent central government policy reform introduces greater national direction and guidance, to bring about a step-change in freshwater management. An existing national policy for freshwater management introduced in 2011 requires regional authorities to produce freshwater management plans containing clear freshwater objectives (measurable statements about the desired environmental state for water bodies) and associated limits to resource use (such as environmental flows and quantity allocation limits, and loads of contaminants to be discharged). These plans must integrate water quantity and quality management, consider climate change, and incorporate tangata whenua (New Zealand māori) roles and interests. In recent (2014) national policy amendments, the regional authorities are also required to implement national 'bottom-line' standards for certain attributes of the system to be managed; undertake accounting for all water takes and all sources of contaminants; and to develop and implement their plans in a collaborative way with communities. This rapid change in national policy has necessitated a new way of working for authorities tasked with implementation; many obstacles lie in their path. The scientific methods required to help set water quantity limits are well established, but water quality methods are less so. Collaborative processes have well documented benefits but also raise many challenges, particularly for the communication of complex and often uncertain scientific information. This paper provides background on the national policy changes and offers some early lessons learned by the regional authorities implementing collaborative freshwater management in New Zealand.

Local School Wellness Policy Implementation Under the Healthy, Hunger-Free Kids Act of 2010. Final rule.

PubMed

2016-07-29

This final rule requires all local educational agencies that participate in the National School Lunch and School Breakfast Programs to meet expanded local school wellness policy requirements consistent with the requirements set forth in section 204 of the Healthy, Hunger-Free Kids Act of 2010. The final rule requires each local educational agency to establish minimum content requirements for the local school wellness policies, ensure stakeholder participation in the development and updates of such policies, and periodically assess and disclose to the public schools' compliance with the local school wellness policies. These regulations are expected to result in local school wellness policies that strengthen the ability of a local educational agency to create a school nutrition environment that promotes students' health, well-being, and ability to learn. In addition, these regulations will increase transparency for the public with regard to school wellness policies and contribute to integrity in the school nutrition program.

Policy support, norms, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico city.

PubMed

Thrasher, James F; Pérez-Hernández, Rosaura; Swayampakala, Kamala; Arillo-Santillán, Edna; Bottai, Matteo

2010-09-01

We assessed attitudes and beliefs about smoke-free laws, compliance, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico City. Trends and odds of change in attitudes and beliefs were analyzed across 3 representative surveys of Mexico City inhabitants: before implementation of the policy (n=800), 4 months after implementation (n=961), and 8 months after implementation (n=761). Results indicated high and increasing support for 100% smoke-free policies, although support did not increase for smoke-free bars. Agreement that such policies improved health and reinforced rights was high before policy implementation and increased thereafter. Social unacceptability of smoking increased substantially, although 25% of nonsmokers and 50% of smokers agreed with smokers' rights to smoke in public places at the final survey wave. Secondhand smoke exposure declined generally as well as in venues covered by the law, although compliance was incomplete, especially in bars. Comprehensive smoke-free legislation in Mexico City has been relatively successful, with changes in perceptions and behavior consistent with those revealed by studies conducted in high-income countries. Normative changes may prime populations for additional tobacco control interventions.

Prevention of childhood obesity and food policies in Latin America: from research to practice.

PubMed

Pérez-Escamilla, R; Lutter, C K; Rabadan-Diehl, C; Rubinstein, A; Calvillo, A; Corvalán, C; Batis, C; Jacoby, E; Vorkoper, S; Kline, L; Ewart-Pierce, E; Rivera, J A

2017-07-01

Addressing childhood obesity in Latin America requires a package of multisectoral, evidence-based policies that enable environments conducive to healthy lifestyles. Identify and examine key elements to translating research into effective obesity policies in Latin America. We examined obesity prevention policies through case studies developed with an expert in the specific policy. Policies were selected based on their level of implementation, visibility and potential impact to reduce childhood obesity. They include: (i) excise taxes on sugar sweetened beverages and energy-dense foods; (ii) front-of-package food label legislation; (iii) trans fatty acids removal from processed foods; and (iv) Ciclovías recreativas or 'open streets'. Case studies were coded to identify components that explained successful implementation and sustainability using the Complex Adaptive Health Systems framework. The analysis identified key elements for effective and sustainable policy, including evidence justifying policy; evidence-based advocacy by civil society; political will; and legislation and skillful negotiations across government, academia, the private sector and civil society. Scientific evidence and evaluation played an important role in achieving tipping points for policies' launch and sustain effective implementation. Well-coordinated, intersectoral partnerships are needed to successfully implement evidence-based anti-obesity policies. Prospective policy research may be useful for advancing knowledge translation. © 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity.

Proposals for Standardizing and Improving the Policy of Adding Points on the Entrance Exam

ERIC Educational Resources Information Center

Yuhong, Deng

2013-01-01

This article reviews policies for adding points on the College Entrance Examination. It analyzes the rationales and specific implementation strategies of various policies for adding points on the entrance exam, as well as their advantages and pitfalls. Based on these observations and analysis, the author also offers policy recommendations on the…

Successful implementation of a wellness and tobacco cessation curriculum in psychosocial rehabilitation clubhouses

PubMed Central

2011-01-01

Background Tobacco remains a seemingly intractable problem for individuals living with severe and persistent mental illness. This study evaluated the implementation, technical assistance, and perceived impact of a model curriculum ("Learning About Healthy Living") to promote wellness and motivation to quit tobacco use in psychosocial rehabilitation clubhouses. Methods We used semi-structured interviews (n = 9) with clubhouse staff (n = 12) and a survey of participating clubhouse members (n = 271) in nine clubhouses. Results Fifty-eight percent of clubhouse participants completed surveys. Results showed tobacco users open to tobacco-free policies (62%) and perceiving more discussions about quitting tobacco with healthcare providers (69%). Analyses of staff interviews and member surveys revealed four key themes: (1) the curriculum was successfully implemented and appreciated; (2) technical assistance kept implementation on track; (3) adding wellness content and interactive components should enhance the curriculum; and, (4) the curriculum advanced other healthful policies and practices. Conclusions Mental health settings are important locations for implementing programs to address tobacco use. In this real-world implementation of a model curriculum in psychosocial rehabilitation clubhouses, the curriculum tested well, was feasible and well-received, and suggests potential impact on tobacco use outcomes. Revision, dissemination, and a randomized controlled trial evaluation of the model curriculum should now occur. PMID:21917179

Results of Evaluability Assessments of Local Wellness Policies in 6 US School Districts

ERIC Educational Resources Information Center

Pitt Barnes, Seraphine; Robin, Leah; O'Toole, Terrence P.; Dawkins, Nicola; Kettel Khan, Laura; Leviton, Laura C.

2011-01-01

Background: A US federal mandate that school districts devise and implement local wellness policies (LWPs) has potential widespread impact on the nutritional content of foods and beverages available in schools and on the amount of physical activity that students engage in; however, evidence concerning the mandate's effectiveness is limited. This…

Model Wellness Policy

ERIC Educational Resources Information Center

South Dakota Department of Education, 2005

2005-01-01

In the Child Nutrition and WIC Reauthorization Act of 2004, PL 105-268, the U.S. Congress established a new requirement for all local agencies with a federally funded National School Lunch program. The local agencies are required to develop and implement wellness policies that address nutrition and physical activity by the start of the 2006-07…

European Higher Education Area and the Introduction of a Quality Assurance Program in Greek Universities: Is Policy-Oriented Learning Present?

ERIC Educational Resources Information Center

Stamelos, George; Kavasakalis, Aggelos

2013-01-01

This paper aims to investigate the production (or not) of policy-oriented learning during the establishment and implementation of a specific policy program in the policy sub-system of the Greek university as well as the interpretation of the existence (or not) of policy-oriented learning. The theoretical tools were drawn mainly from the…

The role of government policy in service development in a New Zealand statutory mental health service: implications for policy planning and development.

PubMed

Stanley-Clarke, Nicky; Sanders, Jackie; Munford, Robyn

2014-12-01

To explore the relationship between government policy and service development in a New Zealand statutory mental health provider, Living Well. An organisational case study utilising multiple research techniques including qualitative interviews, analysis of business and strategic documents and observation of meetings. Staff understood and acknowledged the importance of government policy, but there were challenges in its implementation. Within New Zealand's statutory mental health services staff struggled to know how to implement government policy as part of service development; rather, operational concerns, patient need, local context and service demands drove the service development process. © The Royal Australian and New Zealand College of Psychiatrists 2014.

The cost-effectiveness of quality improvement projects: a conceptual framework, checklist and online tool for considering the costs and consequences of implementation-based quality improvement.

PubMed

Thompson, Carl; Pulleyblank, Ryan; Parrott, Steve; Essex, Holly

2016-02-01

In resource constrained systems, decision makers should be concerned with the efficiency of implementing improvement techniques and technologies. Accordingly, they should consider both the costs and effectiveness of implementation as well as the cost-effectiveness of the innovation to be implemented. An approach to doing this effectively is encapsulated in the 'policy cost-effectiveness' approach. This paper outlines some of the theoretical and practical challenges to assessing policy cost-effectiveness (the cost-effectiveness of implementation projects). A checklist and associated (freely available) online application are also presented to help services develop more cost-effective implementation strategies. © 2015 John Wiley & Sons, Ltd.

The experience of implementing the board of trustees’ policy in teaching hospitals in Iran: an example of health system decentralization

PubMed Central

Doshmangir, Leila; Rashidian, Arash; Ravaghi, Hamid; Takian, Amirhossein; Jafari, Mehdi

2015-01-01

Background: In 2004, the health system in Iran initiated an organizational reform aiming to increase the autonomy of teaching hospitals and make them more decentralized. The policy led to the formation of a board of trustees in each hospital and significant modifications in hospitals’ financing. Since the reform aimed to improve its predecessor policy (implementation of hospital autonomy began in 1995), it expected to increase user satisfaction, as well as enhance effectiveness and efficiency of healthcare services in targeted hospitals. However, such expectations were never realized. In this research, we explored the perceptions and views of expert stakeholders as to why the board of trustees’ policy did not achieve its perceived objectives. Methods: We conducted 47 semi-structured face-to-face interviews and two focus group discussions (involving 8 and 10 participants, respectively) with experts at high, middle, and low levels of Iran’s health system, using purposive and snowball sampling. We also collected a comprehensive set of relevant documents. Interviews were transcribed verbatim and analyzed thematically, following a mixed inductive-deductive approach. Results: Three main themes emerged from the analysis. The implementation approach (including the processes, views about the policy and the links between the policy components), using research evidence about the policy (local and global), and policy context (health system structure, health insurers capacity, hospitals’ organization and capacity and actors’ interrelationships) affected the policy outcomes. Overall, the implementation of hospital decentralization policies in Iran did not seem to achieve their intended targets as a result of assumed failure to take full consideration of the above factors in policy implementation into account. Conclusion: The implementation of the board of trustees’ policy did not achieve its desired goals in teaching hospitals in Iran. Similar decentralization policies in the past and their outcomes were overlooked, while the context was not prepared appropriately and key stakeholders, particularly the government, did not support the decentralization of Iran’s health system. PMID:25844379

Policy development and challenges of global mental health: a systematic review of published studies of national-level mental health policies.

PubMed

Zhou, Wei; Yu, Yu; Yang, Mei; Chen, Lizhang; Xiao, Shuiyuan

2018-05-18

Mental health policy can be an essential and powerful tool to improve a population's mental health. However, around one third of countries do not possess a mental health policy, and there are large disparities in population coverage rates between high- and low-income countries. The goal of this study is to identify the transition and implementation challenges of mental health policies in both high-income countries (HICs) as well as middle- and low-income countries (MLICs). PubMed, Cochrane Library and Campbell Library were searched from inception to 31 December 2017, for studies on implemented mental health policies at the national level. Abstracts and the main texts of papers were double screened, and extracted data were analysed through thematic synthesis. A total of 93 papers were included in this study, covering 24 HICs, 28 MLICs and 5 regions. Studies on mental health policies, especially those of MLICs, kept increasing, but MLICs were still underrepresented in terms of publication quantity and study frequency. Based on the included studies, nine policy domains were summarized: service organizing, service provision, service quality, human resources, legislation and human rights, advocacy, administration, surveillance and research, and financing and budgeting. HICs incrementally enriched their policy content in all domains over centuries of development; following HICs' experience, mental health policies in MLICs have boomed since the 1990s and quickly extended to all domains. Implementation problems in HICs were mainly related to service organizing and service provision; for MLICs, more severe implementation problems converged on financing and budgeting, administration and human resources. Mental health policy developments in both HICs and MLICs present a process of diversification and enrichment. In terms of implementation, MLICs are faced with more and greater challenges than HICs, especially in funding, human resources and administration. Therefore, future efforts should not only be made on helping MLICs developing mental health policies, but also on promoting policy implementation under MLICs' local context.

Whatever the Law Says: Language Policy Implementation and Early-Grade Literacy Achievement in Kenya

ERIC Educational Resources Information Center

Trudell, Barbara; Piper, Benjamin

2014-01-01

Language policy is generally seen as a national-level decision regarding which languages the state will support, and in which public domains. However, the reality is that language policy plays out at regional and local levels as well. In fact, it could be argued that the most important instantiations of language policy are those which directly…

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

What Ever Happened to...? "Personalised Learning" as a Case of Policy Dissipation

ERIC Educational Resources Information Center

Maguire, Meg; Ball, Stephen J.; Braun, Annette

2013-01-01

While a great deal of attention has been given to evaluating how well policies are implemented, that is, how well they are realised in practice, less attention has been paid to understanding and documenting the ways in which schools actually deal with the multiple, and sometimes opaque and contradictory demands of different "types" of…

USDA Snack Policy Implementation: Best Practices From the Front Lines, United States, 2013-2014.

PubMed

Asada, Yuka; Chriqui, Jamie; Chavez, Noel; Odoms-Young, Angela; Handler, Arden

2016-06-16

The Smart Snacks in Schools interim final rule was promulgated by the US Department of Agriculture (USDA) as authorized by the Healthy, Hunger-Free Kids Act of 2010 (PL 111-296) and implementation commenced beginning July 1, 2014; however, in the years leading up to this deadline, national studies suggested that most schools were far from meeting the USDA standards. Evidence to guide successful implementation of the standards is needed. This study examined snack policy implementation in exemplary high schools to learn best practices for implementation. Guided by a multiple case study approach, school professionals (n = 37) from 9 high schools across 8 states were recruited to be interviewed about perceptions of school snack implementation; schools were selected using criterion sampling on the basis of the HealthierUS Schools Challenge: Smarter Lunchrooms (HUSSC: SL) database. Interview transcripts and internal documents were organized and coded in ATLAS.Ti v7; 2 researchers coded and analyzed data using a constant comparative analysis method to identify best practice themes. Best practices for snack policy implementation included incorporating the HUSSC: SL award's comprehensive wellness approach; leveraging state laws or district policies to reinforce snack reform initiatives; creating strong internal and external partnerships; and crafting positive and strategic communications. Implementation of snack policies requires evidence of successful experiences from those on the front lines. As federal, state, and local technical assistance entities work to ensure implementation of the Smart Snacks standards, these best practices provide strategies to facilitate the process.

Multi-Stakeholder Taskforces in Bangladesh — A Distinctive Approach to Build Sustainable Tobacco Control Implementation

PubMed Central

Jackson-Morris, Angela M.; Chowdhury, Ishrat; Warner, Valerie; Bleymann, Kayleigh

2015-01-01

The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the “package” comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce’s ‘potential’ to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model for tobacco control. PMID:25575369

Multi-stakeholder taskforces in Bangladesh--a distinctive approach to build sustainable tobacco control implementation.

PubMed

Jackson-Morris, Angela M; Chowdhury, Ishrat; Warner, Valerie; Bleymann, Kayleigh

2015-01-07

The MPOWER policy package enables countries to implement effective, evidence-based strategies to address the threat posed to their population by tobacco. All countries have challenges to overcome when implementing tobacco control policy. Some are generic such as tobacco industry efforts to undermine and circumvent legislation; others are specific to national or local context. Various factors influence how successfully challenges are addressed, including the legal-political framework for enforcement, public and administrative attitudes towards the law, and whether policy implementation measures are undertaken. This paper examines District Tobacco Control Taskforces, a flexible policy mechanism developed in Bangladesh to support the implementation of the Smoking and Tobacco Products Usage (Control) Act 2005 and its 2013 Amendment. At the time of this study published research and/or data was not available and understanding about these structures, their role, contribution, limitations and potential, was limited. We consider Taskforce characteristics and suggest that the "package" comprises a distinctive tobacco control implementation model. Qualitative data is presented from interviews with key informants in ten districts with activated taskforces (n = 70) to provide insight from the perspectives of taskforce members and non-members. In all ten districts taskforces were seen as a crucial tool for tobacco control implementation. Where taskforces were perceived to be functioning well, current positive impacts were perceived, including reduced smoking in public places and tobacco advertising, and increased public awareness and political profile. In districts with less well established taskforces, interviewees believed in their taskforce's 'potential' to deliver similar benefits once their functioning was improved. Recommendations to improve functioning and enhance impact were made. The distinctive taskforce concept and lessons from their development may provide other countries with a flexible local implementation model for tobacco control.

Policy Support, Norms, and Secondhand Smoke Exposure Before and After Implementation of a Comprehensive Smoke-Free Law in Mexico City

PubMed Central

Thrasher, James F.; Pérez-Hernández, Rosaura; Swayampakala, Kamala; Arillo-Santillán, Edna; Bottai, Matteo

2010-01-01

Objectives. We assessed attitudes and beliefs about smoke-free laws, compliance, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico City. Methods. Trends and odds of change in attitudes and beliefs were analyzed across 3 representative surveys of Mexico City inhabitants: before implementation of the policy (n = 800), 4 months after implementation (n = 961), and 8 months after implementation (n = 761). Results. Results indicated high and increasing support for 100% smoke-free policies, although support did not increase for smoke-free bars. Agreement that such policies improved health and reinforced rights was high before policy implementation and increased thereafter. Social unacceptability of smoking increased substantially, although 25% of nonsmokers and 50% of smokers agreed with smokers' rights to smoke in public places at the final survey wave. Secondhand smoke exposure declined generally as well as in venues covered by the law, although compliance was incomplete, especially in bars. Conclusions. Comprehensive smoke-free legislation in Mexico City has been relatively successful, with changes in perceptions and behavior consistent with those revealed by studies conducted in high-income countries. Normative changes may prime populations for additional tobacco control interventions. PMID:20466952

Policy and Practice in Madrid Multilingual Schools

ERIC Educational Resources Information Center

Pastor, Ana Maria Relano

2009-01-01

This article focuses on Spain's most recent implementing of education policies designed to address the needs of immigrant students. It overviews how the latest education policies do not meet the needs of a diverse body of students, drawing on information provided in focus group interviews from several Madrid schools, as well as from other official…

Trimming the Fat in America's Schools: Where Are We One Year Following Implementation of Federally Mandated Local School Wellness Plans (LSWPs)?

ERIC Educational Resources Information Center

Curriculum Review, 2007

2007-01-01

This article presents the results of a survey by the School Nutrition Association (SNA) on the year-long adoption of wellness policies of 15,000 local schools nationwide. Released September 5, SNA's "From Cupcakes to Carrots: Local Wellness Policies One Year Later" was compiled from a survey of 976 school nutrition directors conducted in May 2007.…

Forest biodiversity policies: where are they leading us? Are we going where we expected to go?

Treesearch

Jonathan Thompson

2005-01-01

Policies to achieve biodiversity goals have been implemented across many different forest ownerships in the last 10 years. Surprisingly, little research has been done to examine how well those policies might achieve their goals, how they might change landscapes in the future, and how the policies affecting different owners add up to a total picture of forest...

Noncommunicable Disease Prevention and Control in Mongolia: A Policy Analysis.

PubMed

Chimeddamba, Oyun; Peeters, Anna; Walls, Helen L; Joyce, Catherine

2015-07-14

Noncommunicable diseases (NCDs) are the major global cause of morbidity and mortality. In Mongolia, a number of health policies have been developed targeting the prevention and control of noncommunicable diseases. This paper aimed to evaluate the extent to which NCD-related policies introduced in Mongolia align with the World Health Organization (WHO) 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. We conducted a review of policy documents introduced by the Government of Mongolia from 2000 to 2013. A literature review, internet-based search, and expert consultation identified the policy documents. Information was extracted from the documents using a matrix, mapping each document against the six objectives of the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs and five dimensions: data source, aim and objectives of document, coverage of conditions, coverage of risk factors and implementation plan. 45 NCD-related policies were identified. Prevention and control of the common NCDs and their major risk factors as described by WHO were widely addressed, and policies aligned well with the objectives of the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. Many documents included explicit implementation or monitoring frameworks. It appears that each objective of the WHO 2008-2013 NCD Action Plan was well addressed. Specific areas less well and/or not addressed were chronic respiratory disease, physical activity guidelines and dietary standards. The Mongolian Government response to the emerging burden of NCDs is a population-based public health approach that includes a national multisectoral framework and integration of NCD prevention and control policies into national health policies. Our findings suggest gaps in addressing chronic respiratory disease, physical activity guidelines, specific food policy actions restricting sales advertising of food products, and a lack of funding specifically supporting NCD research. The neglect of these areas may hamper addressing the NCD burden, and needs immediate action. Future research should explore the effectiveness of national NCD policies and the extent to which the policies are implemented in practice.

Digital telephony analysis model and issues

NASA Astrophysics Data System (ADS)

Keuthan, Lynn M.

1995-09-01

Experts in the fields of digital telephony and communications security have stated the need for an analytical tool for evaluating complex issues. Some important policy issues discussed by experts recently include implementing digital wire-taps, implementation of the 'Clipper Chip', required registration of encryption/decryption keys, and export control of cryptographic equipment. Associated with the implementation of these policies are direct costs resulting from implementation, indirect cost benefits from implementation, and indirect costs resulting from the risks of implementation or factors reducing cost benefits. Presented herein is a model for analyzing digital telephony policies and systems and their associated direct costs and indirect benefit and risk factors. In order to present the structure of the model, issues of national importance and business-related issues are discussed. The various factors impacting the implementation of the associated communications systems and communications security are summarized, and various implementation tradeoffs are compared based on economic benefits/impact. The importance of the issues addressed herein, as well as other digital telephony issues, has greatly increased with the enormous increases in communication system connectivity due to the advance of the National Information Infrastructure.

The Forum, 1998-2002. Research Forum on Children, Families, and the New Federalism.

ERIC Educational Resources Information Center

Oshinsky, Carole J., Ed.

2002-01-01

This document contains 16 issues of the first 5 years of a newsletter encouraging collaborative research and informed policy on welfare reform and focusing on the use of an on-line database of child welfare research projects, as well as research and policy issues related to implementation studies, indicators of well-being, and administrative data.…

Assessing School Wellness Policies and Identifying Priorities for Action: Results of a Bi-State Evaluation

ERIC Educational Resources Information Center

Harvey, Susan P.; Markenson, Deborah; Gibson, Cheryl A.

2018-01-01

Background: Obesity is a complex health problem affecting more than one-third of school-aged youth. The increasing obesity rates in Kansas and Missouri has been particularly concerning, with efforts being made to improve student health through the implementation of school wellness policies (SWPs). The primary purpose of this study was to conduct a…

A Quantitative Examination of School Leadership and Response to Intervention

ERIC Educational Resources Information Center

Maier, Michael P.; Pate, James L.; Gibson, Nicole M.; Hilgert, Larry; Hull, Karla; Campbell, Patti C.

2016-01-01

This study sought to provide educational researchers, policy-makers, and professionals with quantitative data on the status of RTI implementation, as well as on which leadership behaviors have been associated with successful implementation. School psychologists and other RTI professionals rated their schools on RTI implementation using the RTI…

Examining gender equity in health policies in a low- (Peru), middle- (Colombia), and high- (Canada) income country in the Americas.

PubMed

Stewart, Donna E; Dorado, Linda M; Diaz-Granados, Natalia; Rondon, Marta; Saavedra, Javier; Posada-Villa, Jose; Torres, Yolanda

2009-12-01

Gender inequities in health prevail in most countries despite ongoing attempts to eliminate them. Assessment of gender-sensitive health policies can be used to identify country specific progress as well as gaps and issues that need to be addressed to meet health equity goals. This study selected and measured the existence of gender-sensitive health policies in a low- (Peru), middle- (Colombia), and high (Canada)-income country in the Americas. Investigators selected 10 of 20 gender-sensitive health policy indicators and found eight to be feasible to measure in all three countries, although the wording and scope varied. The results from this study inform policy makers and program planners who aim to develop, improve, implement, and monitor national gender-sensitive health policies. Future studies should assess the implementation of policy indicators within countries and assess their performance in increasing gender equity.

Using Research Evidence to Inform Public Policy Decisions

ERIC Educational Resources Information Center

Moseley, Charles; Kleinert, Harold; Sheppard-Jones, Kathleen; Hall, Stephen

2013-01-01

The application of scientific data in the development and implementation of sound public policy is a well-established practice, but there appears to be less consensus on the nature of the strategies that can and should be used to incorporate research data into policy decisions. This paper describes the promise and the challenges of using research…

Understanding Lifelong Learning and Adult Education Policy in Estonia: Tendencies and Contradictions

ERIC Educational Resources Information Center

Jogi, Larissa

2012-01-01

There have been many theoretical and empirical analyses of lifelong learning policies and how to implement, develop, measure and facilitate lifelong learning and lifelong learning policy in order to cater for the needs and requirements of individuals as well as society in general. The particular slant on lifelong learning in different countries…

Using a Participatory Approach to the Development of a School-Based Physical Activity Policy in an Indigenous Community

ERIC Educational Resources Information Center

Hogan, Lindsay; Bengoechea, Enrique García; Salsberg, Jon; Jacobs, Judi; King, Morrison; Macaulay, Ann C.

2014-01-01

Background: This study is part of a larger community-based participatory research (CBPR) project to develop, implement, and evaluate the physical activity component of a school-based wellness policy. The policy intervention is being carried out by community stakeholders and academic researchers within the Kahnawake Schools Diabetes Prevention…

Implementing a Paid Leave Policy for Graduate Students at UW-Madison: The Department Chair Perspective

NASA Astrophysics Data System (ADS)

Mathieu, Robert D.

2013-01-01

In 2010 the University of Wisconsin - Madison Astronomy Department developed and implemented a departmental paid leave policy for our graduate students, even though the university lacks a campus-wide policy and cannot provide institutional funding for such programs. This policy includes 12 weeks of paid leave in event of a medical emergency or chronic medical condition, as well as paid parental leave for both male and female graduate research assistants. Building on the graduate student perspective of Gosnell (2012), I will discuss the process of this successful development of a departmental family and medical leave policy for graduate students from the perspective of a faculty member and chair. In particular I will discuss implications of university policies, the importance of faculty and staff support, the role of private funds, and issues of effort certification.

USDA Snack Policy Implementation: Best Practices From the Front Lines, United States, 2013–2014

PubMed Central

Chriqui, Jamie; Chavez, Noel; Odoms-Young, Angela; Handler, Arden

2016-01-01

Introduction The Smart Snacks in Schools interim final rule was promulgated by the US Department of Agriculture (USDA) as authorized by the Healthy, Hunger-Free Kids Act of 2010 (PL 111–296) and implementation commenced beginning July 1, 2014; however, in the years leading up to this deadline, national studies suggested that most schools were far from meeting the USDA standards. Evidence to guide successful implementation of the standards is needed. This study examined snack policy implementation in exemplary high schools to learn best practices for implementation. Methods Guided by a multiple case study approach, school professionals (n = 37) from 9 high schools across 8 states were recruited to be interviewed about perceptions of school snack implementation; schools were selected using criterion sampling on the basis of the HealthierUS Schools Challenge: Smarter Lunchrooms (HUSSC: SL) database. Interview transcripts and internal documents were organized and coded in ATLAS.Ti v7; 2 researchers coded and analyzed data using a constant comparative analysis method to identify best practice themes. Results Best practices for snack policy implementation included incorporating the HUSSC: SL award’s comprehensive wellness approach; leveraging state laws or district policies to reinforce snack reform initiatives; creating strong internal and external partnerships; and crafting positive and strategic communications. Conclusion Implementation of snack policies requires evidence of successful experiences from those on the front lines. As federal, state, and local technical assistance entities work to ensure implementation of the Smart Snacks standards, these best practices provide strategies to facilitate the process. PMID:27309416

Opening the black box of transfer systems in public sector health services in a Western state in India.

PubMed

Purohit, Bhaskar; Martineau, Tim; Sheikh, Kabir

2016-08-22

Limited research on Posting and Transfer (P&T) policies and systems in the public sector health services and the reluctance for an open debate on the issue makes P&T as a black box. Limited research on P&T in India suggests that P&T policies and systems are either non-existent, weak, poorly implemented or characterized by corruption. Hence the current study aimed at opening the "black box" of P&T systems in public sector health services in India by assessing the implementation gaps between P&T policies and their actual implementation. This was a qualitative study carried out in Department of Health, in a Western State in India. To understand the extant P&T policies, a systems map was first developed with the help of document review and Key Informant (KI) Interviews. Next systems audit was carried out to assess the actual implementation of transfer policies by interviewing Medical Officers (MOs), the group mainly affected by the P&T policies. Job histories were constructed from the interviews to understand transfer processes like frequencies of transfers and to assess if transfer rules were adhered. The analysis is based on a synthesis of document review, 19 in-depth interviews with MOs working with state health department and five in-depth interviews with Key Informants (KIs). Framework analysis approach was used to analyze data using NVIVO. The state has a generic transfer guideline applicable to all government officers but there is no specific transfer policy or guideline for government health personnel. The generic transfer guidelines are weakly implemented indicating a significant gap between policy and actual implementation. The formal transfer guidelines are undermined by a parallel system in which desirable posts are attained, retained or sometimes given up by the use of political connections and money. MOs' experiences of transfers were marked by perceptions of unfairness and irregularities reflected through interviews as well as the job histories. The generic transfer rules and ambiguity in how transfers are treated may explain the discrepancy between policy and implementation leading to systems abuse. This discrepancy could have negative influence on MOs' morale which could in turn affect distribution of MOs. Where possible, ambiguity in the rules should be avoided and a greater transparency on implementation of the transfer rules is needed. However, it may not be possible to make any significant improvements to P&T policies and how they are implemented until the external pressure that creates parallel systems is greatly reduced in translating HR policy into HR practice. Effective P&T policies and implementation may have important implications for organizational performance and may help to improve Human Resource (HR) policy and HR expertise. Also there is a greater need for transparency on implementation of the rules. However, it may not be possible to make any significant improvements to P&T policies and how they are implemented until the external pressure that creates parallel systems is greatly reduced.

Evaluation of the Healthy Lifestyles Initiative for Improving Community Capacity for Childhood Obesity Prevention.

PubMed

Berman, Marcie; Bozsik, Frances; Shook, Robin P; Meissen-Sebelius, Emily; Markenson, Deborah; Summar, Shelly; DeWit, Emily; Carlson, Jordan A

2018-02-22

Policy, systems, and environmental approaches are recommended for preventing childhood obesity. The objective of our study was to evaluate the Healthy Lifestyles Initiative, which aimed to strengthen community capacity for policy, systems, and environmental approaches to healthy eating and active living among children and families. The Healthy Lifestyles Initiative was developed through a collaborative process and facilitated by community organizers at a local children's hospital. The initiative supported 218 partners from 170 community organizations through training, action planning, coalition support, one-on-one support, and the dissemination of materials and sharing of resources. Eighty initiative partners completed a brief online survey on implementation strategies engaged in, materials used, and policy, systems, and environmental activities implemented. In accordance with frameworks for implementation science, we assessed associations among the constructs by using linear regression to identify whether and which of the implementation strategies were associated with materials used and implementation of policy, systems, and environmental activities targeted by the initiative. Each implementation strategy was engaged in by 30% to 35% of the 80 survey respondents. The most frequently used materials were educational handouts (76.3%) and posters (66.3%). The most frequently implemented activities were developing or continuing partnerships (57.5%) and reviewing organizational wellness policies (46.3%). Completing an action plan and the number of implementation strategies engaged in were positively associated with implementation of targeted activities (action plan, effect size = 0.82; number of strategies, effect size = 0.51) and materials use (action plan, effect size = 0.59; number of strategies, effect size = 0.52). Materials use was positively associated with implementation of targeted activities (effect size = 0.35). Community-capacity-building efforts can be effective in supporting community organizations to engage in policy, systems, and environmental activities for healthy eating and active living. Multiple implementation strategies are likely needed, particularly strategies that involve a high level of engagement, such as training community organizations and working with them on structured action plans.

Developing a holistic strategy for integrated waste management within municipal planning: challenges, policies, solutions and perspectives for Hellenic municipalities in the zero-waste, low-cost direction.

PubMed

Zotos, G; Karagiannidis, A; Zampetoglou, S; Malamakis, A; Antonopoulos, I-S; Kontogianni, S; Tchobanoglous, G

2009-05-01

The present position paper addresses contemporary waste management options, weaknesses and opportunities faced by Hellenic local authorities. It focuses on state-of-the-art, tested as well as innovative, environmental management tools on a municipal scale and identifies a range of different collaboration schemes between local authorities and related service providers. Currently, a policy implementation gap is still experienced among Hellenic local authorities; it appears that administration at the local level is inadequate to manage and implement many of the general policies proposed; identify, collect, monitor and assess relevant data; and safeguard efficient and effective implementation of MSWM practices in the framework of integrated environmental management as well. This shortfall is partly due to the decentralisation of waste management issues to local authorities without a parallel substantial budgetary and capacity support, thus resulting in local activity remaining often disoriented and isolated from national strategies, therefore yielding significant planning and implementation problems and delays against pressing issues at hand as well as loss or poor use of available funds. This paper develops a systemic approach for MSWM at both the household and the non-household level, summarizes state-of-the-art available tools and compiles a set of guidelines for developing waste management master plans at the municipal level. It aims to provide a framework in the MSWM field for municipalities in Greece as well as other countries facing similar problems under often comparable socioeconomic settings.

Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting.

PubMed

Bloomrosen, Meryl; Starren, Justin; Lorenzi, Nancy M; Ash, Joan S; Patel, Vimla L; Shortliffe, Edward H

2011-01-01

Federal legislation (Health Information Technology for Economic and Clinical Health (HITECH) Act) has provided funds to support an unprecedented increase in health information technology (HIT) adoption for healthcare provider organizations and professionals throughout the U.S. While recognizing the promise that widespread HIT adoption and meaningful use can bring to efforts to improve the quality, safety, and efficiency of healthcare, the American Medical Informatics Association devoted its 2009 Annual Health Policy Meeting to consideration of unanticipated consequences that could result with the increased implementation of HIT. Conference participants focused on possible unintended and unanticipated, as well as undesirable, consequences of HIT implementation. They employed an input-output model to guide discussion on occurrence of these consequences in four domains: technical, human/cognitive, organizational, and fiscal/policy and regulation. The authors outline the conference's recommendations: (1) an enhanced research agenda to guide study into the causes, manifestations, and mitigation of unintended consequences resulting from HIT implementations; (2) creation of a framework to promote sharing of HIT implementation experiences and the development of best practices that minimize unintended consequences; and (3) recognition of the key role of the Federal Government in providing leadership and oversight in analyzing the effects of HIT-related implementations and policies.

Anticipating and addressing the unintended consequences of health IT and policy: a report from the AMIA 2009 Health Policy Meeting

PubMed Central

Starren, Justin; Lorenzi, Nancy M; Ash, Joan S; Patel, Vimla L; Shortliffe, Edward H

2010-01-01

Federal legislation (Health Information Technology for Economic and Clinical Health (HITECH) Act) has provided funds to support an unprecedented increase in health information technology (HIT) adoption for healthcare provider organizations and professionals throughout the U.S. While recognizing the promise that widespread HIT adoption and meaningful use can bring to efforts to improve the quality, safety, and efficiency of healthcare, the American Medical Informatics Association devoted its 2009 Annual Health Policy Meeting to consideration of unanticipated consequences that could result with the increased implementation of HIT. Conference participants focused on possible unintended and unanticipated, as well as undesirable, consequences of HIT implementation. They employed an input–output model to guide discussion on occurrence of these consequences in four domains: technical, human/cognitive, organizational, and fiscal/policy and regulation. The authors outline the conference's recommendations: (1) an enhanced research agenda to guide study into the causes, manifestations, and mitigation of unintended consequences resulting from HIT implementations; (2) creation of a framework to promote sharing of HIT implementation experiences and the development of best practices that minimize unintended consequences; and (3) recognition of the key role of the Federal Government in providing leadership and oversight in analyzing the effects of HIT-related implementations and policies. PMID:21169620

The political economy of noncompliance in China: The case of industrial energy policy

DOE PAGES

Van Aken, Tucker; Lewis, Orion A.

2015-03-18

One of the greatest challenges facing China today is the central government's ability to ensure that policies are implemented effectively at the local level, particularly policies that seek to make China's economic growth model more sustainable. These policies face resistance from local authorities and enterprises that benefit from the status quo. This raises a key research question: why do some provinces more fully implement these central policies? We argue the extent of local implementation is best conceptualized as a rational balance between economic and political incentives: localities with regulatory autonomy, low regulatory capacity and alternative interests will not fully implementmore » policies that are at odds with local economic imperatives. By examining a critical case of central policy implementation—industrial energy intensity reduction in the eleventh five-year plan—this article demonstrates that, regardless of industrial makeup or economic development, provinces that have greater regulatory autonomy for noncompliance coupled with alternative economic interests do not, on average, perform as well. As a result, using a nested analysis approach this study illustrates this argument with both quantitative analysis and original case study evidence from fieldwork interviews.« less

Comparative federal health care policy: evidence of collaborative federalism in Pakistan and Venezuela.

PubMed

Baracskay, Daniel

2013-01-01

Collaborative federalism has provided an effective analytical foundation for understanding how complex public policies are implemented in federal systems through intergovernmental and intersectoral alignments. This has particularly been the case in issue areas like public health policy where diseases are detected and treated at the local level. While past studies on collaborative federalism and health care policy have focused on federal systems that are largely democratic, little research has been conducted to examine the extent of collaboration in authoritarian structures. This article applies the collaborative federalism approach to the Islamic Republic of Pakistan and the Bolivarian Republic of Venezuela. Evidence suggests that while both nations have exhibited authoritarian governing structures, there have been discernible policy areas where collaborative federalism is embraced to facilitate the implementation process. Further, while not an innate aspect of their federal structures, Pakistan and Venezuela can potentially expand their use of the collaborative approach to successfully implement health care policy and the epidemiological surveillance and intervention functions. Yet, as argued, this would necessitate further development of their structures on a sustained basis to create an environment conducive for collaborative federalism to flourish, and possibly expand to other policy areas as well.

Counteracting obesity: developing a policy framework to guide action.

PubMed

Cismaru, Magdalena

2008-01-01

The purpose of this paper is to stimulate further debate regarding possible courses of policy action aimed at preventing obesity. Gostin's framework for classifying antiobesity legal interventions is tested and extended to incorporate non-legislative policy initiatives to include a comprehensive array of policy actions available to deal with obesity. A web search of the literature has been conducted. Initiatives from USA, Canada and the European Union were discussed in terms of their objectives and fit with the framework. Gostin's framework was found to be a useful tool in organizing all the initiatives (legislative and non-legislative). However, sometimes a broader definition of the category was needed. As well, in some categories, few initiatives were implemented to date and several new categories have to be added to the framework to classify all the existing initiatives. The theoretical developed framework will assist new initiatives assess possible courses of action as well as countries or organizations that have already implemented some measures identify what else can be done to effectively fight overweight and obesity.

The Teacher as a "Colony": A Case Study of Agentive Responses to "Colonising" Education Policy in Vietnam

ERIC Educational Resources Information Center

Saito, Eisuke; Atencio, Matthew; Khong, Thi Diem Hang; Takasawa, Naomi; Murase, Masatsugu; Tsukui, Atsushi; Sato, Manabu

2018-01-01

Neo-liberal educational policies that are being implemented globally work to foster competition among schools and teachers, as well as among children. In this situation, teachers must often come to accept the dominant representations of curricular policy developed by higher authorities. In this study, a case study design is used to describe how…

Policy Driven Development: Flexible Policy Insertion for Large Scale Systems.

PubMed

Demchak, Barry; Krüger, Ingolf

2012-07-01

The success of a software system depends critically on how well it reflects and adapts to stakeholder requirements. Traditional development methods often frustrate stakeholders by creating long latencies between requirement articulation and system deployment, especially in large scale systems. One source of latency is the maintenance of policy decisions encoded directly into system workflows at development time, including those involving access control and feature set selection. We created the Policy Driven Development (PDD) methodology to address these development latencies by enabling the flexible injection of decision points into existing workflows at runtime , thus enabling policy composition that integrates requirements furnished by multiple, oblivious stakeholder groups. Using PDD, we designed and implemented a production cyberinfrastructure that demonstrates policy and workflow injection that quickly implements stakeholder requirements, including features not contemplated in the original system design. PDD provides a path to quickly and cost effectively evolve such applications over a long lifetime.

Wildland Fire Management Plan

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

Schwager, K.

The Wildland Fire Management Plan (FMP) for Brookhaven National Lab (BNL) is written to comply with Department of Energy (DOE) Integrated Safety Management Policy; Federal Wildland Fire Management Policy and Program Review; and Wildland and Prescribed Fire Management Policy and Implementation Procedures Reference Guide. This current plan incorporates changes resulting from new policies on the national level as well as significant changes to available resources and other emerging issues, and replaces BNL's Wildland FMP dated 2014.

The dynamic of non-communicable disease control policy in Indonesia.

PubMed

Christiani, Yodi; Dugdale, Paul; Tavener, Meredith; Byles, Julie E

2017-05-01

Objective The aim of the present study was to examine non-communicable disease (NCD) policy formation and implementation in Indonesia. Methods Interviews were conducted with 13 Indonesian health policy workers. The processes and issues relating to NCD policy formation were mapped, exploring the interactions between policy makers, technical/implementation bodies, alliances across various levels and the mobilisation of non-policy actors. Results Problems in NCD policy formation include insufficient political interest in NCD control, disconnected policies and difficulty in multisectoral coordination. These problems are well illustrated in relation to tobacco control, but also apply to other control efforts. Nevertheless, participants were optimistic that there are plentiful opportunities for improving NCD control policies given growing global attention to NCD, increases in the national health budget and the growing body of Indonesia-relevant NCD-related research. Conclusion Indonesia's success in the creation and implementation of NCD policy will be dependent on high-level governmental leadership, including support from the President, the Health Minister and coordinating ministries. What is known about the topic? The burden of NCD in Indonesia has increased gradually. Nationally, NCD-related mortality accounted for 65% of deaths in 2010. Indonesia is also a country with the highest burden of tobacco smoking in the world. However, the government has not instituted sufficient policy action to tackle NCDs, including tobacco control. What does this paper add? This paper deepens our understanding of current NCD control policy formation in Indonesia, including the possible underlying reason why Indonesia has weak tobacco control policies. It describes the gaps in the current policies, the actors involved in policy formation, the challenges in policy formation and implementation and potential opportunities for improving NCD control. What are the implications for practitioners? An effective NCD control program requires strong collaboration, including between government and health professionals. Health professionals can actively engage in policy formation, for example through knowledge production.

Exploring knowledge exchange at the research-policy-practice interface in children's behavioral health services.

PubMed

Leslie, Laurel K; Maciolek, Susan; Biebel, Kathleen; Debordes-Jackson, Gifty; Nicholson, Joanne

2014-11-01

This case study explored core components of knowledge exchange among researchers, policymakers, and practitioners within the context of the Rosie D. versus Romney class action lawsuit in Massachusetts and the development and implementation of its remedial plan. We identified three distinct, sequential knowledge exchange episodes with different purposes, stakeholders, and knowledge exchanged, as decision-making moved from Federal Medicaid policy to state Medicaid program standards and to community-level practice. The knowledge exchanged included research regarding Wraparound, a key component of the remedial plan, as well as contextual information critical for implementation (e.g., Federal Medicaid policy, managed care requirements, community organizations' characteristics).

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

15 CFR 1170.6 - Reporting requirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... transition to the metric system, as well as actions planned for the budget year involved to implement fully the metric system, in accordance with this policy. Reporting shall cease for an agency in the fiscal...) TECHNOLOGY ADMINISTRATION, DEPARTMENT OF COMMERCE METRIC CONVERSION POLICY FOR FEDERAL AGENCIES § 1170.6...

15 CFR 1170.6 - Reporting requirement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... transition to the metric system, as well as actions planned for the budget year involved to implement fully the metric system, in accordance with this policy. Reporting shall cease for an agency in the fiscal...) TECHNOLOGY ADMINISTRATION, DEPARTMENT OF COMMERCE METRIC CONVERSION POLICY FOR FEDERAL AGENCIES § 1170.6...

15 CFR 1170.6 - Reporting requirement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... transition to the metric system, as well as actions planned for the budget year involved to implement fully the metric system, in accordance with this policy. Reporting shall cease for an agency in the fiscal...) TECHNOLOGY ADMINISTRATION, DEPARTMENT OF COMMERCE METRIC CONVERSION POLICY FOR FEDERAL AGENCIES § 1170.6...

15 CFR 1170.6 - Reporting requirement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... transition to the metric system, as well as actions planned for the budget year involved to implement fully the metric system, in accordance with this policy. Reporting shall cease for an agency in the fiscal...) TECHNOLOGY ADMINISTRATION, DEPARTMENT OF COMMERCE METRIC CONVERSION POLICY FOR FEDERAL AGENCIES § 1170.6...

Observations of Drinking Water Access in School Food Service Areas Before Implementation of Federal and State School Water Policy, California, 2011

PubMed Central

Chandran, Kumar; Hampton, Karla E.; Hecht, Kenneth; Grumbach, Jacob M.; Kimura, Amanda T.; Braff-Guajardo, Ellen; Brindis, Claire D.

2012-01-01

Introduction Recent legislation requires schools to provide free drinking water in food service areas (FSAs). Our objective was to describe access to water at baseline and student water intake in school FSAs and to examine barriers to and strategies for implementation of drinking water requirements. Methods We randomly sampled 24 California Bay Area public schools. We interviewed 1 administrator per school to assess knowledge of water legislation and barriers to and ideas for policy implementation. We observed water access and students’ intake of free water in school FSAs. Wellness policies were examined for language about water in FSAs. Results Fourteen of 24 schools offered free water in FSAs; 10 offered water via fountains, and 4 provided water through a nonfountain source. Four percent of students drank free water at lunch; intake at elementary schools (11%) was higher than at middle or junior high schools (6%) and high schools (1%). In secondary schools when water was provided by a nonfountain source, the percentage of students who drank free water doubled. Barriers to implementation of water requirements included lack of knowledge of legislation, cost, and other pressing academic concerns. No wellness policies included language about water in FSAs. Conclusion Approximately half of schools offered free water in FSAs before implementation of drinking water requirements, and most met requirements through a fountain. Only 1 in 25 students drank free water in FSAs. Although schools can meet regulations through installation of fountains, more appealing water delivery systems may be necessary to increase students’ water intake at mealtimes. PMID:22765930

Observations of drinking water access in school food service areas before implementation of federal and state school water policy, California, 2011.

PubMed

Patel, Anisha I; Chandran, Kumar; Hampton, Karla E; Hecht, Kenneth; Grumbach, Jacob M; Kimura, Amanda T; Braff-Guajardo, Ellen; Brindis, Claire D

2012-01-01

Recent legislation requires schools to provide free drinking water in food service areas (FSAs). Our objective was to describe access to water at baseline and student water intake in school FSAs and to examine barriers to and strategies for implementation of drinking water requirements. We randomly sampled 24 California Bay Area public schools. We interviewed 1 administrator per school to assess knowledge of water legislation and barriers to and ideas for policy implementation. We observed water access and students' intake of free water in school FSAs. Wellness policies were examined for language about water in FSAs. Fourteen of 24 schools offered free water in FSAs; 10 offered water via fountains, and 4 provided water through a nonfountain source. Four percent of students drank free water at lunch; intake at elementary schools (11%) was higher than at middle or junior high schools (6%) and high schools (1%). In secondary schools when water was provided by a nonfountain source, the percentage of students who drank free water doubled. Barriers to implementation of water requirements included lack of knowledge of legislation, cost, and other pressing academic concerns. No wellness policies included language about water in FSAs. Approximately half of schools offered free water in FSAs before implementation of drinking water requirements, and most met requirements through a fountain. Only 1 in 25 students drank free water in FSAs. Although schools can meet regulations through installation of fountains, more appealing water delivery systems may be necessary to increase students' water intake at mealtimes.

Alcohol consumption policies and the prevention of alcohol consumption-related problems: needs, duties, and responsibilities.

PubMed

Allamani, Allaman

2012-10-01

Alcohol-related policies and the prevention of alcohol use-related problems, as well as their creation, are accomplished through planned interventions- laws, social and health programs, community-based initiatives-as well as through complex social movements and efforts implemented by the communities. Among both citizens and alcohol use intervention experts, the following three human dimensions are considered: needs, duties, and responsibilities.

Adaptation to Climatic Hazards in the Savannah Ecosystem: Improving Adaptation Policy and Action

NASA Astrophysics Data System (ADS)

Yiran, Gerald A. B.; Stringer, Lindsay C.

2017-10-01

People in Ghana's savannah ecosystem have historically experienced a range of climatic hazards that have affected their livelihoods. In view of current climate variability and change, and projected increases in extreme events, adaptation to climate risks is vital. Policies have been put in place to enhance adaptation across sub-Saharan Africa in accordance with international agreements. At the same time, local people, through experience, have learned to adapt. This paper examines current policy actions and their implementation alongside an assessment of barriers to local adaptation. In doing so it links adaptation policy and practice. Policy documents were analysed that covered key livelihood sectors, which were identified as climate sensitive. These included agriculture, water, housing and health policies, as well as the National Climate Change Policy. In-depth interviews and focus group discussions were also held with key stakeholders in the Upper East Region of Ghana. Analyses were carried using thematic content analysis. Although policies and actions complement each other, their integration is weak. Financial, institutional, social, and technological barriers hinder successful local implementation of some policy actions, while lack of local involvement in policy formulation also hinders adaptation practice. Integration of local perspectives into policy needs to be strengthened in order to enhance adaptation. Coupled with this is a need to consider adaptation to climate change in development policies and to pursue efforts to reduce or remove the key barriers to implementation at the local level.

How States Can Promote Local Innovation, Options, and Problem-Solving in Public Education. Linking State and Local School Improvement

ERIC Educational Resources Information Center

Posamentier, Jordan; Lake, Robin; Hill, Paul

2017-01-01

State policy plays a critical role in determining whether and how well local education improvement strategies can be implemented. As states rework their education policies under the Every Student Succeeds Act (ESSA), state and local leaders need a way to assess their current policy environment and identify the changes needed to encourage local…

Greek Educational Policy: From the Collaborative Model of the School Counselor Institution of the A. Papandreou's (1981) Educational Policy towards the Model of Superintendence and Supervision of the Period 2008-2013

ERIC Educational Resources Information Center

Evaggelia, Kalerante

2014-01-01

The present paper is concerned about the Greek educational policy throughout 2008-2013, which is related to teachers' evaluation and their teaching work, in comparison to the one implemented in 1981. The investigation is focused on Primary and Secondary Education in which the policy of intentions as well as legislation are concentrated on a form…

A theoretical analysis of the barriers and facilitators to the implementation of school-based physical activity policies in Canada: a mixed methods scoping review.

PubMed

Weatherson, Katie A; Gainforth, Heather L; Jung, Mary E

2017-03-27

Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. This review descriptively summarizes the implementation status, approaches used to implement DPA, and the effectiveness of DPA at increasing the physical activity of children at school. In addition, the Theoretical Domains Framework (TDF) was used to explore the barriers and facilitators to DPA implementation. A scoping review of English articles using ERIC, CINAHL, and Google Scholar (2005 to 2016) was conducted. Only studies that evaluated the implementation and/or student-level effectiveness of DPA policies in Canadian elementary schools were included. Only articles that examined DPA implementation barriers and facilitators by teachers, principals, and/or administration were eligible for the TDF analysis. Data on study characteristics and major findings regarding implementation status, implementation approach used, and impact on student's physical activity were extracted and were summarized descriptively, including study quality indicators. Two coders extracted and categorized implementation barriers and facilitators into TDF domains. The search resulted in 66 articles being retrieved and 38 being excluded for not meeting the eligibility criteria, leaving 15 eligible for review (10 of which examined barriers and facilitators to implementation from DPA deliverers' perspective). Eleven of 15 studies examined the Ontario DPA policy, and 2 studies were from both Alberta and British Columbia. Thirteen studies examined implementation, and only two examined effectiveness. DPA implementation status, approaches to delivery, and effectiveness on student's PA levels are inconsistent across the three provinces. A total of 203 barriers/facilitators were extracted across the ten implementation studies, most of which related to the environmental context and resources (ECR; n = 86; 37.4%), beliefs about consequences (n = 41; 17.8%), and social influences (n = 36; 15.7%) TDF domains. With the limited research examining the DPA policy in Canada, the current status and approaches used to implement DPA and the student-level effectiveness is not well understood; however, this review revealed that DPA deliverers often report many barriers to DPA implementation. Most importantly, in conducting a TDF-based analysis of the barriers/facilitators affecting implementation, this review provides a theoretical basis by which researchers and policy-makers can design interventions to better target these problems in the future. A protocol for this review was not registered.

A conceptual framework for the emerging discipline of conservation physiology

PubMed Central

Coristine, Laura E.; Robillard, Cassandra M.; Kerr, Jeremy T.; O'Connor, Constance M.; Lapointe, Dominique; Cooke, Steven J.

2014-01-01

Current rates of biodiversity decline are unprecedented and largely attributed to anthropogenic influences. Given the scope and magnitude of conservation issues, policy and management interventions must maximize efficiency and efficacy. The relatively new field of conservation physiology reveals the physiological mechanisms associated with population declines, animal–environment relationships and population or species tolerance thresholds, particularly where these relate to anthropogenic factors that necessitate conservation action. We propose a framework that demonstrates an integrative approach between physiology, conservation and policy, where each can inform the design, conduct and implementation of the other. Each junction of the conservation physiology process has the capacity to foster dialogue that contributes to effective implementation, monitoring, assessment and evaluation. This approach enables effective evaluation and implementation of evidence-based conservation policy and management decisions through a process of ongoing refinement, but may require that scientists (from the disciplines of both physiology and conservation) and policy-makers bridge interdisciplinary knowledge gaps. Here, we outline a conceptual framework that can guide and lead developments in conservation physiology, as well as promote innovative research that fosters conservation-motivated policy. PMID:27293654

15 CFR 273.6 - Reporting requirement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... implementation plans, with a current timetable for the agency's transition to the metric system, as well as actions planned for the budget year involved to implement fully the metric system, in accordance with this... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE METRIC CONVERSION POLICY FOR FEDERAL AGENCIES...

Effective Evaluation of Quality Rating and Improvement Systems for Early Care and Education and School-Age Care. Research-to-Policy, Research-to-Practice Brief OPRE 2011-11a

ERIC Educational Resources Information Center

Zellman, Gail L.; Brandon, Richard N.; Boller, Kimberly; Kreader, J. Lee

2011-01-01

It is important to evaluate Quality Rating and Improvement Systems (QRISs) so that policy makers and stakeholders can learn how well they are working and how they might be improved. Well-designed QRIS evaluations go beyond a "pass/fail" judgment to identify implementation successes and problems and assess what needs to be done to improve…

Qualitative Assessment of Smoke-Free Policy Implementation in Low-Income Housing: Enhancing Resident Compliance.

PubMed

Anthony, Jodi; Goldman, Roberta; Rees, Vaughan W; Frounfelker, Rochelle L; Davine, Jessica; Keske, Robyn R; Brooks, Daniel R; Geller, Alan C

2018-01-01

As public housing agencies and other low-income housing providers adopt smoke-free policies, data are needed to inform implementation approaches that support compliance. Focused ethnography used including qualitative interviews with staff, focus groups with residents, and property observations. Four low-income housing properties in Massachusetts, 12 months postpolicy adoption. Individual interviews (n = 17) with property staff (managers, resident service coordinators, maintenance, security, and administrators) and focus groups with resident smokers (n = 28) and nonsmokers (n = 47). Informed by the social-ecological model: intrapersonal, interpersonal, organizational, and community factors relating to compliance were assessed. Utilized MAXQDA in a theory-driven immersion/crystallization analytic process with cycles of raw data examination and pattern identification until no new themes emerged. Self-reported secondhand smoke exposure (SHSe) was reduced but not eliminated. Challenges included relying on ambivalent maintenance staff and residents to report violations, staff serving as both enforcers and smoking cessation counsellors, and inability to enforce on nights and weekends. Erroneous knowledge of the policy, perception that SHSe is not harmful to neighbors, as well as believing that smokers were losing their autonomy and being unfairly singled out when other resident violations were being unaddressed, hindered policy acceptance among resident smokers. The greatest challenge to compliance was the lack of allowable outdoor smoking areas that may have reduced the burden of the policy on smokers. Smoke-free policy implementation to support compliance could be enhanced with information about SHSe for smokers and nonsmokers, cessation support from external community partners, discussion forums for maintenance staff, resident inclusion in decision-making, and framing the policy as part of a broader wellness initiative.

Engaging Communities to Develop and Sustain Comprehensive Wellness Policies: Louisiana’s Schools Putting Prevention to Work

PubMed Central

Kennedy, Betty Monroe; Bourgeois, Brandi F.; Broyles, Stephanie T.; Katzmarzyk, Peter T.

2014-01-01

Background Tobacco use, obesity, and physical inactivity among Louisiana’s youth pose a serious public health problem. Given the potential of school environments to affect student well-being, the Louisiana Tobacco Control Program developed and tested a pilot program, Schools Putting Prevention to Work. The objective was to assist school districts in developing a comprehensive school wellness policy and engaging their school community to generate environments that support healthful choices and behaviors. Community Context The pilot was implemented in 27 school districts, reaching an estimated 325,000 people across the state. Demographics of participating students were similar to all Louisiana’s public school students. Methods A school wellness project state team advised project development. A subgroup that included contractors and partners implemented and modified the pilot. Sites were selected though an application process. Site representatives received trainings, technical assistance, and funding to organize school-based support-building activities and coordinate a school health advisory council to develop policy and sustain healthy school environments. Project sites reported progress monthly; evaluation included data from sites and project administrators. Outcome Twenty-five comprehensive school wellness policies (covering 100% tobacco-free schools and daily physical activity and healthier cafeteria items) were approved by school boards. Environmental changes such as physical activity breaks, healthier vending options, and tobacco-free campuses were adopted. Interpretation This pilot demonstrated a successful approach to achieving policy and environmental change. The state team engaged and guided school districts to motivate students, parents, faculty/staff/administration, and businesses to establish and maintain opportunities to improve lifestyle health. PMID:24602588

Challenges to the implementation of International Health Regulations (2005) on Preventing Infectious Diseases: experience from Julius Nyerere International Airport, Tanzania

PubMed Central

Bakari, Edith; Frumence, Gasto

2013-01-01

Background The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. Country points of entry (POEs) have been identified as potential areas for effective interventions to prevent the transmission of infectious diseases across borders. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam. Design A cross-sectional, descriptive study, employing qualitative methods, was conducted at the Ministry of Health and Social Welfare (MoHSW), WHO, and JNIA. In-depth interviews, focus group discussions (FGDs) and documentary reviews were used to obtain relevant information. Respondents were purposively enrolled into the study. Thematic analysis was used to generate study findings. Results Several challenges that hamper implementation of the IHR (2005) were identified: (1) none of the 42 Tanzanian POEs have been specifically designated to implement IHR (2005). (2) Implementation of the IHR (2005) at the POE was complicated as it falls under various uncoordinated government departments. Although there were clear communication channels at JNIA that enhanced reliable risk communication, the airport lacked isolated rooms specific for emergence preparedness and response to public health events. Conclusions JNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should also ensure that implementation of the IHR (2005) follow the policy implementation framework, particularly the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy. PMID:23958240

Challenges to the implementation of International Health Regulations (2005) on preventing infectious diseases: experience from Julius Nyerere International Airport, Tanzania.

PubMed

Bakari, Edith; Frumence, Gasto

2013-08-16

The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. Country points of entry (POEs) have been identified as potential areas for effective interventions to prevent the transmission of infectious diseases across borders. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam. A cross-sectional, descriptive study, employing qualitative methods, was conducted at the Ministry of Health and Social Welfare (MoHSW), WHO, and JNIA. In-depth interviews, focus group discussions (FGDs) and documentary reviews were used to obtain relevant information. Respondents were purposively enrolled into the study. Thematic analysis was used to generate study findings. Several challenges that hamper implementation of the IHR (2005) were identified: (1) none of the 42 Tanzanian POEs have been specifically designated to implement IHR (2005). (2) Implementation of the IHR (2005) at the POE was complicated as it falls under various uncoordinated government departments. Although there were clear communication channels at JNIA that enhanced reliable risk communication, the airport lacked isolated rooms specific for emergence preparedness and response to public health events. JNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should also ensure that implementation of the IHR (2005) follow the policy implementation framework, particularly the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy.

Evaluation of the Healthy Lifestyles Initiative for Improving Community Capacity for Childhood Obesity Prevention

PubMed Central

Berman, Marcie; Bozsik, Frances; Shook, Robin P.; Meissen-Sebelius, Emily; Markenson, Deborah; Summar, Shelly; DeWit, Emily

2018-01-01

Purpose and Objectives Policy, systems, and environmental approaches are recommended for preventing childhood obesity. The objective of our study was to evaluate the Healthy Lifestyles Initiative, which aimed to strengthen community capacity for policy, systems, and environmental approaches to healthy eating and active living among children and families. Intervention Approach The Healthy Lifestyles Initiative was developed through a collaborative process and facilitated by community organizers at a local children’s hospital. The initiative supported 218 partners from 170 community organizations through training, action planning, coalition support, one-on-one support, and the dissemination of materials and sharing of resources. Evaluation Methods Eighty initiative partners completed a brief online survey on implementation strategies engaged in, materials used, and policy, systems, and environmental activities implemented. In accordance with frameworks for implementation science, we assessed associations among the constructs by using linear regression to identify whether and which of the implementation strategies were associated with materials used and implementation of policy, systems, and environmental activities targeted by the initiative. Results Each implementation strategy was engaged in by 30% to 35% of the 80 survey respondents. The most frequently used materials were educational handouts (76.3%) and posters (66.3%). The most frequently implemented activities were developing or continuing partnerships (57.5%) and reviewing organizational wellness policies (46.3%). Completing an action plan and the number of implementation strategies engaged in were positively associated with implementation of targeted activities (action plan, effect size = 0.82; number of strategies, effect size = 0.51) and materials use (action plan, effect size = 0.59; number of strategies, effect size = 0.52). Materials use was positively associated with implementation of targeted activities (effect size = 0.35). Implications for Public Health Community-capacity–building efforts can be effective in supporting community organizations to engage in policy, systems, and environmental activities for healthy eating and active living. Multiple implementation strategies are likely needed, particularly strategies that involve a high level of engagement, such as training community organizations and working with them on structured action plans. PMID:29470168

Child Sexual Abuse in Zimbabwe.

PubMed

Mantula, Fennie; Saloojee, Haroon

2016-01-01

Although child sexual abuse is a significant public health problem globally, its incidence, prevention, and management is less well described in resource-poor settings. In poorer settings prevention initiatives assume even more importance since resources for managing abused children are severely limited. This article examines the current status of policy and practice related to the prevention of child sexual abuse in Zimbabwe. It identifies implementation challenges and highlights opportunities that could be embraced to reduce CSA in Zimbabwe, based on evidence synthesized from recent work. Although Zimbabwe has a well-established legal and regulatory framework to protect children from child sexual abuse, implementation of existing policies is weak. Financial, human, and material resource constraints are frequently cited to explain limited prevention activity. Effective strategies for the prevention of child sexual abuse should focus on implementing existing legislation, targeting schoolchildren, and getting community involvement. A dedicated budget would help entrench these strategies, but gains can be achieved even in the absence of this.

Effect of school wellness policies and the Healthy, Hunger-Free Kids Act on food-consumption behaviors of students, 2006-2016: a systematic review.

PubMed

Mansfield, Jennifer L; Savaiano, Dennis A

2017-07-01

Federal regulation mandates that the US National School Lunch Program nutrition standards align with the Dietary Guidelines for Americans. As students consume a substantial proportion of their nutrition during school lunch, increasing access to healthy foods is proposed to improve student dietary outcomes. The purpose of this review is to assess whether policy changes impacted food-consumption behaviors of students during periods when (1) school wellness policies were implemented (2006-2007); (2) the Healthy, Hunger-Free Kids Act was passed (2010-2012); and (3) the Healthy, Hunger-Free Kids Act was implemented (2012-present). PubMed, Web of Science, and Science Direct were searched for primary research studies. Policy evaluations and interventions implemented from 2006 to 2016 were included. A total of 31 studies evaluating plate waste, dietary intake, food selection, and/or purchasing patterns were identified and reviewed. Fourteen of 19 intervention and longitudinal observation studies reported improved food-consumption behaviors (increased selection, intake, and sales of healthy foods, and decreased plate waste). Only 2 of 12 one-time observation studies reported food-consumption behaviors meeting target nutrition standards. The majority of studies indicated that increasing access to healthy foods during school lunch improved students' dietary intakes. Challenges related to study design, adaptation period, quality of foods, and policy implementation likely affect a school lunch program's ability to impact students' food-consumption behaviors. Ongoing evaluation of these programs is warranted. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Semantically Enriched Data Access Policies in eHealth.

PubMed

Drozdowicz, Michał; Ganzha, Maria; Paprzycki, Marcin

2016-11-01

Internet of Things (IoT) requires novel solutions to facilitate autonomous, though controlled, resource access. Access policies have to facilitate interactions between heterogeneous entities (devices and humans). Here, we focus our attention on access control in eHealth. We propose an approach based on enriching policies, based on well-known and widely-used eXtensible Access Control Markup Language, with semantics. In the paper we describe an implementation of a Policy Information Point integrated with the HL7 Security and Privacy Ontology.

How well have China's recent five-year plans been implemented for energy conservation and air pollution control?

PubMed

Mao, XianQiang; Zhou, Ji; Corsetti, Gabriel

2014-09-02

This study evaluates how well China's 11th and 12th Five-Year Plans have been implemented in terms of energy conservation and air pollution control and deconstructs the effects of the economic, energy, and environmental policies included in the Plans. A "counterfactual" comparative-scenario method is deployed, which assumes a business as usual scenario in which the changes in economic, energy, and environmental parameters are "frozen", and then reactivates them one by one, with the help of LEAP modeling. It is found that during the 11th Five-Year Plan period, the binding targets were basically achieved. Economic growth put a great strain upon the energy demand and the environment, but energy policy made a decisive contribution by promoting energy efficiency and structure. Environmental policy promoted the deployment of end-of-pipe treatment which led to the control of certain air pollutants but at the expense of an increase in energy use and in the emission of other pollutants. During the ongoing 12th Five-Year Plan period, energy policy's potential for efficiency improvement is shrinking, but economic policy is restraining economic growth thus making a positive contribution. Environmental policy attempts to enforce multipollutant reduction, but there is still insufficient focus on the cocontrol of different pollutants and CO2.

Extending key sharing: how to generate a key tightly coupled to a network security policy

NASA Astrophysics Data System (ADS)

Kazantzidis, Matheos

2006-04-01

Current state of the art security policy technologies, besides the small scale limitation and largely manual nature of accompanied management methods, are lacking a) in real-timeliness of policy implementation and b) vulnerabilities and inflexibility stemming from the centralized policy decision making; even if, for example, a policy description or access control database is distributed, the actual decision is often a centralized action and forms a system single point of failure. In this paper we are presenting a new fundamental concept that allows implement a security policy by a systematic and efficient key distribution procedure. Specifically, we extend the polynomial Shamir key splitting. According to this, a global key is split into n parts, any k of which can re-construct the original key. In this paper we present a method that instead of having "any k parts" be able to re-construct the original key, the latter can only be reconstructed if keys are combined as any access control policy describes. This leads into an easily deployable key generation procedure that results a single key per entity that "knows" its role in the specific access control policy from which it was derived. The system is considered efficient as it may be used to avoid expensive PKI operations or pairwise key distributions as well as provides superior security due to its distributed nature, the fact that the key is tightly coupled to the policy, and that policy change may be implemented easier and faster.

Policy commercializing nonprofits in health: the history of a paradox from the 19th century to the ACA.

PubMed

Fox, Daniel M

2015-03-01

POLICY POINTS: Health policy in the United States has, for more than a century, simultaneously and paradoxically incentivized the growth as well as the commercialization of nonprofit organizations in the health sector. This policy paradox persists during the implementation of the Affordable Care Act of 2010. For more than a century, policy in the United States has incentivized both expansion in the number and size of tax-exempt nonprofit organizations in the health sector and their commercialization. The implementation of the Affordable Care Act of 2010 (ACA) began yet another chapter in the history of this policy paradox. This article explores the origin and persistence of the paradox using what many scholars call "interpretive social science." This methodology prioritizes history and contingency over formal theory and methods in order to present coherent and plausible narratives of events and explanations for them. These narratives are grounded in documents generated by participants in particular events, as well as conversations with them, observing them in action, and analysis of pertinent secondary sources. The methodology achieves validity and reliability by gathering information from multiple sources and making disciplined judgments about its coherence and correspondence with reality. A paradox with deep historical roots persists as a result of consensus about its value for both population health and the revenue of individuals and organizations in the health sector. Participants in this consensus include leaders of governance who have disagreed about many other issues. The paradox persists because of assumptions about the burden of disease and how to address it, as well as about the effects of biomedical science that is translated into professional education, practice, and the organization of services for the prevention, diagnosis, treatment, and management of illness. The policy paradox that has incentivized the growth and commercialization of nonprofits in the health sector since the late 19th century remains influential in health policy, especially for the allocation of resources. However, aspects of the implementation of the ACA may constrain some of the effects of the paradox. © 2015 Milbank Memorial Fund.

Policy Commercializing Nonprofits in Health: The History of a Paradox From the 19th Century to the ACA

PubMed Central

FOX, DANIEL M

2015-01-01

Policy Points: Health policy in the United States has, for more than a century, simultaneously and paradoxically incentivized the growth as well as the commercialization of nonprofit organizations in the health sector. This policy paradox persists during the implementation of the Affordable Care Act of 2010. Context For more than a century, policy in the United States has incentivized both expansion in the number and size of tax-exempt nonprofit organizations in the health sector and their commercialization. The implementation of the Affordable Care Act of 2010 (ACA) began yet another chapter in the history of this policy paradox. Methods This article explores the origin and persistence of the paradox using what many scholars call “interpretive social science.” This methodology prioritizes history and contingency over formal theory and methods in order to present coherent and plausible narratives of events and explanations for them. These narratives are grounded in documents generated by participants in particular events, as well as conversations with them, observing them in action, and analysis of pertinent secondary sources. The methodology achieves validity and reliability by gathering information from multiple sources and making disciplined judgments about its coherence and correspondence with reality. Findings A paradox with deep historical roots persists as a result of consensus about its value for both population health and the revenue of individuals and organizations in the health sector. Participants in this consensus include leaders of governance who have disagreed about many other issues. The paradox persists because of assumptions about the burden of disease and how to address it, as well as about the effects of biomedical science that is translated into professional education, practice, and the organization of services for the prevention, diagnosis, treatment, and management of illness. Conclusions The policy paradox that has incentivized the growth and commercialization of nonprofits in the health sector since the late 19th century remains influential in health policy, especially for the allocation of resources. However, aspects of the implementation of the ACA may constrain some of the effects of the paradox. PMID:25752354

Awareness, Facilitators, and Barriers to Policy Implementation Related to Obesity Prevention for Primary School Children in Malaysia.

PubMed

Chan, Camelina; Moy, Foong Ming; Lim, Jennifer N W; Dahlui, Maznah

2018-03-01

To assess the awareness, facilitators, and barriers to policy implementation related to obesity prevention for primary school children. A cross-sectional study administered using an online questionnaire. Conducted in 447 primary schools in a state in Malaysia. One school administrator from each school served as a participant. The questionnaires consisted of 32 items on awareness, policy implementation, and facilitators and barriers to policy implementation. Descriptive analysis was used to describe the awareness, facilitators, and barriers of policies implementation. Association between schools' characteristics and policy implementation was assessed using logistic regression. The majority (90%) of school administrators were aware of the policies. However, only 50% to 70% of schools had implemented the policies fully. Reported barriers were lack of equipment, insufficient training, and limited time to complete implementation. Facilitators of policy implementation were commitment from the schools, staff members, students, and canteen operators. Policy implementation was comparable in all school types and locality; except the policy on "Food and Drinks sold at the school canteens" was implemented by more rural schools compared to urban schools (odds ratio: 1.74, 95% confidence interval: 1.13-2.69). Majority of the school administrators were aware of the existing policies; however, the implementation was only satisfactory. The identified barriers to policy implementation were modifiable and thus, the stakeholders should consider restrategizing plans in overcoming them.

College Alcohol Policy and Student Drinking-while-Driving: A Multilevel Model

ERIC Educational Resources Information Center

Liu, Jing

2012-01-01

Alcohol prohibition and legal or administrative sanctions have been implemented in attempts to curb alcohol drinking and drinking-while-driving in the general population as well as among college students. This dissertation study examines the impact of college alcohol prohibition and policy enforcement on students' alcohol drinking and…

Healthy Marriage Initiatives: On the Need for Empiricism in Policy Implementation

ERIC Educational Resources Information Center

Johnson, Matthew D.

2012-01-01

The association between marriage and well-being has led to policies that promote marital interventions and discourage divorce. These include federal initiatives specifically targeting poor couples and couples of color. While there are many prospective studies on marriage that have informed some couple interventions, the studies that are included…

Recent Observations on Religion Education in South Africa

ERIC Educational Resources Information Center

Nogueira-Godsey, Elaine

2016-01-01

Thirteen years have passed since the Minister of Education, Kader Asmal, implemented the National Policy on Religion and Education in 2003 (South African Government 2003). The policy provided a new framework to promote diversity by educating young people about the religions of others as well as respect towards freedom of religious expression, a…

Successful Attendance Policies and Programs. Research Brief

ERIC Educational Resources Information Center

Education Partnerships, Inc., 2012

2012-01-01

What steps can be taken to assure that High School students have the best attendance possible? It is commonly believed and well supported by research that students who attend school regularly are more successful than those who do not. The challenge for high schools is to design and implement attendance policies and programs that monitor,…

English Language Teaching in Japan: Policy Plans and Their Implementations

ERIC Educational Resources Information Center

Honna, Nobuyuki; Takeshita, Yuko

2005-01-01

This paper describes Japan's most recent attempts to improve English teaching and learning at all levels of the education system both for students and teachers as well as for the public in general. Based on policy recommendations by several advisory committees, the Japanese Ministry of Education, Culture, Sports, Science and Technology has…

The Botswana Government's Environmental Policies and the Need To Institutionalize Life Long Environmental Education.

ERIC Educational Resources Information Center

JNS, Mutanyatta

This paper highlights the existing Botswana national policy on natural resources conservation and development, as well as the stated conservation strategy, institutions and implementation. In order to achieve Botswana's commitment to sustainable development as a goal which emphasizes both conservation and development, the paper strongly argues for…

Pressure Groups and Education Policy and Administration in Australia.

ERIC Educational Resources Information Center

Harman, G. S.

This report discusses the role and function of pressure groups with regard to policy formation and implementation in Australian education. It is addressed to the scholar interested in gaining further insight into the structure and operation of the political and educational systems, as well as to those engaged or involved in the whole educational…

Opening the black box: a study of the process of NICE guidelines implementation.

PubMed

Spyridonidis, Dimitrios; Calnan, Michael

2011-10-01

This study informs 'evidence-based' implementation by using an innovative methodology to provide further understanding of the implementation process in the English NHS using two distinctly different NICE clinical guidelines as exemplars. The implementation process was tracked retrospectively and prospectively using a comparative case-study and longitudinal design. 74 unstructured interviews were carried out with 48 key informants (managers and clinicians) between 2007 and 2009. This study has shown that the NICE guidelines implementation process has both planned and emergent components, which was well illustrated by the use of the prospective longitudinal design in this study. The implementation process might be characterised as strategic and planned to begin with but became uncontrolled and subject to negotiation as it moved from the planning phase to adoption in everyday practice. The variations in the implementation process could be best accounted for in terms of differences in the structure and nature of the local organisational context. The latter pointed to the importance of managers as well as clinicians in decision-making about implementation. While national priorities determine the context for implementation the shape of the process is influenced by the interactions between doctors and managers, which influence the way they respond to external policy initiatives such as NICE guidelines. NICE and other national health policy-makers need to recognise that the introduction of planned change 'initiatives' in clinical practice are subject to social and political influences at the micro level as well as the macro level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Implementation of Local Wellness Policies in Schools: Role of School Systems, School Health Councils, and Health Disparities.

PubMed

Hager, Erin R; Rubio, Diana S; Eidel, G Stewart; Penniston, Erin S; Lopes, Megan; Saksvig, Brit I; Fox, Renee E; Black, Maureen M

2016-10-01

Written local wellness policies (LWPs) are mandated in school systems to enhance opportunities for healthy eating/activity. LWP effectiveness relies on school-level implementation. We examined factors associated with school-level LWP implementation. Hypothesized associations included system support for school-level implementation and having a school-level wellness team/school health council (SHC), with stronger associations among schools without disparity enrollment (majority African-American/Hispanic or low-income students). Online surveys were administered: 24 systems (support), 1349 schools (LWP implementation, perceived system support, SHC). The state provided school demographics. Analyses included multilevel multinomial logistic regression. Response rates were 100% (systems)/55.2% (schools). Among schools, 44.0% had SHCs, 22.6% majority (≥75%) African-American/Hispanic students, and 25.5% majority (≥75%) low-income (receiving free/reduced-price meals). LWP implementation (17-items) categorized as none = 36.3%, low (1-5 items) = 36.3%, high (6+ items) = 27.4%. In adjusted models, greater likelihood of LWP implementation was observed among schools with perceived system support (high versus none relative risk ratio, RRR = 1.63, CI: 1.49, 1.78; low versus none RRR = 1.26, CI: 1.18, 1.36) and SHCs (high versus none RRR = 6.8, CI: 4.07, 11.37; low versus none RRR = 2.24, CI: 1.48, 3.39). Disparity enrollment did not moderate associations (p > .05). Schools with perceived system support and SHCs had greater likelihood of LWP implementation, with no moderating effect of disparity enrollment. SHCs/support may overcome LWP implementation obstacles related to disparities. © 2016, American School Health Association.

Research on health equity in the SDG era: the urgent need for greater focus on implementation.

PubMed

Rasanathan, Kumanan; Diaz, Theresa

2016-12-09

The tremendous increase in knowledge on inequities in health and their drivers in recent decades has not been matched by improvements in health inequities themselves, or by systematic evidence of what works to reduce health inequities. Within health equity research there is a skew towards diagnostic studies in comparison to intervention studies showing evidence of how interventions can reduce disparities. The lack of sufficient specific evidence on how to implement specific policies and interventions in specific contexts to reduce health inequities creates policy confusion and partly explains the lack of progress on health inequities. In the field of research on equity in health, the time has come to stop focusing so much energy on prevalence and pathways, and instead shift to proposing and testing solutions. Four promising approaches to do so are implementation research, natural experimental policy studies, research on buy-in by policy-makers to action on health inequities, and geospatial analysis. The case for action on social determinants and health inequities has well and truly been made. The community of researchers on health equity now need to turn their attention to supporting implementation efforts towards achievements of the Sustainable Development Goals and substantive reductions in health inequities.

Avoiding Implementation Failure in Catchment Landscapes: A Case Study in Governance of the Great Barrier Reef.

PubMed

Dale, Allan P; Vella, Karen; Gooch, Margaret; Potts, Ruth; Pressey, Robert L; Brodie, Jon; Eberhard, Rachel

2017-10-04

Water quality outcomes affecting Australia's Great Barrier Reef (GBR) are governed by multi-level and multi-party decision-making that influences forested and agricultural landscapes. With international concern about the GBR's declining ecological health, this paper identifies and focuses on implementation failure (primarily at catchment scale) as a systemic risk within the overall GBR governance system. There has been limited integrated analysis of the full suite of governance subdomains that often envelop defined policies, programs and delivery activities that influence water quality in the GBR. We consider how the implementation of separate purpose-specific policies and programs at catchment scale operate against well-known, robust design concepts for integrated catchment governance. We find design concerns within ten important governance subdomains that operate within GBR catchments. At a whole-of-GBR scale, we find a weak policy focus on strengthening these delivery-oriented subdomains and on effort integration across these subdomains within catchments. These governance problems when combined may contribute to failure in the implementation of major national, state and local government policies focused on improving water quality in the GBR, a lesson relevant to landscapes globally.

Reframing "Well-Being" in Schools: The Potential of Recognition

ERIC Educational Resources Information Center

Graham, Anne; Powell, Mary Ann; Thomas, Nigel; Anderson, Donnah

2017-01-01

In Australia and internationally, the well-being of children and young people is a core focus of social policy, with a growing imperative to locate well-being within the sphere of education. However, the term "well-being" remains ambiguous and the implementation of educational approaches to promote and improve it appears fragmented and…

The 5th Annual One Mind Summit: Lessons Learned About "Science Informing Brain Health Policies and Practice".

PubMed

Hicks, Ramona; Johnson, Stephen; Porter, Amy; Zatzick, Douglas F; One Mind Summit Panel Participants, The

2017-03-29

Advances in science frequently precede changes in clinical care by several years or even decades. To better understand the path to translation, we invited experts to share their perspectives at the 5th Annual One Mind Summit: "Science Informing Brain Health Policies and Practice", which was held on May 24-25, 2016 in Crystal City, VA. While the translation of brain research throughout the pipeline - from basic science research to patient care - was discussed, the focus was on the implementation of "best evidence" into patient care. The Summit identified key steps, including the need for professional endorsement and clinical guidelines or policies, acceptance by regulators and payers, dissemination and training for clinicians, patient advocacy, and learning healthcare models. The path to implementation was discussed broadly, as well as in the context of a specific project to implement concussion screening in emergency and urgent care centers throughout the U.S.

HIV policy implementation in two health and demographic surveillance sites in Uganda: findings from a national policy review, health facility surveys and key informant interviews.

PubMed

McRobie, Ellen; Wringe, Alison; Nakiyingi-Miiro, Jessica; Kiweewa, Francis; Lutalo, Tom; Nakigozi, Gertrude; Todd, Jim; Eaton, Jeffrey William; Zaba, Basia; Church, Kathryn

2017-04-05

Successful HIV testing, care and treatment policy implementation is essential for realising the reductions in morbidity and mortality those policies are designed to target. While adoption of new HIV policies is rapid, less is known about the facility-level implementation of new policies and the factors influencing this. We assessed implementation of national policies about HIV testing, treatment and retention at health facilities serving two health and demographic surveillance sites (HDSS) (10 in Kyamulibwa, 14 in Rakai). Ugandan Ministry of Health HIV policy documents were reviewed in 2013, and pre-determined indicators were extracted relating to the content and nature of guidance on HIV service provision. Facility-level policy implementation was assessed via a structured questionnaire administered to in-charge staff from each health facility. Implementation of policies was classified as wide (≥75% facilities), partial (26-74% facilities) or minimal (≤25% facilities). Semi-structured interviews were conducted with key informants (policy-makers, implementers, researchers) to identify factors influencing implementation; data were analysed using the Framework Method of thematic analysis. Most policies were widely implemented in both HDSS (free testing, free antiretroviral treatment (ART), WHO first-line regimen as standard, Option B+). Both had notable implementation gaps for policies relating to retention on treatment (availability of nutritional supplements, support groups or isoniazid preventive therapy). Rakai implemented more policies relating to provision of antiretroviral treatment than Kyamulibwa and performed better on quality of care indicators, such as frequency of stock-outs. Factors facilitating implementation were donor investment and support, strong scientific evidence, low policy complexity, phased implementation and effective planning. Limited human resources, infrastructure and health management information systems were perceived as major barriers to effective implementation. Most HIV policies were widely implemented in the two settings; however, gaps in implementation coverage prevail and the value of ensuring complete coverage of existing policies should be considered against the adoption of new policies in regard to resource needs and health benefits.

Implementing falls prevention research into policy and practice in Australia: past, present and future.

PubMed

Lord, Stephen R; Sherrington, Catherine; Cameron, Ian D; Close, Jacqueline C T

2011-12-01

Falls in older Australians are a significant public health issue with one in three older people falling one or more times each year. Many fall prevention randomized controlled trials have been conducted in Australia as well as across the world. The findings of these studies now constitute a substantial evidence base that can provide direction for health and lifestyle interventions for preventing falls in older people. This research evidence has contributed to health policy in Australia to some extent, but is yet to be widely implemented into practice. This opinion piece overviews previous policy initiatives and describes a new Partnership research program funded by the Australian National Health and Medical Research Council (NHMRC), which seeks to further influence health policy and address the ongoing research-practice gap. Copyright © 2011. Published by Elsevier Ltd.

Lessons from an evaluation of a provincial-level smoking control policy in Shanghai, China.

PubMed

Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J; Wong, Frank Y; Berg, Carla J

2013-01-01

The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Six months after implementation, 82% of the participants agreed that "legislation is enforced most of the time". The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future.

The Implementation of Schools' Policy in the Development of the Local Content Curriculum in Primary Schools in Pacitan, Indonesia

ERIC Educational Resources Information Center

Maryono

2016-01-01

This study aims to describe the culture and local potential in Pacitan, East Java, as well as the implementation of local content in primary schools in the area, and some factors that support and hinder their implementation. This research is a qualitative case study. There were five primary schools used as samples obtained through purposive…

Implementation and research priorities for FCTC Articles 13 and 16: tobacco advertising, promotion, and sponsorship and sales to and by minors.

PubMed

Nagler, Rebekah H; Viswanath, Kasisomayajula

2013-04-01

Article 13 of the Framework Convention on Tobacco Control (FCTC) calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship (TAPS), and Article 16 calls for prohibition of tobacco sales to and by minors. Although these mandates are based on sound science, many countries have found provision implementation to be rife with challenges. This paper reviews the history of tobacco marketing and minor access restrictions in high-, middle-, and low-income countries, identifying past challenges and successes. We consider current challenges to FCTC implementation, how these barriers can be addressed, and what research is necessary to support such efforts. Specifically, we identify implementation and research priorities for FCTC Articles 13 and 16. Although a solid evidence base underpins the FCTC's call for TAPS bans and minor access restrictions, we know substantially less about how best to implement these restrictions. Drawing on the regulatory experiences of high-, middle-, and low-income countries, we discern several implementation and research priorities, which are organized into 4 categories: policy enactment and enforcement, human capital expertise, the effects of FCTC marketing and youth access policies, and knowledge exchange and transfer among signatories. Future research should provide detailed case studies on implementation successes and failures, as well as insights into how knowledge of successful restrictions can be translated into tobacco control policy and practice and shared among different stakeholders. Tobacco marketing surveillance, sales-to-minors compliance checks, enforcement and evaluation of restriction policies, and capacity building and knowledge transfer are likely to prove central to effective implementation.

How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan.

PubMed

Khan, Mishal S; Meghani, Ankita; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

2018-03-01

Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews-14 in Pakistan and 10 in Cambodia-with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors' power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries' health policy processes. © The Author(s) 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan

PubMed Central

Khan, Mishal S; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

2018-01-01

Abstract Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews—14 in Pakistan and 10 in Cambodia—with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors’ power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries’ health policy processes. PMID:29237026

HIV/AIDS workplace policy addressing epidemic drivers through workplace programs.

PubMed

Chatora, Bridget; Chibanda, Harrington; Kampata, Linda; Wilbroad, Mutale

2018-01-25

HIV workplace policies have become an important tool in addressing the HIV Pandemic in Sub-Saharan Africa. In Zambia, the National AIDS Council has been advocating for establishing of HIV/AIDS workplace policies to interested companies, however no formal evaluation has been done to assess uptake and implementation. The study aimed to establish the existence of HIV/AIDS policies and programs in the private sector and to understand implementation factors and experiences in addressing HIV epidemic drivers through these programs. A mixed method assessment of the availability of policies was conducted in 128 randomly selected member companies of Zambia Federation of Employers in Lusaka. Categorized variables were analysed on Policy and programs using Stata version 12.0 for associations: Concurrently, 28 in-depth interviews were conducted on purposively sampled implementers. Qualitative results were analysed thematically before integrating them with qualitative findings. Policies were found in 47/128 (36.72%) workplaces and the private sector accounted for 34/47 (72.34%) of all workplaces with a policy. Programs were available in 56/128 (43.75%) workplaces. The availability of policy was 2.7 times more likely to occur with increased size of a workplace, P value = 0.0001, (P < 0.05). Management support was 0.253 times more likely to occur in workplaces with policy, P value = 0.013, (P < 0.05) compared to those without. Having a specific budget for programs was 0.23 times more likely to occur in workplaces with a policy (P < 0.05) than those without a policy. Implementation was hindered by reduced funding, lack of time, sensitisation and lack of monitoring/evaluation systems. HIV awareness (56/56, 100%) and HIV/AIDS/Stigma (47/56, 83.93%) were the most addressed epidemic drivers through programs while Mother to Child Transmission (30/56 53.57%) and Males having sex with males were the least addressed (18/56, 32.14%). HIV/AIDS policies exist in the private sector at a very low proportion but policy translation was very high suggesting that workplaces with polices are likely to implement programs. The eradication of HIV/AIDS by 2030, requires addressing epidemic drivers with a focus on marginalised populations, gender integration, a wellness and rights based approach within the context of the legal framework.

Policy interventions related to medicines: Survey of measures taken in European countries during 2010-2015.

PubMed

Vogler, Sabine; Zimmermann, Nina; de Joncheere, Kees

2016-12-01

Policy-makers can use a menu of pharmaceutical policy options. This study aimed to survey these measures that were implemented in European countries between 2010 and 2015. We did bi-annual surveys with competent authorities of the Pharmaceutical Pricing and Reimbursement Information network. Additionally, we consulted posters produced by members of this network as well as further published literature. Information on 32 European countries (all European Union Member States excluding Luxembourg; Iceland, Norway, Serbia, Switzerland, Turkey) was included. 557 measures were reported between January 2010 and December 2015. The most frequently mentioned measure was price reductions and price freezes, followed by changes in patient co-payments, modifications related to the reimbursement lists and changes in distribution remuneration. Most policy measures were identified in Portugal, Greece, Belgium, France, the Czech Republic, Iceland, Spain and Germany. 22% of the measures surveyed could be classified as austerity. Countries that were strongly hit by the financial crisis implemented most policy changes, usually aiming to generate savings and briefly after the emergence of the crisis. Improvements in the economic situation tended to lead to an easing of austerity measures. Countries also implemented policies that aimed to enhance enforcement of existing measures and increase efficiency. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Family presence during cardiopulmonary resuscitation: using evidence-based knowledge to guide the advanced practice nurse in developing formal policy and practice guidelines.

PubMed

Doolin, Christopher T; Quinn, Lisa D; Bryant, Lesley G; Lyons, Ann A; Kleinpell, Ruth M

2011-01-01

To provide advanced practice nurses (APNs) with the best available evidence for implementation of policies and procedures to allow family presence during cardiopulmonary resuscitation (CPR) in the acute care environment. A comprehensive review of research-based articles from Ebsco Host, CINAHL, Pre-CINAHL, and Medline Plus, as well as statement alerts from nursing credentialing bodies, and practice guidelines were reviewed. Kolcaba's Theory of Comfort and Lewin's Three Step Change Theory provide a framework for implementation of formal policies and procedures. Best available evidence showed more support in favor of allowing families at the bedside during CPR. Implementation of policies and procedures allowing family presence enables facilities to change and grow in a holistic and family-oriented atmosphere. With this evidence-based knowledge the APN will be able to disseminate information to facilitate collaborative change in current practices surrounding staff education, decision making, and self-governance. The APN can then address controversial changes when developing formal policies and procedures, which will increase patient satisfaction and outcomes. ©2010 The Author Journal compilation ©2010 American Academy of Nurse Practitioners.

How Do We Ensure Research and Scientific Integrity? A Diverse Panel Discusses the Critical Components and Challenges of Crafting and Implementing Effective Scientific Integrity Policies.

NASA Astrophysics Data System (ADS)

Werkheiser, W. H.

2016-12-01

10 Years of Scientific Integrity Policy at the U.S. Geological Survey The U.S. Geological Survey implemented its first scientific integrity policy in January 2007. Following the 2009 and 2010 executive memoranda aimed at creating scientific integrity policies throughout the federal government, USGS' policy served as a template to inform the U.S. Department of Interior's policy set forth in January 2011. Scientific integrity policy at the USGS and DOI continues to evolve as best practices come to the fore and the broader Federal scientific integrity community evolves in its understanding of a vital and expanding endeavor. We find that scientific integrity is best served by: formal and informal mechanisms through which to resolve scientific integrity issues; a well-communicated and enforceable code of scientific conduct that is accessible to multiple audiences; an unfailing commitment to the code on the part of all parties; awareness through mandatory training; robust protection to encourage whistleblowers to come forward; and outreach with the scientific integrity community to foster consistency and share experiences.

Reducing Environmental Allergic Triggers: Policy Issues.

PubMed

Abramson, Stuart L

The implementation of policies to reduce environmental allergic triggers can be an important adjunct to optimal patient care for allergic rhinitis and allergic asthma. Policies at the local level in schools and other public as well as private buildings can make an impact on disease morbidity. Occupational exposures for allergens have not yet been met with the same rigorous policy standards applied for exposures to toxicants by Occupational Safety and Health Administration. Further benefit may be obtained through policies by local, county, state, and national governments, and possibly through international cooperative agreements. The reduction of allergenic exposures can and should be affected by policies with strong scientific, evidence-based derivation. However, a judicious application of the precautionary principle may be needed in circumstances where the health effect of inaction could lead to more serious threats to vulnerable populations with allergic disease. This commentary covers the scientific basis, current implementation, knowledge gaps, and pro/con views on policy issues in reducing environmental allergic triggers. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

How Do We Ensure Research and Scientific Integrity? A Diverse Panel Discusses the Critical Components and Challenges of Crafting and Implementing Effective Scientific Integrity Policies.

NASA Astrophysics Data System (ADS)

Werkheiser, W. H.

2017-12-01

10 Years of Scientific Integrity Policy at the U.S. Geological Survey The U.S. Geological Survey implemented its first scientific integrity policy in January 2007. Following the 2009 and 2010 executive memoranda aimed at creating scientific integrity policies throughout the federal government, USGS' policy served as a template to inform the U.S. Department of Interior's policy set forth in January 2011. Scientific integrity policy at the USGS and DOI continues to evolve as best practices come to the fore and the broader Federal scientific integrity community evolves in its understanding of a vital and expanding endeavor. We find that scientific integrity is best served by: formal and informal mechanisms through which to resolve scientific integrity issues; a well-communicated and enforceable code of scientific conduct that is accessible to multiple audiences; an unfailing commitment to the code on the part of all parties; awareness through mandatory training; robust protection to encourage whistleblowers to come forward; and outreach with the scientific integrity community to foster consistency and share experiences.

Assessing the Universal Basic Education Primary and Koranic Schools' Synergy for "Almajiri" Street Boys in Nigeria

ERIC Educational Resources Information Center

Usman, Lantana M.

2008-01-01

Purpose: The purpose of this paper is to show how Nigeria's current Universal Basic Education on primary schooling targets Muslim "Almajiri" street boys for basic literacy acquisition. The paper examines the policy's management implementation practices and challenges, as well as provides policy options that may minimize discrepancies for…

Autonomy and School Improvement: What Do We Know and Where Do We Go from Here?

ERIC Educational Resources Information Center

Honig, Meredith I.; Rainey, Lydia R.

2012-01-01

New "autonomy initiatives" aim to increase schools' decision-making authority as a strategy to leverage school improvement. These policies build on lessons of previous reforms such as site-based management in ways that bode well for their success. However, how are these policies actually faring in implementation? The authors addressed that…

Simulation: The Effects of Simulation on High Stakes Testing in Undergradute Nursing Education

ERIC Educational Resources Information Center

Walters, Linda

2014-01-01

Many nursing programs use standardized testing packages in order to evaluate students' content mastery as well as predict probability of passing the National Council Licensure for Registered Nurses (NCLEX-RN). Instead of a diagnosis for weak content areas, programs implement testing policies in the belief that such policies ensure student success…

Technical-Vocational Education and Language Policy in Ghana

ERIC Educational Resources Information Center

Adogpa, James Nsoh

2015-01-01

Technical and vocational graduates in Ghana are often ill-equipped to become self-reliant or well-fitted into the demands of the job market. This pattern can be examined in terms of the educational language policy implementation that disregards regional linguistic needs. This seems to arise as a result of the medium of instruction that is…

Concussion management in US college football: progress and pitfalls

PubMed Central

Kroshus, Emily

2015-01-01

Reducing the frequency and severity of concussions from sport is an important issue in public health currently addressed by a multifaceted approach. Given the large number of participants and the comparatively high risk of injury, American football is an important sport to consider when examining concussion management practices. Focusing on American football at the collegiate level, this manuscript describes current research regarding concussion epidemiology, policy, implementation of clinical diagnosis, management and return-to-play standards and athlete concussion education. Although American collegiate sports leagues have put forth concussion-related policies in recent years, the implementation of these policies and related effects on athlete concussion education, clinical management of concussion and ultimately athlete health outcomes are not well understood. Additional research is needed. PMID:27064258

[Harm reduction interventions in drug users: current situation and recommendations].

PubMed

Bosque-Prous, Marina; Brugal, María Teresa

2016-11-01

Harm reduction encompasses interventions, programmes and policies that seek to reduce the negative consequences of the consumption of both legal and illegal drugs on the individual and public health. Harm reduction looks to mitigate the harm suffered by drug users through drug use monitoring and prevention, and promotes initiatives that respect and protect the human rights of this population. The harm reduction policies that have proven effective and efficient are: opioid substitution maintenance therapy (methadone); needle and syringe exchange programmes; supervised drug consumption rooms; and overdose prevention through peer-based naloxone distribution. In order to be effective, these policies must have comprehensive coverage and be implemented in areas where the target population is prevalent. Resident-based opposition to the implementation of these policies is known as the NIMBY (Not In My Back Yard) phenomenon, which is characterised by being against the implementation of new measures in a particular place, but does not question their usefulness. Given that any NIMBY phenomenon is a complex social, cultural and political phenomenon, it is important to conduct a thorough analysis of the situation prior to implementing any of these measures. Harm reduction policies must be extended to other substances such as alcohol and tobacco, as well as to other conditions beyond infectious/contagious diseases and overdose. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Fidelity of Implementation of a State Antibullying Policy with a Focus on Protected Social Classes

ERIC Educational Resources Information Center

Hall, William J.; Chapman, Mimi V.

2018-01-01

Bullying threatens the mental and educational well-being of students. All states have enacted antibullying laws. This study surveyed 634 educators about the implementation of the North Carolina School Violence Prevention Act, which enumerated social classes protected from bullying: race, national origin, gender, socioeconomic status, sexual…

Bangladesh policy on prevention and control of non-communicable diseases: a policy analysis.

PubMed

Biswas, Tuhin; Pervin, Sonia; Tanim, Md Imtiaz Alam; Niessen, Louis; Islam, Anwar

2017-06-19

This paper is aimed at critically assessing the extent to which Non-Communicable Disease NCD-related policies introduced in Bangladesh align with the World Health Organization's (WHO) 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. The authors reviewed all relevant policy documents introduced by the Government of Bangladesh since its independence in 1971. The literature review targeted scientific and grey literature documents involving internet-based search, and expert consultation and snowballing to identify relevant policy documents. Information was extracted from the documents using a specific matrix, mapping each document against the six objectives of the WHO 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. A total of 51 documents were identified. Seven (14%) were research and/or surveys, nine were on established policies (17%), while seventeen (33%) were on action programmes. Five (10%) were related to guidelines and thirteen (25%) were strategic planning documents from government and non-government agencies/institutes. The study covered documents produced by the Government of Bangladesh as well as those by quasi-government and non-government organizations irrespective of the extent to which the intended policies were implemented. The policy analysis findings suggest that although the government has initiated many NCD-related policies or programs, they lacked proper planning, implementation and monitoring. Consequently, Bangladesh over the years had little success in effectively addressing the growing burden of non-communicable diseases. It is imperative that future research critically assess the effectiveness of national NCD policies by monitoring their implementation and level of population coverage.

Nutrition and physical activity in child care centers: the impact of a wellness policy initiative on environment and policy assessment and observation outcomes, 2011.

PubMed

Lyn, Rodney; Maalouf, Joyce; Evers, Sarah; Davis, Justin; Griffin, Monica

2013-05-23

The child care environment has emerged as an ideal setting in which to implement policies that promote healthy body weight of children. The purpose of this study was to assess the effect of a wellness policy and training program on the physical activity and nutrition environment in 24 child care centers in Georgia. We used the Environment and Policy Assessment and Observation instrument to identify changes to foods served, staff behaviors, and physical activity opportunities. Observations were performed over 1 day, beginning with breakfast and concluding when the program ended for the day. Observations were conducted from February 2010 through April 2011 for a total of 2 observations in each center. Changes to nutrition and physical activity in centers were assessed on the basis of changes in scores related to the physical activity and nutrition environment documented in the observations. Paired t test analyses were performed to determine significance of changes. Significant improvements to total nutrition (P < .001) and physical activity scores (P < .001) were observed. Results indicate that centers significantly improved the physical activity environments of centers by enhancing active play (P = .02), the sedentary environment (P = .005), the portable environment (P = .002), staff behavior (P = .004), and physical activity training and education (P < .001). Significant improvements were found for the nutrition environment (P < .001), and nutrition training and education (P < .001). Findings from this study suggest that implementing wellness policies and training caregivers in best practices for physical activity and nutrition can promote healthy weight for young children in child care settings.

Decision makers, scientists and the public as stakeholders: the connection between traffic intervention policy and air quality in a local context.

NASA Astrophysics Data System (ADS)

Weiand, L.; von Schneidemesser, E.; Schmitz, S.; Niehoff, N.

2017-12-01

Urban mobility is a key issue to make cities more inclusive, safer, and more environmentally friendly. To ensure a sustainable future, local policy should, among other actions, aim to improve access to sustainable transport systems and enhance mobility opportunities, while at the same time addressing critical environmental and health targets. In order to assess whether these objectives are met, measures should be informed and evaluated from a social and environmental perspective. Citizens' opinions and the acceptance of environmental policies are crucial to successful implementation of urban mobility measures. The complexity of urban air quality issues require transparent decision-making processes that are grounded in evidence-based research and embrace local knowledge. From this basis, our research group and the city council collaborated to assess a new policy action intended to address environmental and health targets. This talk will present the results from the assessment of this new policy, that was implemented in large part to alleviate air quality exceedances, from the perspective of public acceptability of the measure and the approach taken by the city council to implement the measure. Parallel to assessing the effect of this policy on the recorded levels of air pollution and traffic counts, we conducted a social survey to examine public opinions of this measure, as well as the link between air quality awareness and mobility decisions. 4661 responses were collected over a one month period. Survey participants were those most affected by the traffic measure, including commuters and local residents. The results show that there is an overall low acceptance rate of the measure (8%) as well as low concern for air quality (2,90 - where 1 = not concerned and 6 = very concerned). We also found that there is a negative relationship between air quality rating and air quality concern. A similar approach was taken to understand climate change concern, which will be discussed further in the talk as well as how concern for air quality can increase acceptability for climate change mitigation policies.

Disability Policy Implementation From a Cross-Cultural Perspective.

PubMed

Verdugo, Miguel A; Jenaro, Cristina; Calvo, Isabel; Navas, Patricia

2017-07-01

Implementation of disability policy is influenced by social, political, and cultural factors. Based on published work, this article discusses four guidelines considered critical for successful policy implementation from a cross-cultural perspective. These guidelines are to: (a) base policy implementation on a contextual analysis, (b) employ a value-based approach, (c) align the service delivery system both vertically and horizontally, and (d) engage in a partnership in policy implementation. Public policy should be understood from a systems perspective that includes cross-cultural issues, such as how different stakeholders are acting and the way they plan and implement policy.

Interdependence between government levels in Brazilian health policy: the implementation of Emergency Care Units in the State of Rio de Janeiro, Brazil.

PubMed

de Lima, Luciana Dias; Machado, Cristiani Veira; O'Dwyer, Gisele; Baptista, Tatiana Wargas de Faria; de Andrade, Carla Lourenço Tavares; Konder, Mariana Teixeira

2015-02-01

This article addresses policymaking related to Emergency Care Units (ECU) in the State of Rio de Janeiro between 2007 and 2013, duly identifying the relationships between the various levels of government in this process. It prioritized the context of policy formulation, the factors that motivated the inclusion and maintenance of ECUs on the state agenda and the process of how the policy was implemented in the state. The study was based on the literature that defines the agenda and implementation of public policies and on contributions from historic institutionalism. The research involved analysis of documents, secondary data, and 51 interviews with people in positions of authority in state and municipal governments. The priority given to ECUs in the government agenda was the result of a confluence of historical, structural, political and institutional factors, as well as the current context. The results of this study indicate the existence of interdependence between levels of government, however federal coordination problems have prejudiced the integration of the various components of emergency health care in the state.

14 CFR 313.2 - Policy.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS IMPLEMENTATION OF THE ENERGY POLICY AND CONSERVATION ACT § 313.2 Policy. (a) General. It is the... policies and missions. (b) Implementation. Implementation of this policy is through the integration of...

14 CFR 313.2 - Policy.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATIONS IMPLEMENTATION OF THE ENERGY POLICY AND CONSERVATION ACT § 313.2 Policy. (a) General. It is the... policies and missions. (b) Implementation. Implementation of this policy is through the integration of...

14 CFR 313.2 - Policy.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS IMPLEMENTATION OF THE ENERGY POLICY AND CONSERVATION ACT § 313.2 Policy. (a) General. It is the... policies and missions. (b) Implementation. Implementation of this policy is through the integration of...

14 CFR 313.2 - Policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS IMPLEMENTATION OF THE ENERGY POLICY AND CONSERVATION ACT § 313.2 Policy. (a) General. It is the... policies and missions. (b) Implementation. Implementation of this policy is through the integration of...

14 CFR 313.2 - Policy.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS IMPLEMENTATION OF THE ENERGY POLICY AND CONSERVATION ACT § 313.2 Policy. (a) General. It is the... policies and missions. (b) Implementation. Implementation of this policy is through the integration of...

Diet and physical activity in schools: perspectives from the implementation of the WHO global strategy on diet, physical activity and health.

PubMed

Candeias, Vanessa; Armstrong, Timothy P; Xuereb, Godfrey C

2010-01-01

Non-communicable diseases (NCD), such as heart disease, stroke, cancer and diabetes, are by far the leading cause of mortality in the world, representing 60% of all deaths. Unhealthy diets and physical inactivity are well-established risk factors for overweight and the major NCD. In response to the rapid global growth of the NCD burden, the 2008 Action Plan on Prevention and Control of NCD and the 2004 Global Strategy on Diet, Physical Activity and Health (DPAS) have been developed and endorsed as key international policy instruments. As part of the work of the World Health Organization (WHO) to implement these resolutions, a framework describing the core elements for the development and implementation of a national school policy focused on diet and physical activity has been developed. This framework is included in the "DPAS implementation tool box", and it aims to guide policy-makers in the development and implementation of policies that promote healthy eating and physical activity in the school setting through changes in environment, behaviour and education. The article describes the key elements of the framework and details how this tool is integrated into other WHO activities to provide leadership, guidance, capacity building, evidence-based recommendations and advocacy for action to improve dietary practices and increase physical activity globally.

Analysis of a government policy to address nursing shortage and nursing education quality.

PubMed

Abhicharttibutra, K; Kunaviktikul, W; Turale, S; Wichaikhum, O-A; Srisuphan, W

2017-03-01

A well-educated, sufficient nursing workforce improves population health and standards of nursing care. Analysing workforce policies assists nurses to learn from the past and develop better future policies. Describe policy-making processes in the first Thai government plan to increase nursing capacity and improve nursing education quality. A qualitative study employing Longest's model to examine policy-making processes. Data were obtained from 28 in-depth interviews with key informants, who had been committee members and former deans of nursing involved with the policy processes in the 1990s. Both qualitative and quantitative data were extracted from relevant documents, and content analysis employed with all data. Three policy phases were identified. Policy formulation, where three streams of problems, politics and policy resulted in identification of nursing shortage, changes of government incumbents and needing to increase nurse production; Policy implementation included creating methods of implementation, appointing responsible people and committees, creating operational plans, producing more nurses and faculty development projects and Policy modification which incorporated implementing the first Thai international doctoral degree in English, a collaborative programme between universities. Not all key informants could be accessed due to the passage of time. Findings are unique to Thailand but inform internationally of nurses' abilities and need to be involved in policy. Nurses were involved in all policy phases. While the policy produced positive developments in growing nursing capacity and education in the past, nursing shortages remained and are now acute in Thailand. Lessons learned from this policy analysis help explain why the nursing education and nursing shortage policy was legislated through the government agenda, and the active involvement of Thai nurses in this process. Nurses globally need to be at the policy-making table to try to reduce nursing shortages, and enhance practice and education environments. © 2016 International Council of Nurses.

Evidence-informed policy formulation and implementation: a comparative case study of two national policies for improving health and social care in Sweden.

PubMed

Strehlenert, H; Richter-Sundberg, L; Nyström, M E; Hasson, H

2015-12-08

Evidence has come to play a central role in health policymaking. However, policymakers tend to use other types of information besides research evidence. Most prior studies on evidence-informed policy have focused on the policy formulation phase without a systematic analysis of its implementation. It has been suggested that in order to fully understand the policy process, the analysis should include both policy formulation and implementation. The purpose of the study was to explore and compare two policies aiming to improve health and social care in Sweden and to empirically test a new conceptual model for evidence-informed policy formulation and implementation. Two concurrent national policies were studied during the entire policy process using a longitudinal, comparative case study approach. Data was collected through interviews, observations, and documents. A Conceptual Model for Evidence-Informed Policy Formulation and Implementation was developed based on prior frameworks for evidence-informed policymaking and policy dissemination and implementation. The conceptual model was used to organize and analyze the data. The policies differed regarding the use of evidence in the policy formulation and the extent to which the policy formulation and implementation phases overlapped. Similarities between the cases were an emphasis on capacity assessment, modified activities based on the assessment, and a highly active implementation approach relying on networks of stakeholders. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was empirically useful to organize the data. The policy actors' roles and functions were found to have a great influence on the choices of strategies and collaborators in all policy phases. The Conceptual Model for Evidence-Informed Policy Formulation and Implementation was found to be useful. However, it provided insufficient guidance for analyzing actors involved in the policy process, capacity-building strategies, and overlapping policy phases. A revised version of the model that includes these aspects is suggested.

Draft national health policy 2015: A critical appraisal.

PubMed

Ahmed, Faruque U

2016-01-01

Revising a health policy of any country is a periodic procedure dependent on the change of demographic profile, current health status of the population including epidemiological changes in disease prevalence pattern, and progress made under the earlier policies. Along with it, newer research revelation of the natural history of the existing and emerging health problems, availability of newer technology as well as changing sociopolitical commitment to improve the health status of the population are the driving forces in the change of policy. Draft National Health Policy (NHP) 2015 is an attempt for the same. A review of the draft has been undertaken. The chapter on introduction is crisp and clear. Situation analysis of the draft is sketchy and without any reference of sources. Shifting the health goal is without any basis, and the objectives defined for the policy change are incongruous with the introduction. A detailed description does not give a clear picture but rather confuses the reader as it talks of comprehensive universal health-care services to be provided with a holistic concept but maximum emphasis is made in the implementation of a national program. Private health-care services are an area to reckon but except for mere references on the involvement in private-public mode, nothing concrete is observed, especially in the primary care level. Involvement envisaged in the secondary and tertiary levels is nebulous. The implementation health insurance program as well as regulatory mechanISM with the existing is also not defined exclusively in the context of a newer health policy.

Anticipating issues related to increasing preimplantation genetic diagnosis use: a research agenda.

PubMed

Klitzman, Robert; Appelbaum, Paul S; Chung, Wendy; Sauer, Mark

2008-01-01

Increasing use of preimplantation genetic diagnosis (PGD) poses numerous clinical, social, psychological, ethical, legal and policy dilemmas, many of which have received little attention. Patients and providers are now considering and using PGD for a widening array of genetic disorders, and patients may increasingly seek 'designer babies.' In the USA, although governmental oversight policies have been discussed, few specific guidelines exist. Hence, increasingly, patients and providers will face challenging ethical and policy questions of when and for whom to use PGD, and how it should be financed. These issues should be better clarified and addressed through collection of data concerning the current use of PGD in the USA, including factors involved in decision making about PGD use, as well as the education of the various communities that are, and should be, involved in its implementation. Improved understanding of these issues will ultimately enhance the development and implementation of future clinical guidelines and policies.

Law in practice: Obstacles to a smokefree workplace policy in bars serving Asian patrons

PubMed Central

2010-01-01

The California smokefree workplace ordinance (AB13) has been well-received, even in bars where deeply-established traditions of smoking may exist. However, a closer investigation of bars where indoor smoking persists reveals that bar workers in some immigrant communities continue to be exposed to secondhand smoke in their workplaces. To identify sociocultural factors that may impede the adoption of AB13, 150 observations and 29 qualitative interviews were conducted in 50 California bars serving Asian patrons. Observers witnessed indoor smoking in 82% of the bars. Interviews revealed that social relationships, social interactions, and confrontation avoidance complicated the positive reception of AB13 within these bars. By understanding the implications of sociocultural factors on policy, we provide a nuanced understanding of the challenges involved in implementing tobacco control policy in diverse settings, which may help inform future policy development and implementation in other jurisdictions. PMID:18712482

School wellness policies and foods and beverages available in schools.

PubMed

Hood, Nancy E; Colabianchi, Natalie; Terry-McElrath, Yvonne M; O'Malley, Patrick M; Johnston, Lloyd D

2013-08-01

Since 2006-2007, education agencies (e.g., school districts) participating in U.S. federal meal programs are required to have wellness policies. To date, this is the only federal policy that addresses foods and beverages sold outside of school meals (in competitive venues). To examine the extent to which federally required components of school wellness policies are associated with availability of foods and beverages in competitive venues. Questionnaire data were collected in 2007-2008 through 2010-2011 school years from 892 middle and 1019 high schools in nationally representative samples. School administrators reported the extent to which schools had required wellness policy components (goals, nutrition guidelines, implementation plan/person responsible, stakeholder involvement) and healthier and less-healthy foods and beverages available in competitive venues. Analyses were conducted in 2012. About one third of students (31.8%) were in schools with all four wellness policy components. Predominantly white schools had higher wellness policy scores than other schools. After controlling for school characteristics, higher wellness policy scores were associated with higher availability of low-fat and whole-grain foods and lower availability of regular-fat/sugared foods in middle and high schools. In middle schools, higher scores also were associated with lower availability of 2%/whole milk. High schools with higher scores also had lower sugar-sweetened beverage availability and higher availability of 1%/nonfat milk, fruits/vegetables, and salad bars. Because they are associated with lower availability of less-healthy and higher availability of healthier foods and beverages in competitive venues, federally required components of school wellness policies should be encouraged in all schools. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Including Alternative Resources in State Renewable Portfolio Standards: Current Design and Implementation Experience

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

Heeter, J.; Bird, L.

2012-11-01

Currently, 29 states, the District of Columbia, and Puerto Rico have instituted a renewable portfolio standard (RPS). An RPS sets a minimum threshold for how much renewable energy must be generated in a given year. Each state policy is unique, varying in percentage targets, timetables, and eligible resources. This paper examines state experience with implementing renewable portfolio standards that include energy efficiency, thermal resources, and non-renewable energy and explores compliance experience, costs, and how states evaluate, measure, and verify energy efficiency and convert thermal energy. It aims to gain insights from the experience of states for possible federal clean energymore » policy as well as to share experience and lessons for state RPS implementation.« less

Never the twain shall meet? - a comparison of implementation science and policy implementation research

PubMed Central

2013-01-01

Background Many of society’s health problems require research-based knowledge acted on by healthcare practitioners together with implementation of political measures from governmental agencies. However, there has been limited knowledge exchange between implementation science and policy implementation research, which has been conducted since the early 1970s. Based on a narrative review of selective literature on implementation science and policy implementation research, the aim of this paper is to describe the characteristics of policy implementation research, analyze key similarities and differences between this field and implementation science, and discuss how knowledge assembled in policy implementation research could inform implementation science. Discussion Following a brief overview of policy implementation research, several aspects of the two fields were described and compared: the purpose and origins of the research; the characteristics of the research; the development and use of theory; determinants of change (independent variables); and the impact of implementation (dependent variables). The comparative analysis showed that there are many similarities between the two fields, yet there are also profound differences. Still, important learning may be derived from several aspects of policy implementation research, including issues related to the influence of the context of implementation and the values and norms of the implementers (the healthcare practitioners) on implementation processes. Relevant research on various associated policy topics, including The Advocacy Coalition Framework, Governance Theory, and Institutional Theory, may also contribute to improved understanding of the difficulties of implementing evidence in healthcare. Implementation science is at a relatively early stage of development, and advancement of the field would benefit from accounting for knowledge beyond the parameters of the immediate implementation science literature. Summary There are many common issues in policy implementation research and implementation science. Research in both fields deals with the challenges of translating intentions into desired changes. Important learning may be derived from several aspects of policy implementation research. PMID:23758952

Never the twain shall meet?--a comparison of implementation science and policy implementation research.

PubMed

Nilsen, Per; Ståhl, Christian; Roback, Kerstin; Cairney, Paul

2013-06-10

Many of society's health problems require research-based knowledge acted on by healthcare practitioners together with implementation of political measures from governmental agencies. However, there has been limited knowledge exchange between implementation science and policy implementation research, which has been conducted since the early 1970s. Based on a narrative review of selective literature on implementation science and policy implementation research, the aim of this paper is to describe the characteristics of policy implementation research, analyze key similarities and differences between this field and implementation science, and discuss how knowledge assembled in policy implementation research could inform implementation science. Following a brief overview of policy implementation research, several aspects of the two fields were described and compared: the purpose and origins of the research; the characteristics of the research; the development and use of theory; determinants of change (independent variables); and the impact of implementation (dependent variables). The comparative analysis showed that there are many similarities between the two fields, yet there are also profound differences. Still, important learning may be derived from several aspects of policy implementation research, including issues related to the influence of the context of implementation and the values and norms of the implementers (the healthcare practitioners) on implementation processes. Relevant research on various associated policy topics, including The Advocacy Coalition Framework, Governance Theory, and Institutional Theory, may also contribute to improved understanding of the difficulties of implementing evidence in healthcare. Implementation science is at a relatively early stage of development, and advancement of the field would benefit from accounting for knowledge beyond the parameters of the immediate implementation science literature. There are many common issues in policy implementation research and implementation science. Research in both fields deals with the challenges of translating intentions into desired changes. Important learning may be derived from several aspects of policy implementation research.

Barriers and Enablers to the Implementation of School Wellness Policies: An Economic Perspective.

PubMed

Schuler, Brittany R; Saksvig, Brit I; Nduka, Joy; Beckerman, Susannah; Jaspers, Lea; Black, Maureen M; Hager, Erin R

2018-01-01

Local wellness policies (LWPs) are mandated among school systems to enhance nutrition/physical activity opportunities in schools. Prior research notes disparities in LWP implementation. This study uses mixed methods to examine barriers/enablers to LWP implementation, comparing responses by student body income. Schools ( n = 744, 24 systems) completed an LWP implementation barriers/enablers survey. Semistructured interviews ( n = 20 random subsample) described barriers/enablers. Responses were compared by majority of lower (≥50% free/reduced-price meals; lower income [LI]) versus higher income (HI) student body. In surveys, LI and HI schools identified common barriers (parents/families, federal/state regulations, students, time, funding) and enablers (school system, teachers, food service, physical education curriculum/resources, and staff). Interviews further elucidated how staffing and funding served as enablers for all schools, and provide context for how and why barriers differed by income: time, food service (HI schools), and parents/families (LI schools). Findings support commonalities in barriers and enablers among all schools, suggesting that regardless of economic context, schools would benefit from additional supports, such as physical education and nutrition education resources integrated into existing curricula, additional funding, and personnel time dedicated to wellness programming. LI schools may benefit from additional funding to support parent and community involvement.

Smoke-free or not: a pilot evaluation in selected Beijing Hospitals

PubMed Central

2013-01-01

Background China enacted a policy to ban smoking in hospitals. The Chinese Association for Tobacco Control (CATC) developed a program to help hospitals implement this policy. They conducted a program and an assessment in 3 Chinese cities (Beijing, Shanghai and Guangdong). A more in-depth evaluation was implemented with a sub-sample of hospitals in Beijing (N = 7) to provide an independent assessment. This independent assessment focused on evaluating policy development and an assessment of secondhand smoke (SHS) to determine compliance with the smoke-free policy initiative. Methods Pre- and post-survey data were collected at each of the selected hospitals with a total sample of 2835 physicians at pre-intervention and 2812 at post-intervention. Smoking rates pre- and post-policy implementation, change in knowledge, attitudes and practices among physicians, and compliance with policy were assessed. Measurements of airborne nicotine concentrations in selected locations in each hospital were taken: main hospital lobby; main outpatient center; emergency waiting room; and stairwell adjacent to a large inpatient ward. Hospital policies were collected, translated and rated for incorporated components necessary to implement a smoke-free policy. Results Physicians’ smoking rates decreased and attitudes towards tobacco control improved significantly from pre-to post-intervention. Smoking was still reported in certain areas of the hospital with 96% of passive nicotine monitors as well as self-report indicating continued smoking. Nicotine levels ranged from <0.0056 to 3.94 μg/m3), with an overall mean of .667 μg/m3. Hospitals that established stronger policies seemed to have lower levels of nicotine, suggesting a relationship between policy development and compliance. This finding is interesting but just suggestive and requires further investigation to truly demonstrate if stronger policies improve compliance and produce better outcomes. Conclusion As implementation strategies for smoke-free environments are improved and more resources are focused on hospitals, China is making progress toward achieving smoke-free hospitals. Using a model program could increase the prevalence of SHS policies across China. However, relying only on survey data may not provide an accurate assessment of this progress, and more extensive evaluation efforts are useful to understand how change can and does occur. PMID:24134057

A Look at the Impact of Raising Standards in Developmental Mathematics

ERIC Educational Resources Information Center

Guy, G. Michael; Puri, Karan; Cornick, Jonathan

2016-01-01

In this paper, we assess the effect of higher entry and exit standards at a community college in New York City. A complex set of university and college-wide policy modifications led to an increase in placement test cut-scores as well as increased requirements to complete remediation. The implementation of this policy change allows us to utilize…

Fighting Poverty: Attentive Policy Can Make a Huge Difference

ERIC Educational Resources Information Center

Smeeding, Timothy M.; Waldfogel, Jane

2010-01-01

This article discusses the implication of the implementation of anti-poverty policy in both the United Kingdom and the United States. International studies of child poverty usually find that the United States and United Kingdom are at the bottom of the league table in terms of child poverty. Indeed, the U.S. and U.K do not fare well in…

Access to Basic Education in Ghana: Politics, Policies and Progress. CREATE Pathways to Access. Research Monograph No. 42

ERIC Educational Resources Information Center

Little, Angela W.

2010-01-01

This monograph examines the history and politics of educational reform in Ghana. Using data from interviews conducted with senior policy-makers, implementers and researchers, as well as documentary sources, to explore the drivers and inhibitors of change at the political, bureaucratic and grass-roots levels. The monograph explores the nature of…

Lessons from an Evaluation of a Provincial-Level Smoking Control Policy in Shanghai, China

PubMed Central

Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J.; Wong, Frank Y.; Berg, Carla J.

2013-01-01

Background The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. Objective To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). Methods A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Results Six months after implementation, 82% of the participants agreed that “legislation is enforced most of the time”. The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Conclusions Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future. PMID:24058544

The challenges for solid waste management in accordance with Agenda 21: a Brazilian case review.

PubMed

Chaves, Gisele de Lorena Diniz; dos Santos, Jorge Luiz; Rocha, Sandra Mara Santana

2014-09-01

This paper aims to evaluate the suitability of the Brazilian solid waste policy (BSWP) with global Agenda 21 and the challenges of implementing the BSWP in municipalities. For this, a review of the principles that guided the creation of this policy was performed to demonstrate that international pressures were important in determining its effectiveness. The contradictory relationship between the satisfactory legal framework that established the Brazilian waste management policy and its weakened implementation in the municipalities is also examined . To illustrate the difficulties faced at the local level, a case study involving municipalities that compose the state of Espírito Santowe was undertaken. In this state, the municipalities signed terms of environmental commitment with supervisory agencies who undertook, within a pre-established schedule, to implement a set of actions to shape the proper management of solid waste, adapted to the requirements of national policy and the guidelines of Agenda 21. Finally, the various difficulties in meeting the requirements are discussed. It is necessary and urgent that Brazil finds a way to coordinate the mechanisms of an innovative and well formulated legal instrument to ensure the successful implementation of solid waste management at the local level to achieve the environmental, economic and social objectives. © The Author(s) 2014.

Two-dimensional gap analysis: a tool for efficient conservation planning and biodiversity policy implementation.

PubMed

Angelstam, Per; Mikusiński, Grzegorz; Rönnbäck, Britt-Inger; Ostman, Anders; Lazdinis, Marius; Roberge, Jean-Michel; Arnberg, Wolter; Olsson, Jan

2003-12-01

The maintenance of biodiversity by securing representative and well-connected habitat networks in managed landscapes requires a wise combination of protection, management, and restoration of habitats at several scales. We suggest that the integration of natural and social sciences in the form of "Two-dimensional gap analysis" is an efficient tool for the implementation of biodiversity policies. The tool links biologically relevant "horizontal" ecological issues with "vertical" issues related to institutions and other societal issues. Using forest biodiversity as an example, we illustrate how one can combine ecological and institutional aspects of biodiversity conservation, thus facilitating environmentally sustainable regional development. In particular, we use regional gap analysis for identification of focal forest types, habitat modelling for ascertaining the functional connectivity of "green infrastructures", as tools for the horizontal gap analysis. For the vertical dimension we suggest how the social sciences can be used for assessing the success in the implementation of biodiversity policies in real landscapes by identifying institutional obstacles while implementing policies. We argue that this interdisciplinary approach could be applied in a whole range of other environments including other terrestrial biota and aquatic ecosystems where functional habitat connectivity, nonlinear response to habitat loss and a multitude of economic and social interests co-occur in the same landscape.

Ensuring quality: a key consideration in scaling-up HIV-related point-of-care testing programs

PubMed Central

Fonjungo, Peter N.; Osmanov, Saladin; Kuritsky, Joel; Ndihokubwayo, Jean Bosco; Bachanas, Pam; Peeling, Rosanna W.; Timperi, Ralph; Fine, Glenn; Stevens, Wendy; Habiyambere, Vincent; Nkengasong, John N.

2016-01-01

Objective: The objective of the WHO/US President's Emergency Plan for AIDS Relief consultation was to discuss innovative strategies, offer guidance, and develop a comprehensive policy framework for implementing quality-assured HIV-related point-of-care testing (POCT). Methods: The consultation was attended by representatives from international agencies (WHO, UNICEF, UNITAID, Clinton Health Access Initiative), United States Agency for International Development, Centers for Disease Control and Prevention/President's Emergency Plan for AIDS Relief Cooperative Agreement Partners, and experts from more than 25 countries, including policy makers, clinicians, laboratory experts, and program implementers. Main outcomes: There was strong consensus among all participants that ensuring access to quality of POCT represents one of the key challenges for the success of HIV prevention, treatment, and care programs. The following four strategies were recommended: implement a newly proposed concept of a sustainable quality assurance cycle that includes careful planning; definition of goals and targets; timely implementation; continuous monitoring; improvements and adjustments, where necessary; and a detailed evaluation; the importance of supporting a cadre of workers [e.g. volunteer quality corps (Q-Corps)] with the role to ensure that the quality assurance cycle is followed and sustained; implementation of the new strategy should be seen as a step-wise process, supported by development of appropriate policies and tools; and joint partnership under the leadership of the ministries of health to ensure sustainability of implementing novel approaches. Conclusion: The outcomes of this consultation have been well received by program implementers in the field. The recommendations also laid the groundwork for developing key policy and quality documents for the implementation of HIV-related POCT. PMID:26807969

Implementation and Research Priorities for FCTC Articles 13 and 16: Tobacco Advertising, Promotion, and Sponsorship and Sales to and by Minors

PubMed Central

2013-01-01

Introduction: Article 13 of the Framework Convention on Tobacco Control (FCTC) calls for a comprehensive ban on tobacco advertising, promotion, and sponsorship (TAPS), and Article 16 calls for prohibition of tobacco sales to and by minors. Although these mandates are based on sound science, many countries have found provision implementation to be rife with challenges. Objective: This paper reviews the history of tobacco marketing and minor access restrictions in high-, middle-, and low-income countries, identifying past challenges and successes. We consider current challenges to FCTC implementation, how these barriers can be addressed, and what research is necessary to support such efforts. Specifically, we identify implementation and research priorities for FCTC Articles 13 and 16. Discussion: Although a solid evidence base underpins the FCTC’s call for TAPS bans and minor access restrictions, we know substantially less about how best to implement these restrictions. Drawing on the regulatory experiences of high-, middle-, and low-income countries, we discern several implementation and research priorities, which are organized into 4 categories: policy enactment and enforcement, human capital expertise, the effects of FCTC marketing and youth access policies, and knowledge exchange and transfer among signatories. Future research should provide detailed case studies on implementation successes and failures, as well as insights into how knowledge of successful restrictions can be translated into tobacco control policy and practice and shared among different stakeholders. Conclusion: Tobacco marketing surveillance, sales-to-minors compliance checks, enforcement and evaluation of restriction policies, and capacity building and knowledge transfer are likely to prove central to effective implementation. PMID:23291641

Evaluation of a student participatory, low-intensity program to improve school wellness environment and students' eating and activity behaviors.

PubMed

Hoelscher, Deanna M; Moag-Stahlberg, Alicia; Ellis, Karen; Vandewater, Elizabeth A; Malkani, Raja

2016-05-13

Most schools have not fully implemented wellness policies, and those that have rarely incorporate meaningful student participation. The aim of the Fuel Up to Play 60 (FUTP60) program is to help schools implement wellness policies by engaging students in activities to improve access to healthful, good tasting food and drinks, and increase the number and type of opportunities for students to be physically active. The aim of this paper is to present initial student-level results from an implementation of FUTP60 in 72 schools, grades 6-9. The study used a non-controlled pretest/posttest with serial cross-sectional data. School process data and student-level data were collected in fall 2009 (pre-intervention) and spring 2010 (post-intervention). School wellness practices were captured during a baseline needs assessment survey. Validated self-administered questionnaires assessing dietary and physical activity (PA) behaviors were administered to students in grades 6-9 in the 72 pilot schools. Mixed-effects logistic regression controlling for clustering of schools and demographics was used to calculate odds ratios and confidence intervals to evaluate changes pre- and post- intervention. All 72 schools implemented FUTP60 during the 2009-2010 school year. Action strategies most frequently chosen by the schools included increasing breakfast participation and new activities before and after school. Positive and significant changes in students' behaviors (n = 32,482 at pretest and 29,839 at post-test) were noted for dairy, whole grains, fruit, and vegetable consumption and PA levels pre- and post-intervention (OR 1.05 to 1.27). Students aware of the program at post-test were significantly more likely to report healthier eating and PA behaviors than students unaware of the program (OR 1.1 to 1.34). FUTP60 pilot findings indicate that a low intensity program focused on wellness policy implementation is associated with small positive changes in student behaviors, especially when students were aware of the program. Although these initial results are promising, a more rigorous controlled study is warranted as a next step.

Implementing smoking bans in American hospitals: results of a national survey

PubMed Central

Longo, D.; Feldman, M.; Kruse, R.; Brownson, R.; Petroski, G.; Hewett, J.

1998-01-01

OBJECTIVES—To determine how well hospitals complied with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) tobacco control standards, which required banning smoking in hospital buildings; to explore issues involved in developing and implementing smoking bans; and to ascertain the perceived success of the policies.
DESIGN—Postal survey conducted January through June 1994.
PARTICIPANTS—Stratified random sample of American hospitals surveyed by JCAHO (n = 1055).
MAIN OUTCOME MEASURES—Enacting smoking policies more restrictive than the JCAHO standard; the respondent's judgment of the relative success of the hospital's smoking policy.
RESULTS—More than 96% of hospitals complied with the smoking ban standard; 41.4% enacted policies that were more restrictive than required by JCAHO. Several characteristics were associated with exceeding JCAHO requirements: location in a "non-tobacco state"; having fewer than 100 beds; location in a metropolitan statistical area; having unionised employees; and having no psychiatric or substance abuse unit, favour having the same tobacco policy in psychiatry and substance abuse units as the rest of the hospital. More than 95% of respondents viewed their hospital's policy as successful. The JCAHO requirements and concern for employees' health were the major forces influencing hospitals to go smoke-free. Negative employee morale and lack of acceptance by visitors and patients were the most commonly cited barriers to overcome when implementing smoke-free policies.
CONCLUSIONS—Smoking bans were successfully implemented in American hospitals, with many restricting smoking beyond the JCAHO standard. Other industries wishing to follow hospitals' lead would be most likely to succeed in the context of a social norm favouring a smoking ban and regulation by an outside agency.


Keywords: smoke-free worksites; hospitals; United States PMID:9706754

The Alcohol Environment Protocol: A new tool for alcohol policy.

PubMed

Casswell, Sally; Morojele, Neo; Williams, Petal Petersen; Chaiyasong, Surasak; Gordon, Ross; Gray-Philip, Gaile; Viet Cuong, Pham; MacKintosh, Anne-Marie; Halliday, Sharon; Railton, Renee; Randerson, Steve; Parry, Charles D H

2018-01-04

To report data on the implementation of alcohol policies regarding availability and marketing, and drink driving, along with ratings of enforcement from two small high-income to three high-middle income countries, and one low-middle income country. This study uses the Alcohol Environment Protocol, an International Alcohol Control study research tool, which documents the alcohol policy environment by standardised collection of data from administrative sources, observational studies and interviews with key informants to allow for cross-country comparison and change over time. All countries showed adoption to varying extents of key effective policy approaches outlined in the World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol (2010). High-income countries were more likely to allocate resources to enforcement. However, where enforcement and implementation were high, policy on availability was fairly liberal. Key Informants judged alcohol to be very available in both high- and middle-income countries, reflecting liberal policy in the former and less implementation and enforcement and informal (unlicensed) sale of alcohol in the latter. Marketing was largely unrestricted in all countries and while drink-driving legislation was in place, it was less well enforced in middle-income countries. In countries with fewer resources, alcohol policies are less effective because of lack of implementation and enforcement and, in the case of marketing, lack of regulation. This has implications for the increase in consumption taking place as a result of the expanding distribution and marketing of commercial alcohol and consequent increases in alcohol-related harm. © 2018 The Authors Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

What impact have tobacco control policies, cigarette price and tobacco control programme funding had on Australian adolescents' smoking? Findings over a 15-year period.

PubMed

White, Victoria M; Warne, Charles D; Spittal, Matthew J; Durkin, Sarah; Purcell, Kate; Wakefield, Melanie A

2011-08-01

To assess the impact of tobacco control policies relating to youth access, clean indoor air and tobacco advertising at point-of-sale and outdoors, in addition to cigarette price and per capita tobacco control spending, on adolescent smoking prevalence. Repeated cross-sectional surveys. Logistic regression analyses examined association between policies and smoking prevalence. Australia, 1990-2005. A nationally representative sample of secondary students (aged 12-17 years) participating in a triennial survey (sample size per survey range: 20 560 to 27 480). Students' report of past-month smoking. In each jurisdiction, extent of implementation of the three policies for the year of the survey was determined. For each survey year, national per capita tobacco control spending was determined and jurisdiction-specific 12-month change in cigarette price obtained. Extent of implementation of the three policy areas varied between states and over the survey years. Multivariate analyses that adjusted for demographic factors, year and all tobacco control variables showed that 12-month cigarette price increases [odds ratio (OR): 0.98, 95% confidence interval (CI): 0.97-0.99], greater per capita tobacco control spending (OR: 0.99, 95% CI: 0.98-0.99) and stronger implementation of clean indoor air policies (OR: 0.93, 95% CI: 0.92-0.94) were associated with reduced smoking prevalence. Adult-directed, population-based tobacco control policies such as clean indoor air laws and increased prices of cigarettes, implemented as part of a well-funded comprehensive tobacco control programme are associated with lower adolescent smoking. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Multilevel spatiotemporal change-point models for evaluating the effect of an alcohol outlet control policy on changes in neighborhood assaultive violence rates.

PubMed

Xu, Yanjun; Yu, Qingzhao; Scribner, Richard; Theall, Katherine; Scribner, Scott; Simonsen, Neal

2012-06-01

Many previous studies have suggested a link between alcohol outlets and assaultive violence rates. In 1997 the City of New Orleans adopted a series of policies, e.g., increased license fee, additional enforcement staff, and expanded powers for the alcohol license board. The policies were specifically enacted to address the proliferation of problem alcohol outlets believed to be the source of a variety of social problems including assaultive violence. In this research, we evaluate the impact of a city level policy in New Orleans to address the problem alcohol outlets and their influence on assaultive violence. The spatial association between rates of assaultive violence at the census tract level (n=170) over a ten year period raises a challenge in statistical analysis. To meet this challenge we developed a hierarchical change-point model that controls for important covariates of assaultive violence and accounts for unexplained spatial and temporal variability. While our model is somewhat complex, its hierarchical Bayesian analysis is accessible via the WinBUGS software program. Keeping other effects fixed, the implementation of the new city level policy was associated with a decrease in the positive association between census tract level rates of assaultive violence and alcohol outlet density. Comparing several candidate change-point models using the DIC criterion, the positive association began decreasing the year of the policy implementation. The magnitude of the association continued to decrease for roughly two years and then stabilized. We also created maps of the fitted assaultive violence rates in New Orleans, as well as spatial residual maps which, together with Moran's I's, suggest that the spatial variation of the data is well accounted for by our model. We reach the conclusion that the implementation of the policy is associated with a significant decrease in the positive relationship between assaultive violence and the off-sale alcohol outlet density. Copyright © 2012 Elsevier Ltd. All rights reserved.

Learning from a Small State's Experience: Acknowledging the Importance of Context in Implementing Learner-Centred Pedagogy

ERIC Educational Resources Information Center

Di Biase, Rhonda

2015-01-01

The challenges of implementing learner-centred pedagogies have been well documented, noting that many reform efforts fail to consider important contextual factors. With attention to the disparity between policy and practice, this study investigated the conditions under which teachers can enact learner-centred pedagogy in the Maldives using…

Higher Education Institutional Agents as Policy Implementers: The Case of Policies That Affect Undocumented and DACAmented Students

ERIC Educational Resources Information Center

Nienhusser, H. Kenny

2018-01-01

This study examines 45 community college institutional agents across four states in their role as implementer of policies that affected undocumented and DACAmented students. The findings delve into the role of changing implementation landscape, policy vagueness, implementation burden, and institutional support in this implementation environment.…

A job analysis of community health workers in the context of integrated nutrition and early child development.

PubMed

Phuka, John; Maleta, Kenneth; Thomas, Mavuto; Gladstone, Melisa

2014-01-01

Stunting and poor child development are major public health concerns in Malawi. Integrated nutrition and early child development (ECD) interventions have shown potential to reduce stunting, but it is not known how these integrated approaches can be implemented in Malawi. In this paper, we aimed to evaluate the current jobs status of community health workers and their potential to implement integrated approaches. This was accomplished by a desk review of nutrition and ECD policy documents, as well as interviews with key informants, community health workers, and community members. We found that Malawi has comprehensive policies and well-outlined coordination structures for nutrition and ECD that advocate for integrated approaches. Strong multidisciplinary interaction exists at central levels but not at the community level. Integration of community health workers from different sectors is limited by workload, logistics, and a lack of synchronized work schedules. Favorable, sound policies and well-outlined coordination structures alone are not enough for the establishment of integrated nutrition and ECD activities. Balanced bureaucratic structures, improved task allocation, and synchronization of work schedules across all relevant sectors are needed for integrated intervention in Malawi. © 2014 New York Academy of Sciences.

From policy to practice: implementing frontline community health services for substance dependence--study protocol.

PubMed

Gill, Kathryn J; Campbell, Emily; Gauthier, Gail; Xenocostas, Spyridoula; Charney, Dara; Macaulay, Ann C

2014-08-20

Substance abuse is a worldwide public health concern. Extensive scientific research has shown that screening and brief interventions for substance use disorders administered in primary care provide substantial benefit at relatively low cost. Frontline health clinicians are well placed to detect and treat patients with substance use disorders. Despite effectiveness shown in research, there are many factors that impact the implementation of these practices in real-world clinical practice. Recently, the Ministry of Health and Social Services in Quebec, Canada, issued two policy documents aimed at introducing screening and early intervention for substance abuse into frontline healthcare clinics in Quebec. The current research protocol was developed in order to study the process of implementation of evidence-based addiction treatment practices at three primary care clinics in Montreal (Phase 1). In addition, the research protocol was designed to examine the efficacy of overall policy implementation, including barriers and facilitators to addictions program development throughout Quebec (Phase 2). Phase 1 will provide an in-depth case study of knowledge translation and implementation. The study protocol will utilize an integrated knowledge translation strategy to build collaborative mechanisms for knowledge exchange between researchers, addiction specialists, and frontline practitioners (guided by the principles of participatory-action research), and directly examine the process of knowledge uptake and barriers to transfer using both qualitative and quantitative methodologies. Evaluation will involve multiple measures, time points and domains; program uptake and effectiveness will be determined by changes in healthcare service delivery, sustainability and outcomes. In Phase 2, qualitative methods will be utilized to examine the contextual facilitators and barriers that frontline organizations face in implementing services for substance dependence. Phase 2 will provide the first study exploring the wide-scale implementation of frontline services for substance dependence in the province of Quebec and yield needed information about how to effectively implement mandated policies into clinical practice and impact public health. Findings from this research program will contribute to the understanding of factors associated with implementation of frontline services for substance dependence and help to inform future policy and organizational support for the implementation of evidence-based practices.

A public school district's vending machine policy and changes over a 4-year period: implementation of a national wellness policy.

PubMed

Han-Markey, T L; Wang, L; Schlotterbeck, S; Jackson, E A; Gurm, R; Leidal, A; Eagle, K

2012-04-01

The school environment has been the focus of many health initiatives over the years as a means to address the childhood obesity crisis. The availability of low-nutrient, high-calorie foods and beverages to students via vending machines further exacerbates the issue of childhood obesity. However, a healthy overhaul of vending machines may also affect revenue on which schools have come to depend. This article describes the experience of one school district in changing the school environment, and the resulting impact on food and beverage vending machines. Observational study in Ann Arbor public schools. The contents and locations of vending machines were identified in 2003 and surveyed repeatedly in 2007. Overall revenues were also documented during this time period. Changes were observed in the contents of both food and beverage vending machines. Revenue in the form of commissions to the contracted companies and the school district decreased. Local and national wellness policy changes may have financial ramifications for school districts. In order to facilitate and sustain school environment change, all stakeholders, including teachers, administrators, students and healthcare providers, should collaborate and communicate on policy implementation, recognizing that change can have negative financial consequences as well as positive, healthier outcomes. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Attitudes of students and employees towards the implementation of a totally smoke free university campus policy at King Saud University in Saudi Arabia: a cross sectional baseline study on smoking behavior following the implementation of policy.

PubMed

Almutairi, Khalid M

2014-10-01

Tobacco smoking is the preventable health issue worldwide. The harmful consequences of tobacco smoking and exposure to second-hand tobacco smoke are well documented. The aim of this study is to compares the prevalence of smoking among students, faculty and staff and examines their interest to quit. Study also determines the difference on perceptions of smoking and non-smoking students, faculty and staff with regard to implementation of a smoke-free policy. A cross-sectional survey was administered to one of the largest universities in Riyadh, Saudi Arabia during the academic year of 2013. A Likert scale was used on questionnaires towards attitude to smoking and smoking free policy. The Chi squared test was used to determine the difference of support on completely smoke free campus for smokers and non-smokers. Smoking rates were highest among staff members (36.8 %) followed by students (11.2 %) and faculty (6.4 %). About half of the smokers (53.7 %) within the university attempted to quit smoking. Students (OR 3.10, 95 % CI 1.00-9.60) and faculty (OR 4.06, 95 % CI 1.16-14.18) were more likely to make quit smoking than staff members. Majority of the respondents (89.6 %) were supportive of a smoking--free policy and indicated that should be strictly enforced especially into public places. Results also showed that smokers were more likely to support a smoke-free policy if there are no fines or penalties. These baseline findings will provide information among administrators in formulating and carrying out a total smoke free policy. Although the majority of people within the King Saud University demonstrate a high support for a smoke-free policy, administrators should consider difference between smokers and non-smokers attitudes when implementing such a policy.

From Biological to Program Efficacy: Promoting Dialogue among the Research, Policy, and Program Communities12

PubMed Central

Habicht, Jean-Pierre; Pelto, Gretel H.

2014-01-01

The biological efficacy of nutritional supplements to complement usual diets in poor populations is well established. This knowledge rests on decades of methodologic research development and, more recently, on codification of methods to compile and interpret results across studies. The challenge now is to develop implementation (delivery) science knowledge and achieve a similar consensus on efficacy criteria for the delivery of these nutrients by public health and other organizations. This requires analysis of the major policy instruments for delivery and well-designed program delivery studies that examine the flow of a nutrient through a program impact pathway. This article discusses the differences between biological and program efficacy, and why elucidating the fidelity of delivery along the program impact pathways is essential for implementing a program efficacy trial and for assessing its internal and external validity. Research on program efficacy is expanding, but there is a lack of adequate frameworks to facilitate the process of harmonizing concepts and vocabulary, which is essential for communication among scientists, policy planners, and program implementers. There is an urgent need to elaborate these frameworks at national and program levels not only for program efficacy studies but also for the broader research agenda to support and improve the science of delivering adequate nutrition to those who need it most. PMID:24425719

What Are the Perceptions, Experiences, and Behaviors of Health Care Providers After Implementation of a Comprehensive Smoke-Free Hospital Policy?

PubMed

Luck, Kerrie E; Doucet, Shelley

2018-01-01

The aim of this study was to explore the perceptions, experiences, and behaviors of health care providers (HCPs) after the implementation of a comprehensive smoke-free policy. This qualitative descriptive study, using semi-structured interviews, was conducted with 28 HCPs working in a Canadian hospital. Four overarching themes emerged from the analysis including (a) greater support for tobacco reduction, (b) enhanced patient care and interactions, (c) improved staff morale, and (d) some barriers still exist. The main findings suggest a comprehensive smoke-free hospital environment can strengthen the tobacco-free workplace culture within a hospital setting among HCPs where support for tobacco reduction is amplified, patient care and interactions regarding tobacco dependence are improved, and staff morale is enhanced. While there are still some challenging barriers as well as opportunities for improvements, the implementation of a comprehensive smoke-free policy heightened the call-to-action among HCPs to take a more active role in tobacco reduction.

What Are the Perceptions, Experiences, and Behaviors of Health Care Providers After Implementation of a Comprehensive Smoke-Free Hospital Policy?

PubMed Central

Luck, Kerrie E.; Doucet, Shelley

2018-01-01

The aim of this study was to explore the perceptions, experiences, and behaviors of health care providers (HCPs) after the implementation of a comprehensive smoke-free policy. This qualitative descriptive study, using semi-structured interviews, was conducted with 28 HCPs working in a Canadian hospital. Four overarching themes emerged from the analysis including (a) greater support for tobacco reduction, (b) enhanced patient care and interactions, (c) improved staff morale, and (d) some barriers still exist. The main findings suggest a comprehensive smoke-free hospital environment can strengthen the tobacco-free workplace culture within a hospital setting among HCPs where support for tobacco reduction is amplified, patient care and interactions regarding tobacco dependence are improved, and staff morale is enhanced. While there are still some challenging barriers as well as opportunities for improvements, the implementation of a comprehensive smoke-free policy heightened the call-to-action among HCPs to take a more active role in tobacco reduction. PMID:29568792

The 5th Annual One Mind Summit: Lessons Learned About “Science Informing Brain Health Policies and Practice”

PubMed Central

Johnson, Stephen; Porter, Amy C.; Zatzick, Douglas

2017-01-01

Abstract Advances in science frequently precede changes in clinical care by several years or even decades. To better understand the path to translation, we invited experts to share their perspectives at the 5th Annual One Mind Summit: “Science Informing Brain Health Policies and Practice,” which was held on May 24–25, 2016, in Crystal City, VA. While the translation of brain research throughout the pipeline—from basic science research to patient care—was discussed, the focus was on the implementation of “best evidence” into patient care. The Summit identified key steps, including the need for professional endorsement and clinical guidelines or policies, acceptance by regulators and payers, dissemination and training for clinicians, patient advocacy, and learning healthcare models. The path to implementation was discussed broadly, as well as in the context of a specific project to implement concussion screening in emergency and urgent care centers throughout the United States. PMID:28351324

Communication Policies in Knowledge Networks

NASA Astrophysics Data System (ADS)

Ioannidis, Evangelos; Varsakelis, Nikos; Antoniou, Ioannis

2018-02-01

Faster knowledge attainment within organizations leads to improved innovation, and therefore competitive advantage. Interventions on the organizational network may be risky or costly or time-demanding. We investigate several communication policies in knowledge networks, which reduce the knowledge attainment time without interventions. We examine the resulting knowledge dynamics for real organizational networks, as well as for artificial networks. More specifically, we investigate the dependence of knowledge dynamics on: (1) the Selection Rule of agents for knowledge acquisition, and (2) the Order of implementation of "Selection" and "Filtering". Significant decrease of the knowledge attainment time (up to -74%) can be achieved by: (1) selecting agents of both high knowledge level and high knowledge transfer efficiency, and (2) implementing "Selection" after "Filtering" in contrast to the converse, implicitly assumed, conventional prioritization. The Non-Commutativity of "Selection" and "Filtering", reveals a Non-Boolean Logic of the Network Operations. The results demonstrate that significant improvement of knowledge dynamics can be achieved by implementing "fruitful" communication policies, by raising the awareness of agents, without any intervention on the network structure.

Farmers' attitudes toward mandatory water-saving policies: A case study in two basins in northwest China.

PubMed

Chang, Genying; Wang, Lu; Meng, Liuyi; Zhang, Wenxia

2016-10-01

China began to implement stringent water-saving policies in 2012. Mandatory water-saving measures implemented in arid inland river basins include the measures of allocating surface water among upper, middle and lower beaches, restricting household agricultural water use, closing wells, reducing farmland and increasing water prices. These measures have negative influences on the agricultural production of farmers. This study aimed to reveal the demographic and psychological correlates of farmers' attitudes toward these policies. The participants included 672 farmers in the Heihe River Basin and the Shule River Basin in northwest China. Structural equation analyses showed that farmers' awareness of the beneficial consequences of restricting household agricultural water and their perception of policy enforcement had significant relationships with their attitudes toward water-saving policies, whereas the effects of the New Ecological Paradigm and collectivism on farmers' attitudes were mediated through their awareness of beneficial consequences and their perception of policy enforcement. Multivariable regression analyses revealed that as a whole, there were no significant correlations between demographic variables and farmers' attitudes. Policy implications include propagandizing these policies among local farmers, strengthening open and fair policy enforcement, and cautiously using water prices as an instrument to control irrigation water. Copyright © 2016 Elsevier Ltd. All rights reserved.

Like Peas and Carrots: Combining Wellness Policy Implementation With Classroom Education for Obesity Prevention in the Childcare Setting.

PubMed

Cotwright, Caree J; Bales, Diane W; Lee, Jung Sun; Parrott, Kathryn; Celestin, Nathalie; Olubajo, Babatunde

We evaluated an intervention combining policy training and technical assistance for childcare teachers with a nutrition education curriculum to improve (1) the knowledge and self-efficacy of childcare teachers in implementing obesity prevention policies and practices, (2) the quantity and quality of nutrition and physical activity education, and (3) the childcare wellness environment. Thirteen teachers and 8 administrators (2 of whom were also teachers) from 8 childcare programs in Clarke County, Georgia, participated in the Healthy Child Care Georgia intervention during June-October 2015. The intervention included (1) training and technical assistance on obesity prevention policies, systems, and practices and (2) direct education by teachers using the Eat Healthy, Be Active curriculum. We assessed changes in program wellness policy adoption and teacher knowledge and self-efficacy from pre- to post-intervention through self-report questionnaires, interviews, and focus groups. Teachers' knowledge scores (maximum score = 100) rose significantly from a mean (SD) pre-intervention of 67.1 (14.6) to post-intervention of 83.2 (14.3) ( P < .001). The mean score for "teaching nutrition and activity to children" (maximum score = 105) rose significantly from 86.9 (8.2) to 93.5 (5.2) ( P = .011) and for "modeling and supporting children" (maximum score = 63) from 55.8 (5.1) to 59.5 (4.5) ( P = .015). The mean (SD) scores for breastfeeding and infant feeding policy/practice adoption (maximum score = 6) increased significantly from 2.5 (1.8) to 3.7 (1.9) ( P = .043) and for nutrition education policy/practice adoption (maximum score = 4) from 2.0 (1.3) to 3.3 (1.4) ( P = .019). The combined approach enhanced classroom nutrition education and improved the adoption of best practices. Future studies should examine the effects of using a combined approach to promote nutrition and physical activity policies and practices in the early care and education setting.

The state of Health in All policies (HiAP) in the European Union: potential and pitfalls.

PubMed

Koivusalo, Meri

2010-06-01

Health in All Policies (HiAP) was formally legitimated as a European Union (EU) approach in 2006. It resulted from more long-term efforts to enhance action on considering health and health policy implications of other policies, as well as recognition that European-level policies affect health systems and scope for health-related regulation at national level. However, implementation of HiAP has remained a challenge. European-level efforts to use health impact assessment to benefit public health and health systems have not become strengthened by the new procedures. And, as a result of the Lisbon Treaty, European-level policy-making is expected to become more important in shaping national policies. HiAP has at European level remained mostly as rhetoric, but legitimate health arguments and provides policy space for health articulation within EU policy-making. HiAP is a broader approach than health impact assessment and at European level requires consideration of mechanisms that recognise the nature of European policy-making, as well as extending from administrative tools to increased transparency, accountability and scope for health and health policy-related arguments within political decision-making in the EU.

The influence of formal and informal policies and practices on health care innovation implementation: A mixed-methods analysis.

PubMed

DiMartino, Lisa D; Birken, Sarah A; Hanson, Laura C; Trogdon, Justin G; Clary, Alecia S; Weinberger, Morris; Reeder-Hayes, Katherine; Weiner, Bryan J

The implementation science literature has contributed important insights regarding the influence of formal policies and practices on health care innovation implementation, whereas informal implementation policies and practices have garnered little attention. The broader literature suggests that informal implementation policies and practices could also influence innovation use. We used the Organizational Theory of Innovation Implementation to further understand the role of formal and informal implementation policies and practices as determinants of implementation effectiveness. We examined their role within the context of initiatives to increase palliative care consultation in inpatient oncology. We used a case study design in two organizational settings within one academic medical center: medical and gynecologic oncology. We completed semistructured interviews with medical (n = 12) and gynecologic (n = 10) oncology clinicians using questions based on organizational theory. Quantitative data assessed implementation effectiveness, defined as aggregated palliative care consult rates within oncology services from 2010 to 2016. Four palliative care clinicians were interviewed to gain additional implementation context insights. Medical oncology employed multiple formal policies and practices including training and clinician prompting to support palliative care consultation and a top-down approach, yet most clinicians were unaware of the policies and practices, contributing to a weak implementation climate. In contrast, gynecologic oncology employed one formal policy (written guideline of criteria for initiating a consult) but also relied on informal policies and practices, such as spontaneous feedback and communication; they adopted a bottom-up approach, contributing to broader clinician awareness and strong implementation climate. Both services exhibited variable, increasing consult rates over time. Informal policies and practices may compensate or substitute for formal policies and practices under certain conditions (e.g., smaller health care organizations). Further research is needed to investigate the role of formal and informal policies and practices in shaping a strong and sustainable implementation climate and subsequent effective innovation implementation.

Research Grants Guidance and Policies

EPA Pesticide Factsheets

These pages are designed to assist prospective applicants as well as recent recipients by conveying key documents that describe the quality assurance, reporting requirements, forms, and FAQs for the NCER STAR grant application and implementation process.

Disability Policy Implementation from a Cross-Cultural Perspective

ERIC Educational Resources Information Center

Verdugo, Miguel A.; Jenaro, Cristina; Calvo, Isabel; Navas, Patricia

2017-01-01

Implementation of disability policy is influenced by social, political, and cultural factors. Based on published work, this article discusses four guidelines considered critical for successful policy implementation from a cross-cultural perspective. These guidelines are to: (a) base policy implementation on a contextual analysis, (b) employ a…

How Congruent Is a Strict Uniform Policy with Enhanced Academic Achievement and Self-Beliefs in Early Adolescence?

ERIC Educational Resources Information Center

Hoskins, Jo A.

2014-01-01

This study focuses on the analysis of the impact of school uniforms on student self-esteem and self-efficacy. In the past, schools have implemented school uniform policies in order to help improve student achievement as well as strengthen discipline. However, previous research has indicated an association, which is tenuous at best, with regard to…

The Idealism of Education Policies and the Realities in Schools: The Implementation of Inclusive Education in South Africa

ERIC Educational Resources Information Center

Engelbrecht, Petra; Nel, Mirna; Smit, Suegnet; van Deventer, Marichelle

2016-01-01

Inclusive education as a global movement emerged over the past 30 years to ensure quality mainstream education for all learners. Since 1994 the newly democratic South Africa also had expectations as well as the political will to change education by adjusting legislation and policies. However, the vision of a truly inclusive education system in…

Implementation science approaches for integrating eHealth research into practice and policy.

PubMed

Glasgow, Russell E; Phillips, Siobhan M; Sanchez, Michael A

2014-07-01

To summarize key issues in the eHealth field from an implementation science perspective and to highlight illustrative processes, examples and key directions to help more rapidly integrate research, policy and practice. We present background on implementation science models and emerging principles; discuss implications for eHealth research; provide examples of practical designs, measures and exemplar studies that address key implementation science issues; and make recommendations for ways to more rapidly develop and test eHealth interventions as well as future research, policy and practice. The pace of eHealth research has generally not kept up with technological advances, and many of our designs, methods and funding mechanisms are incapable of providing the types of rapid and relevant information needed. Although there has been substantial eHealth research conducted with positive short-term results, several key implementation and dissemination issues such as representativeness, cost, unintended consequences, impact on health inequities, and sustainability have not been addressed or reported. Examples of studies in several of these areas are summarized to demonstrate this is possible. eHealth research that is intended to translate into policy and practice should be more contextual, report more on setting factors, employ more responsive and pragmatic designs and report results more transparently on issues important to potential adopting patients, clinicians and organizational decision makers. We outline an alternative development and assessment model, summarize implementation science findings that can help focus attention, and call for different types of more rapid and relevant research and funding mechanisms. Published by Elsevier Ireland Ltd.

Some Key Factors in Policy Implementation.

ERIC Educational Resources Information Center

Rowen, Henry

Business policy texts identify numerous steps that make up the policy implementation process for private firms. On the surface, these steps also appear applicable to the implementation of public policies. However, the problems of carrying out these implementing steps in the public sector are significantly different than in the private sector due…

[Environment and the "Health in All Policies" approach-an overview].

PubMed

Zeeb, Hajo; Hilderink, Henk; Forberger, Sarah

2018-06-01

One quarter of the global disease burden could be avoided with management strategies for environmental risk factors such as air and water pollution, food contamination, injuries and poor road safety. Many decisions influencing health are made outside the health sector; thus, the joint consideration and implementation of health and environmental factors in the relevant policies are becoming increasingly important. By means of a selective literature search, we identified important policy documents and selected research articles as a basis for the introduction and current discussion of the Health in All Policies (HiAP) approach. Parallels with the Environment in All Policies (EIAP) approach are debated. The consideration and reinforcement of environmental topics in HiAP and the link with health in the EiAP approach increase the chances of policies with mutually positive effects, especially with regard to the significance of social factors for health and the environment. The UN Sustainable Development Goals provide a good starting point for a joint strategy for reinforcing health and environmental aspects. Health and Environmental Impact Assessments are accepted procedures in many countries. The HiAP strategy implemented in South Australia provides a well-documented institutional approach to the integration and linkage of health and environmental issues. These examples can be used as well-established starting points for a definition of HiAP incorporating the equitable involvement of environmental issues. Barriers to this goal relate, for example, to the particular interests of the various participating sectors.

Using evidence-based policy, systems, and environmental strategies to increase access to healthy food and opportunities for physical activity among Asian Americans, Native Hawaiians, and Pacific Islanders.

PubMed

Patel, Shilpa; Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

2015-07-01

Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities.

Using Evidence-Based Policy, Systems, and Environmental Strategies to Increase Access to Healthy Food and Opportunities for Physical Activity Among Asian Americans, Native Hawaiians, and Pacific Islanders

PubMed Central

Kwon, Simona; Arista, Pedro; Tepporn, Ed; Chung, Marianne; Ko Chin, Kathy; Rideout, Catlin; Islam, Nadia; Trinh-Shevrin, Chau

2015-01-01

Recent initiatives have focused on the dissemination of evidence-based policy, systems, and environmental (EBPSE) strategies to reduce health disparities. Targeted, community-level efforts are needed to supplement these approaches for comparable results among Asian Americans and Native Hawaiians and Pacific Islanders (NHPIs).The STRIVE Project funded 15 Asian American and NHPI community-based organizations (CBOs) to implement culturally adapted strategies. Partners reached more than 1.4 million people at a cost of $2.04 per person. CBOs are well positioned to implement EBPSE strategies to reduce health disparities. PMID:25905839

Philosophies of Policy Development and Implementation in Technical and Vocational Education. Report on UNESCO/UNEVOC Regional Expert Group Meeting (Auckland, New Zealand, April 2-9, 1995).

ERIC Educational Resources Information Center

Auckland Inst. of Tech. (New Zealand).

This report begins with an outline of key issues in policy development and implementation in technical and vocational education (TVE). It sets forth the bases of policy development and implementation, the purpose of TVE, contextual factors that affect policy development and implementation. The following values significant in policy determination…

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.

Implementation of the Every Student Succeeds Act: Update and Next Steps

ERIC Educational Resources Information Center

Strobach, Kelly Vaillancourt

2018-01-01

Efforts to implement the Every Student Succeeds Act (ESSA) are well underway, as states submitted their state plans to the Department of Education in September 2017. The entire education policy and advocacy community has been combing through the state plans to get an idea of how states will tackle efforts to improve student outcomes under the new…

Impact of the 1994 alcohol production and sales deregulation policy on traffic crashes and fatalities in Japan.

PubMed

Desapriya, Ediriweera; Fujiwara, Takeo; Dutt, Namrata; Arason, Neil; Pike, Ian

2012-09-01

. Many studies have demonstrated a strong relationship between alcohol availability and traffic crashes involving alcohol-impaired drivers. The present analysis focuses on the evaluation of the impact of alcohol availability on the Japanese population by comparing fatal and nonfatal motor vehicle crash rates before and after implementation of the alcohol deregulation policy in 1994. Participants and method. Poisson regression with robust standard error was used to model the before-to-after change in incidence rate ratios (IRRs) in the population. To control for potential confounders, per capita alcohol consumption, unemployment rate, and vehicle miles travelled (VMT) were also added to the model. The exponents of the fitted coefficients are equivalent to the IRRs. . Implementation of the policy deregulating alcohol sales and production did not appear to increase traffic fatalities and other traffic crashes in Japan. In the overall study results, nighttime fatalities were reduced statistically significantly by 6% since the implementation of the alcohol deregulation policy in 1994. Discussion. Contrary to previous research, the findings of this study demonstrated lower rates of fatalities and higher compliance with alcohol-related driving legislation. Further well-designed, nonaligned studies on alcohol availability and traffic fatalities in other countries are urgently needed.

Material efficiency: providing material services with less material production

PubMed Central

Allwood, Julian M.; Ashby, Michael F.; Gutowski, Timothy G.; Worrell, Ernst

2013-01-01

Material efficiency, as discussed in this Meeting Issue, entails the pursuit of the technical strategies, business models, consumer preferences and policy instruments that would lead to a substantial reduction in the production of high-volume energy-intensive materials required to deliver human well-being. This paper, which introduces a Discussion Meeting Issue on the topic of material efficiency, aims to give an overview of current thinking on the topic, spanning environmental, engineering, economics, sociology and policy issues. The motivations for material efficiency include reducing energy demand, reducing the emissions and other environmental impacts of industry, and increasing national resource security. There are many technical strategies that might bring it about, and these could mainly be implemented today if preferred by customers or producers. However, current economic structures favour the substitution of material for labour, and consumer preferences for material consumption appear to continue even beyond the point at which increased consumption provides any increase in well-being. Therefore, policy will be required to stimulate material efficiency. A theoretically ideal policy measure, such as a carbon price, would internalize the externality of emissions associated with material production, and thus motivate change directly. However, implementation of such a measure has proved elusive, and instead the adjustment of existing government purchasing policies or existing regulations— for instance to do with building design, planning or vehicle standards—is likely to have a more immediate effect. PMID:23359746

Material efficiency: providing material services with less material production.

PubMed

Allwood, Julian M; Ashby, Michael F; Gutowski, Timothy G; Worrell, Ernst

2013-03-13

Material efficiency, as discussed in this Meeting Issue, entails the pursuit of the technical strategies, business models, consumer preferences and policy instruments that would lead to a substantial reduction in the production of high-volume energy-intensive materials required to deliver human well-being. This paper, which introduces a Discussion Meeting Issue on the topic of material efficiency, aims to give an overview of current thinking on the topic, spanning environmental, engineering, economics, sociology and policy issues. The motivations for material efficiency include reducing energy demand, reducing the emissions and other environmental impacts of industry, and increasing national resource security. There are many technical strategies that might bring it about, and these could mainly be implemented today if preferred by customers or producers. However, current economic structures favour the substitution of material for labour, and consumer preferences for material consumption appear to continue even beyond the point at which increased consumption provides any increase in well-being. Therefore, policy will be required to stimulate material efficiency. A theoretically ideal policy measure, such as a carbon price, would internalize the externality of emissions associated with material production, and thus motivate change directly. However, implementation of such a measure has proved elusive, and instead the adjustment of existing government purchasing policies or existing regulations-- for instance to do with building design, planning or vehicle standards--is likely to have a more immediate effect.

Policy as Boundary Object: A New Way to Look at Educational Policy Design and Implementation

ERIC Educational Resources Information Center

Emad, Gholamreza; Roth, Wolff-Michael

2009-01-01

Policy implementation research in general and educational policy in particular is loosely connected to policy-making processes. There is a gap particularly in the field of vocational education. This often leads to conflicts and contradictions between policy-maker objectives and end-user implementation. To avoid such a disconnect, the relation…

State of the States 2009: Renewable Energy Development and the Role of Policy

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

Doris, E.; McLaren, J.; Healey, V.

2009-10-01

As U.S. states increasingly focus on developing renewable energy resources, there is a need to track the progress of development, as well as the policies and support mechanisms being implemented to encourage this development. Beyond tracking, the evaluation of policy measures is necessary to determine their effectiveness, guide future efforts, and efficiently allocate resources. This report addresses each of these needs. It provides a detailed picture of the status of renewable energy development in each of the U.S. states using a variety of metrics and discusses the policies being used to encourage this development. The report then explores the contextmore » in which renewable energy development occurs by discussing the factors that can affect the uptake of power generation technologies. The analysis offers suggestions on how policies can be used to address these variables, which leads to tailored policy support that considers the specific circumstances within each state. The analysis presents results of several quantitative evaluation methods that have been designed to explore the link between policy implementation and actual development. Finally, the report discusses contextual factors, aside from policy, that affect renewable energy development. The report concludes with a summary of the main points from each chapter, discussion of next steps, and a list of resources.« less

School Health Promotion Policies and Adolescent Risk Behaviors in Israel: A Multilevel Analysis.

PubMed

Tesler, Riki; Harel-Fisch, Yossi; Baron-Epel, Orna

2016-06-01

Health promotion policies targeting risk-taking behaviors are being implemented across schools in Israel. This study identified the most effective components of these policies influencing cigarette smoking and alcohol consumption among adolescents. Logistic hierarchical linear model (HLM) analysis of data for 5279 students in 95 Jewish public schools from the Health Behavior in School-Aged Children (HBSC) 2010-2011 survey in Israel enabled simultaneous estimation of the relationship between student- and school-level variables (health promotion policy) to alcohol consumption and smoking behavior. Principals of participating schools also were interviewed to ascertain their degree of adoption and implementation of a health promotion policy. Most of the variance in adolescent risk behaviors is explained by student-level variables: negative perceptions of school, lack of parental support for school issues, and more time spent with friends. Among the school-level policy measures, parental participation in health promotion intervention programs was repeatedly associated with lower rates of risk behaviors, over and above student characteristics. School health promotion policies should focus on parents' involvement in intervention programs and should seek to improve students' perceptions of school and their sense of well-being to promote resilience. Further research is needed to identify additional factors that may increase the effectiveness of school health promotion policies. © 2016, American School Health Association.

The Role of School Context in Implementing a Statewide Anti-Bullying Policy and Protecting Students

PubMed Central

Hall, William J.; Chapman, Mimi V.

2016-01-01

Bullying is a significant problem in U.S. schools. Policies have been developed to reduce bullying, yet policy implementation by educators is an essential yet difficult and complex process. Few studies have investigated factors that act as barriers to or facilitators of bullying policy implementation and teacher protection of students. This study examined the influence of school context on educators’ capacity to implement a statewide bullying law and protect students from bullying following the enactment of the policy. Data were collected from 505 educators in 324 schools. School administrators tended to rate fidelity of policy implementation and teacher protection of students higher than teachers, education support professionals, and student service professionals. Policy implementation fidelity scores were higher in high schools than elementary schools. School size and the prevalence of student suspensions were inversely related to implementation fidelity. Higher levels of teacher protection were reported in elementary schools.

The Role of School Context in Implementing a Statewide Anti-Bullying Policy and Protecting Students.

PubMed

Hall, William J; Chapman, Mimi V

2018-06-01

Bullying is a significant problem in U.S. schools. Policies have been developed to reduce bullying, yet policy implementation by educators is an essential yet difficult and complex process. Few studies have investigated factors that act as barriers to or facilitators of bullying policy implementation and teacher protection of students. This study examined the influence of school context on educators' capacity to implement a statewide bullying law and protect students from bullying following the enactment of the policy. Data were collected from 505 educators in 324 schools. School administrators tended to rate fidelity of policy implementation and teacher protection of students higher than teachers, education support professionals, and student service professionals. Policy implementation fidelity scores were higher in high schools than elementary schools. School size and the prevalence of student suspensions were inversely related to implementation fidelity. Higher levels of teacher protection were reported in elementary schools.

Research Grants Guidance and Policies Resources

EPA Pesticide Factsheets

These pages are designed to assist prospective applicants as well as recent recipients by conveying key documents that describe the quality assurance, reporting requirements, forms, and FAQs for the NCER STAR grant application and implementation process.

Three Decades of Implementation Research in Higher Education: Limitations and Prospects of Theory Development

ERIC Educational Resources Information Center

Kohoutek, Jan

2013-01-01

The article adopts a comparative approach to review three periods of theory development in research into higher education policy implementation. Given the conceptual affinity between Cerych and Sabatier's 1986 seminal study into higher education policy implementation and public policy implementation theory, the field of public policy is chosen for…

Implementing a province-wide mandatory vaccinate-or-mask policy at healthcare facilities in British Columbia, Canada.

PubMed

Nunn, Alexandra; Campbell, Audrey C; Naus, Monika; Kwong, Jeffrey C; Puddicombe, David; Quach, Susan; Henry, Bonnie

2018-01-08

In 2012, British Columbia (BC) became the first Canadian province to implement an influenza prevention policy requiring healthcare workers (HCW) to either be vaccinated annually against influenza or wear a mask in patient care areas during the influenza season. This study describes an evaluation of influenza policy implementation processes and identifies supports and challenges related to successful policy implementation at the level of healthcare facilities, during the second policy year (2013/14). Implementation leaders from 262 long-term care (LTC) and acute care facilities, mostly in three of BC's five regional Health Authorities, were invited to participate in an online survey following the 2013/14 influenza season. Descriptive quantitative and qualitative analyses identified common and effective strategies for improving vaccination coverage and policy compliance. A total of 127 respondents completed the survey on behalf of 33 acute care and 99 LTC facilities, representing 36% of acute care and 27% of LTC facilities in BC. Respondents agreed that the policy was successfully implemented at 89% of facilities, and implementation was reported to be easy at 52% of facilities. The findings elaborate on communication and leadership strategies, campaign logistics and enforcement approaches involved in policy implementation. Implementation of a vaccinate-or-mask influenza policy is complex. This study provides insight for other jurisdictions considering implementing such a policy and offers practical recommendations for facilities and health authorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fail to prepare and you can prepare to fail: the experience of financing path changes in teaching hospitals in Iran.

PubMed

Doshmangir, Leila; Rashidian, Arash; Jafari, Mehdi; Ravaghi, Hamid; Takian, Amirhossein

2016-04-21

In 1995, teaching and public hospitals that are affiliated with the ministry of health and medical education (MOHME) in Iran were granted financial self-sufficiency to practice contract-based relations with insurance organizations. The so-called "hospital autonomy" policy involved giving authority to the insurance organizations to purchase health services. The policy aimed at improving hospitals' performance, hoping to reduce government's costs. However, the policy was never implemented as intended. This was because most participating hospitals gave up to implement autonomous financing and took other financing pathways. This paper analyses the reasons for the gap between the intended policy and its execution. The lessons learned from this analysis can inform, we envisage, the implementation of similar initiatives in other settings. We conducted semi-structured interviews with 28 national and 13 regional health policy experts. We also gathered a comprehensive and purposeful set of related documents and analyzed their content. The qualitative data were analyzed by thematic inductive-deductive approach. We found a number of prerequisites and requirements that were not prepared prior to the implementing hospital autonomy policy and categorized them into policy content (sources of funds for the policy), implementation context (organization of insurance organizations, medical tariffs, hospitals' organization, feasibility of policy implementation, actors and stakeholders' support), and implementation approach (implementation method, blanket approach to the implementation and timing of implementation). These characteristics resulted in unsuitable platform for policy implementation and eventually led to policy failure. Autonomy of teaching hospitals and their exclusive financing through insurance organizations did not achieve the desired goals of purchaser-provider split in Iran. Unless contextual preparations are in place, hospital autonomy will not succeed and problematic financial relations between service providers and patients in autonomous hospitals may not be ceased as a result.

Evidence-Based Policy Making: Assessment of the American Heart Association's Strategic Policy Portfolio: A Policy Statement From the American Heart Association.

PubMed

Labarthe, Darwin R; Goldstein, Larry B; Antman, Elliott M; Arnett, Donna K; Fonarow, Gregg C; Alberts, Mark J; Hayman, Laura L; Khera, Amit; Sallis, James F; Daniels, Stephen R; Sacco, Ralph L; Li, Suhui; Ku, Leighton; Lantz, Paula M; Robinson, Jennifer G; Creager, Mark A; Van Horn, Linda; Kris-Etherton, Penny; Bhatnagar, Aruni; Whitsel, Laurie P

2016-05-03

American Heart Association (AHA) public policy advocacy strategies are based on its Strategic Impact Goals. The writing group appraised the evidence behind AHA's policies to determine how well they address the association's 2020 cardiovascular health (CVH) metrics and cardiovascular disease (CVD) management indicators and identified research needed to fill gaps in policy and support further policy development. The AHA policy research department first identified current AHA policies specific to each CVH metric and CVD management indicator and the evidence underlying each policy. Writing group members then reviewed each policy and the related metrics and indicators. The results of each review were summarized, and topic-specific priorities and overarching themes for future policy research were proposed. There was generally close alignment between current AHA policies and the 2020 CVH metrics and CVD management indicators; however, certain specific policies still lack a robust evidence base. For CVH metrics, the distinction between policies for adults (age ≥20 years) and children (<20 years) was often not considered, although policy approaches may differ importantly by age. Inclusion of all those <20 years of age as a single group also ignores important differences in policy needs for infants, children, adolescents, and young adults. For CVD management indicators, specific quantitative targets analogous to criteria for ideal, intermediate, and poor CVH are lacking but needed to assess progress toward the 2020 goal to reduce deaths from CVDs and stroke. New research in support of current policies needs to focus on the evaluation of their translation and implementation through expanded application of implementation science. Focused basic, clinical, and population research is required to expand and strengthen the evidence base for the development of new policies. Evaluation of the impact of targeted improvements in population health through strengthened surveillance of CVD and stroke events, determination of the cost-effectiveness of policy interventions, and measurement of the extent to which vulnerable populations are reached must be assessed for all policies. Additional attention should be paid to the social determinants of health outcomes. AHA's public policies are generally robust and well aligned with its 2020 CVH metrics and CVD indicators. Areas for further policy development to fill gaps, overarching research strategies, and topic-specific priority areas are proposed. © 2016 American Heart Association, Inc.

Analysis of agency relationships in the design and implementation process of the equity fund in Madagascar.

PubMed

Honda, Ayako

2015-02-04

There are large gaps in the literature relating to the implementation of user fee policy and fee exemption measures for the poor, particularly on how such schemes are implemented and why many have not produced expected outcomes. In October 2003, Madagascar instituted a user fee exemption policy which established "equity funds" at public health centres, and used medicine sales revenue to subsidise the cost of medicine for the poor. This study examines the policy design and implementation process of the equity fund in Madagascar in an attempt to explore factors influencing the poor equity outcomes of the scheme. This study applied an agency-incentive framework to investigate the equity fund policy design and implementation practices. It analysed agency relationships established during implementation; examined incentive structures given to the agency relationships in the policy design; and considered how incentive structures were shaped and how agents responded in practice. The study employed a case-study approach with in-depth analysis of three equity fund cases in Madagascar's Boeny region. Policy design problems, triggering implementation problems, caused poor equity performance. These problems were compounded by the re-direction of policy objectives by health administrators and strong involvement of the administrators in the implementation of policy. The source of the policy design and implementation failure was identified as a set of principal-agent problems concerning: monitoring mechanisms; facility-based fund management; and the nature and level of community participation. These factors all contributed to the financial performance of the fund receiving greater attention than its ability to financially protect the poor. The ability of exemption policies to protect the poor from user fees can be found in the details of the policy design and implementation; and implications of the policy design and implementation in a specific context determine whether a policy can realise its objectives. The equity fund experience in Madagascar, which illustrates the challenges of beneficiary identification, casts doubts on the application of the 'targeting' approach in health financing and raises issues to be considered in universal health policy formulation. The agency framework provides a useful lens through which to examine policy process issues.

Rising Pendapatan Asli Daerah (PAD) in Pekanbaru: Billboard Planning Policy Tax

NASA Astrophysics Data System (ADS)

Hernimawati; Prihati; Dailiati, Surya; Saputra, Trio

2018-05-01

This research is based on the principal issues concerning the billboard planning policy which has not been optimally being able to improve the Local Revenue of Pekanbaru City and has not improved the beauty of Pekanbaru City. It was estimated to be caused by the model of the billboard planning policy can not increase PAD through billboard tax receipts as well as to enhance the visual beauty of Pekanbaru City. The method used in this research is descriptive qualitative, which aims to establish model of billboard planning policy implementation which be able to improve the PAD of Pekanbaru City. The research result indicated that the model of billboard planning policy implementation which be able to improve the PAD of Pekanbaru City mandated the Regional Revenue Office of Pekanbaru City as the responsible agency for organizing and billboard planning in Pekanbaru City. Regarding the supervision and control, the Regional Revenue Office of Pekanbaru City coordinates with the Municipal Police of Pekanbaru City who is conducting surveillance and control in the field up to a dismantling of the billboard that violates the rules.

Applying the World Health Organization Mental Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia.

PubMed

Happell, Brenda; Platania-Phung, Chris; Webster, Stephanie; McKenna, Brian; Millar, Freyja; Stanton, Robert; Galletly, Cherrie; Castle, David; Furness, Trentham; Liu, Dennis; Scott, David

2015-09-01

The aim of the present study was to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs. A search of state and federal policies on mental and physical illness was conducted, as well as detailed analysis of policy content and the relationships between policies, by applying the World Health Organization Mental Health Action Plan 2013-2020 as an evaluative framework. National policy attention to the physical health of people with mental illness has grown, but there is little interconnection at the national and state levels. State policies across the country are inconsistent, and there is little evidence of consistent policy implementation. A coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritised.

Healthier Fundraising in U. S. Elementary Schools: Associations between Policies at the State, District, and School Levels

PubMed Central

Turner, Lindsey; Chriqui, Jamie F.; Chaloupka, Frank J.

2012-01-01

Objectives We examined whether state laws and district policies pertaining to nutritional restrictions on school fundraisers were associated with school policies as reported by administrators in a nationally-representative sample of United States public elementary schools. Methods We gathered data on school-level fundraising policies via a mail-back survey during the 2009–10 and 2010–11 school years. Surveys were received from 1,278 public elementary schools (response rate = 60.9%). Data were also gathered on corresponding school district policies and state laws. After removing cases with missing data, the sample size for analysis was 1,215 schools. Results After controlling for school characteristics, school policies were consistently associated with state laws and district policies, both those pertaining to fundraising generally, as well as specific restrictions on the sale of candy and soda in fundraisers (all Odds Ratios >2.0 and Ps<.05). However, even where district policies and state laws required fundraising restrictions, school policies were not uniformly present; school policies were also in place at only 55.8% of these schools, but were more common at schools in the West (77.1%) and at majority-Latino schools (71.4%), indicating uneven school-level implementation of district policy and state law. Conclusions District policies and state laws were associated with a higher prevalence of elementary school-level fundraising policies, but many schools that were subject to district policies and state laws did not have school-level restrictions in place, suggesting the need for further attention to factors hindering policy implementation in schools. PMID:23166788

Healthier fundraising in U. S. elementary schools: associations between policies at the state, district, and school levels.

PubMed

Turner, Lindsey; Chriqui, Jamie F; Chaloupka, Frank J

2012-01-01

We examined whether state laws and district policies pertaining to nutritional restrictions on school fundraisers were associated with school policies as reported by administrators in a nationally-representative sample of United States public elementary schools. We gathered data on school-level fundraising policies via a mail-back survey during the 2009-10 and 2010-11 school years. Surveys were received from 1,278 public elementary schools (response rate = 60.9%). Data were also gathered on corresponding school district policies and state laws. After removing cases with missing data, the sample size for analysis was 1,215 schools. After controlling for school characteristics, school policies were consistently associated with state laws and district policies, both those pertaining to fundraising generally, as well as specific restrictions on the sale of candy and soda in fundraisers (all Odds Ratios >2.0 and Ps<.05). However, even where district policies and state laws required fundraising restrictions, school policies were not uniformly present; school policies were also in place at only 55.8% of these schools, but were more common at schools in the West (77.1%) and at majority-Latino schools (71.4%), indicating uneven school-level implementation of district policy and state law. District policies and state laws were associated with a higher prevalence of elementary school-level fundraising policies, but many schools that were subject to district policies and state laws did not have school-level restrictions in place, suggesting the need for further attention to factors hindering policy implementation in schools.

Using a participatory approach to the development of a school-based physical activity policy in an Indigenous community.

PubMed

Hogan, Lindsay; García Bengoechea, Enrique; Salsberg, Jon; Jacobs, Judi; King, Morrison; Macaulay, Ann C

2014-12-01

This study is part of a larger community-based participatory research (CBPR) project to develop, implement, and evaluate the physical activity component of a school-based wellness policy. The policy intervention is being carried out by community stakeholders and academic researchers within the Kahnawake Schools Diabetes Prevention Project, a well-established health promotion organization in the Indigenous community of Kahnawake, Quebec. We explored how a group of stakeholders develop a school physical activity policy in a participatory manner, and examined factors serving as facilitators and barriers to the development process. This case study was guided by an interpretive description approach and draws upon data from documentary analysis and participant observation. A CBPR approach allowed academic researchers and community stakeholders to codevelop a physical activity policy that is both evidence-based and contextually appropriate. The development process was influenced by a variety of barriers and facilitators including working within existing structures, securing appropriate stakeholders, and school contextual factors. This research offers a process framework that others developing school-based wellness policies may use with appropriate modifications based on local environments. © 2014, American School Health Association.

Darkness to dawn: the evolution of electric power policy in the Pacific Northwest. [From 1934 to 1983

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

Olsen, D.

1983-01-01

Electric power policy has become a prominent concern, affecting the well-being of all who live in the Pacific Northwest. This study focuses on the formulation of electric power policy in the Pacific Northwest from the New Deal era (1934) to the development of the first regional power plan (1983) prepared by the Regional Power Council. The methodology relied upon to prepare this study may best be described as historical geography. Historical geography adopts the conceptual and technical perspectives of several research fields: geography, regional planning, economics, environmental science, political science, sociology, and policy sciences - in addition to traditional historicalmore » methods. Four key power policy components were evaluated in this study: decision makers and influential groups, policy issues, policy implementation process, and policy results.« less

The privatization of spa companies in Poland - An evaluation of policy assumptions and implementation.

PubMed

Szromek, Adam R; Romaniuk, Piotr; Hadzik, Andrzej

2016-04-01

The aim of this article is to present the course of privatization of spa companies in Poland during the period 2001-2011. We discuss assumptions of the privatization process, as well as actual implementation, having identified the process as chaotic and inconsistent with prior legal provisions. We found that in its applied form the process resulted in limitation of the therapeutic potential of spas, and reduction of the State's ability to implement health policy in a legally determined form. We also found that privatization potentially improved spa infrastructure standards and increases the tourist potential of spa resorts. We recommend that clear eligibility criteria are applied to institutions in the privatization process, as well as the provision of legal guarantees for access to spa services financed from public resources. Such guarantees should be made a public obligation, to ensure the availability of services for insured persons, and there should be an obligation to maintain a specific part of a given institution's potential for the needs of patients funded by public health insurance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Level of implementation of best practice policies for creating healthy food environments: assessment by state and non-state actors in Thailand.

PubMed

Phulkerd, Sirinya; Vandevijvere, Stefanie; Lawrence, Mark; Tangcharoensathien, Viroj; Sacks, Gary

2017-02-01

To determine and compare the level of implementation of policies for healthy food environments in Thailand with reference to international best practice by state and non-state actors. Data on the current level of implementation of food environment policies were assessed independently using the adapted Healthy Food Environment Policy Index (Food-EPI) by two groups of actors. Concrete actions were proposed for Thai Government. A joint meeting between both groups was subsequently held to reach consensus on priority actions. Thailand. Thirty state actors and twenty-seven non-state actors. Level of policy implementation varied across different domains and actor groups. State actors rated implementation levels higher than non-state actors. Both state and non-state actors rated level of implementation of monitoring of BMI highest. Level of implementation of policies promoting in-store availability of healthy foods and policies increasing tax on unhealthy foods were rated lowest by state and non-state actors, respectively. Both groups reached consensus on eleven priority actions for implementation, focusing on food provision in public-sector settings, food composition, food promotion, leadership, monitoring and intelligence, and food trade. Although the implementation gaps identified and priority actions proposed varied between state and non-state actors, both groups achieved consensus on a comprehensive food policy package to be implemented by the Thai Government to improve the healthiness of food environments. This consensus is a platform for continued policy dialogue towards cross-sectoral policy coherence and effective actions to address the growing burden of non-communicable diseases and obesity in Thailand.

Students' Perceptions of the Value of the Elements of an Online Learning Environment: Looking Back in Moving Forward

ERIC Educational Resources Information Center

Palmer, Stuart; Holt, Dale

2010-01-01

In 2003, Deakin University implemented a centralised learning management system (LMS) under the banner of Deakin Studies Online (DSO), as well as implementing policies requiring all its units of study to have at least a basic online presence from 2004. Given the scope of the university's commitment to online education, it was considered essential…

"Five hundred years of medicine gone to waste"? Negotiating the implementation of an intercultural health policy in the Ecuadorian Andes.

PubMed

Llamas, Ana; Mayhew, Susannah

2018-06-04

In Ecuador, indigenous women have poorer maternal health outcomes and access to maternity services. This is partly due to cultural barriers. A hospital in Ecuador implemented the Vertical Birth (VB) policy to address such inequities by adapting services to the local culture. This included conducting upright deliveries, introducing Traditional Birth Attendants (TBAs) and making physical adaptations to hospital facilities. Using qualitative methods, we studied the VB policy implementation in an Ecuadorian hospital to analyse the factors that affect effective implementation of intercultural health policies at the local level. We collected data through observation, in-depth interviews, a focus group discussion, and documentation review. We conducted 46 interviews with healthcare workers, managers, TBAs, key informants and policy-makers involved in maternal health. Data analysis was guided by grounded theory and drew heavily on concepts of "street-level bureaucracy" to interpret policy implementation. The VB policy was highly controversial; actors' values (including concerns over patient safety) motivated their support or opposition to the Vertical Birth policy. For those who supported the policy, managers, policy-makers, indigenous actors and a minority of healthcare workers supported the policy, it was critical to address ethnic discrimination to improve indigenous women's access to the health service. Most healthcare workers initially resisted the policy because they believed vertical births led to poorer clinical outcomes and because they resented working alongside TBAs. Healthcare workers developed coping strategies and effectively modified the policy. Managers accepted these as a compromise to enable implementation. Although contentious, intercultural health policies such as the VB policy have the potential to improve maternity services and access for indigenous women. Evidence-base medicine should be used as a lever to facilitate the dialogue between healthcare workers and TBAs and to promote best practice and patient safety. Actors' values influenced policy implementation; policy implementation resulted from an ongoing negotiation between healthcare workers and managers.

Universal financial protection through National Health Insurance: a stakeholder analysis of the proposed one-time premium payment policy in Ghana.

PubMed

Abiiro, Gilbert Abotisem; McIntyre, Di

2013-05-01

Extending coverage to the informal sector is a key challenge to achieving universal coverage through contributory health insurance schemes. Ghana introduced a mandatory National Health Insurance system in 2004 to provide financial protection for both the formal and informal sectors through a combination of taxes and annual premium payments. As part of its election promise in 2008, the current government (then in opposition) promised to make the payment of premiums 'one-time'. This has been a very controversial policy issue in Ghana. This study sought to contribute to assessing the feasibility of the proposed policy by exploring the understandings of various stakeholders on the policy, their interests or concerns, potential positions, power and influences on it, as well as the general prospects and challenges for its implementation. Data were gathered from a review of relevant documents in the public domain, 28 key informant interviews and six focus group discussions with key stakeholders in Accra and two other districts. The results show that there is a lot of confusion in stakeholders' understanding of the policy issue, and, because of the uncertainties surrounding it, most powerful stakeholders are yet to take clear positions on it. However, stakeholders raised concerns that revolved around issues such as: the meaning of a one-time premium within an insurance scheme context, the affordability of the one-time premium, financing sources and sustainability of the policy, as well as the likely impact of the policy on equity in access to health care. Policy-makers need to clearly explain the meaning of the one-time premium policy and how it will be funded, and critically consider the concerns raised by stakeholders before proceeding with further attempts to implement it. For other countries planning universal coverage reforms, it is important that the terminology of their reforms clearly reflects policy objectives.

Evaluation of carbon emission reductions promoted by private driving restrictions based on automatic fare collection data in Beijing, China.

PubMed

Zhang, Wandi; Chen, Feng; Wang, Zijia; Huang, Jianling; Wang, Bo

2017-11-01

Public transportation automatic fare collection (AFC) systems are able to continuously record large amounts of passenger travel information, providing massive, low-cost data for research on regulations pertaining to public transport. These data can be used not only to analyze characteristics of passengers' trips but also to evaluate transport policies that promote a travel mode shift and emission reduction. In this study, models combining card, survey, and geographic information systems (GIS) data are established with a research focus on the private driving restriction policies being implemented in an ever-increasing number of cities. The study aims to evaluate the impact of these policies on the travel mode shift, as well as relevant carbon emission reductions. The private driving restriction policy implemented in Beijing is taken as an example. The impact of the restriction policy on the travel mode shift from cars to subways is analyzed through a model based on metro AFC data. The routing paths of these passengers are also analyzed based on the GIS method and on survey data, while associated carbon emission reductions are estimated. The analysis method used in this study can provide reference for the application of big data in evaluating transport policies. Motor vehicles have become the most prevalent source of emissions and subsequently air pollution within Chinese cities. The evaluation of the effects of driving restriction policies on the travel mode shift and vehicle emissions will be useful for other cities in the future. Transport big data, playing an important support role in estimating the travel mode shift and emission reduction considered, can help related departments to estimate the effects of traffic jam alleviation and environment improvement before the implementation of these restriction policies and provide a reference for relevant decisions.

The challenges of changing national malaria drug policy to artemisinin-based combinations in Kenya.

PubMed

Amin, Abdinasir A; Zurovac, Dejan; Kangwana, Beth B; Greenfield, Joanne; Otieno, Dorothy N; Akhwale, Willis S; Snow, Robert W

2007-05-29

Sulphadoxine/sulphalene-pyrimethamine (SP) was adopted in Kenya as first line therapeutic for uncomplicated malaria in 1998. By the second half of 2003, there was convincing evidence that SP was failing and had to be replaced. Despite several descriptive investigations of policy change and implementation when countries moved from chloroquine to SP, the different constraints of moving to artemisinin-based combination therapy (ACT) in Africa are less well documented. A narrative description of the process of anti-malarial drug policy change, financing and implementation in Kenya is assembled from discussions with stakeholders, reports, newspaper articles, minutes of meetings and email correspondence between actors in the policy change process. The narrative has been structured to capture the timing of events, the difficulties and hurdles faced and the resolutions reached to the final implementation of a new treatment policy. Following a recognition that SP was failing there was a rapid technical appraisal of available data and replacement options resulting in a decision to adopt artemether-lumefantrine (AL) as the recommended first-line therapy in Kenya, announced in April 2004. Funding requirements were approved by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and over 60 million US$ were agreed in principle in July 2004 to procure AL and implement the policy change. AL arrived in Kenya in May 2006, distribution to health facilities began in July 2006 coincidental with cascade in-service training in the revised national guidelines. Both training and drug distribution were almost complete by the end of 2006. The article examines why it took over 32 months from announcing a drug policy change to completing early implementation. Reasons included: lack of clarity on sustainable financing of an expensive therapeutic for a common disease, a delay in release of funding, a lack of comparative efficacy data between AL and amodiaquine-based alternatives, a poor dialogue with pharmaceutical companies with a national interest in antimalarial drug supply versus the single sourcing of AL and complex drug ordering, tendering and procurement procedures. Decisions to abandon failing monotherapy in favour of ACT for the treatment of malaria can be achieved relatively quickly. Future policy changes in Africa should be carefully prepared for a myriad of financial, political and legislative issues that might limit the rapid translation of drug policy change into action.

Memoranda about Implementation of the Cancer Guidelines and Accompanying Supplemental Guidance - Science Policy Council Cancer Guidelines Implementation Workgroup Communication I and II

EPA Pesticide Factsheets

Memoranda from the Chair of EPA's Science Policy Council to the Science Policy Council and the Science Policy Council Steering Committee regarding Implementation of the Cancer Guidelines and Accompanying Supplemental Guidance.

Implementing Health in All Policies – Time and Ideas Matter Too!

PubMed Central

Clavier, Carole

2016-01-01

Carey and Friel suggest that we turn to knowledge developed in the field of public administration, especially new public governance, to better understand the process of implementing health in all policies (HiAP). In this commentary, I claim that theories from the policy studies bring a broader view of the policy process, complementary to that of new public governance. Drawing on the policy studies, I argue that time and ideas matter to HiAP implementation, alongside with interests and institutions. Implementing HiAP is a complex process considering that it requires the involvement and coordination of several policy sectors, each with their own interests, institutions and ideas about the policy. Understanding who are the actors involved from the various policy sectors concerned, what context they evolve in, but also how they own and frame the policy problem (ideas), and how this has changed over time, is crucial for those involved in HiAP implementation so that they can relate to and work together with actors from other policy sectors. PMID:27694654

Implementing evidence-based policy in a network setting: road safety policy in the Netherlands.

PubMed

Bax, Charlotte; de Jong, Martin; Koppenjan, Joop

2010-01-01

In the early 1990s, in order to improve road safety in The Netherlands, the Institute for Road Safety Research (SWOV) developed an evidence-based "Sustainable Safety" concept. Based on this concept, Dutch road safety policy, was seen as successful and as a best practice in Europe. In The Netherlands, the policy context has now changed from a sectoral policy setting towards a fragmented network in which safety is a facet of other transport-related policies. In this contribution, it is argued that the implementation strategy underlying Sustainable Safety should be aligned with the changed context. In order to explore the adjustments needed, two perspectives of policy implementation are discussed: (1) national evidence-based policies with sectoral implementation; and (2) decentralized negotiation on transport policy in which road safety is but one aspect. We argue that the latter approach matches the characteristics of the newly evolved policy context best, and conclude with recommendations for reformulating the implementation strategy.

Multi-stakeholder policy modeling for collection and recycling of spent portable battery waste.

PubMed

Gupta, Vimal Kumar; Kaushal, Rajendra Kumar; Shukla, Sheo Prasad

2018-06-01

Policies have been structured for collection and recycling of spent portable battery waste within a framework of stakeholders (recycling council body, producer, recycler and consumer) especially for those battery units that are discarded worldwide because of their expensive cost of recycling. Applicability of stakeholders' policies in their coalition framework have been reviewed and critically analyzed using the Shapley value of cooperative game theory models. Coalition models for 'manufacturer and recycler' indicated the dominating role of manufacturers over the recyclers, and waste management is highly influenced by producer responsibility. But, the take-back policy enables recyclers' dominance role in the management and yields maximum benefit to both recyclers and consumers. The polluter pays principle has been implemented in formulating policies to key stakeholders, 'manufacturers' as well as 'consumers', of battery products by the introduction of penalties to encourage their willingness to join the Environment, Health and Safety program. Results indicated that the policies of the framework have the potential to be implemented within a marginal rise in battery price by 12% to 14.3% in the range of recycling cost per tonne of US$2000 to US$5000. The policy of the stakeholders' framework presented in the study could be an important aid to achieve high collection and recycling rates of spent portable batteries.

Changes in the policy environment for infant and young child feeding in Vietnam, Bangladesh, and Ethiopia, and the role of targeted advocacy.

PubMed

Harris, Jody; Frongillo, Edward A; Nguyen, Phuong H; Kim, Sunny S; Menon, Purnima

2017-06-13

There is limited literature examining shifts in policy environments for nutrition and infant and young child feeding (IYCF) over time, and on the potential contribution of targeted advocacy to improved policy environments in low- and middle-income countries. This study tracked changes in the policy environment over a four-year period in three countries, and examined the role of targeted nutrition and IYCF advocacy strategies by a global initiative. Qualitative methods, including key informant interviews, social network mapping, document and literature review, and event tracking, were used to gather data on nutrition and IYCF policies and programs, actor networks, and perceptions and salience of nutrition as an issue in 2010 and 2014 in Bangladesh, Ethiopia, and Vietnam. Theoretical frameworks from the policy sciences were used to analyze policy change over time, and drivers of change, across countries. The written policy environment improved to differing extents in each country. By 2014, the discourse in all three countries mirrored international priorities of stunting reduction and exclusive breastfeeding. Yet competing nutrition priorities such as acute malnutrition, food insecurity, and nutrition transitions remained in each context. Key actor groups in each country were government, civil society, development partners and the private sector. Infant formula companies, in particular, emerged as key players against enforcement of IYCF legislation. The role of a targeted IYCF advocacy and policy support initiative was well-recognized in supporting multiple facets of the policy environment in each country, ranging from alliances to legislation and implementation support. Despite progress, however, government commitment to funding, implementation, and enforcement is still emerging in each country, thus challenging the potential impact of new and improved policies. Targeted policy advocacy can catalyze change in national nutrition and IYCF policy environments, especially actor commitment, policy guidance, and legislation. Implementation constraints - financing, capacity and commitment of systems, and competing priorities and actors - are essential to address to sustain further progress. The lack of pressing political urgency for nutrition and IYCF, and the uncertain role of international networks in national policy spaces, has implications for the potential for change.

Ethical Considerations in Mandatory Disclosure of Data Acquired While Caring for Human Trafficking Survivors.

PubMed

Kerr, Patrick L; Dash, Rachel

2017-01-01

Accurate data on the prevalence and psychological effects of human trafficking as well as treatment outcomes for survivors are essential for measuring the impact of interventions and generating better understanding of this phenomenon. However, such data are difficult to obtain. A legal mandate for health care professionals to report trafficking opens opportunities for advancing our work in the field of human trafficking but also poses risks to survivors seeking services. In this article, we provide an analysis of some critical ethical considerations for the development and implementation of a mandatory reporting policy and offer recommendations for the ethical implementation of such a policy. © 2017 American Medical Association. All Rights Reserved.

Local smoke-free policy development in Santa Fe, Argentina

PubMed Central

Glantz, Stanton A

2010-01-01

Objective To describe the process of approval and implementation of a comprehensive smoke-free law in the province of Santa Fe, Argentina, between 2005 and 2009. Methods Review of the Santa Fe smoke-free legislation, articles published in local newspapers and documentation on two lawsuits filed against the law, and interviews with key individuals in Santa Fe. Results Efforts to implement smoke-free policies in Santa Fe began during the 1990s without success, and resumed in 2005 when the provincial Legislature approved the first 100% smoke-free subnational law in Argentina. There was no strong opposition during the discussions within the legislature. As in other parts of the world, pro-tobacco industry interests attempted to block the implementation of the law using well known strategies. These efforts included a controversy media campaign set up, the creation of a hospitality industry association and a virtual smokers' rights group, the introduction of a counterproposal seeking modification of the law, the challenge of the law in the Supreme Court, and the proposal of a weak national bill that would ‘conflict’ with the subnational law. Tobacco control advocates sought media attention as a strategy to protect the law. Conclusions Santa Fe is the first subnational jurisdiction in Latin America to have enacted a comprehensive smoke-free policy following the recommendations of the World Health Organization (WHO) Framework Convention on Tobacco Control. After 3 years of implementation, pro-tobacco industry forces failed to undermine the law. Other subnational jurisdictions in Argentina, as well as in Mexico and Brazil are following the Santa Fe example. PMID:19955534

Local smoke-free policy development in Santa Fe, Argentina.

PubMed

Sebrié, Ernesto M; Glantz, Stanton A

2010-04-01

To describe the process of approval and implementation of a comprehensive smoke-free law in the province of Santa Fe, Argentina, between 2005 and 2009. Review of the Santa Fe smoke-free legislation, articles published in local newspapers and documentation on two lawsuits filed against the law, and interviews with key individuals in Santa Fe. Efforts to implement smoke-free policies in Santa Fe began during the 1990s without success, and resumed in 2005 when the provincial Legislature approved the first 100% smoke-free subnational law in Argentina. There was no strong opposition during the discussions within the legislature. As in other parts of the world, pro-tobacco industry interests attempted to block the implementation of the law using well known strategies. These efforts included a controversy media campaign set up, the creation of a hospitality industry association and a virtual smokers' rights group, the introduction of a counterproposal seeking modification of the law, the challenge of the law in the Supreme Court, and the proposal of a weak national bill that would 'conflict' with the subnational law. Tobacco control advocates sought media attention as a strategy to protect the law. Santa Fe is the first subnational jurisdiction in Latin America to have enacted a comprehensive smoke-free policy following the recommendations of the World Health Organization (WHO) Framework Convention on Tobacco Control. After 3 years of implementation, pro-tobacco industry forces failed to undermine the law. Other subnational jurisdictions in Argentina, as well as in Mexico and Brazil are following the Santa Fe example.

Advancing team-based primary health care: a comparative analysis of policies in western Canada.

PubMed

Suter, Esther; Mallinson, Sara; Misfeldt, Renee; Boakye, Omenaa; Nasmith, Louise; Wong, Sabrina T

2017-07-17

We analyzed and compared primary health care (PHC) policies in British Columbia, Alberta and Saskatchewan to understand how they inform the design and implementation of team-based primary health care service delivery. The goal was to develop policy imperatives that can advance team-based PHC in Canada. We conducted comparative case studies (n = 3). The policy analysis included: Context review: We reviewed relevant information (2007 to 2014) from databases and websites. Policy review and comparative analysis: We compared and contrasted publically available PHC policies. Key informant interviews: Key informants (n = 30) validated narratives prepared from the comparative analysis by offering contextual information on potential policy imperatives. Advisory group and roundtable: An expert advisory group guided this work and a key stakeholder roundtable event guided prioritization of policy imperatives. The concept of team-based PHC varies widely across and within the three provinces. We noted policy gaps related to team configuration, leadership, scope of practice, role clarity and financing of team-based care; few policies speak explicitly to monitoring and evaluation of team-based PHC. We prioritized four policy imperatives: (1) alignment of goals and policies at different system levels; (2) investment of resources for system change; (3) compensation models for all members of the team; and (4) accountability through collaborative practice metrics. Policies supporting team-based PHC have been slow to emerge, lacking a systematic and coordinated approach. Greater alignment with specific consideration of financing, reimbursement, implementation mechanisms and performance monitoring could accelerate systemic transformation by removing some well-known barriers to team-based care.

77 FR 47862 - National Environmental Policy Act: Implementing Procedures; Addition to Categorical Exclusions...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... DEPARTMENT OF THE INTERIOR Office of the Secretary National Environmental Policy Act: Implementing... Interior. ACTION: Notice of Final National Environmental Policy Act Implementing Procedures. SUMMARY: This notice announces the addition of a new categorical exclusion under the National Environmental Policy Act...

Pakistan's maternal and child health policy: analysis, lessons and the way forward.

PubMed

Siddiqi, S; Haq, I U; Ghaffar, A; Akhtar, T; Mahaini, R

2004-07-01

An estimated 400,000 infant and 16,500 maternal deaths occur annually in Pakistan. These translate into an infant mortality rate and maternal mortality ratio that should be unacceptable to any state. Disease states including communicable diseases and reproductive health (RH) problems, which are largely preventable account for over 50% of the disease burden. The analysis of Pakistan's maternal and child health (MCH) and family planning (FP) policy covers the period 1990-2002, and focuses on macroeconomic influences, priority programs and gaps, adequacy of resources, equity and organizational aspects, and the process of policy formulation. The overall MCH/FP policy is well directed. MCH/FP has been a priority in all policies; resource allocation, although unacceptably low, has substantially increased during the last decade; and there is a progressive shift from MCH to the reproductive health (RH) agenda. Areas in need of improvement include greater use of evidence as a basis for policy; increased priority to nutrition programs, measures to reduce neonatal and perinatal mortality, provision of emergency obstetric care, availability of skilled birth attendants, and a clear policy on integrated management of childhood illnesses. Enhanced planning capacity, development of a balanced human resource, improved governance to reduce staff absenteeism and frequent transfers, and a greater role of the private sector in the provision of services are some organizational aspects that need the governments' consideration. There are several lessons to be learnt: (i) Ministries of Health need sustained stewardship and well-documented evidence to protect cuts in resource allocation; (ii) frequent policy announcement sends inappropriate signals to managers and weakens on-going implementation; (iii) MCH/FP policies unless informed by evidence and participation of interest groups are unlikely to address gaps in programs; (iv) distributional and equity objectives of MCH/FP be addressed while setting overall national goals; (v) institutional capacity is a vital ingredient in translating MCH/FP policies into effective services. The suggested strategic directions emphasize, among others, the need for a comprehensive MCH/FP framework; strengthened stewardship in ministry of health, cost-effective strategies to address the gaps identified and doubling of the public sector resource allocation to MCH/FP over the next 5 years. The ability to ensure delivery of quality health services remains the biggest challenge in the Pakistani health sector. Unless sound policies are backed by well-functioning programs they are likely to become a victim of poor implementation.

Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.

PubMed

Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

2014-01-01

To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. Research methodology - Evaluation using theory-based realist methods for policy implementation. An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. © 2013 John Wiley & Sons Ltd.

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.

The politics of drug control in Nigeria: Exclusion, repression and obstacles to policy change.

PubMed

Klantschnig, Gernot

2016-04-01

International agencies have viewed West Africa as a major player in the global trade in cocaine and heroin and in efforts to control that trade, as there have been reports of escalating arrests of drug smugglers, large-scale drug seizures and 'narco-states' in the subregion. It is claimed that a substantial share of the drugs available in Western markets transit through West Africa today and are increasingly used there as well. Notwithstanding this growing alarm, there is little serious scholarship addressing the issue of drugs and drug policy in West Africa. The article assesses and challenges some of the existing depictions of drugs and drug policy in West Africa through an empirical case study of drug control in Nigeria - one of West Africa's most notorious 'drug hubs' and recently hailed as a policy model by international experts. Based on previously inaccessible government documents, interviews with key officials in Nigeria, as well as ethnographic work at Nigeria's key drug agency, the article provides a unique insight into the politics of drug policy-making and implementation in West Africa. After describing the dominant official narratives of Nigeria's drug control, the article shows how the key political dynamics underlying drug policy remain obscured by these narratives. Nigerian drug policy has been characterised by a highly exclusive policy-making process, repression as the sole means of implementation and a strong bond with international drug agencies. This policy emerged in the 1980s and 1990s and has remained the unchallenged norm until today. The political processes underlying Nigerian drug policy also explain why policy reform has been and will be difficult to accomplish. These domestic political processes have largely been ignored in the existing depictions of drugs in West Africa, as they have mainly focused on externally driven drug threats and foreign policy responses. Most importantly, they have ignored the role played by the state. Rather than being too weak, the Nigerian state has shown a clear tendency towards repressive and coercive drug policy, which has received little popular support. Copyright © 2015 Elsevier B.V. All rights reserved.

Implementing Health in All Policies - Time and Ideas Matter Too! Comment on "Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities".

PubMed

Clavier, Carole

2016-06-20

Carey and Friel suggest that we turn to knowledge developed in the field of public administration, especially new public governance, to better understand the process of implementing health in all policies (HiAP). In this commentary, I claim that theories from the policy studies bring a broader view of the policy process, complementary to that of new public governance. Drawing on the policy studies, I argue that time and ideas matter to HiAP implementation, alongside with interests and institutions. Implementing HiAP is a complex process considering that it requires the involvement and coordination of several policy sectors, each with their own interests, institutions and ideas about the policy. Understanding who are the actors involved from the various policy sectors concerned, what context they evolve in, but also how they own and frame the policy problem (ideas), and how this has changed over time, is crucial for those involved in HiAP implementation so that they can relate to and work together with actors from other policy sectors. © 2016 by Kerman University of Medical Sciences.

Strategic environmental noise mapping: methodological issues concerning the implementation of the EU Environmental Noise Directive and their policy implications.

PubMed

Murphy, E; King, E A

2010-04-01

This paper explores methodological issues and policy implications concerning the implementation of the EU Environmental Noise Directive (END) across Member States. Methodologically, the paper focuses on two key thematic issues relevant to the Directive: (1) calculation methods and (2) mapping methods. For (1), the paper focuses, in particular, on how differing calculation methods influence noise prediction results as well as the value of the EU noise indicator L(den) and its associated implications for comparability of noise data across EU states. With regard to (2), emphasis is placed on identifying the issues affecting strategic noise mapping, estimating population exposure, noise action planning and dissemination of noise mapping results to the general public. The implication of these issues for future environmental noise policy is also examined. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Students’ attitude and smoking behaviour following the implementation of a university smoke-free policy: a cross-sectional study

PubMed Central

Chaaya, Monique; Alameddine, Maysam; Nakkash, Rima; Afifi, Rima A; Khalil, Joanna; Nahhas, Georges

2013-01-01

Objective In view of the high-smoking rate among university students in Lebanon and the known adverse effects of second-hand smoking, the American University of Beirut (AUB) decided to implement a non-smoking policy on campus. This study sought to examine the students’ compliance and attitudes following the ban. Design Cross-sectional study. Setting A private university in Lebanon. Participants 545 randomly selected students were approached. A stratified cluster sample of classes offered in the spring semester of the 2008/2009 academic year was selected. Students completed a self-administered paper and pencil survey during class time. Primary and secondary outcome measures The main outcomes were compliance with and attitudes towards the ban. Other secondary outcomes were the perception of barriers to implementation of the ban and attitudes towards tobacco control in general. Results 535 students participated in the study. Smokers were generally compliant with the ban (72.7%) and for some (20%) it led to a decrease in their smoking. Students' attitude towards the ban and the enforcement of a non-smoking policy in public places across Lebanon varied according to their smoking status whereby non-smokers possessed a more favourable attitude and strongly supported such policies compared with smokers; overall, the largest proportions of students were satisfied to a large extent with the ban and considered it justified (58.6% and 57.2%, respectively). While much smaller percentages reported that the ban would help in reducing smoking to a large extent (16.7%) or it would help smokers quit (7.4%). Perceived barriers to implementation of the non-smoking policy in AUB included the lack of compliance with and strict enforcement of the policy as well as the small number and crowdedness of the smoking areas. Conclusions An education campaign, smoking cessation services and strict enforcement of the policy might be necessary to boost its effect in further reducing students' cigarette use. PMID:23585386

Students' attitude and smoking behaviour following the implementation of a university smoke-free policy: a cross-sectional study.

PubMed

Chaaya, Monique; Alameddine, Maysam; Nakkash, Rima; Afifi, Rima A; Khalil, Joanna; Nahhas, Georges

2013-01-01

In view of the high-smoking rate among university students in Lebanon and the known adverse effects of second-hand smoking, the American University of Beirut (AUB) decided to implement a non-smoking policy on campus. This study sought to examine the students' compliance and attitudes following the ban. Cross-sectional study. A private university in Lebanon. 545 randomly selected students were approached. A stratified cluster sample of classes offered in the spring semester of the 2008/2009 academic year was selected. Students completed a self-administered paper and pencil survey during class time. The main outcomes were compliance with and attitudes towards the ban. Other secondary outcomes were the perception of barriers to implementation of the ban and attitudes towards tobacco control in general. 535 students participated in the study. Smokers were generally compliant with the ban (72.7%) and for some (20%) it led to a decrease in their smoking. Students' attitude towards the ban and the enforcement of a non-smoking policy in public places across Lebanon varied according to their smoking status whereby non-smokers possessed a more favourable attitude and strongly supported such policies compared with smokers; overall, the largest proportions of students were satisfied to a large extent with the ban and considered it justified (58.6% and 57.2%, respectively). While much smaller percentages reported that the ban would help in reducing smoking to a large extent (16.7%) or it would help smokers quit (7.4%). Perceived barriers to implementation of the non-smoking policy in AUB included the lack of compliance with and strict enforcement of the policy as well as the small number and crowdedness of the smoking areas. An education campaign, smoking cessation services and strict enforcement of the policy might be necessary to boost its effect in further reducing students' cigarette use.

Connecting Classroom and Cafeteria in a School Wellness Initiative

ERIC Educational Resources Information Center

Grenci, Alexandra; Hughes, Luanne J.; Savoca, LeeAnne

2011-01-01

Purpose/Objectives: The Child Nutrition and WIC Reauthorization Act of 2004 required all school districts participating in federally funded child nutrition programs to adopt and implement a school wellness policy by the beginning of the 2006-2007 school year. One drawback of this federal mandate was that it did not provide funding to assist with…

International Air and Trade Shows: DoD Increased Participation, but its Policies Are Not Well-Defined

DTIC Science & Technology

1993-03-01

and Singapore shows, was to pay all personnel, maintenance, logistic, and transportation costs. Recent Legislation Cection 1082 of the National Defense...In addition, the policy on leases to contractors probably will need to be more specifically defined because section 1082 only addresses recovering...Recommendation We recommend that the Secretary of Defense, in implementing Section 1082 of the National Defense Authorization Act for Fiscal Year 1993, issue

Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity--the behavior change ball.

PubMed

Hendriks, Anna-Marie; Jansen, Maria W J; Gubbels, Jessica S; De Vries, Nanne K; Paulussen, Theo; Kremers, Stef P J

2013-04-18

Childhood obesity is a 'wicked' public health problem that is best tackled by an integrated approach, which is enabled by integrated public health policies. The development and implementation of such policies have in practice proven to be difficult, however, and studying why this is the case requires a tool that may assist local policy-makers and those assisting them. A comprehensive framework that can help to identify options for improvement and to systematically develop solutions may be used to support local policy-makers. We propose the 'Behavior Change Ball' as a tool to study the development and implementation of integrated public health policies within local government. Based on the tenets of the 'Behavior Change Wheel' by Michie and colleagues (2011), the proposed conceptual framework distinguishes organizational behaviors of local policy-makers at the strategic, tactical and operational levels, as well as the determinants (motivation, capability, opportunity) required for these behaviors, and interventions and policy categories that can influence them. To illustrate the difficulty of achieving sustained integrated approaches, we use the metaphor of a ball in our framework: the mountainous landscapes surrounding the ball reflect the system's resistance to change (by making it difficult for the ball to roll). We apply this framework to the problem of childhood obesity prevention. The added value provided by the framework lies in its comprehensiveness, theoretical basis, diagnostic and heuristic nature and face validity. Since integrated public health policies have not been widely developed and implemented in practice, organizational behaviors relevant to the development of these policies remain to be investigated. A conceptual framework that can assist in systematically studying the policy process may facilitate this. Our Behavior Change Ball adds significant value to existing public health policy frameworks by incorporating multiple theoretical perspectives, specifying a set of organizational behaviors and linking the analysis of these behaviors to interventions and policies. We would encourage examination by others of our framework as a tool to explain and guide the development of integrated policies for the prevention of wicked public health problems.

Proposing a conceptual framework for integrated local public health policy, applied to childhood obesity - the behavior change ball

PubMed Central

2013-01-01

Background Childhood obesity is a ‘wicked’ public health problem that is best tackled by an integrated approach, which is enabled by integrated public health policies. The development and implementation of such policies have in practice proven to be difficult, however, and studying why this is the case requires a tool that may assist local policy-makers and those assisting them. A comprehensive framework that can help to identify options for improvement and to systematically develop solutions may be used to support local policy-makers. Discussion We propose the ‘Behavior Change Ball’ as a tool to study the development and implementation of integrated public health policies within local government. Based on the tenets of the ‘Behavior Change Wheel’ by Michie and colleagues (2011), the proposed conceptual framework distinguishes organizational behaviors of local policy-makers at the strategic, tactical and operational levels, as well as the determinants (motivation, capability, opportunity) required for these behaviors, and interventions and policy categories that can influence them. To illustrate the difficulty of achieving sustained integrated approaches, we use the metaphor of a ball in our framework: the mountainous landscapes surrounding the ball reflect the system’s resistance to change (by making it difficult for the ball to roll). We apply this framework to the problem of childhood obesity prevention. The added value provided by the framework lies in its comprehensiveness, theoretical basis, diagnostic and heuristic nature and face validity. Summary Since integrated public health policies have not been widely developed and implemented in practice, organizational behaviors relevant to the development of these policies remain to be investigated. A conceptual framework that can assist in systematically studying the policy process may facilitate this. Our Behavior Change Ball adds significant value to existing public health policy frameworks by incorporating multiple theoretical perspectives, specifying a set of organizational behaviors and linking the analysis of these behaviors to interventions and policies. We would encourage examination by others of our framework as a tool to explain and guide the development of integrated policies for the prevention of wicked public health problems. PMID:23597122

The determinants of policy for population health.

PubMed

Fox, Daniel M

2006-10-01

Many advocates of policy to implement the findings of research on the multiple determinants of health accord scant attention to the determinants of health policy in democratic countries. The principle determinants of the allocation of scarce resources to improving health include: the priorities of voters; the diffusion of responsibility for improving health; the absence of evidence about matters of consequence to policy makers; the arraying of some evidence in ways that frustrate policy making; resistance to addressing determinants other than clinical services and traditional public health practices among many professionals in these fields, as well as by industries that supply the health sector; and the special political influence of persons who suffer serious chronic disease and of members of their families.

Developing a policy to empower informal carers to administer subcutaneous medication in community palliative care; a feasibility project.

PubMed

Lee, Louise; Howard, Kay; Wilkinson, Lyn; Kern, Cheryl; Hall, Sarah

2016-08-01

This article describes the development and implementation of a policy to support community professionals to train informal carers to give, 'as required ', subcutaneous medications to their relative. In a rural county, Lincolnshire, despite out of hours responsive services, patients could wait up to one hour for subcutaneous medications. Additionally there were increasing requests from carers to participate in this role. To provide a safe and effective framework via a robust policy to support informal carers to give, as required, subcutaneous medications in today's health-care environment. A group of professionals working in adult community palliative care formed a working party to scope the literature and existing policies, and to consider risks, legalities and local infrastructure. The policy was developed and based on available literature. A consultation process on the policy was commenced before a series of educational workshops supported its roll out. The small number of informal carers (n=5) who undertook this role reported positive experiences and felt empowered. Professionals found the policy was able to be implemented quickly and was adhered to. From the small numbers audited it could be suggested that if the process is well managed and the informal carers feel supported they can safely and effectively administer subcutaneous injections in community palliative care. More importantly, if a policy is available, staff can respond to requests from carers in a timely manner.

The nursing profession in Sri Lanka: time for policy changes.

PubMed

Aluwihare-Samaranayake, D; Ogilvie, L; Cummings, G G; Gellatly, Ian R

2017-09-01

We address issues and challenges in nursing in Sri Lanka with the aim of identifying where and how policy changes need to be made. Increased global interconnectivity calls for professional leadership, research, education, and policy reform in nursing as these are identified as enhancing health workforce performance and professionalization, thereby improving health systems. We draw on first-hand knowledge of health care and nursing in Sri Lanka and a recent survey of nurses at a large urban government hospital in Sri Lanka, followed by discussion and proposed action on themes identified through analysis of published and unpublished literature about the nursing profession. Policy and action are needed to: (a) establish mandatory nurse licensure in the public and private healthcare sectors; (b) implement realistic policies to further develop nursing education; (c) develop a professionalization process to support nursing autonomy and voice; and (d) promote systematic processes for educational accreditation, curriculum revision, continuing professional development, evidence-based practice, research, leadership, and information systems. There is a policy vacuum that requires careful analysis and strategic planning by formal nurse leaders. Implementing change will require political and professional power and strategic, innovative, and evolutionary policy initiatives as well as organizational infrastructure modifications best achieved through committed multidisciplinary collaboration, augmented research capacity, bolstered nursing leadership, and promotion of partnerships with policy makers. © 2017 International Council of Nurses.

Policy Analysis of Road Traffic Injury Prevention in Iran

PubMed Central

Azami-Aghdash, Saber; Gorji, Hassan Abolghasem; Shabaninejad, Hosein; Sadeghi-Bazargani, Homayoun

2017-01-01

Introduction Due to the large number of Road Traffic Injuries (RTIs) in Iran, authorities have implemented a number of policies for the prevention of RTIs. However, a scientific analysis of these policies has thus far been neglected. Therefore, this study was conducted for policy analysis of RTIs prevention in Iran. Methods This qualitative study with a case study approach was conducted in Iran during 2016 in two phases: First, by reviewing literature and documents of the past ten years, policies that have been executed to prevent RTIs in Iran were identified. In the second phase of the study, the identified policies were ranked by prioritization matrices. The two policies with the highest scores were selected. ‘Policy triangle framework’ was used for Policy analyzing. Stakeholders of these policies (42 people) were interviewed. Data were analyzed manually by implementing Content-Analysis methods. Results The policies of “pupil liaisons” and “safety belt” were selected for analysis from thirteen potential identified polices. The results of some studies revealed that safety belts had not been properly used in Iran (less than 80%). There was an eight-year hiatus between the approval of the safety belts policy and implementation of this policy. Eight actors were identified for safety belts policy. Lack of diligence in implementation of the policy, failing to pay adequate attention to education and the culture of driving, and failing to select an organization for the implementation of the policy, were identified as the main weaknesses of this policy. For ‘pupil liaisons’ policy, five actors were identified. Following the implementation of this policy, the number of penalties was reduced (17.9%). Neglecting scientific findings and individual-based nature of the policy were identified as the primary weaknesses of this policy. Conclusions Taking serious measures to properly execute the policy, educating people, selecting an efficient organization that is responsible for the implementation of the policies, and using international experience are the measures that can be taken to reduce the number of RTIs in the country. PMID:28243417

The Implementation Challenge and the Learning Health System for SCI Initiative.

PubMed

Stucki, Gerold; Bickenbach, Jerome

2017-02-01

The paper introduces the special issue by linking the International Spinal Cord Injury (InSCI) Community Survey study to the Learning Health System for SCI Initiative (LHS-SCI). The LHS-SCI was designed to respond to the implementation challenge of bringing about policy reform in light of the targeted policy recommendations of World Health Organization's International Perspectives on SCI report as well as the call for action of WHO's Global Disability Action Plan. The paper reviews the components of LHS-SCI relevant to internationally comparable information, a theory of change to guide for action, and the tools for evidence-informed policy. The interplay between persons, their health needs, and the societal response to those needs provides the foundation for the organization of the LHS-SCI Initiative. Moreover, as the other articles in this special issue describe in detail, the rationale, conceptualization, and study design of the InSCI study are also informed by the rationale, and mission, of the LHS for SCI Initiative. The LHS-SCI, and the implementation challenge that motivates it, is responsible for the design of the InSCI study and the overall mission of LHS-SCI to continuously improve the lived experience of people living with SCI around the world through an international evidence- and rights-informed research and policy reform effort.

Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

PubMed

Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M

2018-01-01

In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

National-Level Wetland Policy Specificity and Goals Vary According to Political and Economic Indicators.

PubMed

Peimer, Alex W; Krzywicka, Adrianna E; Cohen, Dora B; Van den Bosch, Kyle; Buxton, Valerie L; Stevenson, Natalie A; Matthews, Jeffrey W

2017-01-01

Growing recognition of the importance of wetlands to human and ecosystem well-being has led countries worldwide to implement wetland protection policies. Different countries have taken different approaches to wetland protection by implementing various policies, including territorial exclusion, market-based offsetting, and incentive programs for land users. Our objective was to describe the relationship between components of national-level wetland protection policies and national characteristics, including natural resource, economic, social, and political factors. We compiled data on the wetland policies of all 193 countries recognized by the U.N. and described the relationships among wetland policy goals and wetland protection mechanisms using non-metric multidimensional scaling. The first non-metric multidimensional scaling axis strongly correlated with whether a country had a wetland-specific environmental policy in place. Adoption of a comprehensive, wetland-specific policy was positively associated with degree of democracy and a commitment to establishing protected areas. The second non-metric multidimensional scaling axis defined a continuum of policy goals and mechanisms by which wetlands are protected, with goals to protect wetland ecosystem services on one end of the spectrum and goals to protect biodiversity on the other. Goals for protecting ecosystem services were frequently cited in policy documents of countries with agriculture-based economies, whereas goals associated with wetland biodiversity tended to be associated with tourism-based economies. We argue that the components of a country's wetland policies reflect national-level resource and economic characteristics. Understanding the relationship between the type of wetland policy countries adopt and national-level characteristics is critical for international efforts to protect wetlands.

National-Level Wetland Policy Specificity and Goals Vary According to Political and Economic Indicators

NASA Astrophysics Data System (ADS)

Peimer, Alex W.; Krzywicka, Adrianna E.; Cohen, Dora B.; Van den Bosch, Kyle; Buxton, Valerie L.; Stevenson, Natalie A.; Matthews, Jeffrey W.

2017-01-01

Growing recognition of the importance of wetlands to human and ecosystem well-being has led countries worldwide to implement wetland protection policies. Different countries have taken different approaches to wetland protection by implementing various policies, including territorial exclusion, market-based offsetting, and incentive programs for land users. Our objective was to describe the relationship between components of national-level wetland protection policies and national characteristics, including natural resource, economic, social, and political factors. We compiled data on the wetland policies of all 193 countries recognized by the U.N. and described the relationships among wetland policy goals and wetland protection mechanisms using non-metric multidimensional scaling. The first non-metric multidimensional scaling axis strongly correlated with whether a country had a wetland-specific environmental policy in place. Adoption of a comprehensive, wetland-specific policy was positively associated with degree of democracy and a commitment to establishing protected areas. The second non-metric multidimensional scaling axis defined a continuum of policy goals and mechanisms by which wetlands are protected, with goals to protect wetland ecosystem services on one end of the spectrum and goals to protect biodiversity on the other. Goals for protecting ecosystem services were frequently cited in policy documents of countries with agriculture-based economies, whereas goals associated with wetland biodiversity tended to be associated with tourism-based economies. We argue that the components of a country's wetland policies reflect national-level resource and economic characteristics. Understanding the relationship between the type of wetland policy countries adopt and national-level characteristics is critical for international efforts to protect wetlands.

Beyond excise taxes: a systematic review of literature on non-tax policy approaches to raising tobacco product prices

PubMed Central

Golden, Shelley D; Smith, Margaret Holt; Feighery, Ellen C; Roeseler, April; Rogers, Todd; Ribisl, Kurt M

2016-01-01

Objective Raising the price of tobacco products is considered one of the most effective ways to reduce tobacco use. In addition to excise taxes, governments are exploring other policies to raise tobacco prices and minimise price dispersion, both within and across price tiers. We conducted a systematic review to determine how these policies are described, recommended and evaluated in the literature. Data sources We systematically searched six databases and the California Tobacco Control library for English language studies or reports, indexed on or before 18 December 2013, that included a tobacco keyword (eg, cigarette), policy keyword (eg, legislation) and a price keyword (eg, promotion). We identified 3067 abstracts. Study selection Two coders independently reviewed all abstracts and identified 56 studies or reports that explicitly described a public policy likely to impact the retail price of tobacco products through non-tax means. Data extraction Two coders independently identified tobacco products targeted by policies described, recommendations for implementing policies and empirical assessments of policy impacts. Data synthesis The most prevalent non-tax price policies were price promotion restrictions and minimum price laws. Few studies measured the impact of non-tax policies on average prices, price dispersion or disparities in tobacco consumption, but the literature includes suggestions for crafting policies and preparing for legal challenges or tobacco industry opposition. Conclusions Price-focused evaluations of well-implemented non-tax price policies are needed to determine whether they can deliver on their promise to raise prices, reduce price dispersion and serve as an important complement to excise taxes. PMID:26391905

Implementing Childhood Obesity Policy in a New Educational Environment: The Cases of Mississippi and Tennessee

PubMed Central

Wright, Paul M.; Dyson, Ben; Vardaman, James M.; Ferry, Hugh

2012-01-01

Objectives. Our purpose was to investigate the processes involved in, and outcomes of, implementing 3 new state-level, school-oriented childhood obesity policies enacted between 2004 and 2007. Methods. We followed policy implementation in 8 high schools in Mississippi and Tennessee. We collected data between 2006 and 2009 from interviews with policymakers, administrators, teachers, and students; observations of school-based activities; and documents. Results. Significant barriers to the effective implementation of obesity-related policies emerged. These most notably include a value system that prioritizes performances in standardized tests over physical education (PE) and a varsity sport system that negatively influences opportunities for PE. These and other factors, such as resource constraints and the overloading of school administrators with new policies, mitigate against the implementation of policies designed to promote improvements in student health through PE. Conclusions. Policies designed to address health and social problems in high-school settings face significant barriers to effective implementation. To have a broad impact, obesity-related policies must be tied to mainstream educational initiatives that both incentivize, and hold accountable, the school-level actors responsible for their implementation. PMID:22420819

Evaluation of caregiver-friendly workplace policy (CFWPs) interventions on the health of full-time caregiver employees (CEs): implementation and cost-benefit analysis.

PubMed

Williams, Allison M; Tompa, Emile; Lero, Donna S; Fast, Janet; Yazdani, Amin; Zeytinoglu, Isik U

2017-09-20

Current Canadian evidence illustrating the health benefits and cost-effectiveness of caregiver-friendly workplace policies is needed if Canadian employers are to adopt and integrate caregiver-friendly workplace policies into their employment practices. The goal of this three-year, three study research project is to provide such evidence for the auto manufacturing and educational services sectors. The research questions being addressed are: What are the impacts for employers (economic) and workers (health) of caregiver-friendly workplace policy intervention(s) for full-time caregiver-employees? What are the impacts for employers, workers and society of the caregiver-friendly workplace policy intervention(s) in each participating workplace? What contextual factors impact the successful implementation of caregiver-friendly workplace policy intervention(s)? Using a pre-post-test comparative case study design, Study A will determine the effectiveness of newly implemented caregiver-friendly workplace policy intervention(s) across two workplaces to determine impacts on caregiver-employee health. A quasi-experimental pre-post design will allow the caregiver-friendly workplace policy intervention(s) to be tested with respect to potential impacts on health, and specifically on caregiver employee mental, psychosocial, and physical health. Framed within a comparative case study design, Study B will utilize cost-benefit and cost-effectiveness analysis approaches to evaluate the economic impacts of the caregiver-friendly workplace policy intervention(s) for each of the two participating workplaces. Framed within a comparative case study design, Study C will undertake an implementation analysis of the caregiver-friendly workplace policy intervention(s) in each participating workplace in order to determine: the degree of support for the intervention(s) (reflected in the workplace culture); how sex and gender are implicated; co-workers' responses to the chosen intervention(s), and; other nuances at play. It is hypothesized that the benefits of the caregiver-friendly workplace policy intervention(s) will include improvements in caregiver-employees' mental, psychosocial and physical health, as well as evidence of cost-benefit and cost-effectiveness for the employer. The expected project results will provide the research evidence for extensive knowledge translation work, to be carried out in collaboration with our knowledge transition partners, to the employer/human resources and occupational health/safety target populations. ISRCTN16187974 Registered August 25, 2016.

Sexual harassment: preventive steps for the healthcare practitioner.

PubMed

Cooper, C G

1993-01-01

Like other employers, healthcare providers can be held liable for sexual harassment in the workplace. However, by implementing an effective sexual harassment policy, healthcare providers can avoid corporate liability for sexual harassment and create a more productive working environment as well.

School Autonomy and Accountability in Thailand: Does the Gap between Policy Intent and Implementation Matter?

ERIC Educational Resources Information Center

Patrinos, Harry Anthony; Arcia, Gustavo; Macdonald, Kevin

2015-01-01

This article contrasts policy intent and policy implementation in school autonomy and accountability. The analysis uses a conceptual framework based on the interaction between school autonomy, student assessment, and accountability as elements of a closed system. The article analyzes the implementation of school autonomy and accountability policy,…

Implementing Nunavut Education Act: Compulsory School Attendance Policy

ERIC Educational Resources Information Center

Kwarteng, E. Fredua

2006-01-01

This paper discusses the implementation of Nunavut compulsory school attendance policy as part of the Nunavut Education Act (2002). Using a bottom-up approach to policy implementation in the literature and the author's six years teaching experience in Nunavut, the paper argues that the compulsory school attendance policy may not achieve its…

Implementation and Incentive of Education Policies: Experience from the High School Admissions Quota Allocation Policy

ERIC Educational Resources Information Center

Shiyue, Wang

2017-01-01

Improving administrative efficiency is the core problem in administrative governance. This case study of quota allocation policy implementation in City A reveals that a set of education policy implementation and incentive mechanisms revolving around responsibility contracts and target evaluations has already taken shape, to guarantee effective…

78 FR 16679 - Center for Drug Evaluation and Research Medical Policy Council; Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-18

... Council to ensure better coordination of medical policy development and implementation within CDER and... and implementation. II. Range of Medical Policy Issues To Be Considered FDA envisions a variety of... to other products; or Strategies for implementation of a new policy. III. Establishment of a Docket...

Land-use classification map of the greater Denver area, Front Range Urban Corridor, Colorado

USGS Publications Warehouse

Driscoll, L.B.

1975-01-01

The Greater Denver area, in the Front Range Urban Corridor of Colorado, is an area of rapid population growth and expanding land development. At present no overall land-use policy exists for this area, although man individuals and groups are concerned about environmental, economic, and social stresses caused by population pressures. A well-structured land-use policy for the entire Front Range Urban Corridor, in which compatible land uses are taken into account, could lead to overall improvements in land values. A land classification map is the first step toward implementing such a policy.

Partners for a healthy city: implementing policies and environmental changes within organizations to promote health.

PubMed

Feyerherm, Laura; Tibbits, Melissa; Wang, Hongmei; Schram, Sarah; Balluff, Mary

2014-07-01

Current research has suggested that obesity prevention efforts should promote policy and environmental changes. The Partners for a Healthy City project, implemented in Douglas County, Nebraska, focused on collaborating with local organizations to help them select and implement 1 or more policies that promoted healthy eating and physical activity. Of the 346 organizations participating in the project and completing the follow-up assessment, 92% implemented at least 1 new policy or expanded an existing policy related to healthy food and drink options and physical activity, totaling 952 individual policy changes. Common policies included providing water as the primary beverage and installing bike racks to support active commuting to and from work. These findings suggest widespread support for policy changes that promote community health.

Partners for a Healthy City: Implementing Policies and Environmental Changes Within Organizations to Promote Health

PubMed Central

Tibbits, Melissa; Wang, Hongmei; Schram, Sarah; Balluff, Mary

2014-01-01

Current research has suggested that obesity prevention efforts should promote policy and environmental changes. The Partners for a Healthy City project, implemented in Douglas County, Nebraska, focused on collaborating with local organizations to help them select and implement 1 or more policies that promoted healthy eating and physical activity. Of the 346 organizations participating in the project and completing the follow-up assessment, 92% implemented at least 1 new policy or expanded an existing policy related to healthy food and drink options and physical activity, totaling 952 individual policy changes. Common policies included providing water as the primary beverage and installing bike racks to support active commuting to and from work. These findings suggest widespread support for policy changes that promote community health. PMID:24832425

45 CFR 164.308 - Administrative safeguards.

Code of Federal Regulations, 2012 CFR

2012-10-01

...)(i) Standard: Security management process. Implement policies and procedures to prevent, detect... this subpart for the entity. (3)(i) Standard: Workforce security. Implement policies and procedures to...) Standard: Information access management. Implement policies and procedures for authorizing access to...

45 CFR 164.308 - Administrative safeguards.

Code of Federal Regulations, 2011 CFR

2011-10-01

...)(i) Standard: Security management process. Implement policies and procedures to prevent, detect... this subpart for the entity. (3)(i) Standard: Workforce security. Implement policies and procedures to...) Standard: Information access management. Implement policies and procedures for authorizing access to...

Research on effect of China’s energy saving policy of phase-out incandescent lamps

NASA Astrophysics Data System (ADS)

Ding, Qing; Zhao, Yuejin; Liang, Xiuying; Lin, Ling

2017-11-01

China’s energy saving policy of phase-out of incandescent lamps have been introduced and a comprehensive evaluation framework has been put forward. The impact of the implementation of the policy on manufacturing enterprises and places of sale, lighting industry and domestic and foreign markets, as well as the effect of energy conservation and emission reduction have been analyzed from micro, meso and macro layers. The research results show that, under the guidance of the policy, the orderly product mix transformation has been seen in incandescent lamp manufacturing enterprises, incandescent lamps gradually exit the Chinese mainstream lighting product market, and the energy conservation and emission reduction effect is remarkable.

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast.

PubMed

Gillespie, Duncan O S; Allen, Kirk; Guzman-Castillo, Maria; Bandosz, Piotr; Moreira, Patricia; McGill, Rory; Anwar, Elspeth; Lloyd-Williams, Ffion; Bromley, Helen; Diggle, Peter J; Capewell, Simon; O'Flaherty, Martin

2015-01-01

Public health action to reduce dietary salt intake has driven substantial reductions in coronary heart disease (CHD) over the past decade, but avoidable socio-economic differentials remain. We therefore forecast how further intervention to reduce dietary salt intake might affect the overall level and inequality of CHD mortality. We considered English adults, with socio-economic circumstances (SEC) stratified by quintiles of the Index of Multiple Deprivation. We used IMPACTSEC, a validated CHD policy model, to link policy implementation to salt intake, systolic blood pressure and CHD mortality. We forecast the effects of mandatory and voluntary product reformulation, nutrition labelling and social marketing (e.g., health promotion, education). To inform our forecasts, we elicited experts' predictions on further policy implementation up to 2020. We then modelled the effects on CHD mortality up to 2025 and simultaneously assessed the socio-economic differentials of effect. Mandatory reformulation might prevent or postpone 4,500 (2,900-6,100) CHD deaths in total, with the effect greater by 500 (300-700) deaths or 85% in the most deprived than in the most affluent. Further voluntary reformulation was predicted to be less effective and inequality-reducing, preventing or postponing 1,500 (200-5,000) CHD deaths in total, with the effect greater by 100 (-100-600) deaths or 49% in the most deprived than in the most affluent. Further social marketing and improvements to labelling might each prevent or postpone 400-500 CHD deaths, but minimally affect inequality. Mandatory engagement with industry to limit salt in processed-foods appears a promising and inequality-reducing option. For other policy options, our expert-driven forecast warns that future policy implementation might reach more deprived individuals less well, limiting inequality reduction. We therefore encourage planners to prioritise equity.

A quantitative analysis of municipal solid waste disposal charges in China.

PubMed

Wu, Jian; Zhang, Weiqian; Xu, Jiaxuan; Che, Yue

2015-03-01

Rapid industrialization and economic development have caused a tremendous increase in municipal solid waste (MSW) generation in China. China began implementing a policy of MSW disposal fees for household waste management at the end of last century. Three charging methods were implemented throughout the country: a fixed disposal fee, a potable water-based disposal fee, and a plastic bag-based disposal fee. To date, there has been little qualitative or quantitative analysis on the effectiveness of this relatively new policy. This paper provides a general overview of MSW fee policy in China, attempts to verify whether the policy is successful in reducing general waste collected, and proposes an improved charging system to address current problems. The paper presents an empirical statistical analysis of policy effectiveness derived from an environmental Kuznets curve (EKC) test on panel data of China. EKC tests on different kinds of MSW charge systems were then examined for individual provinces or cities. A comparison of existing charging systems was conducted using environmental and economic criteria. The results indicate the following: (1) the MSW policies implemented over the study period were effective in the reduction of waste generation, (2) the household waste discharge fee policy did not act as a strong driver in terms of waste prevention and reduction, and (3) the plastic bag-based disposal fee appeared to be performing well according to qualitative and quantitative analysis. Based on current situation of waste discharging management in China, a three-stage transitional charging scheme is proposed and both advantages and drawbacks discussed. Evidence suggests that a transition from a fixed disposal fee to a plastic bag-based disposal fee involving various stakeholders should be the next objective of waste reduction efforts.

State Fall Prevention Coalitions as Systems Change Agents: An Emphasis on Policy.

PubMed

Schneider, Ellen C; Smith, Matthew Lee; Ory, Marcia G; Altpeter, Mary; Beattie, Bonita Lynn; Scheirer, Mary Ann; Shubert, Tiffany E

2016-03-01

Falls among older adults are an escalating public health issue, which requires a multidisciplinary and multilevel approach to affect systems change to effectively address this problem. The National Council on Aging established the Falls Free® Initiative, enfolding and facilitating statewide Fall Prevention Coalitions. Fall Free® activities included developing the State Policy Toolkit for Advancing Falls Prevention to promote sustainable change by supporting the dissemination and adoption of evidence-based strategies. To (1) determine if the policies being implemented were recommended and supported by the Toolkit, (2) identify the perceived barriers and facilitators to implementing policies, and (3) identify Coalitions' current and future fall prevention policy activities. A 63-item online survey was distributed to State Coalition Leads. Descriptive statistics (frequencies and counts) were used to describe Coalition characteristics and activities. Coalitions had several similarities, and varied greatly in their number of member organizations and members as well as meeting frequencies. Key activities included building partnerships, disseminating programs, and pursuing at least one of the eight National Council on Aging-recommended policy goals. The most commonly reported facilitator was active support from the Coalition Leads, whereas the lack of funding was the most cited barrier. This study serves as the first national census of empirical evidence regarding Falls Coalitions' composition, goals, and activities. Results indicate that Coalitions are actively pursuing evidence-based policies but could benefit from additional technical assistance and resources. Findings support the value of Toolkit recommendations by documenting what is feasible and being implemented. Knowledge about facilitators and barriers will inform future efforts to foster sustainable systems change in states with active Coalitions and encourage Coalitions in other states. © 2015 Society for Public Health Education.

The management of infection with Mycobacterium tuberculosis in young children post-2015: an opportunity to close the policy-practice gap.

PubMed

Graham, Stephen M

2017-01-01

The treatment of infection with Mycobacterium tuberculosis in young children is supported by universal policy based on strong rationale and evidence of effectiveness, but has rarely been implemented in tuberculosis endemic countries. Areas covered: This review highlights a number of important recent developments that provide an unprecedented opportunity to close the policy-practice gap, as well as ongoing needs to facilitate implementation under programmatic conditions and scale-up. Expert commentary: The WHO's End TB Strategy and Stop TB Partnership's Plan to End TB provide ambitious targets for prevention at a time when National Tuberculosis Programs in tuberculosis endemic countries are increasing attention to the challenges of management and prevention of tuberculosis disease in children. This opportunity is greatly enhanced by recent evidence of the effectiveness of shorter, simpler and safer regimens to treat tuberculosis infection. The scale of the challenge for implementation will require a decentralized, integrated, community-based approach. An accurate and low-cost point-of-care test for tuberculous infection would be a major advance to support such implementation. Specific guidance for the treatment of infection in young child contacts of multidrug-resistant tuberculosis cases is a major current need while awaiting further evidence.

Are 1994 alcohol production and the sales deregulation policy in Japan associated with increased road traffic fatalities among adult and teenage males and females in Japan?

PubMed

Desapriya, Ediriweera; Fujiwara, Takeo; Scime, Giulia; Sasges, Deborah; Pike, Ian; Shimizu, Shinji

2009-10-01

International studies have shown a significant association between alcohol availability and traffic crashes that involve alcohol-impaired drivers. A key limitation to previous alcohol availability and motor vehicle crash (MVC) evaluation research is the assumption of population homogeneity in responding to the policies. The present analysis focuses on the evaluation of the impact of alcohol availability on different segments of the Japanese population by comparing MVC fatality rates from before and after implementation of the alcohol deregulation policy in 1994. Poisson regression with robust standard error was used to model the before-to-after change in incidence rate ratios (IRR) in adult males, adult females, teenage males and teenage females. To control potential confounders, unemployment rate, vehicle miles of travel (VMT), vehicle registration, and number of drivers licensed in Japan were added to the model. The exponents of the fitted coefficients are equivalent to incidence rate ratios. Implementation of the policy deregulating alcohol sales and production did not appear to increase traffic fatalities among adult or teenage males or females in Japan. We found that male adult fatalities demonstrated a statistically significant decline following enactment of the deregulation policy in 1994. Contrary to previous research, the findings of this study demonstrated lower rates of fatalities and higher compliance with alcohol-related driving legislation in Japanese society following implementation of the deregulation policy in 1994. Further well designed, nonaligned studies on alcohol availability and traffic fatalities in other countries are urgently needed.

The challenges of the family physician policy in Iran: a systematic review and meta-synthesis of qualitative researches.

PubMed

Behzadifar, Masoud; Behzadifar, Meysam; Heidarvand, Sanaz; Gorji, Hasan Abolghasem; Aryankhesal, Aidin; Taheri Moghadam, Sharare; Mohammadibakhsh, Roghayeh; Bragazzi, Nicola Luigi

2018-05-07

A good level of health requires the establishment of primary health care. Family physician policy (FPP) is probably one of such initiatives, which enables societies attaining the universal health coverage. The present study is the first systematic review and meta-synthesis that seeks to provide a more comprehensive understanding of the challenges for FPP in Iran. Several international scholarly databases (namely, ISI/Web of Sciences, PubMed/MEDLINE via Ovid, Embase, PsycINFO, Scopus and CINAHL via EBSCO), as well as three Iranian databases [MagIran, Irandoc and Scientific Information Database (SID) databases], were mined from January 2006 to December 2017. The Noblit & Hare approach was used to analyse the selected studies. Based on the study inclusion criteria, seven studies were retained. Initially, 133 codes were identified. In the second step, two of the authors examined the codes and merged themes based on their similarities and shared meaning. New codes were created through discussion. In the next and final step, eight themes emerged, namely, (i) financing; (ii) motivational factors; (iii) education; (iv) referral system; (v) performance evaluation; (vi) problems with health policy; (vii) health information system; and (viii) culture-building for proper policy implementation. Although more than 10 years have passed since the implementation of FPP in Iran, and despite its positive effects on health, there are still challenges in implementing this policy, which makes it difficult to achieve its objectives. Health decision- and policy-makers in Iran should address these challenges and use all available capacities to face them.

Factors associated with early childhood education and care service implementation of healthy eating and physical activity policies and practices in Australia: a cross-sectional study.

PubMed

Wolfenden, Luke; Finch, Meghan; Nathan, Nicole; Weaver, Natasha; Wiggers, John; Yoong, Sze Lin; Jones, Jannah; Dodds, Pennie; Wyse, Rebecca; Sutherland, Rachel; Gillham, Karen

2015-09-01

Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating and physical activity. The purpose of this study was to assess whether certain theoretically-based factors are associated with implementation of healthy eating and physical activity policies and practices in a sample of ECEC services. A cross-sectional survey was conducted with Service Managers of ECEC services. The survey assessed the operational characteristics, policy, and practice implementation, and 13 factors were suggested by Damschroder's Consolidated Framework for Implementation Research to impede or promote implementation. Logistic regression analyses found a significant association between implementation factor score and full implementation (OR 1.38; 95% CI 1.18-1.61; p = <0.01), indicating that for every one point increase in implementation score, ECEC services were 38 % more likely to be fully implementing the policies and practices. The findings highlight the opportunities for improving implementation of obesity prevention interventions in this setting by developing interventions that address such factors.

The Implementer Disposition of Teacher Certification Policy in Indonesia

ERIC Educational Resources Information Center

Malkab, Marnih; Nawawi, Juanda; Mahmud, Alimuddin; Sujiono, Eko Hadi

2015-01-01

This research aims to examine and analyze the implementers disposition in the implementation of teacher certification policy in Makassar City and to know how is the disposition affects in successful implementation policy. This research is descriptive by using a qualitative approach. Sources of data in this study are primary data from the…

The Problematic Implementation of Teacher Evaluation Policy: School Failure or Governmental Pitfall?

ERIC Educational Resources Information Center

Tuytens, Melissa; Devos, Geert

2014-01-01

Teacher evaluation policy is implemented in many countries to improve the teaching quality in schools. This paper explores the implementation of teacher evaluation policy in secondary schools in Flanders (Belgium). The case study method is used to explore the implementation process in six schools, which are selected based upon teachers' perception…

Evaluating the sub-national fidelity of national Initiatives in decentralized health systems: Integrated Primary Health Care Governance in Nigeria.

PubMed

Eboreime, Ejemai Amaize; Abimbola, Seye; Obi, Felix Abrahams; Ebirim, Obinna; Olubajo, Olalekan; Eyles, John; Nxumalo, Nonhlanhla Lynette; Mambulu, Faith Nankasa

2017-03-21

Policy making, translation and implementation in politically and administratively decentralized systems can be challenging. Beyond the mere sub-national acceptance of national initiatives, adherence to policy implementation processes is often poor, particularly in low and middle-income countries. In this study, we explore the implementation fidelity of integrated PHC governance policy in Nigeria's decentralized governance system and its implications on closing implementation gaps with respect to other top-down health policies and initiatives. Having engaged policy makers, we identified 9 core components of the policy (Governance, Legislation, Minimum Service Package, Repositioning, Systems Development, Operational Guidelines, Human Resources, Funding Structure, and Office Establishment). We evaluated the level and pattern of implementation at state level as compared to the national guidelines using a scorecard approach. Contrary to national government's assessment of level of compliance, we found that sub-national governments exercised significant discretion with respect to the implementation of core components of the policy. Whereas 35 and 32% of states fully met national criteria for the structural domains of "Office Establishment" and Legislation" respectively, no state was fully compliant to "Human Resource Management" and "Funding" requirements, which are more indicative of functionality. The pattern of implementation suggests that, rather than implementing to improve outcomes, state governments may be more interested in executing low hanging fruits in order to access national incentives. Our study highlights the importance of evaluating implementation fidelity in providing evidence of implementation gaps towards improving policy execution, particularly in decentralized health systems. This approach will help national policy makers identify more effective ways of supporting lower tiers of governance towards improvement of health systems and outcomes.

Incentives for health.

PubMed

Anderson, Peter; Harrison, Oliver; Cooper, Cary; Jané-Llopis, Eva

2011-08-01

This article discusses incentives to help make healthy choices the easy choices for individuals, operating at the levels of the individual, producers and service providers, and governments. Whereas paying individuals directly to be healthier seems to have a limited effect, offering financial incentives through health insurance improves health. Changing the environment to make healthier choices more accessible acts as an incentive to improve health. Employers can provide incentives to improve the health of their employees. Producers and service providers can take voluntary action to make their products less harmful, and they can be nudged into marketing healthier products within a regulatory environment. International agreements and monitoring systems can incentivize governments to do more for health. Lessons from climate change adaptation suggest that multilevel governance and policy integration are greater obstacles to policy change and implementation than knowing what has to be done. Policy change and implementation are triggered by many drivers, many of which are side effects of other policy pressures rather than of the direct policy goal itself. Effective action to reduce noncommunicable diseases will require leveraging social networks into a new ways of thinking about health; making better health prestigious and aspirational, and giving health and wellness a brand that encourages positive behavior change.

The Emergence and Challenging Growth of the Bio-Ethanol Innovation System in Taiwan (1949-2015).

PubMed

Chung, Chao-Chen; Yang, Siang-Cing

2016-02-19

This study explores the bio-ethanol innovation system in Taiwan from the perspective of a technology innovation system (TIS). Taiwan is a newly industrialized country and is not currently a main producer of bio-ethanol. This study analyzes the evolution of bio-ethanol innovation system in Taiwan and places a particular emphasis on challenges that present policies face in the context of potential long-term bio-ethanol development. Through an evaluation of the consistency of the present research, technology, development and innovation (RTDI) policies as well as the influence of these policies on the functional dynamics of bio-ethanol innovation system, mechanisms prohibiting the system from flourishing are determined. It is suggested that the production of bio-ethanol in Taiwan would be achieved if the government: (1) fixes long-term targets for both domestic bio-ethanol development and emission reduction; and (2) comprehensively designs a set of interrelated RTDI policies in accordance with the functional pattern of the bio-ethanol innovation system and consistently implements these policies. If such measures were implemented, it is considered that the bio-ethanol innovation system in Taiwan would flourish.

The Emergence and Challenging Growth of the Bio-Ethanol Innovation System in Taiwan (1949–2015)

PubMed Central

Chung, Chao-Chen; Yang, Siang-Cing

2016-01-01

This study explores the bio-ethanol innovation system in Taiwan from the perspective of a technology innovation system (TIS). Taiwan is a newly industrialized country and is not currently a main producer of bio-ethanol. This study analyzes the evolution of bio-ethanol innovation system in Taiwan and places a particular emphasis on challenges that present policies face in the context of potential long-term bio-ethanol development. Through an evaluation of the consistency of the present research, technology, development and innovation (RTDI) policies as well as the influence of these policies on the functional dynamics of bio-ethanol innovation system, mechanisms prohibiting the system from flourishing are determined. It is suggested that the production of bio-ethanol in Taiwan would be achieved if the government: (1) fixes long-term targets for both domestic bio-ethanol development and emission reduction; and (2) comprehensively designs a set of interrelated RTDI policies in accordance with the functional pattern of the bio-ethanol innovation system and consistently implements these policies. If such measures were implemented, it is considered that the bio-ethanol innovation system in Taiwan would flourish. PMID:26907306

PrEP implementation: moving from trials to policy and practice.

PubMed

Cáceres, Carlos F; O'Reilly, Kevin R; Mayer, Kenneth H; Baggaley, Rachel

2015-01-01

It is increasingly clear that the HIV response will not be sustainable if the number of infections is not significantly reduced. For two decades, research has been ongoing to identify new behavioural and biomedical strategies to prevent HIV infection. In the past few years, the efficacy of several new strategies has been demonstrated, including oral pre-exposure prophylaxis (PrEP; i.e. daily use of tenofovir/emtricitabine). Because several social, political and logistic barriers remain, however, optimal PrEP implementation will require a better dissemination of new evidence in a number of areas and additional implementation research from various disciplinary perspectives (i.e. social science, policy and ethics; health systems; and economics, including cost-effectiveness studies). Discussion of new evidence on those topics, as well as case studies of potential PrEP implementation in diverse environments, can improve the understanding of the role that PrEP may play in addressing the global HIV/AIDS epidemic.In light of these needs, the Network for Multidisciplinary Studies in ARV-based HIV Prevention (NEMUS) and the World Health Organization (WHO) were honoured to co-organize a special issue of JIAS aimed at contributing to a scholarly discussion of current conditions surrounding PrEP implementation, potential impact and efficiency, social science concerns and the study of PrEP implementation in specific country cases. The papers included in this monograph identify and cover many of the main aspects of the complex yet promising discussions around PrEP implementation today. This is a collection of timely contributions from global leaders in HIV research and policy that addresses geographic diversity, uses a trans-disciplinary approach and covers a variety of the complex issues raised by PrEP. As this publication will become accessible to all, we hope that it will remain a valuable resource for policy makers, programme managers, researchers and activists around the world at a moment of a paradigm shift of the global response to HIV.

PrEP implementation: moving from trials to policy and practice

PubMed Central

Cáceres, Carlos F; O'Reilly, Kevin R; Mayer, Kenneth H; Baggaley, Rachel

2015-01-01

Introduction It is increasingly clear that the HIV response will not be sustainable if the number of infections is not significantly reduced. Discussion For two decades, research has been ongoing to identify new behavioural and biomedical strategies to prevent HIV infection. In the past few years, the efficacy of several new strategies has been demonstrated, including oral pre-exposure prophylaxis (PrEP; i.e. daily use of tenofovir/emtricitabine). Because several social, political and logistic barriers remain, however, optimal PrEP implementation will require a better dissemination of new evidence in a number of areas and additional implementation research from various disciplinary perspectives (i.e. social science, policy and ethics; health systems; and economics, including cost-effectiveness studies). Discussion of new evidence on those topics, as well as case studies of potential PrEP implementation in diverse environments, can improve the understanding of the role that PrEP may play in addressing the global HIV/AIDS epidemic. In light of these needs, the Network for Multidisciplinary Studies in ARV-based HIV Prevention (NEMUS) and the World Health Organization (WHO) were honoured to co-organize a special issue of JIAS aimed at contributing to a scholarly discussion of current conditions surrounding PrEP implementation, potential impact and efficiency, social science concerns and the study of PrEP implementation in specific country cases. The papers included in this monograph identify and cover many of the main aspects of the complex yet promising discussions around PrEP implementation today. Conclusions This is a collection of timely contributions from global leaders in HIV research and policy that addresses geographic diversity, uses a trans-disciplinary approach and covers a variety of the complex issues raised by PrEP. As this publication will become accessible to all, we hope that it will remain a valuable resource for policy makers, programme managers, researchers and activists around the world at a moment of a paradigm shift of the global response to HIV. PMID:26198349

Beyond nutrition and agriculture policy: collaborating for a food policy.

PubMed

Stewart, Derek; Kennedy, Anne; Pavel, Anthony

2014-10-01

Global interest in food policy is emerging in parallel with mounting challenges to the food supply and the rising prevalence of diet-related chronic health conditions. Some of the foundational elements of food policies are agricultural practices, finite resources, as well as economic burdens associated with a growing and ageing population. At the intersection of these interests is the need for policy synchronisation and a better understanding of the dynamics within local, regional and national government decision-making that ultimately affect the wellness of the populous and the safety, quality, affordability and quantity of the food supply. Policies, synchronised or not, need to be implemented and, for the food industry, this has seen a myriad of approaches with respect to condensing complex nutritional information and health claims. These include front and/or back of pack labelling, traffic light systems, etc. but in general there is little uniformity at the more regional and global scales. This translation of the nutritional and health-beneficial messages accompanying specific products to the consumer will undoubtedly be an area of intense activity, and hopefully interaction with policy makers, as the food industry continues to become a more global industry.

The Role of School Context in Implementing a Statewide Anti-Bullying Policy and Protecting Students

ERIC Educational Resources Information Center

Hall, William J.; Chapman, Mimi V.

2018-01-01

Bullying is a significant problem in U.S. schools. Policies have been developed to reduce bullying, yet policy implementation by educators is an essential yet difficult and complex process. Few studies have investigated factors that act as barriers to or facilitators of bullying policy implementation and teacher protection of students. This study…

An Explanatory Mixed-Methods Approach to Tracing "Career Pathways" Policy in Virginia: How School Counselors and Student Demographics Influence Implementation Fidelity

ERIC Educational Resources Information Center

Ormsmith, Michael Isaac

2014-01-01

This explanatory mixed-methods policy analysis describes how school counselors' thoughts and attitudes contribute to the implementation fidelity of the Academic and Career Plan (ACP) policy in a suburban Virginia school division. A quantitative survey investigated counselor thoughts about the policy, implementation behaviors, and counselor ideas…

Education Policy Implementation: A Literature Review and Proposed Framework. OECD Education Working Papers, No. 162

ERIC Educational Resources Information Center

Viennet, Romane; Pont, Beatriz

2017-01-01

This literature review focuses on education policy implementation, its definition, processes and determinants. It aims to clarify what implementing policies involve in complex education systems to support policy work, building on the literature and country examples. An introduction delves into the reasons behind the need to update the concept of…

School Leadership Practices That Promote Effective Whole School Behaviour Management: A Study of Australian Primary Schools

ERIC Educational Resources Information Center

De Nobile, John; El Baba, Mariam; London, Teola

2016-01-01

When considering the management of student behaviour issues, a substantial body of literature, as well as logical common sense, points to the advantages of whole school policy over the individual efforts of teachers. Less is known, however, about the direct or indirect role school leadership plays in the development of well-implemented whole…

HIV policy and implementation: a national policy review and an implementation case study of a rural area of northern Malawi.

PubMed

Dasgupta, Aisha N Z; Wringe, Alison; Crampin, Amelia C; Chisambo, Christina; Koole, Olivier; Makombe, Simon; Sungani, Charles; Todd, Jim; Church, Kathryn

2016-09-01

Malawi is a global leader in the design and implementation of progressive HIV policies. However, there continues to be substantial attrition of people living with HIV across the "cascade" of HIV services from diagnosis to treatment, and program outcomes could improve further. Ability to successfully implement national HIV policy, especially in rural areas, may have an impact on consistency of service uptake. We reviewed Malawian policies and guidelines published between 2003 and 2013 relating to accessibility of adult HIV testing, prevention of mother-to-child transmission and HIV care and treatment services using a policy extraction tool, with gaps completed through key informant interviews. A health facility survey was conducted in six facilities serving the population of a demographic surveillance site in rural northern Malawi to investigate service-level policy implementation. Survey data were analyzed using descriptive statistics. Policy implementation was assessed by comparing policy content and facility practice using pre-defined indicators covering service access: quality of care, service coordination and patient tracking, patient support, and medical management. ART was rolled out in Malawi in 2004 and became available in the study area in 2005. In most areas, practices in the surveyed health facilities complied with or exceeded national policy, including those designed to promote rapid initiation onto treatment, such as free services and task-shifting for treatment initiation. However, policy and/or practice were/was lacking in certain areas, in particular those strategies to promote retention in HIV care (e.g., adherence monitoring and home-based care). In some instances, though, facilities implemented alternative progressive practices aimed at improving quality of care and encouraging adherence. While Malawi has formulated a range of progressive policies aiming to promote rapid initiation onto ART, increased investment in policy implementation strategies and quality service delivery, in particular to promote long-term retention on treatment may improve outcomes further.

Impacting Multiunit Housing Managers' Beliefs About the Benefits of Adopting Smoke-Free Policies: A Pilot Investigation.

PubMed

Brett, Emma I; Leavens, Eleanor L; Wiener, Josh I

2018-02-01

To examine the influence of providing multiunit housing (MUH) managers with a resource manual for MUH smoke-free policy implementation on manager perceptions of smoke-free policies. One-group within-subject pretest-posttest design examining manager perceptions of smoke-free policies. Random sampling of MUH managers in Oklahoma. Forty-six MUH managers. The SMOKEFREE Landlord Manual (SLM) provides information on smoke-free policies and implementation resources. Beliefs regarding implementation of smoke-free policies were measured on a Likert scale before and after receiving the manual. A general linear model examined changes in beliefs regarding implementation of a smoke-free policy. After receiving the manual, managers were more likely to agree with positive beliefs about smoke-free policies (Wilks λ = 0.59, F[18, 70] = 2.68, P < .01). The MUH managers endorsed more positive beliefs regarding smoke-free policies following the receipt of the SLM.

78 FR 72679 - Submission for OMB Review: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... OMB Review: Comment Request Title: RPG National Cross-Site Evaluation and Evaluation Technical..., activities, and services designed to increase well-being, improve permanency, and enhance the safety of... Research. The evaluation is being implemented by Mathematica Policy Research and its subcontractors, Walter...

Recovery in Canada: Toward social equality

PubMed Central

PIAT, MYRA; SABETTI, JUDITH

2016-01-01

This article reviews evolution of the recovery paradigm in Canadian mental health. We first trace the origins and development of the recovery concept through the literature, followed by an examination of how the recovery concept has been implemented in national and provincial mental health policy since publication of the 2006 Kirby Commission Report. Based on consultations with Canadian policymakers, and an examination of available policy documents, we explore how the dual theme of ‘recovery’ and ‘well-being’, adopted by the Mental Health Commission of Canada in its 2009 strategy: Toward Recovery and Well-being - A Framework For a Mental Health Strategy has subsequently played out in mental health policymaking at the provincial level. Findings reveal mixed support for recovery as a guiding principle for mental health reform in Canada. While policies in some provinces reflect widespread support for recovery, and strong identification with the aspirations of the consumer movement; other provinces have shifted to population-based, wellness paradigms that privilege evidence-based services and professional expertise. The recognition of social equality for people who experience mental illness emerges as an important value in Canadian mental health policy, cutting across the conceptual divide between recovery and well-being. PMID:22385423

Impact of a smoke-free policy in a large psychiatric hospital on staff attitudes and patient behavior.

PubMed

Voci, Sabrina; Bondy, Susan; Zawertailo, Laurie; Walker, Louise; George, Tony P; Selby, Peter

2010-01-01

The objectives of this work were to examine changes over time in degree of staff support for the implementation of a smoke-free policy in Canada's largest public mental health and addiction teaching hospital and to assess the impact of the policy on patient behavior. Staff completed an anonymous survey, which assessed views toward the smoke-free policy and perceived change in patient behavior, 2-7 and 31-33 months after an indoor smoke-free policy was implemented (September 21, 2005). Objective indicators of patient behavior were also collected in the form of number of emergency code whites (aggressive behavior) and that of code reds (fire) called 1 year prior to and 2 years following policy implementation. Survey response rates were 19.0% (n=481) and 18.1% (n=500) at 2-7 and 31-33 months, respectively. The proportion of staff who supported the policy increased from pre-implementation (82.6%) to post-implementation (89.1%), and a high level of support was maintained 2 years after policy enactment (90.1%). The number of emergency codes did not significantly change after policy implementation, and staff did not perceive a change in most forms of patient behavior. A smoke-free policy can be implemented in a large psychiatric hospital with a high degree of support from staff and no substantial negative impact on patient behavior. Copyright © 2010 Elsevier Inc. All rights reserved.

NATIONAL FRAMEWORK FOR THE SUSTAINABILITY OF HEALTH KNOWLEDGE TRANSLATION INITIATIVES IN UGANDA.

PubMed

Basaza, Robert; Kinegyere, Alison; Mutatina, Boniface; Sewankambo, Nelson

2018-01-01

The aim of this study was to provide evidence about the design and implementation of policies for advancing the sustainability of knowledge translation (KT) initiatives and policies in Uganda's health system. We searched for and reviewed evidence about KT sustainability issues in Uganda, the impacts of options, barriers to implementing these options, and implementation strategies to address such barriers. In instances where the systematic reviews provided limited evidence, these were supplemented with relevant primary studies. Documents such as the government reports and unpublished literature were also included in the search. Key informant interviews and a policy dialogue were conducted, and an expert working group guided the study. The KT sustainability issues identified were: the absence of a specific unit within the health sector to coordinate and synthesize research; health worker not familiar with KT activities and not often used. Furthermore, Uganda lacks a mechanism to sustain its current national health frameworks or platforms, and does not have a system to ensure the sustained coordination of existing national health KT platforms. The policy options proposed include: (i) the identification of a KT champion; (ii) the establishment of an operational KT framework; (iii) KT capacity building for researchers and research users, as well as policy and decision makers. The sustainability of KT will be influenced by the prevailing context and concerns within healthcare both in Uganda and internationally. Furthermore, the availability of resources for KT advocacy, communication, and program design will impact on the sustainability of Uganda's KT activities.

School district wellness policy quality and weight-related outcomes among high school students in Minnesota

PubMed Central

Hoffman, Pamela K.; Davey, Cynthia S.; Larson, Nicole; Grannon, Katherine Y.; Hanson, Carlie; Nanney, Marilyn S.

2016-01-01

Weight-related outcomes were examined among high school students in Minnesota public school districts according to the quality of district wellness policies. Wellness policy strength and comprehensiveness were scored using the Wellness School Assessment Tool (WellSAT) for 325 Minnesota public school districts in 2013. The associations between WellSAT scores and district-level means of high school student responses to a statewide survey of health behaviors were examined in this ecologic study. WellSAT Total Strength and Total Comprehensiveness scores were positively associated with both student mean Body Mass Index (BMI) percentile (Strength: P = 0.018, Comprehensiveness: P = 0.031) and mean percent overweight or obese (Strength: P = 0.008, Comprehensiveness: P = 0.026), but only in districts with >50% of students eligible for Free or Reduced-Price Lunches (FRPLs), or ‘high FRPL districts’. WellSAT Physical Education and Physical Activity subscale scores were also positively associated with the mean days per week students engaged in physical activity for ≥ 60 min in high FRPL districts (Strength: P = 0.008, Comprehensiveness: P = 0.003) and in low FRPL districts (<35% eligible) for Strength score: (P = 0.027). In medium FRPL districts (35–50% eligible), Nutrition Education and Wellness Promotion Strength and Comprehensiveness subscale scores were positively associated with, respectively, daily servings of vegetables (P = 0.037) and fruit (P = 0.027); and WellSAT Total scores were positively associated with daily vegetable servings (Strength: P = 0.037, Comprehensiveness: P = 0.012). Administrators of economically disadvantaged school districts with a higher percentage of overweight students may be recognizing the need for stronger wellness policies and the specific importance of implementing policies pertaining to physical activity as a means to improve student health. PMID:26850060

Ergonomics in the development and implementation of organisational strategy for sustainability.

PubMed

Ryan, Brendan; Wilson, John R

2013-01-01

This is the first phase of an ergonomics study of sustainability in a rail organisation, particularly environmental sustainability. The main emphasis has been on the use of a qualitative approach to carry out in-depth consultation with those in influential and policy setting roles in the organisation, collecting and analysing perceptions on sustainability policy and related business processes. The study identified factors affecting implementation of policy on sustainability and these have been developed to produce a list of requirements for implementing the policy. The findings are valuable in understanding the range of attitudes, aspirations and perceived constraints, from the perspective of those in senior roles in the company, and development of a sustainability strategy for a rail infrastructure owner. There is need for wider consultation, both within the organisation and externally, to validate and refine the understanding of barriers to the implementation of the policy. The role of ergonomics in supporting the work on sustainability is discussed. The study collects in-depth views from senior managers on the challenges of implementing a policy on sustainability in a rail organisation. Outputs include a list of factors affecting implementation of policy and requirements for better implementation of policy in this area. Potential contributions of ergonomics to sustainability in organisational contexts are discussed.

Employee influenza vaccination in residential care facilities.

PubMed

Apenteng, Bettye A; Opoku, Samuel T

2014-03-01

The organizational literature on infection control in residential care facilities is limited. Using a nationally representative dataset, we examined the organizational factors associated with implementing at least 1 influenza-related employee vaccination policy/program, as well as the effect of vaccination policies on health care worker (HCW) influenza vaccine uptake in residential care facilities. The study was a cross-sectional study using data from the 2010 National Survey of Residential Care Facilities. Multivariate logistic regression analysis was used to address the study's objectives. Facility size, director's educational attainment, and having a written influenza pandemic preparedness plan were significantly associated with the implementation of at least 1 influenza-related employee vaccination policy/program, after controlling for other facility-level factors. Recommending vaccination to employees, providing vaccination on site, providing vaccinations to employees at no cost, and requiring vaccination as a condition of employment were associated with higher employee influenza vaccination rates. Residential care facilities can improve vaccination rates among employees by adopting effective employee vaccination policies. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Community Action for Health in India's National Rural Health Mission: One policy, many paths.

PubMed

Gaitonde, Rakhal; San Sebastian, Miguel; Muraleedharan, V R; Hurtig, Anna-Karin

2017-09-01

Community participation as a strategy for health system strengthening and accountability is an almost ubiquitous policy prescription. In 2005, with the election of a new Government in India, the National Rural Health Mission was launched. This was aimed at 'architectural correction' of the health care system, and enshrined 'communitization' as one of its pillars. The mission also provided unique policy spaces and opportunity structures that enabled civil society groups to attempt to bring on to the policy agenda as well as implement a more collective action and social justice based approach to community based accountability. Despite receiving a lot of support and funding from the central ministry in the pilot phase, the subsequent roll out of the process, led in the post-pilot phase by the individual state governments, showed very varied outcomes. This paper using both documentary and interview based data is the first study to document the roll out of this ambitious process. Looking critically at what varied and why, the paper attempts to derive lessons for future implementation of such contested concepts. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Governing the implementation of Emergency Obstetric Care: experiences of Rural District Health Managers, Tanzania

PubMed Central

2014-01-01

Background Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. Methods The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Results Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development. Conclusion The study revealed that implementing EmOC is a process accompanied by challenges that require an approach with multiple partners to address them and that, for effective partnership, the roles and responsibilities of each partner should be well stipulated in a clear working framework within the district health system. Partnerships strengthen health system governance and therefore ensure effective implementation of health policies at a local level. PMID:25086597

Governing the implementation of emergency obstetric care: experiences of rural district health managers, Tanzania.

PubMed

Mkoka, Dickson Ally; Kiwara, Angwara; Goicolea, Isabel; Hurtig, Anna-Karin

2014-08-03

Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development. The study revealed that implementing EmOC is a process accompanied by challenges that require an approach with multiple partners to address them and that, for effective partnership, the roles and responsibilities of each partner should be well stipulated in a clear working framework within the district health system. Partnerships strengthen health system governance and therefore ensure effective implementation of health policies at a local level.

Walking the tightrope-perspectives on local politicians' role in implementing a national social care policy on evidence-based practice.

PubMed

Bäck, A; Ståhl, C; von Thiele Schwarz, U; Richter, A; Hasson, H

2016-01-01

Despite national policy recommending evidence-based practice (EBP), its application in social care has been limited. While local politicians can affect the process, little is known about their knowledge, attitudes and roles regarding EBP. The aim here is twofold: to explore the role of local politicians in the implementation of EBP in social care from both their own and a management perspective; and to examine factors politicians perceive as affecting their decisions and actions concerning the implementation of EBP policy. Local politicians (N = 13) and managers (N = 22) in social care were interviewed. Qualitative thematic analysis with both inductive and deductive codes was used. Politicians were rather uninformed regarding EBP and national policy. The factors limiting their actions were, beside the lack of awareness, lack of ability to question existing working methods, and a need for support in the steering of EBP. Thus, personal interest played a significant part in what role the politicians assumed. This resulted in some politicians taking a more active role in steering EBP while others were not involved. From the managers' perspective, a more active steering by politicians was desired. Setting budget and objectives, as well as active follow-up of work processes and outcomes, were identified as means to affect the implementation of EBP. However, the politicians seemed unaware of the facilitating effects of these actions. Local politicians had a possibility to facilitate the implementation of EBP, but their role was unclear. Personal interest played a big part in determining what role was taken. The results imply that social care politicians might need support in the development of their steering of EBP. Moving the responsibility for EBP facilitation upwards in the political structure could be an important step in developing EBP in social care.

Implementation science in healthcare: Introduction and perspective.

PubMed

Wensing, Michel

2015-01-01

Implementation science is the scientific study of the methods to promote the uptake of research findings into routine healthcare in clinical, organisational, or policy contexts. The presence of gaps between knowledge and practice is well documented and a range of strategies is available to overcome these gaps. To optimize their impact, it is recommended that implementation strategies are tailored to the target population, setting and goals for improvement. Themes for future research in the field are: implementation of personalized medicine, the economics of implementation, knowledge implementation in various health professions, patient involvement in implementation, and a better understanding of the determinants of implementation. Addressing these challenges requires dedicated training programs, research funding, and networks for effective collaboration with stakeholders in healthcare. Copyright © 2015. Published by Elsevier GmbH.

Using Win-Win Strategies to Implement Health in All Policies: A Cross-Case Analysis

PubMed Central

Molnar, Agnes; Renahy, Emilie; O’Campo, Patricia; Muntaner, Carles; Freiler, Alix; Shankardass, Ketan

2016-01-01

Background In spite of increasing research into intersections of public policy and health, little evidence shows how policy processes impact the implementation of Health in All Policies (HiAP) initiatives. Our research sought to understand how and why strategies for engaging partners from diverse policy sectors in the implementation of HiAP succeed or fail in order to uncover the underlying social mechanisms contributing to sustainable implementation of HiAP. Methods In this explanatory multiple case study, we analyzed grey and peer-review literature and key informant interviews to identify mechanisms leading to implementation successes and failures in relation to different strategies for engagement across three case studies (Sweden, Quebec and South Australia), after accounting for the role of different contextual conditions. Findings Our results yielded no support for the use of awareness-raising or directive strategies as standalone approaches for engaging partners to implement HiAP. However, we found strong evidence that mechanisms related to “win-win” strategies facilitated implementation by increasing perceived acceptability (or buy-in) and feasibility of HiAP implementation across sectors. Win-win strategies were facilitated by mechanisms related to several activities, including: the development of a shared language to facilitate communication between actors from different sectors; integrating health into other policy agendas (eg., sustainability) and use of dual outcomes to appeal to the interests of diverse policy sectors; use of scientific evidence to demonstrate the effectiveness of HiAP; and using health impact assessment to make policy coordination for public health outcomes more feasible and to give credibility to policies being developed by diverse policy sectors. Conclusion Our findings enrich theoretical understanding in an under-unexplored area of intersectoral action. They also provide policy makers with examples of HiAP across wealthy welfare regimes, and improve understanding of successful HiAP implementation practices, including the win-win approach. PMID:26845574

Analysis of selected policies towards universal health coverage in Uganda: the policy implementation barometer protocol.

PubMed

Hongoro, Charles; Rutebemberwa, Elizeus; Twalo, Thembinkosi; Mwendera, Chikondi; Douglas, Mbuyiselo; Mukuru, Moses; Kasasa, Simon; Ssengooba, Freddie

2018-01-01

Policy implementation remains an under researched area in most low and middle income countries and it is not surprising that several policies are implemented without a systematic follow up of why and how they are working or failing. This study is part of a larger project called Supporting Policy Engagement for Evidence-based Decisions (SPEED) for Universal Health Coverage in Uganda. It seeks to support policymakers monitor the implementation of vital programmes for the realisation of policy goals for Universal Health Coverage. A Policy Implementation Barometer (PIB) is proposed as a mechanism to provide feedback to the decision makers about the implementation of a selected set of policy programmes at various implementation levels (macro, meso and micro level). The main objective is to establish the extent of implementation of malaria, family planning and emergency obstetric care policies in Uganda and use these results to support stakeholder engagements for corrective action. This is the first PIB survey of the three planned surveys and its specific objectives include: assessment of the perceived appropriateness of implementation programmes to the identified policy problems; determination of enablers and constraints to implementation of the policies; comparison of on-line and face-to-face administration of the PIB questionnaire among target respondents; and documentation of stakeholder responses to PIB findings with regard to corrective actions for implementation. The PIB will be a descriptive and analytical study employing mixed methods in which both quantitative and qualitative data will be systematically collected and analysed. The first wave will focus on 10 districts and primary data will be collected through interviews. The study seeks to interview 570 respondents of which 120 will be selected at national level with 40 based on each of the three policy domains, 200 from 10 randomly selected districts, and 250 from 50 facilities. Half of the respondents at each level will be randomly assigned to either face-to-face or on-line interviews. An integrated questionnaire for these interviews will collect both quantitative data through Likert scale-type questions, and qualitative data through open-ended questions. And finally focused dialogues will be conducted with selected stakeholders for feedback on the PIB findings. Secondary data will be collected using data extraction tools for performance statistics. It is anticipated that the PIB findings and more importantly, the focused dialogues with relevant stakeholders, that will be convened to discuss the findings and establish corrective actions, will enhance uptake of results and effective health policy implementation towards universal health coverage in Uganda.

K-BREF(Korean BAT reference document) development : BAT and BAT-AELs for large combustion plants and waste incinerators in Korea.

NASA Astrophysics Data System (ADS)

Yoo, Heungmin; Lee, Daegyun; Park, Jaehong

2017-04-01

Since the initial environmental policy namely "Regulation on assigning license for environmental pollutant emission facilities" was introduced in 1971, the previous environmental policy that assign licenses on emission facilities of each pollutant has been implementing in Korea. From this, economic standard and environmental quality of Korea are recognized as level of developed countries, even though various development activities for industrialization. However, amount of pollutant, emission route and emission source are increasing with development of various industries, and citizens recognition for environment have been changed as well. Thus, ministry of environment of Korea needs systematic policy based on scientific grounds for conversion of paradigm. For this, ministry of environment was introduced new policy namely "integrated pollution prevention and control(IPPC)", and it will be implemented from 2017 in Korea. IPPC is established for considering environment, economic and efficiency: 10 licenses on each pollutant emission will be integrated to one license, and it can be expected simplification for business licensing process. As well, this policy can be upgraded and processed while considering characteristics on location and industry types, in the future. However, to conduct this system harmoniously, policy demanders have to apply integrated control system to their facilities. Especially, the first applied industries by IPPC are two industries, such as large combustion plants for power generation and waste incineration facilities. Therefore, ministry of environment has to publish technical guideline books firstly for those industries, and they were named to "BAT reference document(BREF)". In this study, essential information for BREFs publishment, that is including emission levels, best available technique(BAT) and so on was investigated. In addition, the BAT-associated emission levels (BAT-AELs) of each industry were set using emission data obtained from realtime-monitoring system.

Implementation lessons for school food policies and marketing restrictions in the Philippines: a qualitative policy analysis.

PubMed

Reeve, Erica; Thow, Anne Marie; Bell, Colin; Engelhardt, Katrin; Gamolo-Naliponguit, Ella Cecilia; Go, John Juliard; Sacks, Gary

2018-01-23

The school environment can enhance children's skills, knowledge and behaviours in relation to healthy eating. However, in many countries, unhealthy foods are commonly available in schools, and children can be exposed to aggressive marketing by the food industry. Taking the perspective of policymakers, this study aimed to identify barriers and enablers to effective school food policy development and implementation in the Philippines. In May 2016, semi-structured interviews were conducted with 21 policymakers and stakeholders involved in school food policymaking and implementation in the Philippines. The Health Policy Analysis Triangle was used to identify interview questions and to guide the thematic analysis. These included the political and socio-environmental context, strengths and limitations of existing policy content, roles and behaviours of actors, implementation processes, policy outcomes, and opportunities to improve policy coherence. The Department of Education's policy 'Orders' represented a relatively strong policy framework for the education sector of the Philippines. However, a lack of human and financial resources for implementation, planning, and policy enforcement limited the impact of the policy on the healthiness of school food provision. Ambiguity in policy wording allowed a wide interpretation of the foods eligible to be provided in schools, and led to difficulties in effective monitoring and enforcement. Food companies used existing relationships with schools to promote their brands and compromise the establishment of a stronger food policy agenda. We found a motivated group of actors engaging in policy-oriented learning and advocating for a stronger policy alternative so as to improve the school food environment. The adoption of policy mechanisms being used to promote healthy dietary practices in the school setting will be strengthened by more robust implementation planning processes, and resources to support implementation and enforcement. Policymakers should ensure policy language clearly and unequivocally promotes healthier food and beverage options. Steps should be taken to achieve policy coherence by ensuring the objectives of one agency or institution are not undermining that of any others. Where there is reliance on the private sector for school resources, safeguards should be established to protect against conflicts of interest.

Understanding Policy Intentions Is Critical for Successful Policy Implementation within the Technical and Vocational Education and Training College's Sector

ERIC Educational Resources Information Center

Sebele, Ntlantla

2015-01-01

Public policy implementation is frequently regarded as problematic globally and reasons for these vary. In particular, the Technical and Vocational Education and Training (TVET) sector has been criticized for lack of delivery and most of the criticism is directed towards the non-implementation of government policy. In South Africa managers of TVET…

A multiple case history and systematic review of adoption, diffusion, implementation and impact of provincial daily physical activity policies in Canadian schools.

PubMed

Olstad, Dana Lee; Campbell, Elizabeth J; Raine, Kim D; Nykiforuk, Candace I J

2015-04-15

Few children meet physical activity (PA) recommendations, and are therefore at increased risk for overweight/obesity and adverse health outcomes. To increase children's opportunities for PA, several Canadian provinces have adopted school-based daily PA (DPA) policies. It is not clear why some jurisdictions have adopted DPA policies, and others have not, nor whether these policies have been implemented and have achieved their intended outcomes. The purpose of this study was to understand the processes underlying adoption and diffusion of Canadian DPA policies, and to review evidence regarding their implementation and impact. We adopted a multiple case history methodology in which we traced the chronological trajectory of DPA policies among Canadian provinces by compiling timelines detailing key historical events that preceded policy adoption. Publicly available documents posted on the internet were reviewed to characterize adopter innovativeness, describe the content of their DPA policies, and explore the context surrounding policy adoption. Diffusion of Innovations theory provided a conceptual framework for the analyses. A systematic literature search identified studies that had investigated adoption, diffusion, implementation or impact of Canadian DPA policies. Five of Canada's 13 provinces and territories (38.5%) have DPA policies. Although the underlying objectives of the policies are similar, there are clear differences among them and in their various policy trajectories. Adoption and diffusion of DPA policies were structured by the characteristics and capacities of adopters, the nature of their policies, and contextual factors. Limited data suggests implementation of DPA policies was moderate but inconsistent and that Canadian DPA policies have had little to no impact on school-aged children's PA levels or BMI. This study detailed the history and current status of Canadian DPA policies, highlighting the conditional nature of policy adoption and diffusion, and describing policy and adopter characteristics and political contexts that shaped policy trajectories. An understanding of the conditions associated with successful policy adoption and diffusion can help identify receptive contexts in which to pioneer novel legislative initiatives to increase PA among children. By reviewing evidence regarding policy implementation and impact, this study can also inform amendments to existing, and development of future PA policies.

Curriculum Policy Implementation: How Schools Respond to Government's "Soft" Policy in the Curriculum Reform

ERIC Educational Resources Information Center

Chan, Jacqueline K. S.

2012-01-01

"Soft" policy has newly emerged as a policy implementation concept in relation to governance. Non-binding in character, "soft" policy is designed for multi-level systems of governance in which there is relative autonomy at different levels of collective decision-making. "Soft" policy has gained attention since the…

The role of policy in improving diets: experiences from the Pacific Obesity Prevention in Communities food policy project.

PubMed

Thow, A M; Snowdon, W; Schultz, J T; Leeder, S; Vivili, P; Swinburn, B A

2011-11-01

There is global interest in using multisectoral policy approaches to improve diets, and reduce obesity and non-communicable disease. However, there has been ad hoc implementation, which in some sectors such as the economic sector has been very limited, because of the lack of quality evidence on potential costs and impacts, and the inherent challenges associated with cross-sectoral policy development and implementation. The Pacific Obesity Prevention in Communities food policy project aimed to inform relevant policy development and implementation in Pacific Island countries. The project developed an innovative participatory approach to identifying and assessing potential policy options in terms of their effectiveness and feasibility. It also used policy analysis methodology to assess three policy initiatives to reduce fatty meat availability and four soft drink taxes in the region, in order to identify strategies for supporting effective policy implementation. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Analysing policy delivery in the United Kingdom: the case of street crime and anti-social behaviour.

PubMed

Smith, Martin; Richards, David; Geddes, Andrew; Mathers, Helen

2011-01-01

For all governments, the principle of how and whether policies are implemented as intended is fundamental. The aim of this paper is to examine the difficulties for governments in delivering policy goals when they do not directly control the processes of implementation. This paper examines two case studies – anti-social behaviour and street crime – and demonstrates the difficulties faced by policy-makers in translating policy into practice when the policy problems are complex and implementation involves many actors.

Using social network analysis to examine the decision-making process on new vaccine introduction in Nigeria.

PubMed

Wonodi, C B; Privor-Dumm, L; Aina, M; Pate, A M; Reis, R; Gadhoke, P; Levine, O S

2012-05-01

The decision-making process to introduce new vaccines into national immunization programmes is often complex, involving many stakeholders who provide technical information, mobilize finance, implement programmes and garner political support. Stakeholders may have different levels of interest, knowledge and motivations to introduce new vaccines. Lack of consensus on the priority, public health value or feasibility of adding a new vaccine can delay policy decisions. Efforts to support country-level decision-making have largely focused on establishing global policies and equipping policy makers with the information to support decision-making on new vaccine introduction (NVI). Less attention has been given to understanding the interactions of policy actors and how the distribution of influence affects the policy process and decision-making. Social network analysis (SNA) is a social science technique concerned with explaining social phenomena using the structural and relational features of the network of actors involved. This approach can be used to identify how information is exchanged and who is included or excluded from the process. For this SNA of vaccine decision-making in Nigeria, we interviewed federal and state-level government officials, officers of bilateral and multilateral partner organizations, and other stakeholders such as health providers and the media. Using data culled from those interviews, we performed an SNA in order to map formal and informal relationships and the distribution of influence among vaccine decision-makers, as well as to explore linkages and pathways to stakeholders who can influence critical decisions in the policy process. Our findings indicate a relatively robust engagement of key stakeholders in Nigeria. We hypothesized that economic stakeholders and implementers would be important to ensure sustainable financing and strengthen programme implementation, but some economic and implementation stakeholders did not appear centrally on the map; this may suggest a need to strengthen the decision-making processes by engaging these stakeholders more centrally and earlier.

Perceived impact and feasibility of strategies to improve access to healthy foods in Washington State, USA.

PubMed

Johnson, Donna B; Quinn, Emilee L; Podrabsky, Mary; Beckwith-Stanley, Nadia; Chan, Nadine; Ellings, Amy; Kovacs, Tricia; Lane, Claire

2013-12-01

The present study measured the perceived impact and political and implementation feasibility of state-level policy strategies related to increasing access to healthy foods and limiting unhealthy foods. Potential state-level policy strategies to improve access to healthy foods were identified through a review of evidence-based literature and policy recommendations. Respondents rated the perceived impact and political and implementation feasibility of each policy on a five-point scale using online surveys. Washington State policy process. Forty-nine content experts (national researchers and subject experts), forty policy experts (state elected officials or their staff, gubernatorial or legislative policy analysts) and forty-five other stakeholders (state-level advocates, programme administrators, food producers). In aggregate, respondents rated policy impact and implementation feasibility higher than political feasibility. Policy experts rated policy strategies as less politically feasible compared with content experts (P < 0·02) or other stakeholders (P < 0·001). Eight policy strategies were rated above the median for impact and political and implementation feasibility. These included policies related to nutrition standards in schools and child-care facilities, food distribution systems, urban planning projects, water availability, joint use agreements and breast-feeding supports. Although they may be perceived as potentially impactful, some policies will be more difficult to enact than others. Information about the potential feasibility of policies to improve access to healthy foods can be used to focus limited policy process resources on strategies with the highest potential for enactment, implementation and impact.

Exploring health facilities' experiences in implementing the free health-care policy (FHCP) in Nepal: how did organizational factors influence the implementation of the user-fee abolition policy?

PubMed

Sato, Midori; Gilson, Lucy

2015-12-01

This article presents an Asian experience of abolishing health-care user fees: Nepal's universal free health-care policy, implemented in 2008. Based on doctoral fieldwork between August 2008 and April 2009, the paper analyses primary-care facilities' and central and district health systems' experiences with the policy. It makes a unique contribution to existing evidence because it explicitly applies organizational theory within a carefully designed, rigorous, multiple case-study analysis to deepen our understanding of the organizational and 'people' factors in the successful removal of user fees. The cases were two pairs of primary-care facilities in one district, paired for comparison of the facilities' experiences with the policy in relation to its effects on health care utilization. Data collection methods included document reviews; key informant interviews at district and central levels; in-depth, semi-structured interviews and group interviews at case facilities. (Data on indicators of utilization and quality changes over time were also collected and will be published separately). Using key elements of Nadler and Tushman's 'Organizational Congruence' model, a degree-of-fit analysis tested the study's initial propositions and yielded generalizations for contexts in and outside Nepal. The study found that Nepal's key implementation challenges were similar to Africa's: insufficient or delayed inputs of drugs and compensation; insufficient workforce and the resulting reduced quality of services that hampered facilities' relationships with their clients and health providers' attitudes. However, the Nepalese case facilities with (1) good intra- and inter-facility relationships, (2) adequate staffing, (3) well-oriented providers and (4) previously trained, better-informed and skilled health management committees experienced higher utilization and better-quality indicators over time. Through its detailed analysis of Nepal's experience in removing user fees, the study highlights the importance of addressing the 'people' and 'organizational' factors in health-policy development and implementation. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

State-mandated accountability as a constraint on teaching and learning science

NASA Astrophysics Data System (ADS)

Wood, Terry

The purpose of this study is to examine the effect of state-mandated policy, emphasizing control through performance-based instruction and student test scores as the basis for determining school accreditation, on the teaching and learning of science. The intended consequence of instigating the rational theory of management by one state is to improve their current level of student literacy. However, some contend that the implementation of the policy has results that are not intended. The identification of the tension between the intended and unintended results of centralized policy making is the basis for examining a specific case in which the rational model is implemented. One hundred and sixty-five seventh-grade science students and four teachers are participants in the study. Qualitative analysis is the research methodology used as a means to provide detailed information about the contextual nature of the classroom processes. The intention is to identify and describe features of the behavior setting that influence the behavior of the teachers and their students. Three assertions generated during the field work were: Teachers redefine the goals of science instruction as the acquisition of facts and isolated skills, teachers alter their usual instructional behavior to implement uniform instructional procedures, and the teacher/student classroom interaction constrains students' opportunities to learn science. The implications of the study indicate that the state-mandated policy has results that are in opposition to the intended results. Instead of improving the practices of teachers, the implementation of the policy constrains and routinizes the teachers' behavior, causing them to violate their own standards of good teaching. They feel pressured to get through the materials so students will score well on tests. The classroom interaction is structured in such a way as to inhibit students from asking questions of their own. As a result, students' opportunity to express curiosity and inquiry - central processes in scientific thinking - are constrained. These unintended consequences of the implemented state policy, instead of improving science teaching and learning, continue to reduce science instruction to the literal comprehension of isolated facts and skills.

Beyond excise taxes: a systematic review of literature on non-tax policy approaches to raising tobacco product prices.

PubMed

Golden, Shelley D; Smith, Margaret Holt; Feighery, Ellen C; Roeseler, April; Rogers, Todd; Ribisl, Kurt M

2016-07-01

Raising the price of tobacco products is considered one of the most effective ways to reduce tobacco use. In addition to excise taxes, governments are exploring other policies to raise tobacco prices and minimise price dispersion, both within and across price tiers. We conducted a systematic review to determine how these policies are described, recommended and evaluated in the literature. We systematically searched six databases and the California Tobacco Control library for English language studies or reports, indexed on or before 18 December 2013, that included a tobacco keyword (eg, cigarette), policy keyword (eg, legislation) and a price keyword (eg, promotion). We identified 3067 abstracts. Two coders independently reviewed all abstracts and identified 56 studies or reports that explicitly described a public policy likely to impact the retail price of tobacco products through non-tax means. Two coders independently identified tobacco products targeted by policies described, recommendations for implementing policies and empirical assessments of policy impacts. The most prevalent non-tax price policies were price promotion restrictions and minimum price laws. Few studies measured the impact of non-tax policies on average prices, price dispersion or disparities in tobacco consumption, but the literature includes suggestions for crafting policies and preparing for legal challenges or tobacco industry opposition. Price-focused evaluations of well-implemented non-tax price policies are needed to determine whether they can deliver on their promise to raise prices, reduce price dispersion and serve as an important complement to excise taxes. 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/

Policy Analysis: A Tool for Setting District Computer Use Policy. Paper and Report Series No. 97.

ERIC Educational Resources Information Center

Gray, Peter J.

This report explores the use of policy analysis as a tool for setting computer use policy in a school district by discussing the steps in the policy formation and implementation processes and outlining how policy analysis methods can contribute to the creation of effective policy. Factors related to the adoption and implementation of innovations…

Introduction of male circumcision for HIV prevention in Uganda: analysis of the policy process.

PubMed

Odoch, Walter Denis; Kabali, Kenneth; Ankunda, Racheal; Zulu, Joseph Mumba; Tetui, Moses

2015-06-20

Health policy analysis is important for all health policies especially in fields with ever changing evidence-based interventions such as HIV prevention. However, there are few published reports of health policy analysis in sub-Saharan Africa in this field. This study explored the policy process of the introduction of male circumcision (MC) for HIV prevention in Uganda in order to inform the development processes of similar health policies. Desk review of relevant documents was conducted between March and May 2012. Thematic analysis was used to analyse the data. Conceptual frameworks that demonstrate the interrelationship within the policy development processes and influence of actors in the policy development processes guided the analysis. Following the introduction of MC on the national policy agenda in 2007, negotiation and policy formulation preceded its communication and implementation. Policy proponents included academic researchers in the early 2000s and development partners around 2007. Favourable contextual factors that supported the development of the policy included the rising HIV prevalence, adoption of MC for HIV prevention in other sub-Saharan African countries, and expertise on MC. Additionally, the networking capability of proponents facilitated the change in position of non-supportive or neutral actors. Non-supportive and neutral actors in the initial stages of the policy development process included the Ministry of Health, traditional and Muslim leaders, and the Republican President. Using political authority, legitimacy, and charisma, actors who opposed the policy tried to block the policy development process. Researchers' initial disregard of the Ministry of Health in the research process of MC and the missing civil society advocacy arm contributed to delays in the policy development process. This study underscores the importance of securing top political leadership as well as key implementing partners' support in policy development processes. Equally important is the appreciation of the various forms of actors' power and how such power shapes the policy agenda, development process, and content.

Strategies for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease.

PubMed

Wolfenden, Luke; Nathan, Nicole K; Sutherland, Rachel; Yoong, Sze Lin; Hodder, Rebecca K; Wyse, Rebecca J; Delaney, Tessa; Grady, Alice; Fielding, Alison; Tzelepis, Flora; Clinton-McHarg, Tara; Parmenter, Benjamin; Butler, Peter; Wiggers, John; Bauman, Adrian; Milat, Andrew; Booth, Debbie; Williams, Christopher M

2017-11-29

A number of school-based policies or practices have been found to be effective in improving child diet and physical activity, and preventing excessive weight gain, tobacco or harmful alcohol use. Schools, however, frequently fail to implement such evidence-based interventions. The primary aims of the review are to examine the effectiveness of strategies aiming to improve the implementation of school-based policies, programs or practices to address child diet, physical activity, obesity, tobacco or alcohol use.Secondary objectives of the review are to: Examine the effectiveness of implementation strategies on health behaviour (e.g. fruit and vegetable consumption) and anthropometric outcomes (e.g. BMI, weight); describe the impact of such strategies on the knowledge, skills or attitudes of school staff involved in implementing health-promoting policies, programs or practices; describe the cost or cost-effectiveness of such strategies; and describe any unintended adverse effects of strategies on schools, school staff or children. All electronic databases were searched on 16 July 2017 for studies published up to 31 August 2016. We searched the following electronic databases: Cochrane Library including the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; Embase Classic and Embase; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); Dissertations and Theses; and SCOPUS. We screened reference lists of all included trials for citations of other potentially relevant trials. We handsearched all publications between 2011 and 2016 in two specialty journals (Implementation Science and Journal of Translational Behavioral Medicine) and conducted searches of the WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/) as well as the US National Institutes of Health registry (https://clinicaltrials.gov). We consulted with experts in the field to identify other relevant research. 'Implementation' was defined as the use of strategies to adopt and integrate evidence-based health interventions and to change practice patterns within specific settings. We included any trial (randomised or non-randomised) conducted at any scale, with a parallel control group that compared a strategy to implement policies or practices to address diet, physical activity, overweight or obesity, tobacco or alcohol use by school staff to 'no intervention', 'usual' practice or a different implementation strategy. Citation screening, data extraction and assessment of risk of bias was performed by review authors in pairs. Disagreements between review authors were resolved via consensus, or if required, by a third author. Considerable trial heterogeneity precluded meta-analysis. We narratively synthesised trial findings by describing the effect size of the primary outcome measure for policy or practice implementation (or the median of such measures where a single primary outcome was not stated). We included 27 trials, 18 of which were conducted in the USA. Nineteen studies employed randomised controlled trial (RCT) designs. Fifteen trials tested strategies to implement healthy eating policies, practice or programs; six trials tested strategies targeting physical activity policies or practices; and three trials targeted tobacco policies or practices. Three trials targeted a combination of risk factors. None of the included trials sought to increase the implementation of interventions to delay initiation or reduce the consumption of alcohol. All trials examined multi-strategic implementation strategies and no two trials examined the same combinations of implementation strategies. The most common implementation strategies included educational materials, educational outreach and educational meetings. For all outcomes, the overall quality of evidence was very low and the risk of bias was high for the majority of trials for detection and performance bias.Among 13 trials reporting dichotomous implementation outcomes-the proportion of schools or school staff (e.g. classes) implementing a targeted policy or practice-the median unadjusted (improvement) effect sizes ranged from 8.5% to 66.6%. Of seven trials reporting the percentage of a practice, program or policy that had been implemented, the median unadjusted effect (improvement), relative to the control ranged from -8% to 43%. The effect, relative to control, reported in two trials assessing the impact of implementation strategies on the time per week teachers spent delivering targeted policies or practices ranged from 26.6 to 54.9 minutes per week. Among trials reporting other continuous implementation outcomes, findings were mixed. Four trials were conducted of strategies that sought to achieve implementation 'at scale', that is, across samples of at least 50 schools, of which improvements in implementation were reported in three trials.The impact of interventions on student health behaviour or weight status were mixed. Three of the eight trials with physical activity outcomes reported no significant improvements. Two trials reported reductions in tobacco use among intervention relative to control. Seven of nine trials reported no between-group differences on student overweight, obesity or adiposity. Positive improvements in child dietary intake were generally reported among trials reporting these outcomes. Three trials assessed the impact of implementation strategies on the attitudes of school staff and found mixed effects. Two trials specified in the study methods an assessment of potential unintended adverse effects, of which, they reported none. One trial reported implementation support did not significantly increase school revenue or expenses and another, conducted a formal economic evaluation, reporting the intervention to be cost-effective. Trial heterogeneity, and the lack of consistent terminology describing implementation strategies, were important limitations of the review. Given the very low quality of the available evidence, it is uncertain whether the strategies tested improve implementation of the targeted school-based policies or practices, student health behaviours, or the knowledge or attitudes of school staff. It is also uncertain if strategies to improve implementation are cost-effective or if they result in unintended adverse consequences. Further research is required to guide efforts to facilitate the translation of evidence into practice in this setting.

The Ontological Politics of Evidence and Policy Enablement

ERIC Educational Resources Information Center

Carusi, F. Tony; Rawlins, Peter; Ashton, Karen

2018-01-01

Ontological politics has received increasing attention within education policy studies, particularly as a support for the notion of policy enactment. While policy enactment offers serious challenges to traditional approaches toward policy implementation, this paper takes up ontological politics as a concept that extends beyond implementation and…

Nursing home resident smoking policies.

PubMed

Stefanacci, Richard G; Lester, Paula E; Kohen, Izchak

2008-01-01

To identify nursing home standards related to resident smoking through a nation wide survey of directors of nursing. A national survey was distributed online and was completed by 248 directors of nursing. The directors of nurses answered questions concerning resident smoking including the criteria utilized to determine an unsafe resident smoker. For those residents identified as unsafe, the questions asked were specifically related to monitoring, staff involvement, safety precautions and policy. The results of the survey demonstrated a consistent policy practiced among facilities across the United States. The monitoring of nursing home residents is based on a resident's mental acuity, physical restrictions and equipment requirements. Once a resident was identified as a smoker at risk of harm to self or others, staff involvement ranged from distributing cigarettes to direct supervision. In addition, the majority of facilities required residents to wear fire resistant aprons and provided a fire extinguisher in smoking areas. Monitoring policies of nursing home residents who smoke starts with identifying those residents at risk based on an assessment of mental acuity, physical restrictions and equipment requirements. Those that are identified as being at risk smokers have their cigarettes controlled and distributed by nursing staff and are supervised by facility staff when smoking. This policy is implemented through written policy as well as staff education. Despite some discrepancies in the actual implementation of policies to supervise residents who smoke, the policies for assessment for at-risk smokers requiring monitoring is consistent on a national basis.

Healthy food procurement and nutrition standards in public facilities: evidence synthesis and consensus policy recommendations

PubMed Central

Kim D., Raine; Kayla, Atkey; Dana Lee, Dana Lee; Alexa R., Ferdinands; Dominique, Beaulieu; Susan, Buhler; Norm, Campbell; Brian, Cook; Mary, L’Abbé; Ashley, Lederer; David, Mowat; Joshna, Maharaj; Candace, Nykiforuk; Jacob, Shelley; Jacqueline, Street

2018-01-01

Abstract Introduction: Unhealthy foods are widely available in public settings across Canada, contributing to diet-related chronic diseases, such as obesity. This is a concern given that public facilities often provide a significant amount of food for consumption by vulnerable groups, including children and seniors. Healthy food procurement policies, which support procuring, distributing, selling, and/or serving healthier foods, have recently emerged as a promising strategy to counter this public health issue by increasing access to healthier foods. Although numerous Canadian health and scientific organizations have recommended such policies, they have not yet been broadly implemented in Canada. Methods: To inform further policy action on healthy food procurement in a Canadian context, we: (1) conducted an evidence synthesis to assess the impact of healthy food procurement policies on health outcomes and sales, intake, and availability of healthier food, and (2) hosted a consensus conference in September 2014. The consensus conference invited experts with public health/nutrition policy research expertise, as well as health services and food services practitioner experience, to review evidence, share experiences, and develop a consensus statement/recommendations on healthy food procurement in Canada. Results: Findings from the evidence synthesis and consensus recommendations for healthy food procurement in Canada are described. Specifically, we outline recommendations for governments, publicly funded institutions, decision-makers and professionals, citizens, and researchers. Conclusion: Implementation of healthy food procurement policies can increase Canadians’ access to healthier foods as part of a broader vision for food policy in Canada. PMID:29323862

Energy-efficient Public Procurement: Best Practice in Program Delivery

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

Payne, Christopher; Weber, Andrew; Semple, Abby

2013-02-15

This document illustrates the key issues and considerations involved in implementing energy-efficient public procurement. Our primary sources of information have been our partners in the Super Efficient Equipment and Appliance Deployment (SEAD) Initiative Procurement Working Group. Where applicable, we have highlighted specific ways in which working group participants have successfully overcome barriers to delivering effective programs. The following key points emerge from this analysis of programs for energy-efficient public procurement. Lessons for both developed and developing programs are highlighted throughout the guide. 1. Policy: Policy provides the initiative to begin a transition from first cost to life-cycle cost based purchasingmore » methods and culture. Effective policy is well-communicated, establishes accountability from top to bottom of organizations and simplifies the processes necessary to comply. Flexibility and responsiveness are essential in policy development and implementation. Mandatory and voluntary policies may complement one another. 2. Procurement Criteria: Procurement staff must be confident that energy-efficient procurement criteria offer the best long-term value for their organization’s money and represent real environmental gains. Involving multiple stakeholders at the early stages of the criteria creation process can result in greater levels of cooperation from private industry. Criteria should make comparison of products easy for purchasers and require minimal additional calculations. Criteria will need to be regularly updated to reflect market developments. 3. Training: Resources for the creation of training programs are usually very limited, but well-targeted training is necessary in order for a program to be effective. Training must emphasize a process that is efficient for purchasers and simplifies compliance. Purchaser resources and policy must be well designed for training to be effective. Training program development is an excellent opportunity for collaboration amongst public authorities. 4. Procurement Processes: Many tools and guides intended to help buyers comply with energy-efficient procurement policy are designed without detailed knowledge of the procurement process. A deeper understanding of purchasing pathways allows resources to be better directed. Current research by national and international bodies aims to analyze purchasing pathways and can assist in developing future resources.« less

“Moving forward: a cross sectional baseline study of staff and student attitudes towards a totally smoke free university campus”

PubMed Central

2013-01-01

Background Baseline data were collected to inform the adoption, implementation and institutionalisation phases of a completely smoke free campus policy at a large Western Australian university with a diverse student and staff community. Methods An online survey was randomly emailed to staff and students to measure the attitudes towards and the acceptability and enforcement of the policy prior to implementation. In total, 969 respondents completed the survey. Results General attitudes towards smoking were negative. While smokers, ex-smokers and non-smokers were supportive of smoke free policy on campus, 65.7% of respondents felt the campus should be completely smoke free. Respondents indicated a smoke free policy should be stringently enforced. The majority of respondents reported that they had been exposed to second-hand smoke on campus (n = 768; 79.5%). Conclusion Theory of Organisational Change provides a useful framework to support the implementation of the completely smoke free policy in the University setting. The implementation process needs to consider the broad range of issues associated with implementing a completely smoke free policy and address issues such as safety of smokers, ensuring smokers are not marginalised and ensuring a comprehensive program is implemented. These baseline findings can be used to advocate for the implementation of a comprehensive range of strategies that recognise the addictive nature of tobacco smoking and address attitude and behaviour change, environmental adaptations and effective implementation of the policy. Administration should consider smokers and non-smokers when policy is implemented. PMID:23924040

Ecosystem change and human health: implementation economics and policy

PubMed Central

Kramer, R. A.; Vincent, J. R.

2017-01-01

Several recent initiatives such as Planetary Health, EcoHealth and One Health claim that human health depends on flourishing natural ecosystems. However, little has been said about the operational and implementation challenges of health-oriented conservation actions on the ground. We contend that ecological–epidemiological research must be complemented by a form of implementation science that examines: (i) the links between specific conservation actions and the resulting ecological changes, and (ii) how this ecological change impacts human health and well-being, when human behaviours are considered. Drawing on the policy evaluation tradition in public economics, first, we present three examples of recent social science research on conservation interventions that affect human health. These examples are from low- and middle-income countries in the tropics and subtropics. Second, drawing on these examples, we present three propositions related to impact evaluation and non-market valuation that can help guide future multidisciplinary research on conservation and human health. Research guided by these propositions will allow stakeholders to determine how ecosystem-mediated strategies for health promotion compare with more conventional biomedical prevention and treatment strategies for safeguarding health. This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’. PMID:28438919

Ecosystem change and human health: implementation economics and policy.

PubMed

Pattanayak, S K; Kramer, R A; Vincent, J R

2017-06-05

Several recent initiatives such as Planetary Health , EcoHealth and One Health claim that human health depends on flourishing natural ecosystems. However, little has been said about the operational and implementation challenges of health-oriented conservation actions on the ground. We contend that ecological-epidemiological research must be complemented by a form of implementation science that examines: (i) the links between specific conservation actions and the resulting ecological changes, and (ii) how this ecological change impacts human health and well-being, when human behaviours are considered. Drawing on the policy evaluation tradition in public economics, first, we present three examples of recent social science research on conservation interventions that affect human health. These examples are from low- and middle-income countries in the tropics and subtropics. Second, drawing on these examples, we present three propositions related to impact evaluation and non-market valuation that can help guide future multidisciplinary research on conservation and human health. Research guided by these propositions will allow stakeholders to determine how ecosystem-mediated strategies for health promotion compare with more conventional biomedical prevention and treatment strategies for safeguarding health.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.

Policy implementation for methicillin-resistant Staphylococcus aureus in seven European countries: a comparative analysis from 1999 to 2015.

PubMed

Kinoshita, Takuya; Tokumasu, Hironobu; Tanaka, Shiro; Kramer, Axel; Kawakami, Koji

2017-01-01

Background : Policies to reduce methicillin-resistant Staphylococcus aureus (MRSA) infections, both healthcare-acquired (HA-MRSA) and livestock-associated (LA-MRSA) are implemented Europe-wide, but evaluations are difficult for countries yet to implement such policies. A descriptive study was conducted, describing multinational MRSA rates and policy implementation, focusing on MRSA mandatory surveillance. We also investigated antibiotic use and MRSA rates and the use of veterinary antibiotics. Methods : This study used Europe-wide surveillance data on infectious diseases (EARS-Net), antibiotic consumption (ESAC-Net), and veterinary medicine (ESVAC). We visualized LA- and HA-MRSA related policies and MRSA rates from 1999 to 2015 in seven European countries. Changes in MRSA rates after implementation of an MRSA mandatory surveillance policy were investigated by setting each country as rate of 1.0 and compared countries with and without such policy. Correlations between antibiotic use and MRSA rates from 1999 to 2012 were investigated using defined daily dose. Sales data were used to investigate veterinary antibiotic use. Results : MRSA rates were 1-45.4% across the seven countries between 1999 and 2015. MRSA rates changed between 0.61 and 0.24 after the implementation of mandatory surveillance policies within a 6-12 year span. The rate of decrease rate in implemented and non-implemented countries ranged from 10% in Spain to 76% in the UK. The correlation between MRSA rate and cephalosporin consumption was r  = 0.419, and for fluoroquinolones r  = 0.305. Mean annual sales of veterinary cephalosporin and quinolone antibiotics were lowest in the UK (0.8 mg/PCU) and highest in Spain (9.7 mg/PCU) between 2009 and 2014. Conclusions : There were similar but different health policy implications in the seven countries regarding LA- and HA-MRSA. Although causation could not be defined, some policies such as mandatory surveillance may be helpful for countries that have yet to implement an MRSA policy. Further investigations are needed to evaluate each policies.

32 CFR 321.14 - DSS implementation policies.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) PRIVACY PROGRAM DEFENSE SECURITY SERVICE PRIVACY PROGRAM § 321.14 DSS implementation policies. (a) General... matters of particular concern to the Defense Security Service. (b) Privacy Act rules application. Any... 32 National Defense 2 2014-07-01 2014-07-01 false DSS implementation policies. 321.14 Section 321...

32 CFR 321.14 - DSS implementation policies.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) PRIVACY PROGRAM DEFENSE SECURITY SERVICE PRIVACY PROGRAM § 321.14 DSS implementation policies. (a) General... matters of particular concern to the Defense Security Service. (b) Privacy Act rules application. Any... 32 National Defense 2 2013-07-01 2013-07-01 false DSS implementation policies. 321.14 Section 321...

32 CFR 321.14 - DSS implementation policies.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) PRIVACY PROGRAM DEFENSE SECURITY SERVICE PRIVACY PROGRAM § 321.14 DSS implementation policies. (a) General... matters of particular concern to the Defense Security Service. (b) Privacy Act rules application. Any... 32 National Defense 2 2012-07-01 2012-07-01 false DSS implementation policies. 321.14 Section 321...

Improving maternal and child healthcare programme using community-participatory interventions in Ebonyi State Nigeria.

PubMed

Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Ezeoha, Abel Abeh; Urochukwu, Henry Chukwuemeka; Ezeonu, Chinonyelum Thecla

2014-10-01

In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP). The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government's FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers' groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities' health.

Improving maternal and child healthcare programme using community-participatory interventions in Ebonyi State Nigeria

PubMed Central

Uneke, Chigozie Jesse; Ndukwe, Chinwendu Daniel; Ezeoha, Abel Abeh; Urochukwu, Henry Chukwuemeka; Ezeonu, Chinonyelum Thecla

2014-01-01

In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP). The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government’s FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers’ groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities’ health. PMID:25337602

Managing Scarce Water Resources in China's Coal Power Industry.

PubMed

Zhang, Chao; Zhong, Lijin; Fu, Xiaotian; Zhao, Zhongnan

2016-06-01

Coal power generation capacity is expanding rapidly in the arid northwest regions in China. Its impact on water resources is attracting growing concerns from policy-makers, researchers, as well as mass media. This paper briefly describes the situation of electricity-water conflict in China and provides a comprehensive review on a variety of water resources management policies in China's coal power industry. These policies range from mandatory regulations to incentive-based instruments, covering water withdrawal standards, technological requirements on water saving, unconventional water resources utilization (such as reclaimed municipal wastewater, seawater, and mine water), water resources fee, and water permit transfer. Implementing these policies jointly is of crucial importance for alleviating the water stress from the expanding coal power industry in China.

Managing Scarce Water Resources in China's Coal Power Industry

NASA Astrophysics Data System (ADS)

Zhang, Chao; Zhong, Lijin; Fu, Xiaotian; Zhao, Zhongnan

2016-06-01

Coal power generation capacity is expanding rapidly in the arid northwest regions in China. Its impact on water resources is attracting growing concerns from policy-makers, researchers, as well as mass media. This paper briefly describes the situation of electricity-water conflict in China and provides a comprehensive review on a variety of water resources management policies in China's coal power industry. These policies range from mandatory regulations to incentive-based instruments, covering water withdrawal standards, technological requirements on water saving, unconventional water resources utilization (such as reclaimed municipal wastewater, seawater, and mine water), water resources fee, and water permit transfer. Implementing these policies jointly is of crucial importance for alleviating the water stress from the expanding coal power industry in China.

Incentives for Research Participation: Policy and Practice From Canadian Corrections

PubMed Central

Forrester, Pamela; Brazil, Amanda; Doherty, Sherri; Affleck, Lindy

2012-01-01

We explored current policies and practices on the use of incentives in research involving adult offenders under correctional supervision in prison and in the community (probation and parole) in Canada. We contacted the correctional departments of each of the Canadian provinces and territories, as well as the federal government department responsible for offenders serving sentences of two years or more. Findings indicated that two departments had formal policy whereas others had unwritten practices, some prohibiting their use and others allowing incentives on a case-by-case basis. Given the differences across jurisdictions, it would be valuable to examine how current incentive policies and practices are implemented to inform national best practices on incentives for offender-based research. PMID:22698018

Colombia's space policy: An analysis of six years of progress and challenges

NASA Astrophysics Data System (ADS)

Becerra, Jairo

2014-07-01

This paper analyzes Colombia's space policy: its successes, its failures and what it still needs to achieve. The paper examines the interaction among the different players, and how this policy contributes to economic and social development of the country. And postulates that, unless a real national plan of action, with specific milestones and budget as well as a managing agency are developed, this policy may be in danger of disappearing. The Colombian Space Commission (Comisión Colombiana del Espacio, or CCE) was created by Presidential Decree 2442 in 2006. It is a multi-sectorial entity, in charge of coordinating, planning, and leading in the implementation of national policies for the development and application of space technologies. The CCE was also charged with the drafting of plans and programs in this field. The CCE began with only a few members (15) and today is comprised of 47 members: 13 ministries, 4 administrative departments, another 21 governmental entities and 9 universities, the latter acting as consultants. The Vice-President of the Republic is the President of the CCE. These different actors gave great importance to the development of Colombia's space sector, and 6 years later, they are continuing support and development the country's space policy. This analysis takes into account three aspects: first, achieving the objectives of the CCE: the creation and development of a national space policy for Colombia; secondly, focussing on “target groups” and “end users”; and thirdly, the “outcomes” or achievements to date. Some conclusions are worth highlighting: first, the warm reception and support of the CCE by both the public and private sectors on high levels, but the poor knowledge of the national space policy by the Colombian people and the small and medium companies. Secondly, in the context of public policy [9], the strategic plan called “National Policy in regard to Space Activities”, is caught between two phases: the formulation and decision-making regarding the program, and its implementation. And finally, the members of the CCE do not necessarily act in accordance with a national strategy, but follow their own interests, resulting in undue influence (and perhaps interference) in the development of a coherent national space policy. In brief, the author hopes that this first analysis of Colombia's experience with its Space Commission will serve as an example to other developing countries that also are seeking to develop their space sector, and implement a national space policy. Further, the author hopes that this analysis will allow the various politico-administrative actors “policy makers” in Colombia, as well as the general public, to realize that, while much has been accomplished, much still remains to be done. It is essential to keep alive the interest shown in space activities; otherwise, Colombia's space policy may become an “endangered species”, in danger of failing and disappearing.

The Colorado Crisis Education and Response Network: an analysis of policy and practices.

PubMed

Crepeau-Hobson, Franci; Drennen, Curt

2011-01-01

The Federal government has recognized the importance of including behavioral health in disaster response plans and policies. Many states have responded to these directives with the development and implementation of disaster behavioral health response teams. The Colorado Crisis Education and Response Network (CoCERN) is a statewide asset that is based in community partnerships formed to deliver effective, efficient, and professional disaster behavioral health services to communities impacted by a disaster Using the K. McInnis-Dittrich model of policy analysis, this paper analyzes this approach to disaster behavioral health response. Strengths and weaknesses of the program, as well as implications for practice are discussed.

A Protocol for Evaluating Contextual Design Principles

PubMed Central

Stamps, Arthur

2014-01-01

This paper explains how scientific data can be incorporated into urban design decisions, such as evaluating contextual design principles. The recommended protocols are based on the Cochrane Reviews that have been widely used in medical research. The major concepts of a Cochrane Review are explained, as well as the underlying mathematics. The underlying math is meta-analysis. Data are reported for three applications and seven contextual design policies. It is suggested that use of the Cochrane protocols will be of great assistance to planners by providing scientific data that can be used to evaluate the efficacies of contextual design policies prior to implementing those policies. PMID:25431448

Preparing safety data packages for experimenters using the Get Away Special (GAS) carrier system

NASA Technical Reports Server (NTRS)

Kosko, Jerome

1992-01-01

The implementation of NSTS 1700.7B and more forceful scruntiny of data packages by the Johnson Space Flight Center (JSC) lead to the development of a classification policy for GAS/CAP payloads. The purpose of this policy is to classify experiments using the carrier system so that they receive an appropriate level of JSC review (i.e., one or multiphase reviews). This policy is based on energy containment to show inherent payload safety. It impacts the approach to performing hazard analyses and the nature of the data package. This paper endeavors to explain the impact of this policy as well as the impact of recent JSC as well as Kennedy Space Flight Center (KSC) 'interpretations' of existing requirements. The GAS canister does adequately contain most experiments when flown in the sealed configuration (however this must be shown, not merely stated). This paper also includes data package preparation guidelines for those experiments that require an opening door which often present unique safety issues.

Shaping legal abortion provision in Ghana: using policy theory to understand provider-related obstacles to policy implementation

PubMed Central

2013-01-01

Background Unsafe abortion is a major public health problem in Ghana; despite its liberal abortion law, access to safe, legal abortion in public health facilities is limited. Theory is often neglected as a tool for providing evidence to inform better practice; in this study we investigated the reasons for poor implementation of the policy in Ghana using Lipsky’s theory of street-level bureaucracy to better understand how providers shape and implement policy and how provider-level barriers might be overcome. Methods In-depth interviews were conducted with 43 health professionals of different levels (managers, obstetricians, midwives) at three hospitals in Accra, as well as staff from smaller and private sector facilities. Relevant policy and related documents were also analysed. Results Findings confirm that health providers’ views shape provision of safe-abortion services. Most prominently, providers experience conflicts between their religious and moral beliefs about the sanctity of (foetal) life and their duty to provide safe-abortion care. Obstetricians were more exposed to international debates, treaties, and safe-abortion practices and had better awareness of national research on the public health implications of unsafe abortions; these factors tempered their religious views. Midwives were more driven by fundamental religious values condemning abortion as sinful. In addition to personal views and dilemmas, ‘social pressures’ (perceived views of others concerning abortion) and the actions of facility managers affected providers’ decision to (openly) provide abortion services. In order to achieve a workable balance between these pressures and duties, providers use their ‘discretion’ in deciding if and when to provide abortion services, and develop ‘coping mechanisms’ which impede implementation of abortion policy. Conclusions The application of theory confirmed its utility in a lower-middle income setting and expanded its scope by showing that provider values and attitudes (not just resource constraints) modify providers’ implementation of policy; moreover their power of modification is constrained by organisational hierarchies and mid-level managers. We also revealed differing responses of ‘front line workers’ regarding the pressures they face; whilst midwives are seen globally as providers of safe-abortion services, in Ghana the midwife cadre displays more negative attitudes towards them than doctors. These findings allow the identification of recommendations for evidence-based practice. PMID:23829555

What Can We Learn About the Processes of Regulation of Tuberculosis Medicines From the Experiences of Health Policy and System Actors in India, Tanzania, and Zambia?

PubMed

Sheikh, Kabir; Uplekar, Mukund

2016-03-09

The unregulated availability and irrational use of tuberculosis (TB) medicines is a major issue of public health concern globally. Governments of many low- and middle-income countries (LMICs) have committed to regulating the quality and availability of TB medicines, but with variable success. Regulation of TB medicines remains an intractable challenge in many settings, but the reasons for this are poorly understood. The objective of this paper is to elaborate processes of regulation of quality and availability of TB medicines in three LMICs - India, Tanzania, and Zambia - and to understand the factors that constrain and enable these processes. We adopted the action-centred approach of policy implementation analysis that draws on the experiences of relevant policy and health system actors in order to understand regulatory processes. We drew on data from three case studies commissioned by the World Health Organization (WHO), on the regulation of TB medicines in India, Tanzania, and Zambia. Qualitative research methods were used, including in-depth interviews with 89 policy and health system actors and document review. Data were organized thematically into accounts of regulators' authority and capacity; extent of policy implementation; and efficiency, transparency, and accountability. In India, findings included the absence of a comprehensive policy framework for regulation of TB medicines, constraints of authority and capacity of regulators, and poor implementation of prescribing and dispensing norms in the majority private sector. Tanzania had a policy that restricted import, prescribing and dispensing of TB medicines to government operators. Zambia procured and dispensed TB medicines mainly through government services, albeit in the absence of a single policy for restriction of medicines. Three cross-cutting factors emerged as crucially influencing regulatory processes - political and stakeholder support for regulation, technical and human resource capacity of regulatory bodies, and the manner of private actors' influence on regulatory policy and implementation. Strengthening regulation to ensure the quality and availability of TB medicines in LMIC with emerging private markets may necessitate financial and technical inputs to upgrade regulatory bodies, as well as broader political and ethical actions to reorient and transform their current roles. © 2016 by Kerman University of Medical Sciences

Evaluating implementation of the World Health Organization's Strategic Approach to strengthening sexual and reproductive health policies and programs to address unintended pregnancy and unsafe abortion.

PubMed

Rashid, Shusmita; Moore, Julia E; Timmings, Caitlyn; Vogel, Joshua P; Ganatra, Bela; Khan, Dina N; Sayal, Radha; Metin Gülmezoglu, A; Straus, Sharon E

2017-11-21

We conducted a process evaluation to assess how the World Health Organization's (WHO) Strategic Approach to strengthening sexual and reproductive health policies and programs ("the SA") was used in 15 countries that requested WHO's technical support in addressing unintended pregnancy and unsafe abortion. The SA is a three-stage planning, policy, and program implementation process. We used the social ecological model (SEM) to analyze the contextual factors that influenced SA implementation. We used a two-phased sequential approach to data collection and analysis. In Phase A, we conducted a document and literature review and synthesized data thematically. In Phase B, we conducted interviews with stakeholders who used the SA in the countries of interest. We used a qualitative method triangulation technique to analyze and combine data from both phases to understand how the SA was implemented in each country. Data from 145 documents and 19 interviews described the SA process and activities in each country. All 15 countries completed Stage 1 activities. The activities of Stage 1 determined activities in subsequent stages and varied across countries. Following Stage 1, some countries focused on reforming policies to improve access to sexual and reproductive health (SRH) services whereas others focused on improving provider-level capacity to enhance SRH service quality and improving community-level SRH education. We identified factors across SEM levels that affected SA implementation, including individual- and community-level perceptions of using the SA and the recommendations that emerged from its use, organizational capacity to conduct SA activities, and how well these activities aligned with the existing political climate. Stakeholders perceived SA implementation to be country-driven and systematic in bringing attention to important SRH issues in their countries. We identified key success factors for influencing the individual, organization, and system change required for implementing the SA. These include sustaining stakeholder engagement for all SA stages, monitoring and reporting on activities, and leveraging activities and outputs from each SA stage to obtain technical and financial support for subsequent stages. Results may be used to optimize ongoing implementation efforts to improve access to and the quality of SRH services.

Why UFI nudges will get stuck in the policy process.

PubMed

Lawson, Joshua; Howard, Brendan

2012-01-01

User financial incentives (UFI), in the context of behavioural public policy, have the potential to shape Canadian health policy by replacing or augmenting traditional information-based mechanisms and by imparting a viewpoint that has traditionally been foreign to the public sphere. Whether or not UFI and more traditional "nudges" should be used, they will likely be limited by traditional moral, efficacy and cost/ benefit challenges, as well as the political and bureaucratic impediments that emerge throughout the policy implementation process. These challenges will likely preclude UFI and nudges from having a transformative effect on public policy, but this new school of thought will likely gain prominence through more amorphous means as more individuals learn and adopt its central theory. We should be excited about the potential of UFI and the use of behavioural public policy, but should temper our excitement with realistic expectations about how extensively such an approach should and will be used.

Policy to implementation: evidence-based practice in community mental health – study protocol

PubMed Central

2013-01-01

Background Evidence-based treatments (EBTs) are not widely available in community mental health settings. In response to the call for implementation of evidence-based treatments in the United States, states and counties have mandated behavioral health reform through policies and other initiatives. Evaluations of the impact of these policies on implementation are rare. A systems transformation about to occur in Philadelphia, Pennsylvania, offers an important opportunity to prospectively study implementation in response to a policy mandate. Methods/design Using a prospective sequential mixed-methods design, with observations at multiple points in time, we will investigate the responses of staff from 30 community mental health clinics to a policy from the Department of Behavioral Health encouraging and incentivizing providers to implement evidence-based treatments to treat youth with mental health problems. Study participants will be 30 executive directors, 30 clinical directors, and 240 therapists. Data will be collected prior to the policy implementation, and then at two and four years following policy implementation. Quantitative data will include measures of intervention implementation and potential moderators of implementation (i.e., organizational- and leader-level variables) and will be collected from executive directors, clinical directors, and therapists. Measures include self-reported therapist fidelity to evidence-based treatment techniques as measured by the Therapist Procedures Checklist-Revised, organizational variables as measured by the Organizational Social Context Measurement System and the Implementation Climate Assessment, leader variables as measured by the Multifactor Leadership Questionnaire, attitudes towards EBTs as measured by the Evidence-Based Practice Attitude Scale, and knowledge of EBTs as measured by the Knowledge of Evidence- Based Services Questionnaire. Qualitative data will include semi-structured interviews with a subset of the sample to assess the implementation experience of high-, average-, and low-performing agencies. Mixed methods will be integrated through comparing and contrasting results from the two methods for each of the primary hypotheses in this study. Discussion Findings from the proposed research will inform both future policy mandates around implementation and the support required for the success of these policies, with the ultimate goal of improving the quality of treatment provided to youth in the public sector. PMID:23522556

Policy to implementation: evidence-based practice in community mental health--study protocol.

PubMed

Beidas, Rinad S; Aarons, Gregory; Barg, Frances; Evans, Arthur; Hadley, Trevor; Hoagwood, Kimberly; Marcus, Steven; Schoenwald, Sonja; Walsh, Lucia; Mandell, David S

2013-03-24

Evidence-based treatments (EBTs) are not widely available in community mental health settings. In response to the call for implementation of evidence-based treatments in the United States, states and counties have mandated behavioral health reform through policies and other initiatives. Evaluations of the impact of these policies on implementation are rare. A systems transformation about to occur in Philadelphia, Pennsylvania, offers an important opportunity to prospectively study implementation in response to a policy mandate. Using a prospective sequential mixed-methods design, with observations at multiple points in time, we will investigate the responses of staff from 30 community mental health clinics to a policy from the Department of Behavioral Health encouraging and incentivizing providers to implement evidence-based treatments to treat youth with mental health problems. Study participants will be 30 executive directors, 30 clinical directors, and 240 therapists. Data will be collected prior to the policy implementation, and then at two and four years following policy implementation. Quantitative data will include measures of intervention implementation and potential moderators of implementation (i.e., organizational- and leader-level variables) and will be collected from executive directors, clinical directors, and therapists. Measures include self-reported therapist fidelity to evidence-based treatment techniques as measured by the Therapist Procedures Checklist-Revised, organizational variables as measured by the Organizational Social Context Measurement System and the Implementation Climate Assessment, leader variables as measured by the Multifactor Leadership Questionnaire, attitudes towards EBTs as measured by the Evidence-Based Practice Attitude Scale, and knowledge of EBTs as measured by the Knowledge of Evidence- Based Services Questionnaire. Qualitative data will include semi-structured interviews with a subset of the sample to assess the implementation experience of high-, average-, and low-performing agencies. Mixed methods will be integrated through comparing and contrasting results from the two methods for each of the primary hypotheses in this study. Findings from the proposed research will inform both future policy mandates around implementation and the support required for the success of these policies, with the ultimate goal of improving the quality of treatment provided to youth in the public sector.

An Integrated Approach to Disability Policy Development, Implementation, and Evaluation

ERIC Educational Resources Information Center

Shogren, Karrie A.; Luckasson, Ruth; Schalock, Robert L.

2017-01-01

This article provides a framework for an integrated approach to disability policy development, implementation, and evaluation. The article discusses how a framework that combines systems thinking and valued outcomes can be used by coalition partners across ecological systems to implement disability policy, promote the effective use of resources,…

Public Policies that Help Foster Social Inclusion

ERIC Educational Resources Information Center

Cheung, Chau-kiu

2013-01-01

Public policies can be effective in raising people's social inclusion as intended only reasonably through their implementation. With respect to the implementation perspective, this study examines the effectiveness of eight policies as perceived to implement in Hong Kong, China. The study employs data collected from 1,109 Chinese adults randomly…

Arts Curriculum Implementation: "Adopt and Adapt" as Policy Translation

ERIC Educational Resources Information Center

Chapman, Sian; Wright, Peter; Pascoe, Robin

2018-01-01

This article examines macro, meso, and micro understandings of policy enactment within Western Australian primary school arts education where a new national arts curriculum is being revised and implemented through a process colloquially known as "adopt and adapt." This article focuses on how a government-led implementation policy has…

Understanding Policy Implementation: District-Level Leaders' Perceptions of Reading Policy Implementation Efforts

ERIC Educational Resources Information Center

Hall, Charles Dana

2013-01-01

Research investigating the complex, multi-directional relationships inherent to public education has become a focal point of reform research. This study investigated the perceptions held by district-level leaders regarding the Colorado Department of Education's efforts to facilitate the successful implementation of reading policy. In addition, it…

Literacy in the 21st century: Towards a dynamic nexus of social relations

NASA Astrophysics Data System (ADS)

Benavot, Aaron

2015-06-01

Literacy is an essential means of communication. It enables individuals, communities and institutions to interact, over time and across space, as they develop a web of social relations via language. Effective literacy policies, programmes and practices expand the scale of social communication and interaction. Thus, literacy thrives when a state of connectedness - or social nexus of relations - is forged and sustained among individuals, households, communities and social institutions. This paper provides an overview of recent literacy trends and challenges as well as core aspects of the policy strategies which seek to address them. It reviews the main barriers or complicating factors which limit the effective implementation of literacy policies. The paper describes how the notion of non-formal education, which frames many scholarly and policy accounts of adult literacy work today, is under-conceptualised. One result of this is a relatively undifferentiated view of literacy programmes and their specific non-formal components. The author argues that the concept of the social nexus of literacy is implicit in many analyses of literacy policies and strategies. Thus, well-defined, context-specific and sharply conceived literacy policies, which enhance the social nexus of literacy, are crucial for improving the effectiveness of literacy work.

A situational analysis of ocular health promotion in the South African primary health-care system.

PubMed

Sithole, Hlupheka Lawrence

2017-03-01

South Africa has a serious burden of avoidable blindness and visual impairment, which may be due to poor ocular health promotional policies and programs or implementation. Therefore, this paper sought to critically analyse the South African primary health-care policies and programs, to identify the components of ocular health promotional policies and programs as well as how they are currently being implemented and to suggest areas that can be improved in order to minimise the burden of blindness and visual impairment. Triangulated quantitative and qualitative research methods were used in the study. Questionnaire and interviews were used to solicit data from national and provincial managers of different health directorates. Eye-care managers from each province also completed the questionnaire. Furthermore, relevant health policy and program documents from national and provincial departments of health were studied to identify areas relating to ocular health promotion. The study found varying degrees of implementation of various ocular health promotional activities in the provinces with the majority of respondents (62 per cent) indicating that ocular health promotion was not part of their responsibility and another 81 per cent revealing that vision screening does not form part of their health promotional programs. It further revealed a lack of a dedicated directorate for ocular health-care issues and the absence of an integrated ocular health promotional policy. Ocular health promotional activities were absent in other provinces. This may be a major contributing factor to poor ocular health promotion in South Africa and hence, the high prevalence of blindness and visual impairment. Therefore, it is recommended that an integrated ocular health promotional model (directorate and policies) be developed and be part of the South African primary health-care system. © 2016 Optometry Australia.

Breast cancer policy in Latin America: account of achievements and challenges in five countries.

PubMed

Nigenda, Gustavo; Gonzalez-Robledo, Maria Cecilia; Gonzalez-Robledo, Luz Maria; Bejarano-Arias, Rosa Maria

2016-07-12

The recent increase of breast cancer mortality has put on alert to most countries in the region. However it has taken some time before breast cancer could be considered as a relevant problem. Only in recent years breast cancer has been considered a priority in some Latin American countries and resources have been mobilized to confront the problem at the institutional level. The article analyzes the efforts made in five Latin American countries (Argentina, Brazil, Colombia, Mexico and Venezuela) in the last 15 years to design and implement policies to address the growing incidence of breast cancer. Data was collected between July and December 2010 from both primary and secondary sources. Semi-structured interviews were conducted with key informants from governmental and non-governmental organizations. Secondary data was obtained from publications in journals, government reports and official statistics in each country. Analysis combines information from both types of sources. Countries have followed different paths and are in different stages of policy implementation. In all cases early detection is a key strategy. Through the design of programs and guidelines, the allocation of financial resources to treat patients, as well as a formally structured information system, Brazil and Mexico have been able to set up comprehensive national policies. Argentina, Colombia and Venezuela have made important advancements but not yet capable of coordinating comprehensive national policies. Breast cancer is being considered a priority in all five countries but there are different stages in the rolling out of comprehensive national policies due to differences in their capacity to allocate resources, implement operational strategies and encourage the participation of relevant stakeholders.

Ontario's daily physical activity policy for elementary schools: is everything in place for success?

PubMed

Robertson-Wilson, Jennifer E; Lévesque, Lucie

2009-01-01

The development, implementation, and evaluation of policies may play an important role in promoting health behaviours such as physical activity. The Ontario Ministry of Education (OME) recently mandated Memorandum No. 138 requiring daily physical activity (DPA) for Ontario elementary students in grades one through eight. The purpose of this paper is to examine implementation strategies. Hogwood and Gunn's 10 preconditions for "perfect implementation" are used to examine publicly available Ministry DPA policy documents to assess whether these implementation strategies have been considered in the policy documents. Several preconditions (e.g., allocation of resources, task specification) appear to have been considered, however a number of preconditions (e.g., the sustainability of resources, extent to which the policy is valued, and evaluation plans) thought to be important require additional attention to ensure optimal DPA implementation. Additional reflection upon Hogwood and Gunn's implementation preconditions would, in our opinion, assist in facilitating optimal DPA implementation as per Memorandum No. 138.

Healthcare access and mobility between the UK and other European Union states: an 'implementation surplus'.

PubMed

Sheaff, R

1997-12-01

European Union (EU) policy on mobility requires ensuring healthcare access for EU residents who travel between EU states. This case-study investigates how this policy has been implemented in respect of EU visitors to the UK. EU visitors to the UK have similar access to 'immediately needed' National Health Service (NHS) healthcare to UK residents. For non-urgent healthcare, the NHS has official systems to discourage 'medical tourism' and divert such patients to the private sector or to reclaim the costs of NHS hospital treatment for EU visitors. Yet these official systems contrast with the flexibility and liberality of actual NHS practice towards EU visitors. Research on health policy implementation mostly examines reasons for 'implementation failure'. However, the present study indicates a health policy being implemented more fully than policy-makers may have anticipated. In the case of healthcare access for EU visitors to the UK, an implementation surplus is evident rather than an implementation deficit.

Performance-Based Funding Brief

ERIC Educational Resources Information Center

Washington Higher Education Coordinating Board, 2011

2011-01-01

A number of states have made progress in implementing performance-based funding (PFB) and accountability. This policy brief summarizes main features of performance-based funding systems in three states: Tennessee, Ohio, and Indiana. The brief also identifies key issues that states considering performance-based funding must address, as well as…

Health reform requires policy capacity

PubMed Central

Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D.; Helms, David

2015-01-01

Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476

Understanding Australian policies on public health using social and political science theories: reflections from an Academy of the Social Sciences in Australia Workshop.

PubMed

Baum, Fran; Graycar, Adam; Delany-Crowe, Toni; de Leeuw, Evelyne; Bacchi, Carol; Popay, Jennie; Orchard, Lionel; Colebatch, Hal; Friel, Sharon; MacDougall, Colin; Harris, Elizabeth; Lawless, Angela; McDermott, Dennis; Fisher, Matthew; Harris, Patrick; Phillips, Clare; Fitzgerald, Jane

2018-04-19

There is strong, and growing, evidence documenting health inequities across the world. However, most governments do not prioritize policies to encourage action on the social determinants of health and health equity. Furthermore, despite evidence concerning the benefits of joined-up, intersectoral policy to promote health and health equity, it is rare for such policy approaches to be applied systematically. To examine the usefulness of political and social science theory in understanding the reasons for this disjuncture between evidence and practice, researchers and public servants gathered in Adelaide for an Academy of the Social Sciences in Australia (ASSA) Workshop. This paper draws together the learnings that emerged from the Workshop, including key messages about the usefulness of various theories as well as insights drawn from policy practice. Discussions during the Workshop highlighted that applying multiple theories is particularly helpful in directing attention to, and understanding, the influence of all stages of the policy process; from the construction and framing of policy problems, to the implementation of policy and evaluation of outcomes, including those outcomes that may be unintended. In addition, the Workshop emphasized the value of collaborations among public health researchers, political and social scientists and public servants to open up critical discussion about the intersections between theory, research evidence and practice. Such critique is vital to render visible the processes through which particular sources of knowledge may be privileged over others and to examine how political and bureaucratic environments shape policy proposals and implementation action.

Taxing soft drinks in the Pacific: implementation lessons for improving health.

PubMed

Thow, Anne Marie; Quested, Christine; Juventin, Lisa; Kun, Russ; Khan, A Nisha; Swinburn, Boyd

2011-03-01

A tax on soft drinks is often proposed as a health promotion strategy for reducing their consumption and improving health outcomes. However, little is known about the processes and politics of implementing such taxes. We analysed four different soft drink taxes in Pacific countries and documented the lessons learnt regarding the process of policy agenda-setting and implementation. While local social and political context is critically important in determining policy uptake, these case studies suggest strategies for health promotion practitioners that can help to improve policy uptake and implementation. The case studies reveal interaction between the Ministries of Health, Finance and Revenue at every stage of the policy making process. In regard to agenda-setting, relevance to government fiscal priorities was important in gaining support for soft drink taxes. The active involvement of health policy makers was also important in initiating the policies, and the use of existing taxation mechanisms enabled successful policy implementation. While the earmarking of taxes for health has been widely recommended, the revenue may be redirected as government priorities change. Health promotion practitioners must strategically plan for agenda-setting, development and implementation of intersectoral health-promoting policies by engaging with stakeholders in finance at an early stage to identify priorities and synergies, developing cross-sectoral advocacy coalitions, and basing proposals on existing legislative mechanisms where possible.

Contextual Positive Psychology: Policy Recommendations for Implementing Positive Psychology into Schools

PubMed Central

Ciarrochi, Joseph; Atkins, Paul W. B.; Hayes, Louise L.; Sahdra, Baljinder K.; Parker, Philip

2016-01-01

There has been a rapid growth in positive psychology, a research and intervention approach that focuses on promoting optimal functioning and well-being. Positive psychology interventions are now making their way into classrooms all over the world. However, positive psychology has been criticized for being decontextualized and coercive, and for putting an excessive emphasis on positive states, whilst failing to adequately consider negative experiences. Given this, how should policy be used to regulate and evaluate these interventions? We review evidence that suggests these criticisms may be valid, but only for those interventions that focus almost exclusively on changing the content of people’s inner experience (e.g., make it more positive) and personality (improving character strength), and overemphasize the idea that inner experience causes action. We describe a contextualized form of positive psychology that not only deals with the criticisms, but also has clear policy implications for how to best implement and evaluate positive education programs so that they do not do more harm than good. PMID:27777564

Psychologically Informed Implementations of Sugary-Drink Portion Limits

PubMed Central

John, Leslie K.; Donnelly, Grant E.; Roberto, Christina A.

2017-01-01

In 2012, the New York City Board of Health prohibited restaurants from selling sugary drinks in containers that would hold more than 16 oz. Although a state court ruled that the Board of Health did not have the authority to implement such a policy, it remains a legally viable option for governments and a voluntary option for restaurants. However, there is very limited empirical data on how such a policy might affect the purchasing and consumption of sugary drinks. We report four well-powered, incentive-compatible experiments in which we evaluated two possible ways that restaurants might comply with such a policy: bundling (i.e., dividing the contents of oversized cups into two regulation-size cups) and providing free refills (i.e., offering a regulation-size cup with unlimited refills). Bundling caused people to buy less soda. Free refills increased consumption, especially when a waiter served the refills. This perverse effect was reduced in self-service contexts that required walking just a few steps to get a refill. PMID:28362567

Contextual Positive Psychology: Policy Recommendations for Implementing Positive Psychology into Schools.

PubMed

Ciarrochi, Joseph; Atkins, Paul W B; Hayes, Louise L; Sahdra, Baljinder K; Parker, Philip

2016-01-01

There has been a rapid growth in positive psychology, a research and intervention approach that focuses on promoting optimal functioning and well-being. Positive psychology interventions are now making their way into classrooms all over the world. However, positive psychology has been criticized for being decontextualized and coercive, and for putting an excessive emphasis on positive states, whilst failing to adequately consider negative experiences. Given this, how should policy be used to regulate and evaluate these interventions? We review evidence that suggests these criticisms may be valid, but only for those interventions that focus almost exclusively on changing the content of people's inner experience (e.g., make it more positive) and personality (improving character strength), and overemphasize the idea that inner experience causes action. We describe a contextualized form of positive psychology that not only deals with the criticisms, but also has clear policy implications for how to best implement and evaluate positive education programs so that they do not do more harm than good.

Law in practice: obstacles to a smokefree workplace policy in bars serving Asian patrons.

PubMed

Antin, Tamar M J; Moore, Roland S; Lee, Juliet P; Satterlund, Travis D

2010-04-01

The California smokefree workplace ordinance (AB13) has been well-received, even in bars where deeply established traditions of smoking may exist. However, a closer investigation of bars where indoor smoking persists revealed that bar workers in some ethnic minority communities continue to be exposed to secondhand smoke in their workplaces. To identify sociocultural factors that may impede the adoption of AB13, the researchers conducted 150 observations and 29 patron and staff interviews in 50 California bars serving Asian patrons in Los Angeles and San Francisco counties. Observers witnessed indoor smoking in 82% of the bars. Interviews revealed that social relationships, social interactions, and a tendency to avoid confrontation complicated the positive reception of AB13 within these bars. Accounting for sociocultural factors provides a nuanced understanding of the challenges involved in implementing tobacco control policy in such diverse settings and may allow for culturally appropriate tobacco policy development and implementation in other jurisdictions.

Implementing hospital quality assurance policies in Iran: balancing licensing, annual evaluation, inspections and quality management systems.

PubMed

Aghaei Hashjin, Asgar; Delgoshaei, Bahram; Kringos, Dionne S; Tabibi, Seyed Jamaladin; Manouchehri, Jila; Klazinga, Niek S

2015-01-01

The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran. A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010. The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government's strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity. The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries. This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

Position of the American Dietetic Association: local support for nutrition integrity in schools.

PubMed

Bergman, Ethan A; Gordon, Ruth W

2010-08-01

It is the position of the American Dietetic Association (ADA) that schools and communities have a shared responsibility to provide students with access to high-quality, affordable, nutritious foods and beverages. School-based nutrition services, including the provision of meals through the National School Lunch Program and the School Breakfast Program, are an integral part of the total education program. Strong wellness policies promote environments that enhance nutrition integrity and help students to develop lifelong healthy behaviors. ADA actively supported the 2004 and proposed 2010 Child Nutrition reauthorization which determines school nutrition policy. ADA believes that the Dietary Guidelines for Americans should serve as the foundation for all food and nutrition assistance programs and should apply to all foods and beverages sold or served to students during the school day. Local wellness policies are mandated by federal legislation for all school districts participating in the National School Lunch Program. These policies support nutrition integrity,including a healthy school environment. Nutrition integrity also requires coordinating nutrition education and promotion and funding research on program outcomes. Registered dietitians and dietetic technicians, registered, and other credentialed staff, are essential for nutrition integrity in schools to perform in policy-making, management, education, and community building roles. A healthy school environment can be achieved through adequate funding of school meals programs and through implementation and evaluation of strong local wellness policies.

Barriers and facilitators to the implementation of physical activity policies in schools: A systematic review.

PubMed

Nathan, Nicole; Elton, Ben; Babic, Mark; McCarthy, Nicole; Sutherland, Rachel; Presseau, Justin; Seward, Kirsty; Hodder, Rebecca; Booth, Debbie; Yoong, Sze Lin; Wolfenden, Luke

2018-02-01

Research consistently indicates that schools fail to implement mandatory physical activity policies. This review aimed to describe factors (barriers and facilitators) that may influence the implementation of school physical activity policies which specify the time or intensity that physical activity should be implemented and to map these factors to a theoretical framework. A systematic search was undertaken in six databases for quantitative or qualitative studies published between 1995-March 2016 that examined teachers', principals' or school administrators' reported barriers and/or facilitators to implementing mandated school physical activity policies. Two independent reviewers screened texts, extracted and coded data from identified articles using the Theoretical Domains Framework (TDF). Of the 10,346 articles identified, 17 studies met the inclusion criteria (8 quantitative, 9 qualitative). Barriers and facilitators identified in qualitative studies covered 9 and 10 TDF domains respectively. Barriers and facilitators reported in quantitative studies covered 8 TDF domains each. The most common domains identified were: 'environmental context and resources' (e.g., availability of equipment, time or staff), 'goals' (e.g., the perceived priority of the policy in the school), 'social influences' (e.g., support from school boards), and 'skills' (e.g., teachers' ability to implement the policy). Implementation support strategies that target these factors may represent promising means to improve implementation of physical activity policies and increase physical activity among school-aged children. Future studies assessing factors that influence school implementation of physical activity policies would benefit from using a comprehensive framework to help identify if any domains have been overlooked in the current literature. This review was prospectively registered with PROSPERO (CRD42016051649) on the 8th December 2016. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluating Common Privacy Vulnerabilities in Internet Service Providers

NASA Astrophysics Data System (ADS)

Kotzanikolaou, Panayiotis; Maniatis, Sotirios; Nikolouzou, Eugenia; Stathopoulos, Vassilios

Privacy in electronic communications receives increased attention in both research and industry forums, stemming from both the users' needs and from legal and regulatory requirements in national or international context. Privacy in internet-based communications heavily relies on the level of security of the Internet Service Providers (ISPs), as well as on the security awareness of the end users. This paper discusses the role of the ISP in the privacy of the communications. Based on real security audits performed in national-wide ISPs, we illustrate privacy-specific threats and vulnerabilities that many providers fail to address when implementing their security policies. We subsequently provide and discuss specific security measures that the ISPs can implement, in order to fine-tune their security policies in the context of privacy protection.

Policy and Procedures for Managing Dual Use Research of Concern

EPA Pesticide Factsheets

The DURC and iDURC Policies require all federal departments and agencies that conduct life sciences research to implement their provisions. EPA Order 1000.19, Policy and Procedures for Managing Dual Use Research of Concern, implements both policies at EPA.

Staff and patient perspectives of a smoke-free health services policy in South Australia: A state-wide implementation.

PubMed

Martin, Kimberley; Dono, Joanne; Sharplin, Greg; Bowden, Jacqueline; Miller, Caroline

2017-08-01

Few jurisdictions have implemented and evaluated a complete smoking ban across all health sites in their jurisdiction, with no designated smoking areas. This article examines staff and patient perceptions and experiences of a mandated smoke-free policy implemented across all government health facilities in South Australia, including mental health sites. An online survey of health staff was conducted prior to policy implementation (n=3098), 3 months post-implementation (n=2673) and 15 months post-implementation (n=2890). Consumer experiences of the policy were assessed via a telephone survey (n=1722; smokers n=254). Staff support for the policy was high across all time points. Two thirds of staff reported having witnessed some policy non-compliance, and self-reported exposure to second-hand smoke was comparable pre-implementation to 15 months post-implementation. Under the policy, 56.3% of smoking patients abstained completely whilst hospitalised and 37.6% cut down the amount that they smoked. Furthermore, 34.7% reported having been offered cessation support during hospitalisation. Whilst the smoke-free policy was viewed positively and had benefits for staff and patients, reports of witnessing some non-compliance were prevalent. While the extent of non-compliance is not known, and the measure used was sensitive, complementary strategies may be needed to reduce exposure to second-hand smoke, particularly at entrances. Health-care staff should be further encouraged to offer support to nicotine-dependent patients to foster compliance and promote abstinence during hospitalisation. Copyright © 2017 Elsevier B.V. All rights reserved.

Are some health professionals more cognizant of clinical governance development concepts than others? Findings from a New Zealand study.

PubMed

Gauld, Robin; Horsburgh, Simon

2016-06-01

Clinical governance has been promoted in recent years as core to improving patient safety. Effective clinical governance requires partnerships between 'management' and health professionals as well as equal involvement of all professional groups. Professionals must also be willing to engage in clinical governance activities such as working to improve care systems and patient safety. There is limited research into the relative understanding of core clinical governance concepts amongst different professional groups or the extent to which professionals are prepared to take up opportunities to 'change the system'. A 2012 national survey study of health professionals employed in New Zealand health boards sought to probe understanding of and commitment to clinical governance following introduction of a 2009 policy. Respondent data showed only limited policy implementation had occurred. Regression analyses revealed statistically significant differences in perceptions of knowledge of clinical governance concepts and structures by gender, age, experience and profession, as well as in seeking opportunities to change the system. These findings have implications for policy makers in terms of ensuring that clinical governance implementation provides equal opportunity for engendering involvement of different health professionals. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An Exploration of the Perspectives of Associate Nurse Unit Managers Regarding the Implementation of Smoke-free Policies in Adult Mental Health Inpatient Units.

PubMed

Dean, Tania D; Cross, Wendy; Munro, Ian

2018-04-01

In Adult Mental Health Inpatient Units, it is not unexpected that leadership of Associate Nurse Unit Managers contributes to successful implementation of smoke-free policies. In light of challenges facing mental health nursing, and limited research describing their leadership and the role it plays in addressing smoke-free policy implementation, the aim of this study is to explore Associate Nurse Unit Managers perspectives' regarding the implementation of smoke-free policies, which were introduced on 1 July, 2015. Individual in-depth semi-structured interviews were undertaken six months post the implementation of smoke-free policies. In this qualitative descriptive study, six Associate Nurse Unit Managers working in a Victorian public Adult Mental Health Inpatient Unit, were asked eight questions which targeted leadership and the implementation and enforcement of smoke-free policies. Associate Nurse Unit Managers provide leadership and role modeling for staff and they are responsible for setting the standards that govern the behavior of nurses within their team. All participants interviewed believed that they were leaders in the workplace. Education and consistency were identified as crucial for smoke-free policies to be successful. Participants acknowledged that the availability of therapeutic interventions, staff resources and the accessibility of nicotine replacement therapy were crucial to assist consumers to remain smoke-free while on the unit. The findings from this research may help to improve the understanding of the practical challenges that Associate Nurse Unit Manager's face in the implementation of smoke-free policies with implications for policies, nursing practice, education and research.

Policy commitments vs. lived realities of young pregnant women and mothers in school, Western Cape, South Africa.

PubMed

Ngabaza, Sisa; Shefer, Tamara

2013-05-01

Reproductive rights in South Africa continue to be undermined for young women who fall pregnant and become mothers while still at school. Before 1994, exclusionary practices were common and the majority of those who fell pregnant failed to resume their education. With the adoption of new policies in 2007, young pregnant women and mothers are supposed to be supported to complete school successfully. Notwithstanding these new policies, there are incongruities between policy implementation and young women's lived experience in school. This paper explores the experiences of pregnancy and parenting among a group of 15 young women who fell pregnant and became mothers while attending three high schools in Khayelitsha township, a working-class community in the Western Cape of South Africa. Qualitative, in-depth interviews, conducted between 2007 and 2008, highlighted two key areas of concern: continuing exclusionary practices on the part of schools, based on conservative interpretations of policy, and negative and moralistic responses from teachers and peers. Such practices resulted in secrecy and shame about being pregnant, affecting the young women's emotional and physical well-being and their decisions whether to remain in school during pregnancy and return after having the baby. Further attention is required to ensure appropriate implementation of policies aimed at supporting pregnant and parenting young women to complete their education successfully. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010-2016.

PubMed

Grumbach, Kevin; Vargas, Roberto A; Fleisher, Paula; Aragón, Tomás J; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R; Santiago, Amor; Lang, Perry L; Jones, Paula; Liu, Wylie; Schmidt, Laura A

2017-03-23

The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children's oral health. SFHIP is governed by a steering committee. Partnership working groups for each initiative collaborate to 1) develop and implement action plans emphasizing feasible, scalable, translational-science-informed interventions and 2) consider sustainability early in the planning process by including policy and structural interventions. Through SFHIP's efforts, San Francisco enacted ordinances regulating sale and advertising of SSBs and a ballot measure establishing a soda tax. Most San Francisco hospitals implemented or committed to implementing healthy-beverage policies that prohibited serving or selling SSBs. SFHIP helped prevent Starbucks and Taco Bell from receiving alcohol licenses in San Francisco and helped prevent state authorization of sale of powdered alcohol. SFHIP increased the number of primary care clinics providing fluoride varnish at routine well-child visits from 3 to 14 and acquired a state waiver to allow dental clinics to be paid for dental services delivered in schools. The SFHIP model of collective impact emphasizing community engagement and policy change accomplished many of its intermediate goals to create an environment promoting health and health equity.

Effects of Targeted Subsidies Policy on Health Behavior in Iranian Households: A Qualitative Study

PubMed Central

DOSHMANGIR, Leila; DOSHMANGIR, Parinaz; ABOLHASSANI, Nazanin; MOSHIRI, Esmaeil; JAFARI, Mehdi

2015-01-01

Background: This study aimed to explore the effects of national targeted subsidies policy on health behavior of Iranian households. Methods: In this qualitative study, data were collected between January 2012 and December 2013 through face-to-face interviews (23 experts in national and provincial levels of health system and 18 household heads) and through a comprehensive and purposive document analysis. The data was analyzed using a thematic analysis method (inductive-deductive) and assisted by Atlas-ti software. Results: Rising health care costs, removing some food subsidies and the increase in price of most goods and services due to the implementation of economic policy of targeted subsidies have led to significant changes in the demand for health services, changes in the consumption trends of goods and services affecting health as well as changes in the health habits of households. Conclusion: Targeted subsidies and the cash subsidy policy have some negative effects on population health behavior especially among poor people. Hence, maintaining or increasing the cash subsidy is not an efficient allocation of resources toward health care system. So, it is necessary to identify appropriate strategies and policies and apply interventions in order to moderate negative effects and enhance positive effects resulted from implementing this economic reform on population health behavior. PMID:26056676

Extended Cost-Effectiveness Analysis for Health Policy Assessment: A Tutorial.

PubMed

Verguet, Stéphane; Kim, Jane J; Jamison, Dean T

2016-09-01

Health policy instruments such as the public financing of health technologies (e.g., new drugs, vaccines) entail consequences in multiple domains. Fundamentally, public health policies aim at increasing the uptake of effective and efficient interventions and at subsequently leading to better health benefits (e.g., premature mortality and morbidity averted). In addition, public health policies can provide non-health benefits in addition to the sole well-being of populations and beyond the health sector. For instance, public policies such as social and health insurance programs can prevent illness-related impoverishment and procure financial risk protection. Furthermore, public policies can improve the distribution of health in the population and promote the equalization of health among individuals. Extended cost-effectiveness analysis was developed to address health policy assessment, specifically to evaluate the health and financial consequences of public policies in four domains: (1) the health gains; (2) the financial risk protection benefits; (3) the total costs to the policy makers; and (4) the distributional benefits. Here, we present a tutorial that describes both the intent of extended cost-effectiveness analysis and its keys to allow easy implementation for health policy assessment.

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2011 CFR

2011-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2010 CFR

2010-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2013 CFR

2013-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

32 CFR 148.11 - Policy.

Code of Federal Regulations, 2014 CFR

2014-07-01

... IMPLEMENTATION OF RECIPROCITY OF FACILITIES Guidelines for the Implementation and Oversight of the Policy on Reciprocity of use and Inspections of Facilities § 148.11 Policy. (a) Agency heads, or their designee, shall..., and efficient, and that those policies and procedures enable and promote interagency reciprocity. (b...

ESL and Internationalization at Purdue University: A History and Analysis

ERIC Educational Resources Information Center

Haan, Jennifer E.

2009-01-01

With the ever growing cultural and linguistic diversity at institutions of higher education, local and institutional language planning is becoming increasingly important. By examining university policies and planning processes, ESL professionals can more appropriately advocate for their students, as well as create and implement language policies…

School Uniforms: A Critical Review of the Literature. From Inquiry to Practice.

ERIC Educational Resources Information Center

Brunsma, David L.

The debate surrounding the effectiveness of school-uniform policies, as well as discussions concerning when and how to implement them, is rooted in anecdote. This review summarizes anecdotal literature on which the current debate is based and critically reviews the empirical literature, including theoretical underpinnings, findings, and…

Common Misconceptions of Suspension: Ideas and Alternatives for School Leaders

ERIC Educational Resources Information Center

Green, Ambra L.; Maynard, Deanna K.; Stegenga, Sondra M.

2018-01-01

The use of exclusionary discipline practices in schools has been well documented since the 1970s with the passing of the Safe Schools Act and implementation of zero-tolerance policies. Despite research indicating the ineffectiveness of exclusionary practices, students continue to receive suspensions and expulsions at alarming rates. Additional…

Addressing the social determinants of health at the local level: Opportunities and challenges.

PubMed

Fosse, E; Helgesen, M K; Hagen, S; Torp, S

2018-02-01

The gradient in health inequalities reflects a relationship between health and social circumstance, demonstrating that health worsens as you move down the socio-economic scale. For more than a decade, the Norwegian National government has developed policies to reduce social inequalities in health by levelling the social gradient. The adoption of the Public Health Act in 2012 was a further movement towards a comprehensive policy. The main aim of the act is to reduce social health inequalities by adopting a Health in All Policies approach. The municipalities are regarded key in the implementation of the act. The SODEMIFA project aimed to study the development of the new public health policy, with a particular emphasis on its implementation in municipalities. In the SODEMIFA project, a mixed-methods approach was applied, and the data consisted of surveys as well as qualitative interviews. The informants were policymakers at the national and local level. Our findings indicate that the municipalities had a rather vague understanding of the concept of health inequalities, and even more so, the concept of the social gradient in health. The most common understanding was that policy to reduce social inequalities concerned disadvantaged groups. Accordingly, policies and measures would be directed at these groups, rather than addressing the social gradient. A movement towards an increased understanding and adoption of the new, comprehensive public health policy was observed. However, to continue this process, both local and national levels must stay committed to the principles of the act.

Results from an evaluation of tobacco control policies at the 2010 Shanghai World Expo.

PubMed

Li, Xiang; Zheng, PinPin; Fu, Hua; Berg, Carla; Kegler, Michelle

2013-09-01

Large-scale international events such as World Expos and Olympic Games have the potential to strengthen smoke-free norms globally. The Shanghai 2010 World Expo was one of the first large-scale events to implement and evaluate the adoption of strict tobacco control policies. To evaluate implementation of tobacco control policies at the 2010 World Expo in Shanghai, China. This mixed methods evaluation was conducted from July to October 2010. Observations were conducted in all 155 pavilions and outdoor queuing areas, all 45 souvenir shops, a random sample of restaurants (51 of 119) and selected outdoor non-smoking areas in all sections of the Expo. In addition, intercept surveys were completed with 3022 visitors over a 4-month period. All pavilions and souvenir shops were smoke-free. Restaurants were smoke-free, with only 0.1% of customers observed smoking. Smoking was more common in outdoor non-smoking areas, but still relatively rare overall with only 4.5% of visitors observed smoking. Tobacco products were not sold or marketed in any public settings except for three pavilions that had special exemptions from the policy. Overall, 80.3% of visitors were aware of the smoke-free policy at the World Expo, 92.5% of visitors supported the policy and 97.1% of visitors were satisfied with the smoke-free environment. Tobacco control policies at the World Expo sites were generally well-enforced and accepted although compliance was not 100%, particularly in outdoor non-smoking areas.

Barriers and Facilitators to Implementing Primary Stroke Center Policy in the United States: Results From 4 Case Study States

PubMed Central

Slade, Catherine P.; Brewer, Gene A.; Gase, Lauren N.

2011-01-01

Objectives. We identified barriers and facilitators to the state-level implementation of primary stroke center (PSC) policies, which encourage the certification or designation of specialized stroke treatment facilities and may address concerns such as transportation bypass, telemedicine, and treatment protocols. Methods. We studied the experiences of 4 states (Florida, Massachusetts, New Mexico, and New York) selected from the 18 states that had enacted PSC policies or were actively considering doing so. We conducted semistructured interviews during fieldwork in each case study state. Results. Our results showed that system fragmentation, gaps in human and financial resources, and complexity at the interorganizational and operational levels are common barriers and that policy champions, stakeholder support and communication, and operational adaptation are essential facilitators in the adoption and implementation of PSC policies. Conclusions. The identification of barriers and facilitators reveals the contextual elements that can help or hinder policy implementation and may be useful in informing policy formulation and implementation in other jurisdictions. Proactively identifying jurisdictional challenges and opportunities may help facilitate the policy process for PSC designation and allow jurisdictions to develop more effective stroke systems of care. PMID:21233430

Implementing SDG 15.3 on Land Degradation Neutrality in the EU and EU Member States

NASA Astrophysics Data System (ADS)

Wunder, Stephanie; Starke, Sue Martina; Frelih-Larsen, Ana; Kaphengst, Timo

2017-04-01

The continuing degradation of land and soils is a severe threat to the provision of ecosystem services and economic development. Sustainable use of land and soils are therefore an integral part of the "Agenda 2030" with its 17 Sustainable Development Goals (SDGs) and 169 targets adopted by the UNGeneral Assembly in September 2015. The SDGs provide new opportunities for an ambitious and integrated environmental policy worldwide and in the EU. Among the many relevant targets that directly or indirectly address soils (such as goals on zero hunger, well being, clean energy, climate change, water and sustainable cities), target 15.3 that aims to achieve "a land degradation-neutral world" by 2030 is the most relevant. The concept of "Land Degradation Neutrality" (LDN) is not only about halting the loss of healthy and fertile land, but also actively reversing degradation by restoring land in order to counterbal-ance losses that cannot be avoided. It is a very ambitious target but due to a lack of balancing mechanisms for degradation and restoration in most countries also a new concept. Land Degra-dation Neutrality therefore both needs a scientific conceptual framework as well as a political debate about its implementation and development of instruments. In the EU and its Member States, this debate can also serve as a catalyst to revive the discussion on a common soil policy in Europe after the withdrawal of the proposal for a soil framework directive in 2014. To analyze options for the implementation of target 15.3 in Germany and Europe the research project "Implementing the Sustainable Development Goals on Soils in Germany" (http://ecologic.eu/12876) is currently carried out by the Ecologic Institute on behalf of the Ger-man Environment Agency (UBA) and the German Federal Environment Ministry (BMUB). The project will run until spring 2017 and the session "European Environmental Policies and Sustainability" at the EGU will be an ideal opportunity to present the final outcomes of the project and give participants an overview of this very dynamic political process and its science policy interface. Specifically, the presentation can provide an overview about two key results of the project: A) Steps and guiding questions to implement LDN on a national level for policy makers (including a reflection about key definitions and concept) B) Appropriate indicators for LDN (with a special focus on Land Use Change) The results are based on a literature review, more than 50 international expert interviews and discussions within two German workshops and one international workshop (that brought together 15 EU Member State representatives, EEA, UNCCD and the European Commission) to discuss the political options to implement LDN. The results also build on the extensive work that the UNCCD and the global Target Setting Programme have conducted to further develop and define the concept of land degradation neutrality. The continuing degradation of land and soils is a severe threat to the provision of ecosystem services and economic development. Sustainable use of land and soils are therefore an integral part of the "Agenda 2030" with its 17 Sustainable Development Goals (SDGs) and 169 targets adopted by the UNGeneral Assembly in September 2015. The SDGs provide new opportunities for an ambitious and integrated environmental policy worldwide and in the EU. Among the many relevant targets that directly or indirectly address soils (such as goals on zero hunger, well being, clean energy, climate change, water and sustainable cities), target 15.3 that aims to achieve "a land degradation-neutral world" by 2030 is the most relevant. The concept of "Land Degradation Neutrality" (LDN) is not only about halting the loss of healthy and fertile land, but also actively reversing degradation by restoring land in order to counterbal-ance losses that cannot be avoided. It is a very ambitious target but due to a lack of balancing mechanisms for degradation and restoration in most countries also a new concept. Land Degra-dation Neutrality therefore both needs a scientific conceptual framework as well as a political debate about its implementation and development of instruments. In the EU and its Member States, this debate can also serve as a catalyst to revive the discussion on a common soil policy in Europe after the withdrawal of the proposal for a soil framework directive in 2014. To analyze options for the implementation of target 15.3 in Germany and Europe the research project "Implementing the Sustainable Development Goals on Soils in Germany" (http://ecologic.eu/12876) is currently carried out by the Ecologic Institute on behalf of the Ger-man Environment Agency (UBA) and the German Federal Environment Ministry (BMUB). The project runs until spring 2017 and the session "European Environmental Policies and Sustainability" at the EGU is an ideal opportunity to present the final outcomes of the project and give participants an overview of this very dynamic political process and its science policy interface. Specifically, the presentation can provide an overview about two key results of the project: A) Steps and guiding questions to implement LDN on a national level for policy makers (including a reflection about key definitions and concept) B) Appropriate indicators for LDN (with a special focus on Land Use Change) The results are based on a literature review, more than 50 international expert interviews and discussions within two German workshops and one international workshop (that brought together 15 EU Member State representatives, EEA, UNCCD and the European Commission) to discuss the political options to implement LDN. The results also build on the extensive work that the UNCCD and the global Target Setting Programme have conducted to further develop and define the concept of land degradation neutrality.

A Comparative Analysis of Education Policy and Practice: The Case of Institutions in Mumbai and Delhi

ERIC Educational Resources Information Center

Iyengar, Radhika; Surianarain, Sharmi

2010-01-01

There exist many actors within the realm of education policy planning and implementation, namely: the policy makers; the national, local and regional institutions engaged in the dissemination and interpretation of these policies; and the educational institutions that implement these policies at the ground level (schools). While schools are largely…

Secondhand Smoke Exposure and Smoke-free Policy in Philadelphia Public Housing.

PubMed

Klassen, Ann C; Lee, Nora L; Pankiewicz, Aaron; Ward, Rikki; Shuster, Michelle; Ogbenna, Bethany Townsend; Wade, Anita; Boamah, Maxwell; Osayameh, Olufunlayo; Rule, Ana M; Szymkowiak, Dorota; Coffman, Ryan; Bragg, Virginius; Mallya, Giridhar

2017-04-01

Multi-unit housing environments remain significant sources of secondhand smoke (SHS) exposure, especially for vulnerable populations in subsidized housing. In Philadelphia, the largest US housing authority to implement smoke-free policies, we measured baseline resident smoking-related behaviors and attitudes, and longitudinal exposures to airborne nicotine, during policy development and implementation. In 4 communities, we collected data in 2013, 2014, and 2016, before and after introduction of comprehensive smoke-free policies, interviewing persons in 172 households, and monitoring air-borne nicotine in non-smoking homes and public areas. Average nicotine level differences across years were estimated with multi-level models. Fifty-six percent of respondents smoked. Only 37% of households were smoke-free, with another 41% restricting smoking by area or time of day. The number of locations with detectable nicotine did not differ before and after policy implementation, with approximately 20% of non-smoking homes and 70%-80% of public areas having detectable nicotine. However, public area nicotine levels were lower in 2016, after policy implementation, than in 2013 and 2014 (-0.19 μg/m 3 , p = .03). Findings suggest that initial policy implementation was associated with reduced SHS exposure in Philadelphia. As HUD strengthens smoke-free policies, SHS monitoring can be useful to educate stakeholders and build support for policy enforcement.

Governance and human resources for health.

PubMed

Dieleman, Marjolein; Hilhorst, Thea

2011-11-24

Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH), HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic series has aimed to expand the evidence base on the role of governance in addressing the HRH crisis. The six articles comprising the series present a range of experiences. The articles report on governance in relation to developing a joint vision, building adherence and strengthening accountability, and on governance with respect to planning, implementation, and monitoring. Other governance issues warrant attention as well, such as corruption and transparency in decision-making in HRH policies and strategies. Acknowledging and dealing with governance should be part and parcel of HRH planning and implementation. To date, few experiences have been shared on improving governance for HRH policy making and implementation, and many questions remain unanswered. There is an urgent need to document experiences and for mutual learning.

Southeast Asia Report No. 1323, Vietnam Tap Chi Cong San No. 6, June 1983

DTIC Science & Technology

1983-08-10

safety in every situation, implement the mechanism "the party leads, the people exercise ownership and the state manages" well and have an intense...scientific-technological research and training cadres. The outskirts of the city have been expanded. The majority of the people of Hanoi are urban cadres...economy and the standard of living, the party organization and people of Hanoi have made many efforts to implement the lines, positions and policies of

Impacts of Changing Marijuana Policies on Alcohol Use in the United States

PubMed Central

Guttmannova, Katarina; Lee, Christine M.; Kilmer, Jason R.; Fleming, Charles B.; Rhew, Isaac C.; Kosterman, Rick; Larimer, Mary E.

2015-01-01

Background Marijuana policies are rapidly evolving. In the United States, recreational use of marijuana is now legal in four states and medical marijuana is legal in 23 states. Research evaluating such policies has focused primarily on how policies affect issues of price, access to, use, and consequences of marijuana. Due to potential spillover effects, researchers also need to examine how marijuana policies may impact use and consequences of alcohol. Methods The current paper is a critical review of articles evaluating alcohol outcomes associated with marijuana decriminalization, medical marijuana legalization, and non-medical or recreational marijuana legalization. We identified articles and reports through (1) online searches of EBSCO host database including Academic search premier, Econlit, Legal collection, Medline, Psych articles, and PsycINFO, as well as PubMed and Google Scholar databases; (2) review of additional articles cited in papers identified through electronic searches; and (3) targeted searches of state and local government records regarding marijuana law implementation. We reviewed studies with respect to their data sources and sample characteristics, methodology, and the margin of alcohol and marijuana use, timing of policy change, and the aspects of laws examined. Results The extant literature provides some evidence for both substitution (i.e., more liberal marijuana policies related to less alcohol use as marijuana becomes a substitute) and complementary (i.e., more liberal marijuana policies related to increases in both marijuana and alcohol use) relationships in the context of liberalization of marijuana policies in the United States. Conclusions Impact of more liberal marijuana policies on alcohol use is complex, and likely depends on specific aspects of policy implementation, including how long the policy has been in place. Further, evaluation of marijuana policy effects on alcohol use may be sensitive to the age group studied and the margin of alcohol use examined. Design of policy evaluation research requires careful consideration of these issues. PMID:26727520

[The singularity of population policies in Latin America and the Caribbean in the late 20th century].

PubMed

Sojo, A

1993-06-01

This work questions the assumption that population policies in Latin America and the Caribbean are closely related to population growth, identifies common obstacles to population policies, and recommends actions to increase the efficacy of population policies. The demographic transition has occurred in Latin American countries with widely varying levels of economic development, cultural traditions, and family planning programs. The governments of the region that regard their rates of population growth and fertility as satisfactory seldom intervene to modify them. The demographic transition is well underway in all these countries except Guatemala and Paraguay. A diverse array of strategies has been used by the countries that have achieved significant fertility reductions, ranging from family planning services provided through the national health system in Mexico to key roles by the private and commercial sectors and intensive use of the mass media in Brazil. Governments adopting population policies defined various institutional forms for them, ranging from small technical units at a high level to interministerial councils. Institutionalization of population policies created high hopes for integration of population concerns into development strategies, but performance has largely failed to meet expectations, both because of the fragility and inferior status in the government bureaucracy of policy structures, and because of their inability to develop effective programs integrating population and development. The economic crisis of the 1980s lowered the priority of population themes. Political instability, lack of adequate human resources and financing, limited decision making capacity, and failure to establish strong interinstitutional ties have all been factors in the disappointing results of population policies. The difficulty of pinpointing exactly what constitutes the population policy and the tendency to equate population policy and family planning have been other factors hindering their full implementation. The effectiveness of population policies appears to have been compromised by their lack of specificity among government policies. To increase their efficacy it will be necessary to define their uniqueness with respect to other social policies. Population policies, their institutional framework, and the actors called upon to support then must be redefined. A national population policy should orient interventions in three areas: establishment of consensus regarding population goals, channeling funds to the implementing agencies, and providing follow-up and evaluation of demographic effects. Implementation of population policies and programs should be decentralized and should be achieved through insertion of population parameters in the activities of the health, education, and other social sectors.

Environmental potentials of policy instruments to mitigate nutrient emissions in Chinese livestock production.

PubMed

Zheng, Chaohui; Liu, Yi; Bluemling, Bettina; Mol, Arthur P J; Chen, Jining

2015-01-01

To minimize negative environmental impact of livestock production, policy-makers face a challenge to design and implement more effective policy instruments for livestock farmers at different scales. This research builds an assessment framework on the basis of an agent-based model, named ANEM, to explore nutrient mitigation potentials of five policy instruments, using pig production in Zhongjiang county, southwest China, as the empirical filling. The effects of different policy scenarios are simulated and compared using four indicators and differentiating between small, medium and large scale pig farms. Technology standards, biogas subsidies and information provisioning prove to be the most effective policies, while pollution fees and manure markets fail to environmentally improve manure management in pig livestock farming. Medium-scale farms are the more relevant scale category for a more environmentally sound development of Chinese livestock production. A number of policy recommendations are formulated as conclusion, as well as some limitations and prospects of the simulations are discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

Addressing Household Food Insecurity in Canada - Position Statement and Recommendations - Dietitians of Canada.

PubMed

2016-09-01

POSITION STATEMENT It is the position of Dietitians of Canada that household food insecurity is a serious public health issue with profound effects on physical and mental health and social well-being. All households in Canada must have sufficient income for secure access to nutritious food after paying for other basic necessities. Given the alarming prevalence, severity and impact of household food insecurity in Canada, Dietitians of Canada calls for a pan-Canadian, government-led strategy to specifically reduce food insecurity at the household level, including policies that address the unique challenges of household food insecurity among Indigenous Peoples. Regular monitoring of the prevalence and severity of household food insecurity across all of Canada is required. Research must continue to address gaps in knowledge about household vulnerability to food insecurity and to evaluate the impact of policies developed to eliminate household food insecurity in Canada. Dietitians of Canada recommends: Development and implementation of a pan-Canadian government-led strategy that includes coordinated policies and programs, to ensure all households have consistent and sufficient income to be able to pay for basic needs, including food. Implementation of a federally-supported strategy to comprehensively address the additional and unique challenges related to household food insecurity among Indigenous Peoples, including assurance of food sovereignty, with access to lands and resources, for acquiring traditional/country foods, as well as improved access to more affordable and healthy store-bought/market foods in First Nation reserves and northern and remote communities. Commitment to mandatory, annual monitoring and reporting of the prevalence of marginal, moderate and severe household food insecurity in each province and territory across Canada, including among vulnerable populations, as well as regular evaluation of the impact of poverty reduction and protocols for screening within the health care system. Support for continued research to address gaps in knowledge about populations experiencing greater prevalence and severity of household food insecurity and to inform the implementation and evaluation of strategies and policies that will eliminate household food insecurity in Canada.

Characteristics and Differences of Lifelong Learning Policy Implementation for the Elderly in Thailand

ERIC Educational Resources Information Center

Dhirathiti, Nopraenue S.; Pichitpatja, Pojjana

2018-01-01

The study examined the process of policy implementation of lifelong learning for the elderly in Thailand, covering four main regions within the country. The study empirically compared inputs, processes, outputs, and outcomes of policy implementation in the north, south, northeast, and central regions of Thailand and captured the rigor of policy…

Principals as Middle Managers: School Leadership during the Implementation of Primary Class Size Reduction Policy in Ontario

ERIC Educational Resources Information Center

Flessa, Joseph J.

2012-01-01

Previous work on policy implementation has often suggested that schools leave their "thumbprints" on policies received from above. During the implementation of Primary Class Size Reduction (PCS) Initiative in Ontario, Canada, however, school principals spoke with remarkable uniformity about the ways PCS affected their work. This article…

Local Adaptation of Central Policies: The Policymaking and Implementation of Compulsory Education for Migrant Children in China

ERIC Educational Resources Information Center

Wang, Lihua

2016-01-01

This article looks at the central and local governments' policymaking and implementation of compulsory education for migrant children in China. Three distinct models of policy implementation were identified through a case study approach. They indicated a selective adaptation of central policy objective and principles by the local governments and…

Reinventing Your Board: A Step-by-Step Guide to Implementing Policy Governance. The Jossey-Bass Nonprofit and Public Management Series.

ERIC Educational Resources Information Center

Carver, John; Carver, Miriam Mayhew

This guide provides practical advice regarding implementation of the Policy Governance model for school boards. Chapter 1, "Setting the Stage," explores questions commonly raised by boards prior to implementation of the Policy Governance model. Chapter 2, "The Theoretical Foundation," reviews the key theoretical principles of…

ICT Policy and Implementation in Education: Cases in Canada, Northern Ireland and Ireland

ERIC Educational Resources Information Center

Austin, Roger; Hunter, Bill

2013-01-01

Countries with similar levels of economic development often implement different education ICT policies. Much of the existing research attributes such differences to economic and political factors. In this paper, we examine the development of ICT policy and implementation in the two parts of Ireland and in two Canadian provinces and find that…

Shared decision making in the United States: policy and implementation activity on multiple fronts.

PubMed

Frosch, Dominick L; Moulton, Benjamin W; Wexler, Richard M; Holmes-Rovner, Margaret; Volk, Robert J; Levin, Carrie A

2011-01-01

Shared decision making in the United States has become an important element in health policy debates. The recently passed federal health care reform legislation includes several key provisions related to shared decision making (SDM) and patient decision support. Several states have passed or are considering legislation that incorporates SDM as a key component of improved health care provision. Research on SDM is funded by a range of public and private organizations. Non-profit, for-profit, academic and government organizations are developing decision support interventions for numerous conditions. Some interventions are publicly available; others are distributed to patients through health insurance and healthcare providers. A significant number of clinical implementation projects are underway to test and evaluate different ways of incorporating SDM and patient decision support into routine clinical care. Numerous professional organizations are advocating for SDM and social networking efforts are increasing their advocacy as well. Policy makers are intrigued by the potential of SDM to improve health care provision and potentially lower costs. The role of shared decision making in policy and practice will be part of the larger health care reform debate. 2011. Published by Elsevier GmbH.

Cleanliness Policy Implementation: Evaluating Retribution Model to Rise Public Satisfaction

NASA Astrophysics Data System (ADS)

Dailiati, Surya; Hernimawati; Prihati; Chintia Utami, Bunga

2018-05-01

This research is based on the principal issues concerning the evaluation of cleanliness retribution policy which has not been optimally be able to improve the Local Revenue of Pekanbaru City and has not improved the cleanliness of Pekanbaru City. It was estimated to be caused by the performance of Garden and Sanitation Department are not in accordance with the requirement of society of Pekanbaru City. The research method used in this study is a mixed method with sequential exploratory strategy. The data collection used are observation, interview and documentation for qualitative research as well as questionnaires for quantitative research. The collected data were analyzed with interactive model of Miles and Huberman for qualitative research and multiple regression analysis for quantitative research. The research result indicated that the model of cleanliness policy implementation that can increase of PAD Pekanbaru City and be able to improve people’s satisfaction divided into two (2) which are the evaluation model and the society satisfaction model. The evaluation model influence by criteria/variable of effectiveness, efficiency, adequacy, equity, responsiveness, and appropriateness, while the society satisfaction model influence by variables of society satisfaction, intentions, goals, plans, programs, and appropriateness of cleanliness retribution collection policy.

The impact of tobacco control research on policy: 20 years of progress.

PubMed

Warner, Kenneth E; Tam, Jamie

2012-03-01

To assess progress in tobacco control policy research and the relevance of research to policy making. Over 100 experts were surveyed about their opinions on the body of research existing in 1992 and 2011 concerning 11 areas of tobacco control policy, the state of policy implementation in both years, the extent to which research has affected policy adoption and how experience with policy has influenced research. Case studies of how research and policy implementation have interacted were developed. The body of research was not judged 'substantial' in any of the policy areas in 1992. In 2011, 6 of the 11 areas were evaluated as substantial. None ranked as substantial regarding policy implementation in 1992, but by 2011 half were so ranked for developed countries; in low-income and middle-income countries policy implementation moved from very low to moderate. Respondents judged the role of research in actual policy making as 'substantial' regarding clean indoor air, taxation and cessation treatment policy. Case studies illustrate how research can directly affect policy (taxation), how policy and research can have iterative effects (clean indoor air), and how research and policy interact in the case of novel policies (graphic cigarette pack warnings). The role of research in the formulation of the Framework Convention on Tobacco Control is also examined. Policy research goals established in 1992 have been largely realised. For select tobacco control policies, research has made truly important contributions to saving lives. Evidence-based policy adoption will continue to be essential to minimising the toll of tobacco, especially in the world's poorer countries.

Opening the Black Box: The Experiences and Lessons From the Public Hospitals Autonomy Policy in Iran.

PubMed

Doshmangir, Leila; Rashidian, Arash; Jafari, Mehdi; Takian, Amirhossein; Ravaghi, Hamid

2015-07-01

Policy formulation and adoption often happen in a black box. Implementation challenges affect and modify the nature of a policy. We analyzed hospitals' autonomy policy in Iran that was intended to reduce hospitals' financial burden on government and improve their efficiency. We followed a retrospective case-study methodology, involving inductive and deductive analyses of parliamentary proceedings, policy documents, gray literature, published papers and interview transcripts. We analyzed data to develop a policy map that included important dates and events leading to the policy process milestones. We identified four time-periods with distinctive features: 'moving toward the policy' (1989 - 1994), disorganized implementation' (1995 - 1997), 'continuing challenges and indecisiveness in hospitals financing' (1998 - 2003), and 'other structural and financial policies in public hospitals' (2004 to date). We found that stakeholders required different and conflicting objectives, which certainly resulted in an unsatisfactory implementation process. The policy led to long-lasting and often negative changes in the hospital sector and the entire Iranian health system. Hospital autonomy appeared to be an ill-advised policy to remedy the inefficiency problems in low socioeconomic areas of the country. The assumption that hospital autonomy reforms would necessarily result in a better health system, may be a false assumption as their success relies on many contextual, structural and policy implementation factors.

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.

Compulsory Schooling Policy in Nunavut: Challenges and Suggestions

ERIC Educational Resources Information Center

Fredua-Kwarteng, Eric

2008-01-01

This paper uses Nunavut's compulsory schooling policy as a case study to discuss the role that cultural difference plays in policy development and implementation. The central argument of the paper is that the implementation and sustainability of the compulsory schooling policy would be fraught with enormous problems, given its colonialist,…

42 CFR 121.4 - OPTN policies: Secretarial review and appeals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false OPTN policies: Secretarial review and appeals. 121... comments received in developing and adopting policies for implementation by the OPTN; and (2) Provide to the Secretary, at least 60 days prior to their proposed implementation, proposed policies it...

Essays on Environmental Economics and Policy

NASA Astrophysics Data System (ADS)

Walker, W. Reed

A central feature of modern government is its role in designing welfare improving policies to address and correct market failures stemming from externalities and public goods. The rationale for most modern environmental regulations stems from the failure of markets to efficiently allocate goods and services. Yet, as with any policy, distributional effects are important there exist clear winners and losers. Despite the clear theoretical justification for environmental and energy policy, empirical work credibly identifying both the source and consequences of these externalities as well as the distributional effects of existing policies remains in its infancy. My dissertation focuses on the development of empirical methods to investigate the role of environmental and energy policy in addressing market failures as well as exploring the distributional implications of these policies. These questions are important not only as a justification for government intervention into markets but also for understanding how distributional consequences may shape the design and implementation of these policies. My dissertation investigates these questions in the context of programs and policies that are important in their own right. Chapters 1 and 2 of my dissertation explore the economic costs and distributional implications associated with the largest environmental regulatory program in the United States, the Clean Air Act. Chapters 3 and 4 examine the social costs of air pollution in the context of transportation externalities, showing how effective transportation policy has additional co-benefits in the form of environmental policy. My dissertation remains unified in both its subject matter and methodological approach -- using unique sources of data and sound research designs to understand important issues in environmental policy.

A study on the implementation fidelity of the performance-based financing policy in Burkina Faso after 12 months.

PubMed

Bodson, Oriane; Barro, Ahmed; Turcotte-Tremblay, Anne-Marie; Zanté, Nestor; Somé, Paul-André; Ridde, Valéry

2018-01-01

Performance-based financing (PBF) in the health sector has recently gained momentum in low- and middle-income countries (LMICs) as one of the ways forward for achieving Universal Health Coverage. The major principle underlying PBF is that health centers are remunerated based on the quantity and quality of services they provide. PBF has been operating in Burkina Faso since 2011, and as a pilot project since 2014 in 15 health districts randomly assigned into four different models, before an eventual scale-up. Despite the need for expeditious documentation of the impact of PBF, caution is advised to avoid adopting hasty conclusions. Above all, it is crucial to understand why and how an impact is produced or not. Our implementation fidelity study approached this inquiry by comparing, after 12 months of operation, the activities implemented against what was planned initially and will make it possible later to establish links with the policy's impacts. Our study compared, in 21 health centers from three health districts, the implementation of activities that were core to the process in terms of content, coverage, and temporality. Data were collected through document analysis, as well as from individual interviews and focus groups with key informants. In the first year of implementation, solid foundations were put in place for the intervention. Even so, implementation deficiencies and delays were observed with respect to certain performance auditing procedures, as well as in payments of PBF subsidies, which compromised the incentive-based rationale to some extent. Over next months, efforts should be made to adjust the intervention more closely to context and to the original planning.

Implementation issues for consumer-directed programs: comparing views of policy experts, consumers, and representatives.

PubMed

Simon-Rusinowitz, Lori; Marks, Lori N; Loughlin, Dawn M; Desmond, Sharon M; Mahoney, Kevin J; Zacharias, B Lee; Squillace, Marie R; Allison, Ann Marie

2002-01-01

An increasing number of aging community providers and consumers support consumer-direction (CD) in long-term care services. In regard to devolution, consumer-direction goes beyond the usual approach of shifting responsibilities from the federal government to state governments to bring programs "closer to the people." Consumer-direction goes even further by placing resources directly in the hands of consumers. Yet, many questions remain unanswered regarding how to implement CD personal assistance services in general, and especially for older persons. This article describes the importance of examining views from multiple key stakeholders involved in implementing CD programs. We report on three background studies that have informed the Cash and Counseling Demonstration and Evaluation (CCDE) design and implementation-policy expert interviews as well as surveys and focus groups with consumers and representatives. As a fourth data source, we drew upon experiences in designing the CCDE and initial results from the first year of implementation. Each of the three studies on its own provided essential information for planning the CCDE. However, when we examined the studies together, and added CCDE design and implementation experiences, views expressed by the different stakeholders formed a type of multi-perspective "dialogue" that expanded our knowledge about implementing CD services. We hope this increased knowledge will help expand the availability of such services for consumers of any age who want to direct their own care.

The politics of public health policy.

PubMed

Oliver, Thomas R

2006-01-01

Politics, for better or worse, plays a critical role in health affairs. The purpose of this article is to articulate a role for political analysis of public health issues, ranging from injury and disease prevention to health care reform. It begins by examining how health problems make it onto the policy agenda. Perceptions regarding the severity of the problem, responsibility for the problem, and affected populations all influence governmental responses. Next, it considers how bounded rationality, fragmented political institutions, resistance from concentrated interests, and fiscal constraints usually lead political leaders to adopt incremental policy changes rather than comprehensive reforms even when faced with serious public health problems. It then identifies conditions under which larger-scale transformation of health policy can occur, focusing on critical junctures in policy development and the role of policy entrepreneurs in seizing opportunities for innovation. Finally, it reviews the challenges confronting officials and agencies who are responsible for implementing and administering health policies. Public health professionals who understand the political dimensions of health policy can conduct more realistic research and evaluation, better anticipate opportunities as well as constraints on governmental action, and design more effective policies and programs.

The Health Equity and Effectiveness of Policy Options to Reduce Dietary Salt Intake in England: Policy Forecast

PubMed Central

Gillespie, Duncan O. S.; Allen, Kirk; Guzman-Castillo, Maria; Bandosz, Piotr; Moreira, Patricia; McGill, Rory; Anwar, Elspeth; Lloyd-Williams, Ffion; Bromley, Helen; Diggle, Peter J.; Capewell, Simon; O’Flaherty, Martin

2015-01-01

Background Public health action to reduce dietary salt intake has driven substantial reductions in coronary heart disease (CHD) over the past decade, but avoidable socio-economic differentials remain. We therefore forecast how further intervention to reduce dietary salt intake might affect the overall level and inequality of CHD mortality. Methods We considered English adults, with socio-economic circumstances (SEC) stratified by quintiles of the Index of Multiple Deprivation. We used IMPACTSEC, a validated CHD policy model, to link policy implementation to salt intake, systolic blood pressure and CHD mortality. We forecast the effects of mandatory and voluntary product reformulation, nutrition labelling and social marketing (e.g., health promotion, education). To inform our forecasts, we elicited experts’ predictions on further policy implementation up to 2020. We then modelled the effects on CHD mortality up to 2025 and simultaneously assessed the socio-economic differentials of effect. Results Mandatory reformulation might prevent or postpone 4,500 (2,900–6,100) CHD deaths in total, with the effect greater by 500 (300–700) deaths or 85% in the most deprived than in the most affluent. Further voluntary reformulation was predicted to be less effective and inequality-reducing, preventing or postponing 1,500 (200–5,000) CHD deaths in total, with the effect greater by 100 (−100–600) deaths or 49% in the most deprived than in the most affluent. Further social marketing and improvements to labelling might each prevent or postpone 400–500 CHD deaths, but minimally affect inequality. Conclusions Mandatory engagement with industry to limit salt in processed-foods appears a promising and inequality-reducing option. For other policy options, our expert-driven forecast warns that future policy implementation might reach more deprived individuals less well, limiting inequality reduction. We therefore encourage planners to prioritise equity. PMID:26131981

Navigating institutional complexity in the health sector: lessons from tobacco control in Kenya

PubMed Central

Lencucha, Raphael; Magati, Peter; Drope, Jeffrey

2016-01-01

Introduction This research examines the institutional dynamics of tobacco control following the establishment of Kenya’s 2007 landmark tobacco control legislation. Our analysis focuses specifically on coordination challenges within the health sector. Methods We conducted semi-structured interviews with key informants (n = 17) involved in tobacco regulation and control in Kenya. We recruited participants from different offices and sectors of government and non-governmental organizations. Results We find that the main challenges toward successful implementation of tobacco control are a lack of coordination and clarity of mandate of the principal institutions involved in tobacco control efforts. In a related development, the passage of a new constitution in 2010 created structural changes that have affected the successful implementation of the country’s tobacco control legislation. Discussion We discuss how proponents of tobacco control navigated these two overarching institutional challenges. These findings point to the institutional factors that influence policy implementation extending beyond the traditional focus on the dynamic between government and the tobacco industry. These findings specifically point to the intragovernmental challenges that bear on policy implementation. The findings suggest that for effective implementation of tobacco control legislation and regulation, there is need for increased cooperation among institutions charged with tobacco control, particularly within or involving the Ministry of Health. Decisive leadership was also widely presented as a component of successful institutional reform. Conclusion This study points to the importance of coordinating policy development and implementation across levels of government and the need for leadership and clear mandates to guide cooperation within the health sector. The Kenyan experience offers useful lessons in the pitfalls of institutional incoherence, but more importantly, the value of investing in and then promoting well-functioning institutions. PMID:27418654

Monitoring HIV and AIDS Related Policy Reforms: A Road Map to Strengthen Policy Monitoring and Implementation in PEPFAR Partner Countries

PubMed Central

2016-01-01

Achieving an AIDS-free generation will require the adoption and implementation of critical health policy reforms. However, countries with high HIV burden often have low policy development, advocacy, and monitoring capacity. This lack of capacity may be a significant barrier to achieving the AIDS-free generation goals. This manuscript describes the increased focus on policy development and implementation by the United States President’s Emergency Plan for AIDS Relief (PEPFAR). It evaluates the curriculum and learning modalities used for two regional policy capacity building workshops organized around the PEPFAR Partnership Framework agreements and the Road Map for Monitoring and Implementing Policy Reforms. A total of 64 participants representing the U.S. Government, partner country governments, and civil society organizations attended the workshops. On average, participants responded that their policy monitoring skills improved and that they felt they were better prepared to monitor policy reforms three months after the workshop. When followed-up regarding utilization of the Road Map action plan, responses were mixed. Reasons cited for not making progress included an inability to meet or a lack of time, personnel, or governmental support. This lack of progress may point to a need for building policy monitoring systems in high HIV burden countries. Because the success of policy reforms cannot be measured by the mere adoption of written policy documents, monitoring the implementation of policy reforms and evaluating their public health impact is essential. In many high HIV burden countries, policy development and monitoring capacity remains weak. This lack of capacity could hinder efforts to achieve the ambitious AIDS-free generation treatment, care and prevention goals. The Road Map appears to be a useful tool for strengthening these critical capacities. PMID:26914708

What Is "Policy" and What Is "Policy Response"? An Illustrative Study of the Implementation of the Leadership Standards for Social Justice in Scotland

ERIC Educational Resources Information Center

Ward, S. C.; Bagley, C.; Lumby, J.; Hamilton, T.; Woods, P.; Roberts, A.

2016-01-01

This article examines "policy" and "policy response" through documentary analysis and an illustrative study of policy implementation. Our approach is informed by Foucault's (2009) theory that power relations in society are conditioned by a culturally generated set of ideas, and that these relations contain the space for both…

Integrated community case management in Malawi: an analysis of innovation and institutional characteristics for policy adoption.

PubMed

Rodríguez, Daniela C; Banda, Hastings; Namakhoma, Ireen

2015-12-01

In 2007, Malawi became an early adopter of integrated community case management for childhood illnesses (iCCM), a policy aimed at community-level treatment for malaria, diarrhoea and pneumonia for children below 5 years. Through a retrospective case study, this article explores critical issues in implementation that arose during policy formulation through the lens of the innovation (i.e. iCCM) and of the institutions involved in the policy process. Data analysis is founded on a documentary review and 21 in-depth stakeholder interviews across institutions in Malawi. Findings indicate that the characteristics of iCCM made it a suitable policy to address persistent challenges in child mortality, namely that ill children were not interacting with health workers on a timely basis and consequently were dying in their communities. Further, iCCM was compatible with the Malawian health system due to the ability to build on an existing community health worker cadre of health surveillance assistants (HSAs) and previous experiences with treatment provision at the community level. In terms of institutions, the Ministry of Health (MoH) demonstrated leadership in the overall policy process despite early challenges of co-ordination within the MoH. WHO, United Nations Children's Fund (UNICEF) and implementing organizations played a supportive role in their position as knowledge brokers. Greater challenges were faced in the organizational capacity of the MoH. Regulatory issues around HSA training as well as concerns around supervision and overburdening of HSAs were discussed, though not fully addressed during policy development. Similarly, the financial sustainability of iCCM, including the mechanisms for channelling funding flows, also remains an unresolved issue. This analysis highlights the role of implementation questions during policy development. Despite several outstanding concerns, the compatibility between iCCM as a policy alternative and the local context laid the foundation for Malawi's road to early adoption of iCCM. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

An appraisal of policies and institutional frameworks impacting on smallholder agricultural water management in Zimbabwe

NASA Astrophysics Data System (ADS)

Nyagumbo, I.; Rurinda, J.

Policies and institutional frameworks associated with and / or impacting on agricultural water management (AWM) in smallholder farming systems in Zimbabwe were analyzed through literature reviews, feedback from stakeholder workshops, key informant interviews and evaluation of policy impacts on implemented case study projects/programmes. The study showed that Zimbabwe has gone a long way towards developing a water management policy addressing both equity and access, through the Water and ZINWA of 1998. However, lack of incentives for improving efficient management and utilization of water resources once water has reached the farm gate was apparent, apart from punitive economic instruments levied on usage of increased volumes of water. For example, the new water reforms of 1998 penalized water savers through loss of any unused water in their permits to other users. In addition, the ability of smallholder farmers to access water for irrigation or other purposes was influenced by macro and micro-economic policies such as Economic Structural and Adjustment Programme (ESAP), Zimbabwe Programme for Economic and Social Transformation (ZIMPREST), prevailing monetary and fiscal policies, as well as the Land and Agrarian Reform policies. For instance, the implementation of ESAP from 1991 to 95 resulted in a decline in government support to management of communal irrigation schemes, and as a result only gravity-fed schemes survived. Also AWM projects/programmes that were in progress were prematurely terminated. While considerable emphasis was placed on rehabilitation of irrigation infrastructure since the fast track land reform in 1998, the policies remained rather silent on strategies for water management in rainfed systems. The piecemeal nature and fragmentation of policies and institutional frameworks scattered across government ministries and sectors were complex and created difficulties for smallholder farmers to access water resources. Poor policy implementation strategies and lack of funding were some of the major weaknesses in Zimbabwe’s AWM policies. It was apparent that the prevailing institutional frameworks that underwent restructuring exercises since 2000, failed to effectively deliver services to smallholder farmers due to lack of human and financial capital. Nevertheless, the study showed that policies that can improve efficient utilization of agricultural water in rainfed systems need to target timely provision of the prime movers, i.e. credit, input markets and viable output markets, among other factors, so as to fully utilize good rainfall seasons. It was recommended that a forum led by ZINWA be set up to harmonize AWM issues across sectors and monitor their implementation. Such a forum would be mandated mainly to run periodic water management workshops in which relevant and interested stakeholders participate. ZINWA stands for Zimbabwe National Water Authority.

Targeting the impact of agri-environmental policy - Future scenarios in two less favoured areas in Portugal.

PubMed

Jones, Nadia; Fleskens, Luuk; Stroosnijder, Leo

2016-10-01

Targeting agri-environmental measures (AEM) improves their effectiveness in the delivery of public goods, provided the necessary coordination with other incentives. In less favoured areas (LFA) measures focusing on the conservation of extensive farming contribute to sustainable land management in these areas. In this paper we investigate the implementation of a possible AEM supporting the improvement of permanent pastures coordinated with the extensive livestock and single farm payments actually in place. Through applying a spatially-explicit mixed integer optimisation model we simulate future land use scenarios for two less favoured areas in Portugal (Centro and Alentejo) considering two policy scenarios: a 'targeted AEM', and a 'non-targeted AEM'. We then compare the results with a 'basic policy' option (reflecting a situation without AEM). This is done with regard to landscape-scale effects on the reduction of fire hazard and erosion risk, as well as effects on farm income. The results show that an AEM for permanent pastures would be more cost-effective for erosion and fire hazard mitigation if implemented within a spatially targeted framework. However when cost-effectiveness is assessed with other indicators (e.g. net farm income and share of grazing livestock) 'non-targeted AEM' implementation delivers the best outcome in Alentejo. In Centro the implementation of an AEM involves important losses of income compared to the 'basic policy'. 'Targeted AEM' tends to favour farms in very marginal conditions, i.e. targeting is demonstrated to perform best in landscapes where spatial heterogeneity is higher. The results also show the risk of farm abandonment in the two studied less favoured areas: in all three scenarios more than 30% of arable land is deemed to be abandoned. Copyright © 2016 Elsevier Ltd. All rights reserved.

Process evaluation of a regional public health model to reduce chronic disease through policy and systems changes, Washington State, 2010-2014.

PubMed

Walkinshaw, Lina P; Mason, Caitlin; Allen, Claire L; Vu, Thuy; Nandi, Paj; Santiago, Patti Migliore; Hannon, Peggy A

2015-03-19

Although the regionalization of public health systems has been well documented in the case of emergency preparedness, there is little literature on the application of regional approaches to other aspects of public health. From 2011 through 2014 the Washington State Department of Health implemented a Community Transformation Grant to support community-level policy and systems changes to decrease chronic disease risk factors and increase access to clinical preventive services. The Department of Health implemented the grant through a regional model, grouping 32 of the state's 35 local health jurisdictions into 5 regions. Our process evaluation identifies the challenges and facilitators to Community Transformation Grant planning and implementation. We conducted 34 key informant interviews with people directly involved in the implementation of the Community Transformation Grant. We interviewed state and local partners, including representatives from each region, the Department of Health, external consultants, and regional partners. We collected data from October 2013 through July 2014. Challenges for planning, building, and implementing a regional model for chronic disease prevention included stakeholder buy-in, regional geography, and communication; facilitators included shared regional history and infrastructure, strong leadership, collaborative relationships, shared vision and goals, sufficient funding, and direct technical assistance and training. Lessons learned in Washington State provide a foundation for other states interested in using a regional approach to reduce chronic disease risk. Policy and systems changes require adequate time, funding, and staffing. States and funders should work closely with local leaders to address these challenges and facilitators.

School district wellness policy quality and weight-related outcomes among high school students in Minnesota.

PubMed

Hoffman, Pamela K; Davey, Cynthia S; Larson, Nicole; Grannon, Katherine Y; Hanson, Carlie; Nanney, Marilyn S

2016-04-01

Weight-related outcomes were examined among high school students in Minnesota public school districts according to the quality of district wellness policies. Wellness policy strength and comprehensiveness were scored using the Wellness School Assessment Tool (WellSAT) for 325 Minnesota public school districts in 2013. The associations between WellSAT scores and district-level means of high school student responses to a statewide survey of health behaviors were examined in this ecologic study. WellSAT Total Strength and Total Comprehensiveness scores were positively associated with both student mean Body Mass Index (BMI) percentile (Strength: P = 0.018, Comprehensiveness: P = 0.031) and mean percent overweight or obese (Strength: P = 0.008, Comprehensiveness: P = 0.026), but only in districts with > 50% of students eligible for Free or Reduced-Price Lunches (FRPLs), or 'high FRPL districts'. WellSAT Physical Education and Physical Activity subscale scores were also positively associated with the mean days per week students engaged in physical activity for ≥ 60 min in high FRPL districts (Strength: P = 0.008, Comprehensiveness: P = 0.003) and in low FRPL districts (< 35% eligible) for Strength score: (P = 0.027). In medium FRPL districts (35-50% eligible), Nutrition Education and Wellness Promotion Strength and Comprehensiveness subscale scores were positively associated with, respectively, daily servings of vegetables (P = 0.037) and fruit (P = 0.027); and WellSAT Total scores were positively associated with daily vegetable servings (Strength: P = 0.037, Comprehensiveness: P = 0.012). Administrators of economically disadvantaged school districts with a higher percentage of overweight students may be recognizing the need for stronger wellness policies and the specific importance of implementing policies pertaining to physical activity as a means to improve student health. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Perceived justice and popular support for public health laws: a case study around comprehensive smoke-free legislation in Mexico City.

PubMed

Thrasher, James F; Besley, John C; González, Wendy

2010-03-01

The World Health Organization's Framework Convention on Tobacco Control promotes comprehensive smoke-free laws. The effective implementation of these laws requires citizen participation and support. Risk communication research suggests that citizens' perceptions of the fairness of smoke-free laws would help explain their support for the law. This study aimed to assess the factors that correlate with citizens' perceptions of the distributive, procedural and interpersonal justice of smoke-free laws, as well as how these perceptions are related to support for and intention to help enforce these laws. Study data came from a cross-sectional, population-based survey of 800 Mexico City inhabitants before a comprehensive smoke-free policy was implemented there in 2008. Structural equation modeling was used to estimate the bivariate and multivariate adjusted paths relating study variables. In the final multivariate model, the three justice concepts mediated the influence of smoking status, perceived dangers of secondhand smoke exposure, strength of home smoking ban, and perceived rights of smokers on the two distal constructs of support for smoke-free policy and intention to help enforce it. Statistically significant paths were estimated from distributive and procedural justice to support for the law and intention help enforce it. The path from interpersonal justice to support for the law was not significant, but the path to intention to help enforce the law was. Finally, the path from support for the law to the intention to enforce it was statistically significant. These results suggest that three distinct dimensions of perceived justice help explain citizen support for smoke-free policies. These dimensions of perceived justice may explain the conditions under which smoke-free policies are effectively implemented and could help shape the focus for communication strategies that aim to ensure effective implementation of this and other public health policies. 2009 Elsevier Ltd. All rights reserved.

Impact of changes in Medicare Home Health care reimbursement on month-to-month Home Health utilization between 1996 and 2001 for a national sample of patients undergoing orthopedic procedures.

PubMed

FitzGerald, John D; Mangione, Carol M; Boscardin, John; Kominski, Gerald; Hahn, Bevra; Ettner, Susan L

2006-09-01

Beginning October 1, 1997, Medicare implemented a series of major changes to the Home Health (HH) reimbursement system. Reimbursements were first significantly reduced under the Interim Payment System (IPS) and then relaxed slightly until implementation of the HH Prospective Payment System (PPS) on October 1, 2000. The objective of this study was to examine the impact of reimbursement policy on HH care utilization. We postulated that in response to the initial changes, there would be reductions in both the probability of any HH use and the number of HH visits per HH user. Under PPS, we postulated there would be further reduction in number of HH visits. We tested whether the policy response differed by HH agency structure and whether subgroups of patients were differentially affected. An interrupted time-series analysis was conducted to examine month-to-month probability of HH selection and the number of HH visits among users. A 100% sample of all Medicare recipients undergoing either elective joint replacement (1.6 million hospital discharges) or surgical management of hip fracture (1.2 million hospital discharges) between January 1996 and December 2001 was selected. Under the IPS, the probability of any HH use and number of visits per episode of HH care fell until the IPS was refined in October 1998. With implementation of the PPS, HH visits fell commensurately. Differentially larger reductions in care were noted at for-profit HH agencies, for the elderly, women, patients receiving state assistance, and patients first discharged to skilled nursing facility or rehabilitation hospitals. Changes in month-to-month utilization of HH services were sharp and well correlated with policy implementation dates, strengthening the evidence for a causal association between policy and patient care in the midst of a sea of concurrent policy changes. Greater reductions in HH visits were noted for vulnerable groups.

'Nurse entrepreneurs' a case of government rhetoric?

PubMed

Traynor, Michael; Drennan, Vari; Goodman, Claire; Mark, Annabelle; Davis, Kathy; Peacock, Richard; Banning, Maggi

2008-01-01

Nursing has come to play a prominent role in government health policy since 1997. Extending the scope of nursing practice into activities previously carried out by doctors can assist a managerialist and 'modernizing' project of increasing National Health Service (NHS) efficiency by removing demarcations between professional groups. Drawing on elements of poststructuralist linguistics, this paper presents an analysis of a key government speech in the context of a discussion of overall policy intentions. The speech can be seen as an example of how government has attempted to use rhetoric to make its goals attractive to nurses. Policy-makers have to make their policies acceptable to those whom they expect to implement them. In this case, organizational efficiency, chiefly in terms of broader access to NHS services, as well as role substitution, is aligned with government policy promoting social enterprise and 'sold' to the nursing profession as enhancing its status compared with medicine.

Politicize or perish! the importance of policy for Australian psychiatric-mental health nurses.

PubMed

Sgro, Silvana; Happell, Brenda

2006-05-01

As the largest professional group within the Australian mental health nursing workforce, psychiatric-mental health nurses are well positioned to influence mental health policy. However, the dominance of nursing by the medical profession has limited the extent to which this potential has been realized, with nurses remaining relatively unheard within the political arena. In recognition of this situation, the Centre for Psychiatric Nursing Research and Practice implemented a position for a policy analyst. Three primary aims were identified for this position: networking and relationship building, building profile, and providing a voice for psychiatric-mental health nursing. This article provides an overview of these three aims and the achievements to date. It is concluded that the policy analyst position has made a significant contribution to increasing the profile of psychiatric-mental health nursing and, therefore, to its capacity to influence policy.

The development of scientific evidence for health policies for obesity: why and how

PubMed Central

Richardson, Molly B.; Williams, Michelle S.; Fontaine, Kevin R.; Allison, David B.

2017-01-01

Potential obesity-related policy approaches have recently been receiving more attention. While some have been implemented and others only proposed, few have been formally evaluated. We discuss the relevance, and in some cases irrelevance, of some of the types of evidence that are often brought to bear in considering obesity-related policy decisions. We discuss major methods used to generate such evidence, emphasizing study design and the varying quality of the evidence obtained. Third, we consider what the standards of evidence should be in various contexts, who ought to set those standards, as well as the inherent subjectivity involved in making policy decisions. Finally, we suggest greater transparency from both academics and policymakers in the acknowledgment of subjectivities so they can distinguish and communicate the roles played by empirical evidence and subjective values in the formulation of policy. PMID:28293021

Strengthening the health workforce and rolling out universal health coverage: the need for policy analysis.

PubMed

Koon, Adam D; Mayhew, Susannah H

2013-07-24

This article opens a debate about how to think about moving forward with the emerging twin movements of human resources for health (HRH) and universal health coverage (UHC). There is sufficient evidence to warrant these movements, but actors and the policy process significantly affect which policies are adopted and how they are implemented. How exactly this occurs in low- and middle-income countries (LMICs) is not very well understood. Furthermore, it is not clear whether actors will mobilize for or against the emergent HRH and UHC agendas. Policy analysis should help illuminate potential strategies to account for multiple interests and divergent values in volatile stakeholder environments. We argue that not only should the movement for UHC be paired with current efforts to address the human resources crisis, but also, for both to succeed, we need to know more about how health policy works in LMICs.

An assessment of America's tobacco-free colleges and universities.

PubMed

Plaspohl, Sara S; Parrillo, Anthony V; Vogel, Robert; Tedders, Stuart; Epstein, Andrew

2012-01-01

This study examined the extent to which US campuses identified as "100% tobacco-free" by the American Lung Association of Oregon adhered to the American College Health Association's the most recent guidelines and recommendations promoting tobacco-free environments in colleges and universities. A key informant from 162 of 175 institutions (92.6% response rate) completed an online survey between January 2010 and February 2010. The variables under study were assessed via a cross-sectional research design. Participants completed a 35-item survey regarding their school's tobacco policies, procedures, and enforcement practices. Although the vast majority of schools had written policies and procedures in place, schools with current policies were the most compliant. Numerous opportunities for improved adherence were identified in the results. Findings from this study may help institutions in the development and implementation of a new tobacco policy, as well as strengthen policies among existing tobacco-free schools.

Food Service Perspectives on National School Lunch Program Implementation.

PubMed

Tabak, Rachel G; Moreland-Russell, Sarah

2015-09-01

Explore barriers and facilitators to implementation of the new National School Lunch Program (NSLP) policy guidelines. Interviews with eight food service directors using an interview guide informed by the Consolidated Framework for Implementation Research. Food service personnel; parents, teachers, school staff; and students were important stakeholders. Characteristics of the new NSLP policy guidelines were reported to create increased demands; resources alleviated some barriers. Directors reported increased food and labor costs, food sourcing challenges, decreased student participation, and organizational constraints as barriers to implementation. Creativity in menu planning facilitated success. Factors within the food service department, characteristics of implementing individuals and the new NSLP policy guidelines, and stakeholder involvement in the implementation process relate to successful implementation.

Promoting a Culture of Tailoring for Systems Engineering Policy Expectations

NASA Technical Reports Server (NTRS)

Blankenship, Van A.

2016-01-01

NASA's Marshall Space Flight Center (MSFC) has developed an integrated systems engineering approach to promote a culture of tailoring for program and project policy requirements. MSFC's culture encourages and supports tailoring, with an emphasis on risk-based decision making, for enhanced affordability and efficiency. MSFC's policy structure integrates the various Agency requirements into a single, streamlined implementation approach which serves as a "one-stop-shop" for our programs and projects to follow. The engineers gain an enhanced understanding of policy and technical expectations, as well as lesson's learned from MSFC's history of spaceflight and science missions, to enable them to make appropriate, risk-based tailoring recommendations. The tailoring approach utilizes a standard methodology to classify projects into predefined levels using selected mission and programmatic scaling factors related to risk tolerance. Policy requirements are then selectively applied and tailored, with appropriate rationale, and approved by the governing authorities, to support risk-informed decisions to achieve the desired cost and schedule efficiencies. The policy is further augmented by implementation tools and lifecycle planning aids which help promote and support the cultural shift toward more tailoring. The MSFC Customization Tool is an integrated spreadsheet that ties together everything that projects need to understand, navigate, and tailor the policy. It helps them classify their project, understand the intent of the requirements, determine their tailoring approach, and document the necessary governance approvals. It also helps them plan for and conduct technical reviews throughout the lifecycle. Policy tailoring is thus established as a normal part of project execution, with the tools provided to facilitate and enable the tailoring process. MSFC's approach to changing the culture emphasizes risk-based tailoring of policy to achieve increased flexibility, efficiency, and effectiveness in project execution, while maintaining appropriate rigor to ensure mission success.

Why do women pay more than they should? A mixed methods study of the implementation gap in a policy to subsidize the costs of deliveries in Burkina Faso.

PubMed

Ridde, Valéry; Kouanda, Seni; Yameogo, Maurice; Kadio, Kadidiatou; Bado, Aristide

2013-02-01

In 2007, Burkina Faso launched a public policy to subsidize 80% of the cost of normal deliveries. Although women are required to pay only the remaining 20%, i.e., 900F CFA (1.4 Euros), some qualitative evidence suggests they actually pay more. The aim of this study is to test and then (if confirmed) to understand the hypothesis that the amounts paid by women are more than the official fee, i.e., their 20% portion. A mixed method sequential explanatory design giving equal priority to both quantitative (n=883) and qualitative (n=50) methods was used in a rural health district of Ouargaye. Half (50%, median) of the women reported paying more than the official fee for a delivery. Health workers questioned the methodology of the study and the veracity of the women's reports. The three most plausible explanations for this payment disparity are: (i) the payments were for products used that were not part of the delivery kit covered by the official fee; (ii) the implementers had difficulty in understanding the policy; and (iii) there was improper conduct on the part of some health workers. Institutional design and organizational practices, as well as weak rule enforcement and organizational capacity, need to be considered more carefully to avoid an implementation gap in this public policy. Copyright © 2012 Elsevier Ltd. All rights reserved.

Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches.

PubMed

Langlois, Etienne V; Becerril Montekio, Victor; Young, Taryn; Song, Kayla; Alcalde-Rabanal, Jacqueline; Tran, Nhan

2016-03-17

There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings. The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals' abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a 'buddying' process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design. In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge. The collaborative evidence-to-policy approaches underline the importance of iterations and continuity in the engagement of researchers and policymakers/programme managers, in order to account for swift evolutions in health policy planning and implementation. In developing and supporting evidence-to-policy interventions, due consideration should be given to fit-for-purpose approaches, as different needs in policymaking cycles require adapted processes and knowledge. Greater consideration should be provided to approaches embedding the use of research in real-world policymaking, better suited to the complex adaptive nature of health systems.

Implementation and spread of interventions into the multilevel context of routine practice and policy: implications for the cancer care continuum.

PubMed

Yano, Elizabeth M; Green, Lawrence W; Glanz, Karen; Ayanian, John Z; Mittman, Brian S; Chollette, Veronica; Rubenstein, Lisa V

2012-05-01

The promise of widespread implementation of efficacious interventions across the cancer continuum into routine practice and policy has yet to be realized. Multilevel influences, such as communities and families surrounding patients or health-care policies and organizations surrounding provider teams, may determine whether effective interventions are successfully implemented. Greater recognition of the importance of these influences in advancing (or hindering) the impact of single-level interventions has motivated the design and testing of multilevel interventions designed to address them. However, implementing research evidence from single- or multilevel interventions into sustainable routine practice and policy presents substantive challenges. Furthermore, relatively few multilevel interventions have been conducted along the cancer care continuum, and fewer still have been implemented, disseminated, or sustained in practice. The purpose of this chapter is, therefore, to illustrate and examine the concepts underlying the implementation and spread of multilevel interventions into routine practice and policy. We accomplish this goal by using a series of cancer and noncancer examples that have been successfully implemented and, in some cases, spread widely. Key concepts across these examples include the importance of phased implementation, recognizing the need for pilot testing, explicit engagement of key stakeholders within and between each intervention level; visible and consistent leadership and organizational support, including financial and human resources; better understanding of the policy context, fiscal climate, and incentives underlying implementation; explication of handoffs from researchers to accountable individuals within and across levels; ample integration of multilevel theories guiding implementation and evaluation; and strategies for long-term monitoring and sustainability.

Implementation and Spread of Interventions Into the Multilevel Context of Routine Practice and Policy: Implications for the Cancer Care Continuum

PubMed Central

Green, Lawrence W.; Glanz, Karen; Ayanian, John Z.; Mittman, Brian S.; Chollette, Veronica; Rubenstein, Lisa V.

2012-01-01

The promise of widespread implementation of efficacious interventions across the cancer continuum into routine practice and policy has yet to be realized. Multilevel influences, such as communities and families surrounding patients or health-care policies and organizations surrounding provider teams, may determine whether effective interventions are successfully implemented. Greater recognition of the importance of these influences in advancing (or hindering) the impact of single-level interventions has motivated the design and testing of multilevel interventions designed to address them. However, implementing research evidence from single- or multilevel interventions into sustainable routine practice and policy presents substantive challenges. Furthermore, relatively few multilevel interventions have been conducted along the cancer care continuum, and fewer still have been implemented, disseminated, or sustained in practice. The purpose of this chapter is, therefore, to illustrate and examine the concepts underlying the implementation and spread of multilevel interventions into routine practice and policy. We accomplish this goal by using a series of cancer and noncancer examples that have been successfully implemented and, in some cases, spread widely. Key concepts across these examples include the importance of phased implementation, recognizing the need for pilot testing, explicit engagement of key stakeholders within and between each intervention level; visible and consistent leadership and organizational support, including financial and human resources; better understanding of the policy context, fiscal climate, and incentives underlying implementation; explication of handoffs from researchers to accountable individuals within and across levels; ample integration of multilevel theories guiding implementation and evaluation; and strategies for long-term monitoring and sustainability. PMID:22623601

The Gateway Paper--stewardship and governance in the health sector in Pakistan.

PubMed

Nishtar, Sania

2006-12-01

As an opening for a dialogue on health reforms in the country, the Gateway Paper places emphasis on strengthening the stewardship function of mandated State agencies in Pakistan with particular attention to two key areas. Firstly, greater emphasis on a stewardship role for the Ministry and departments of health in the context of inter-sectoral scope of health and secondly, a stronger role for the State agencies as regulators of healthcare within the country. The Gateway Paper envisages that the role of State agencies will become more critical as new models of financing health and delivering services are structured given that these entail regulation of private sector providers, providing oversight for ensuring a system for ongoing education and implementation of frameworks for public-private partnerships. The Gateway Paper refers to stewardship with reference to analysis and overview of health policies within the country, their relationship with evidence, their follow-up into planning and finally their implementation. The Paper also provides an insight into policies from a process-related as well as content and program related perspectives. In doing so a number of questions relating to the evidence and policy disconnect; issues at strategic and operational levels of planning, and governance-related impediments to program implementation have been discussed and a viewpoint articulated on an approach to addressing these challenges.

Association between community characteristics and implementation of community programmes and policies addressing childhood obesity: the Healthy Communities Study.

PubMed

Schultz, J A; Collie-Akers, V L; Fawcett, S B; Strauss, W J; Nagaraja, J; Landgraf, A J; McIver, K L; Weber, S A; Arteaga, S S; Nebeling, L C; Rauzon, S M

2018-06-19

Little is known about whether characteristics of communities are associated with differential implementation of community programmes and policies to promote physical activity and healthy eating. This study examines associations between community characteristics (e.g. region and race/ethnicity) and the intensity of community programmes and policies implemented to prevent childhood obesity. It explores whether community characteristics moderate the intensity of community efforts to prevent childhood obesity. The objective of this study is to investigate associations between community characteristics and the intensity of community policies and programmes to prevent childhood obesity documented in the Healthy Communities Study that engaged a diverse sample of US communities. Programmes and policies were documented in 130 communities across the USA, reporting over 9000 different community programmes and policies to prevent obesity among children ages 4-15. We examined associations between community characteristics and the intensity of community programmes and policies implemented (i.e. their amount and reach, duration and strength of change strategy). Community characteristics explain 25% of the variability in the intensity of community programmes and policies implemented in communities. Particular characteristics - urbanicity, region, being a large county and the per cent of African-Americans in a community - contributed to more (over 18% of the 25%) of the observed variability. © 2018 World Obesity Federation.

Blood Donation, Payment, and Non-Cash Incentives: Classical Questions Drawing Renewed Interest

PubMed Central

Buyx, Alena M.

2009-01-01

Summary Blood is scarce, and ensuring a sufficient blood supply remains difficult for many countries. Payment for blood as a strategy to increase donations has remained highly controversial for decades, and the debate about ethical issues in paying donors has become somewhat stuck. At least from a policy perspective, it is important to find a compromise which allows for devising and implementing acceptable and successful policies to increase the blood supply. In this paper, such a compromise is developed both from a theoretical and empirical perspective, namely implementing well-designed non-cash incentives which cut across the rigid dichotomy of altruistic donations versus payment for donations. In order for this compromise to work, more attention to donation motives, the choice architecture, and the setting in blood donation needs to be paid. PMID:21076552

SUPPORT Tools for evidence-informed health Policymaking (STP) 15: Engaging the public in evidence-informed policymaking

PubMed Central

2009-01-01

This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. In this article, we address strategies to inform and engage the public in policy development and implementation. The importance of engaging the public (both patients and citizens) at all levels of health systems is widely recognised. They are the ultimate recipients of the desirable and undesirable impacts of public policies, and many governments and organisations have acknowledged the value of engaging them in evidence-informed policy development. The potential benefits of doing this include the establishment of policies that include their ideas and address their concerns, the improved implementation of policies, improved health services, and better health. Public engagement can also be viewed as a goal in itself by encouraging participative democracy, public accountability and transparency. We suggest three questions that can be considered with regard to public participation strategies. These are: 1. What strategies can be used when working with the mass media to inform the public about policy development and implementation? 2. What strategies can be used when working with civil society groups to inform and engage them in policy development and implementation? 3. What methods can be used to involve consumers in policy development and implementation? PMID:20018105

Secondhand Smoke Exposure and Smoke-free Policy in Philadelphia Public Housing

PubMed Central

Klassen, Ann C.; Lee, Nora L.; Pankiewicz, Aaron; Ward, Rikki; Shuster, Michelle; Ogbenna, Bethany Townsend; Wade, Anita; Boamah, Maxwell; Osayameh, Olufunlayo; Rule, Ana M.; Szymkowiak, Dorota; Coffman, Ryan; Bragg, Virginius; Mallya, Giridhar

2017-01-01

Objectives Multi-unit housing environments remain significant sources of secondhand smoke (SHS) exposure, especially for vulnerable populations in subsidized housing. In Philadelphia, the largest US housing authority to implement smoke-free policies, we measured baseline resident smoking-related behaviors and attitudes, and longitudinal exposures to airborne nicotine, during policy development and implementation. Methods In 4 communities, we collected data in 2013, 2014, and 2016, before and after introduction of comprehensive smoke-free policies, interviewing persons in 172 households, and monitoring air-borne nicotine in non-smoking homes and public areas. Average nicotine level differences across years were estimated with multi-level models. Results Fifty-six percent of respondents smoked. Only 37% of households were smoke-free, with another 41% restricting smoking by area or time of day. The number of locations with detectable nicotine did not differ before and after policy implementation, with approximately 20% of non-smoking homes and 70%–80% of public areas having detectable nicotine. However, public area nicotine levels were lower in 2016, after policy implementation, than in 2013 and 2014 (−0.19 μg/m3, p = .03). Conclusions Findings suggest that initial policy implementation was associated with reduced SHS exposure in Philadelphia. As HUD strengthens smoke-free policies, SHS monitoring can be useful to educate stakeholders and build support for policy enforcement. PMID:28944277

Key Policy Issues in the Implementation of User Choice. Working Paper No. 8.

ERIC Educational Resources Information Center

Smith, Joy Selby; Smith, Chris Selby; Ferrier, Fran

This working paper examines key policy issues in the implementation of Australia's User Choice policy regarding allocating public funds for vocational education and training (VET). Part 1 explains the process used to obtain stakeholders regarding the User Choice policy, the administrative arrangements required to support it, and issues that must…

45 CFR 162.920 - Availability of implementation specifications and operating rules.

Code of Federal Regulations, 2011 CFR

2011-10-01

... publications is consistent with the policies of other publishers of standards. The transaction implementation... publications is consistent with the policies of other publishers of standards. The transaction implementation... 45 Public Welfare 1 2011-10-01 2011-10-01 false Availability of implementation specifications and...

Measuring Best Practices for Workplace Safety, Health, and Well-Being: The Workplace Integrated Safety and Health Assessment.

PubMed

Sorensen, Glorian; Sparer, Emily; Williams, Jessica A R; Gundersen, Daniel; Boden, Leslie I; Dennerlein, Jack T; Hashimoto, Dean; Katz, Jeffrey N; McLellan, Deborah L; Okechukwu, Cassandra A; Pronk, Nicolaas P; Revette, Anna; Wagner, Gregory R

2018-05-01

To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment. Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing. The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change. The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.

A Model for Good Governance of Healthcare Technology Management in the Public Sector: Learning from Evidence-Informed Policy Development and Implementation in Benin

PubMed Central

Houngbo, P. Th.; Zweekhorst, M.; De Cock Buning, Tj.; Medenou, D.; Bunders, J. F. G.

2017-01-01

Good governance (GG) is an important concept that has evolved as a set of normative principles for low- and middle-income countries (LMICs) to strengthen the functional capacity of their public bodies, and as a conditional prerequisite to receive donor funding. Although much is written on good governance, very little is known on how to implement it. This paper documents the process of developing a strategy to implement a GG model for Health Technology Management (HTM) in the public health sector, based on lessons learned from twenty years of experience in policy development and implementation in Benin. The model comprises six phases: (i) preparatory analysis, assessing the effects of previous policies and characterizing the HTM system; (ii) stakeholder identification and problem analysis, making explicit the perceptions of problems by a diverse range of actors, and assessing their ability to solve these problems; (iii) shared analysis and visioning, delineating the root causes of problems and hypothesizing solutions; (iv) development of policy instruments for pilot testing, based on quick-win solutions to understand the system’s responses to change; (v) policy development and validation, translating the consensus solutions identified by stakeholders into a policy; and (vi) policy implementation and evaluation, implementing the policy through a cycle of planning, action, observation and reflection. The policy development process can be characterized as bottom-up, with a central focus on the participation of diverse stakeholders groups. Interactive and analytical tools of action research were used to integrate knowledge amongst actor groups, identify consensus solutions and develop the policy in a way that satisfies criteria of GG. This model could be useful for other LMICs where resources are constrained and the majority of healthcare technologies are imported. PMID:28056098

CVD Prevention Through Policy: a Review of Mass Media, Food/Menu Labeling, Taxation/Subsidies, Built Environment, School Procurement, Worksite Wellness, and Marketing Standards to Improve Diet.

PubMed

Afshin, Ashkan; Penalvo, Jose; Del Gobbo, Liana; Kashaf, Michael; Micha, Renata; Morrish, Kurtis; Pearson-Stuttard, Jonathan; Rehm, Colin; Shangguan, Siyi; Smith, Jessica D; Mozaffarian, Dariush

2015-11-01

Poor diet is the leading cause of cardiovascular disease in the USA and globally. Evidence-based policies are crucial to improve diet and population health. We reviewed the effectiveness for a range of policy levers to alter diet and diet-related risk factors. We identified evidence to support benefits of focused mass media campaigns (especially for fruits, vegetables, salt), food pricing strategies (both subsidies and taxation, with stronger effects at lower income levels), school procurement policies (for increasing healthful or reducing unhealthful choices), and worksite wellness programs (especially when comprehensive and multicomponent). Evidence was inconclusive for food and menu labeling (for consumer or industry behavior) and changes in local built environment (e.g., availability or accessibility of supermarkets, fast food outlets). We found little empiric evidence evaluating marketing restrictions, although broad principles and large resources spent on marketing suggest utility. Widespread implementation and evaluation of evidence-based policy strategies, with further research on other strategies with mixed/limited evidence, are essential "population medicine" to reduce health and economic burdens and inequities of diet-related illness worldwide.

36 CFR Exhibit B to Part 906 - Guidelines for Establishing Strategy To Implement Affirmative Action Personnel Plan

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION AFFIRMATIVE ACTION POLICY AND PROCEDURE Pt. 906, Exh... Personnel Plan The following are suggested as the types of activities to be considered in the development of... unutilized skills and knowledge as well as opportunities for reassignment. (7) Utilization of merit promotion...

Identification and Validation of a Brief Test Anxiety Screening Tool

ERIC Educational Resources Information Center

von der Embse, Nathaniel P.; Kilgus, Stephen P.; Segool, Natasha; Putwain, Dave

2013-01-01

The implementation of test-based accountability policies around the world has increased the pressure placed on students to perform well on state achievement tests. Educational researchers have begun taking a closer look at the reciprocal effects of test anxiety and high-stakes testing. However, existing test anxiety assessments lack efficiency and…

Overcoming Obesity in Childhood and Adolescence: A Guide for School Leaders

ERIC Educational Resources Information Center

Schumacher, Donald; J. Allen

2006-01-01

This clear, authoritative overview by an educator and a physician helps principals navigate their way through the many contradictory recommendations confronting them. The authors provide a targeted discussion of the "do's," "don'ts," and "can'ts" that school leaders need to know when creating and implementing new school policies for wellness,…

Information Will Not Make You Well. MIS Re-examined. AIR Forum Paper 1978.

ERIC Educational Resources Information Center

Parker, John D.; Gardner, Don E.

Proponents of management information systems (MIS) have traditionally held that educational administrators are in need of better management information with which to make more informed planning and policy decisions. However, few successful implementations have been reported. Literature discussing the lack of success of MIS point to such factors as…

Student and School Staff Strategies to Combat Cyberbullying in an Urban Student Population

ERIC Educational Resources Information Center

Pelfrey, William V., Jr.; Weber, Nicole L.

2015-01-01

Research indicates that cyberbullying is occurring among middle and high school student populations at increasing rates. There is limited research, however, on strategies students use to combat cyberbullying, as well as how schools implement policies, intervention tactics, and prevention strategies. This qualitative study aimed to explore, among a…

The North Dakota Indian Reservation Economy: A Descriptive Study. North Dakota Economic Studies Number 11.

ERIC Educational Resources Information Center

Harris, James J.

Economic development remains one of the most important objectives of American Indian reservations. Various programs for developing the reservations' resources have been implemented. Due to the multiplicity of needs, development policy has been multi-faceted: health programs to upgrade physical well-being; educational programs to enhance scholastic…

Not Funding the Evidence-Based Model in Ohio

ERIC Educational Resources Information Center

Edlefson, Carla

2010-01-01

The purpose of this descriptive case study was to describe the implementation of Ohio's version of the Evidence-Based Model (OEBM) state school finance system in 2009. Data sources included state budget documents and analyses as well as interviews with local school officials. The new system was responsive to three policy objectives ordered by the…

Student Attendance: Research and Strategies. Research Brief

ERIC Educational Resources Information Center

Johnston, Howard

2005-01-01

What are the characteristics of successful student attendance programs for the high school? It is commonly believed and well supported by research that students who attend school regularly are more successful than those who do not. The challenge for high schools is to design and implement attendance policies and programs that monitor, encourage,…

Neoliberalism and the Politics of Disposability: Education, Urbanization, and Displacement in the New Chicago

ERIC Educational Resources Information Center

Means, Alex

2008-01-01

This paper analyzes the relationship between neoliberalism and school restructuring in Chicago. I provide an account of the ideological foundation of neoliberal education policies as well as an account of their development and implementation in the city. Additionally, I analyze Chicago's newest education agenda, Renaissance 2010. Passed into law…

Investigating Positive Psychology Approaches in Case Management and Residential Programming with Incarcerated Youth

ERIC Educational Resources Information Center

Cross, Lara E.; Morrison, William; Peterson, Patricia; Domene, Jose F.

2012-01-01

This article examines how a rural Canadian secure custody facility for youth implemented positive psychology principles in its case management protocols and residential programming. A directed content analysis design was utilized to identify specific factors of positive psychology in the facility's policy and programming manual, as well as in…

The Initiation of Early Childhood Inclusion in China: A Case Study from Beijing

ERIC Educational Resources Information Center

Hu, Bi Ying; Roberts, Sherron Killingsworth; Wang, Yanhua; Zhao, Hongmei

2011-01-01

The national policies of the Chinese government regarding preschool inclusion are emerging to promote the well-being of all children, particularly children with disabilities in natural environments such as regular preschools or in homes. Following the global trend towards inclusive education, preschools in Beijing are gradually implementing both…

Creative Associates International: Corporate Education and "Democracy Promotion" in Iraq

ERIC Educational Resources Information Center

Saltman, Kenneth J.

2006-01-01

This article illustrates how global corporate education initiatives, though profit-motivated, sometimes function both as an instrument of foreign policy and as a manifestation of a broader imperial project. According to neoconservative scholars, as well as their critics, the events of September 11, 2001, allowed the implementation of pre-made…

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.

Developing Policy for Integrating Biomedicine and Traditional Chinese Medical Practice Using Focus Groups and the Delphi Technique

PubMed Central

Chung, Vincent C. H.; Ma, Polly H. X.; Lau, Chun Hong; Griffiths, Sian M.

2012-01-01

In Hong Kong, statutory regulation for traditional Chinese medicine (TCM) practitioners has been implemented in the past decade. Increasing use of TCM on top of biomedicine (BM) services by the population has been followed; but corresponding policy development to integrate their practices has not yet been discussed. Using focus group methodology, we explore policy ideas for integration by collating views from frontline BM (n = 50) and TCM clinicians (n = 50). Qualitative data were analyzed under the guidance of structuration model of collaboration, a theoretical model for understanding interprofessional collaboration. From focus group findings we generated 28 possible approaches, and subsequently their acceptability was assessed by a two round Delphi survey amongst BM and TCM policy stakeholders (n = 12). Consensus was reached only on 13 statements. Stakeholders agreed that clinicians from both paradigms should share common goals of providing patient-centered care, promoting the development of protocols for shared care and information exchange, as well as strengthening interprofessional connectivity and leadership for integration. On the other hand, attitudes amongst policy stakeholders were split on the possibility of fostering trust and mutual learning, as well as on enhancing innovation and governmental support. Future policy initiatives should focus on these controversial areas. PMID:22649469

Context matters in NGO-government contracting for health service delivery: a case study from Pakistan.

PubMed

Zaidi, Shehla; Mayhew, Susannah H; Cleland, John; Green, Andrew T

2012-10-01

Contracting non-governmental organizations (NGOs) for health service provision is gaining increasing importance in low- and middle-income countries. However, the role of the wider context in influencing the effectiveness of contracting is not well studied and is of relevance given that contracting has produced mixed results so far. This paper applies a policy analysis approach to examine the influence of policy and political factors on contracting origin, design and implementation. Evidence is drawn from a country case study of Pakistan involving extensive NGO contracting for human immunodeficiency virus (HIV) prevention services supported by international donor agencies. A multilevel study was conducted using 84 in-depth interviews, 22 semi-structured interviews, document review and direct observation to examine the national policy design, provincial management of contracting and local contract implementation. There were three main findings. First, contracting origin and implementation was an inherently political process affected by the wider policy context. Although in Pakistan a combination of situational events successfully managed to introduce extensive and sophisticated contracting, it ran into difficulties during implementation due to ownership and capacity issues within government. Second, wide-scale contracting was mis-matched with the capacity of local NGOs, which resulted in sub-optimal contract implementation challenging the reliance on market simulation through contracting. Third, we found that contracting can have unintended knock-on effects on both providers and purchasers. As a result of public sector contracts, NGOs became more distanced from their grounded attributes. Effects on government purchasers were more unpredictable, with greater identification with contracting in supportive governance contexts and further distancing in unsupportive contexts. A careful approach is needed in government contracting of NGOs, taking into account acceptance of contracting NGOs, local NGO capacities and potential distancing of NGOs from their traditional attributes under contracts. Political factors and knock-on effects are likely to be heightened in the sudden and aggressive use of contracting in unprepared settings.

THE CLEAN ENERGY-ENVIRONMENT GUIDE TO ACTION ...

EPA Pesticide Factsheets

The Guide to Action identifies and describes sixteen clean energy policies and strategies that are delivering economic and environmental results for states. For each policy, the Guide describes: Objectives and benefits of the policy; Examples of states that have implemented the policy; Responsibilities of key players at the state level, including typical roles of the main stakeholders; Opportunities to coordinate implementation with other federal and state policies, partnerships and technical assistance resources; Best practices for policy design, implementation, and evaluation, including state examples; Action steps for states to take when adopting or modifying their clean energy policies, based on existing state experiences; Resources for additional information on individual state policies, legislative and regulatory language, and analytical tools and methods. States participating in the Clean Energy-Environment State Partnership Program will use the Guide to Action to: Develop their own Clean Energy-Environment Action Plan that is appropriate to their state; Identify the roles and responsibilities of key decision-makers, such as environmental regulators, state legislatures, public utility commissioners, and state energy offices; Access and apply technical assistance resources, models, and tools available for state-specific analyses and program implementation; and Learn from each other as they develop their own clean energy programs and policies.

Scientific integrity - Recent Department of the Interior policies, codes, and their implementation

USGS Publications Warehouse

Thornhill, Alan D.; Coleman, Richard; Gunderson, Linda C.

2017-01-01

Established on January 28, 2011, the Department of Interior's (DOI’s) Scientific and Scholarly Integrity Policy was the first federal agency policy to respond to the Presidential Memorandum on Scientific Integrity (March 9, 2009) and guidance issued by the Office of Science and Technology Policy Memorandum on Scientific Integrity (December 17, 2010). The increasingly important role of science in DOI decision making and heightened awareness of science integrity issues across the science enterprise provided impetus for making this policy a priority and for incorporating it into the DOI Departmental Manual (Part 305: Chapter 3). This paper discusses the history of scientific integrity in the DOI, the key provisions of the first Department-wide policy and its implementation, and the subsequent revision of the policy. During the first 4 years of implementing the scientific integrity policy, the Department received 35 formal complaints. As of March 31, 2015, only two formal scientific integrity complaints resulted in “warranted determinations,” while the other complaints were closed and dismissed as “not warranted.” Based on the experience of the first three years of implementation (2011-2014), the Department policy was revised on December 16, 2014.

Implementation of School Self-Evaluation in Secondary Schools: Teachers' Perspective

ERIC Educational Resources Information Center

Wong, Wai Lun

2010-01-01

The study investigates how teacher administrators and teachers in Hong Kong secondary schools experienced the implementation process of School Self-Evaluation (SSE), perceived the effects of SSE and described the implementation approach of SSE from the perspectives of policy implementation within the policy studies in education. Given that this…

Policy dialogue to improve health outcomes in low income countries: what are the issues and way forward?

PubMed

Nabyonga-Orem, Juliet; Dovlo, Delanyo; Kwamie, Aku; Nadege, Ade; Guangya, Wang; Kirigia, Joses Muthuri

2016-07-18

This paper has three objectives: to review the health development landscape in the World Health Organization African Region, to discuss the role of health policy dialogue in improving harmonisation and alignment to national health policies and strategic plans, and to provide an analytical view of the critical factors in realising a good outcome from a health policy dialogue process. Strengthening policy dialogue to support the development and implementation of robust and comprehensive national health policies and plans, as well as to improve aid effectiveness, is seen as a strategic entry point to improving health sector results. However, unbalanced power relations, the lack of contextualised and relevant evidence, the diverse interests of the actors involved, and the lack of conceptual clarity on what policy dialogue entails impact the outcomes of a policy dialogue process. The critical factors for a successful policy dialogue have been identified as adequate preparation; secured time and resources to facilitate an open, inclusive and informed discussion among the stakeholders; and stakeholders' monitoring and assessment of the dialogue's activities for continued learning. Peculiarities of low income countries pose a challenge to their policy dialogue processes, including the chaotic-policy making processes, the varied capacity of the actors and donor dependence. Policy dialogue needs to be appreciated as a complex and iterative process that spans the whole process of policy-making, implementation, review and monitoring, and subsequent policy revisions. The existence of the critical factors for a successful policy dialogue process needs to be ensured whilst paying special attention to the peculiarities of low income countries and potential power relations, and mitigating the possible negative consequences. There is need to be cognisant of the varied capacities and interests of stakeholders and the need for capacity building, and to put in place mechanisms to manage conflict of interest. The likelihood of a favourable outcome from a policy dialogue process will depend on the characteristics of the issue under consideration and whether it is contested or not, and the policy dialogue process needs to be tailored accordingly.

32 CFR 21.320 - Are there areas in which DoD Components must establish policies and procedures to implement the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... under awards, if the DoD Component makes any awards to institutions of higher education or to other... establish policies and procedures to implement the DoDGARs? 21.320 Section 21.320 National Defense... Components must establish policies and procedures to implement the DoDGARs? Yes, Heads of DoD Components or...

32 CFR 21.320 - Are there areas in which DoD Components must establish policies and procedures to implement the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... under awards, if the DoD Component makes any awards to institutions of higher education or to other... establish policies and procedures to implement the DoDGARs? 21.320 Section 21.320 National Defense... Components must establish policies and procedures to implement the DoDGARs? Yes, Heads of DoD Components or...

32 CFR 21.320 - Are there areas in which DoD Components must establish policies and procedures to implement the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... under awards, if the DoD Component makes any awards to institutions of higher education or to other... establish policies and procedures to implement the DoDGARs? 21.320 Section 21.320 National Defense... Components must establish policies and procedures to implement the DoDGARs? Yes, Heads of DoD Components or...

32 CFR 21.320 - Are there areas in which DoD Components must establish policies and procedures to implement the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... under awards, if the DoD Component makes any awards to institutions of higher education or to other... establish policies and procedures to implement the DoDGARs? 21.320 Section 21.320 National Defense... Components must establish policies and procedures to implement the DoDGARs? Yes, Heads of DoD Components or...

32 CFR 21.320 - Are there areas in which DoD Components must establish policies and procedures to implement the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... under awards, if the DoD Component makes any awards to institutions of higher education or to other... establish policies and procedures to implement the DoDGARs? 21.320 Section 21.320 National Defense... Components must establish policies and procedures to implement the DoDGARs? Yes, Heads of DoD Components or...

Mapping and Analyzing Stakeholders in China's Essential Drug System by Using a Circular Model: Who We Should Deal with Next?

PubMed

Shao, Hui; Li, Shixue; Xu, Lingzhong; Yang, Shuang; Thomas, Nicholas J; Mir, Mohammed Umer; Guo, Zhen; Ning, Bo; Shi, Lizheng

2015-05-01

To predict the prospects of the essential drug system by using the Stakeholder Impact Index (SII) and evaluate the current performance of each main stakeholder and suggested dangerous stakeholders and dormant stakeholders. A Delphi method was used, involving 36 experts with experience in implementation and evaluation of the essential drug policy, to construct the circular model as well as evaluate the performance of each stakeholder. The central government was a dominant stakeholder of the whole essential drug system. The provincial governments were definitive stakeholders, whereas local governments and medical institutions were dependent stakeholders. Furthermore, media and drug stores were dormant stakeholders and pharmaceutical manufacturers and delivery enterprises were dangerous stakeholders. Patients, community residents, and medical insurance programs were discretionary stakeholders. The SII for the essential drug system was positive (SII proj ⁎ = 2.72). The overall anticipation of the essential drug policy is optimistic. Letting definitive stakeholders (provincial governments) having more autonomy can efficiently accelerate the pace of implementation of the essential drug policy in the current situation. Central government, however, also needs to construct an experience exchange platform with the aim of building versatile methods for running the essential drug system in all provinces. Pharmaceutical manufacturers and delivery enterprises were dangerous stakeholders for the essential drug policy. Because of their potential threat to the implementation of the policy, the central government should motivate them to support the construction of the essential drug system spontaneously. In that case, provincial governments need to construct a fair, balanced, and self-stabilized bidding platform. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010–2016

PubMed Central

Vargas, Roberto A.; Fleisher, Paula; Aragón, Tomás J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

2017-01-01

Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children’s oral health. Methods SFHIP is governed by a steering committee. Partnership working groups for each initiative collaborate to 1) develop and implement action plans emphasizing feasible, scalable, translational-science–informed interventions and 2) consider sustainability early in the planning process by including policy and structural interventions. Outcome Through SFHIP’s efforts, San Francisco enacted ordinances regulating sale and advertising of SSBs and a ballot measure establishing a soda tax. Most San Francisco hospitals implemented or committed to implementing healthy-beverage policies that prohibited serving or selling SSBs. SFHIP helped prevent Starbucks and Taco Bell from receiving alcohol licenses in San Francisco and helped prevent state authorization of sale of powdered alcohol. SFHIP increased the number of primary care clinics providing fluoride varnish at routine well-child visits from 3 to 14 and acquired a state waiver to allow dental clinics to be paid for dental services delivered in schools. Interpretation The SFHIP model of collective impact emphasizing community engagement and policy change accomplished many of its intermediate goals to create an environment promoting health and health equity. PMID:28333598

Evaluation of Standardization of Transfer of Accountability between Inpatient Pharmacists.

PubMed

Tsoi, Vivian; Dewhurst, Norman; Tom, Elaine

2018-01-01

A compelling body of evidence supports the notion that transfer of accountability (TOA) improves communication, continuity of care, and patient safety. TOA involves the transmission and receipt of information between clinicians at each transition of care. Without a notification system alerting pharmacists to patient transfers, pharmacists' ability to seek out and complete TOA may be hindered. A standardized policy and process for TOA, with automated workflow, was implemented at the study hospital in 2015, to ensure consistency and timeliness of documentation by pharmacists. To evaluate pharmacists' adherence to and satisfaction with the TOA policy and process. A retrospective audit was conducted, using a random sample of individuals who were inpatients between June 2014 and February 2016. Transition points for TOA were identified, and the computerized pharmacy system was reviewed to determine whether TOA had been documented at each transition point. After the audit, an online survey was distributed to assess pharmacists' response to and satisfaction with the TOA policy and workflow. Before the TOA workflow was implemented, TOA documentation by pharmacists ranged from 11% (10/93) to 43% (48/111) of transitions. Eight months after implementation of the workflow, the rate of TOA documentation was 87% (68/78), exceeding the institution's target of 70%. Of the 32 pharmacists surveyed, most were satisfied with the TOA policy and agreed that the standardized workflow was simple to use, increased the number of TOAs provided and received, and improved the quality of completed TOAs. Respondents also indicated that the TOA workflow had improved patient care (mean score 4.09/5, standard deviation 0.64). The standardized TOA policy and process were well received by pharmacists, and resulted in consistent TOA documentation and a TOA documentation rate that exceeded the institutional target.

Insights from the evaluation of a provincial healthy eating strategy in Nova Scotia, Canada.

PubMed

Sim, S Meaghan; Kirk, Sara F L

2013-10-01

Healthy Eating Nova Scotia represents the first provincial comprehensive healthy eating strategy in Canada and a strategy that is framed within a population-health model. Five years after strategy launch, our objective was to evaluate Healthy Eating Nova Scotia to determine perceptions of strategy implementation and strategy outputs. The focus of the current paper is on the findings of this evaluation. We conducted an evaluation of the strategy through three activities that included a document review, survey of key stakeholders and in-depth interviews with key strategy informants. The findings from each of the activities were integrated to determine what has worked well with strategy implementation, what could be improved and what outputs have resulted. The evaluation was conducted in the Canadian province of Nova Scotia. Participants for this evaluation included survey respondents (n 120) and key informants (n 16). A total of 156 documents were also reviewed. Significant investments have been made towards inter-sectoral partnerships and resourcing that has provided the necessary leadership and momentum for the strategy. Policy development has been leveraged through the strategy primarily in the health and education sectors and is perceived as a visible success. Clarity of human resource roles and funding within the context of a provincial strategy may be beneficial for continued strategy implementation, as is expansion of policy development. Known to be the first evaluation of its kind, these findings and related considerations will be of interest to policy makers developing and implementing similar strategies in their own jurisdictions.

Cervical cancer screening in Bulgaria--past and present experience.

PubMed

Valerianova, Zdravka; Panayotova, Yulia; Amati, Camilla; Baili, Paolo

2010-01-01

In Bulgaria the previously (1970-1985) existing population based cervical cancer screening was replaced in the early 1990s with an opportunistic model due to political and socioeconomic reasons. As a result, in the last 20 years, cervical cancer incidence and mortality rates steady increased. The objective of the EUROCHIP project in Bulgaria was to evaluate the readiness of the health system as well as health providers' attitudes to implementation in the country of a population based screening program for cervical cancer. Using a structured questionnaire, a convenience sample of medical specialists representing different actors involved in cervical cancer prevention, treatment, financing and policy were interviewed. The majority of interviewed practitioners worried that organization and implementation of an effective population-based cervical cancer screening program is not possible in the current unstable health system. A nostalgic attitude to the cervical cancer screening, performed in the past and pessimistic view on the capability of the current health system to cope are strong. As main barriers to implementation of an effective program were pointed financial and organizational ones. Motivation for gynecologists to perform smear test should include better information, organization and payment. Medical specialists in Bulgaria are aware of the alarming rates of cervical cancer incidence and mortality in the country. However, due to the insufficient communication and interaction between policy makers and front-line health care staff, they do not have enough information on the ongoing programs. Absence of health policy regarding screening is considered as main barrier for implementation of an effective screening program.

Faculty and staff health promotion: results from the School Health Policies and Programs Study 2006.

PubMed

Eaton, Danice K; Marx, Eva; Bowie, Sara E

2007-10-01

US schools employ an estimated 6.7 million workers and are thus an ideal setting for employee wellness programs. This article describes the characteristics of school employee wellness programs in the United States, including state-, district-, and school-level policies and programs. The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in 49 states plus the District of Columbia and among a nationally representative sample of school districts (n=445). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=873). During the 2 years preceding the study, 67.3% of states provided assistance to districts or schools on how to develop or implement faculty and staff health promotion activities or services. Although nearly all schools offered at least 1 health promotion service or activity, few schools offered coordinated activities and services within a comprehensive employee wellness program. During the 12 months preceding the study, none of the health screenings were offered by more than one third of schools; only a few of the health promotion activities and services were offered by more than one third of schools; about one third of schools offered physical activity programs, employee assistance programs, and subsidies or discounts for off-site health promotion activities; and only 1 in 10 schools provided health-risk appraisals for faculty and staff. More schools should implement comprehensive employee wellness programs to improve faculty and staff health behaviors and health status.

[A good investment: promoting health in cities and neighbourhoods].

PubMed

Díez, Elia; Aviñó, Dory; Paredes-Carbonell, Joan J; Segura, Javier; Suárez, Óscar; Gerez, Maria Dolores; Pérez, Anna; Daban, Ferran; Camprubí, Lluís

2016-11-01

Local administration is responsible for health-related areas, and evidence of the health impact of urban policies is available. Barriers and recommendations for the full implementation of health promotion in cities and neighbourhoods have been described. The barriers to the promotion of urban health are broad: the lack of leadership and political will, reflectes the allocation of health outcomes to health services, as well as technical, political and public misconceptions about the root causes of health and wellbeing. Ideologies and prejudices, non-evidence-based policies, narrow sectoral cultures, short political periods, lack of population-based health information and few opportunities for participation limit the opportunities for urban health. Local policies on early childhood, healthy schools, employment, active transport, parks, leisure and community services, housing, urban planning, food protection and environmental health have great positive impacts on health. Key tools include the political prioritisation of health and equity, the commitment to «Health in All Policies» and the participation of communities, social movements and civil society. This requires well organised and funded structures and processes, as well as equity-based health information and capacity building in the health sector, other sectors and society. We conclude that local policies have a great potential for maximising health and equity and equity. The recommendations for carrying them out are increasingly solid and feasible. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.