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Canadian Journal of Public Health =... Jun 2023Our aim was to synthesize published scholarship that applies policy diffusion-a theory of the policy process that considers the interdependence of government-level... (Review)
Review
OBJECTIVES
Our aim was to synthesize published scholarship that applies policy diffusion-a theory of the policy process that considers the interdependence of government-level public health policy choices. We paid particular attention to the role of scientific evidence in the diffusion process, and to identifying challenges and gaps towards strengthening the intersection of public health, public policy, and political science.
METHODS
We systematically searched 17 electronic academic databases. We included English-language, peer-reviewed articles published between 2000 and 2021. For each article, we extracted the following information: public health policy domain, geographic setting, diffusion directions and mechanisms, the role of scientific evidence in the diffusion process, and author research discipline.
SYNTHESIS
We identified 39 peer-reviewed, primary research articles. Anti-smoking and tobacco control policies in the United States (n = 9/39) were the most common policy domain and geographic context examined; comparatively fewer studies examined policy diffusion in the Canadian context (n = 4/39). In terms of how policies diffuse, we found evidence of five diffusion mechanisms (learning, emulation, competition, coercion, and social contagion), which could moreover be conditional on internal government characteristics. The role of scientific evidence in the diffusion process was unclear, as only five articles discussed this. Policy diffusion theory was primarily used by public policy and political science scholars (n = 19/39), with comparatively fewer interdisciplinary authorship teams (n = 6/39).
CONCLUSION
Policy diffusion theory provides important insights into the intergovernmental factors that influence public health policy decisions, thus helping to expand our conceptualization of evidence-informed public health. Despite this, policy diffusion research in the Canadian public health context is limited.
Topics: Humans; Canada; Health Policy; Policy Making; Public Health; Public Policy; United States
PubMed: 36944893
DOI: 10.17269/s41997-023-00752-x -
Social Science & Medicine (1982) Dec 2022Epidemiology is increasingly asking questions about the use of policies to address structural inequities and intervene on health disparities and public health...
Epidemiology is increasingly asking questions about the use of policies to address structural inequities and intervene on health disparities and public health challenges. However, there has been limited explicit consideration of governance structures in the design of epidemiologic policy analysis. To advance empirical and theoretical inquiry in this space, we propose a model of governance analysis in which public health researchers consider at what level 1) decision-making authority for policy sits, 2) policy is implemented, 3) and accountability for policy effects appear. We follow with examples of how these considerations might improve the evaluation of the policy drivers of population health. Consideration and integration of multiple levels of governance, as well as interactions between levels, can help epidemiologists design studies including new opportunities for quasi-experimental designs and stronger counterfactuals, better quantify the policy drivers of inequities, and aid research evidence and policy development work in targeting multiple levels of governance, ultimately supporting evidence-based policy making.
Topics: Humans; Public Policy; Policy Making; Public Health; Health Policy
PubMed: 36274459
DOI: 10.1016/j.socscimed.2022.115444 -
Asian Journal of Psychiatry Jan 2023There is a marked paucity of publications on the policy and legislation of mental health, and substance use disorders in the public domain in Qatar. Qatar National...
There is a marked paucity of publications on the policy and legislation of mental health, and substance use disorders in the public domain in Qatar. Qatar National Vision provides a framework for national strategies and the State of Qatar has developed policies and legislation dedicated to mental health and substance use. In doing so, Qatar has adopted international guidance to shape its mental health services and relevant policy and legislation. This article is a narrative description of the evolution of the mental health and substance use policy and legislation in Qatar.
Topics: Humans; Mental Health; Qatar; Substance-Related Disorders; Policy; Mental Health Services; Health Policy; Mental Disorders
PubMed: 36493689
DOI: 10.1016/j.ajp.2022.103368 -
Implementation Science : IS Dec 2022Implementation science aims to accelerate the public health impact of evidence-based interventions. However, implementation science has had too little focus on the role... (Review)
Review
BACKGROUND
Implementation science aims to accelerate the public health impact of evidence-based interventions. However, implementation science has had too little focus on the role of health policy - and its inseparable politics, polity structures, and policymakers - in the implementation and sustainment of evidence-based healthcare. Policies can serve as determinants, implementation strategies, the evidence-based "thing" to be implemented, or another variable in the causal pathway to healthcare access, quality, and patient outcomes. Research describing the roles of policy in dissemination and implementation (D&I) efforts is needed to resolve persistent knowledge gaps about policymakers' evidence use, how evidence-based policies are implemented and sustained, and methods to de-implement policies that are ineffective or cause harm. Few D&I theories, models, or frameworks (TMF) explicitly guide researchers in conceptualizing where, how, and when policy should be empirically investigated. We conducted and reflected on the results of a scoping review to identify gaps of existing Exploration, Preparation, Implementation, and Sustainment (EPIS) framework-guided policy D&I studies. We argue that rather than creating new TMF, researchers should optimize existing TMF to examine policy's role in D&I. We describe six recommendations to help researchers optimize existing D&I TMF. Recommendations are applied to EPIS, as one example for advancing TMF for policy D&I.
RECOMMENDATIONS
(1) Specify dimensions of a policy's function (policy goals, type, contexts, capital exchanged). (2) Specify dimensions of a policy's form (origin, structure, dynamism, outcomes). (3) Identify and define the nonlinear phases of policy D&I across outer and inner contexts. (4) Describe the temporal roles that stakeholders play in policy D&I over time. (5) Consider policy-relevant outer and inner context adaptations. (6) Identify and describe bridging factors necessary for policy D&I success.
CONCLUSION
Researchers should use TMF to meaningfully conceptualize policy's role in D&I efforts to accelerate the public health impact of evidence-based policies or practices and de-implement ineffective and harmful policies. Applying these six recommendations to existing D&I TMF advances existing theoretical knowledge, especially EPIS application, rather than introducing new models. Using these recommendations will sensitize researchers to help them investigate the multifaceted roles policy can play within a causal pathway leading to D&I success.
Topics: Humans; Implementation Science; Evidence-Based Practice; Public Health; Policy
PubMed: 36503520
DOI: 10.1186/s13012-022-01256-x -
BMJ Global Health Dec 2022Lack of political will is frequently invoked as a rhetorical tool to explain the gap between commitment and action for health reforms in sub-Saharan Africa (SSA).... (Review)
Review
BACKGROUND
Lack of political will is frequently invoked as a rhetorical tool to explain the gap between commitment and action for health reforms in sub-Saharan Africa (SSA). However, the concept remains vague, ill defined and risks being used as a scapegoat to actually examine what shapes reforms in a given context, and what to do about it. This study sought to go beyond the rhetoric of political will to gain a deeper understanding of what drives health reforms in SSA.
METHODS
We conducted a scoping review using Arksey and O'Malley (2005) to understand the drivers of health reforms in SSA.
RESULTS
We reviewed 84 published papers that focused on the politics of health reforms in SSA covering the period 2002-2022. Out of these, more than half of the papers covered aspects related to health financing, HIV/AIDS and maternal health with a dominant focus on policy agenda setting and formulation. We found that health reforms in SSA are influenced by six; often interconnected drivers namely (1) the distribution of costs and benefits arising from policy reforms; (2) the form and expression of power among actors; (3) the desire to win or stay in government; (4) political ideologies; (5) elite interests and (6) policy diffusion.
CONCLUSION
Political will is relevant but insufficient to drive health reform in SSA. A framework of differential reform politics that considers how the power and beliefs of policy elites is likely to shape policies within a given context can be useful in guiding future policy analysis.
Topics: Humans; Female; Health Care Reform; Government; Policy; Maternal Health; Africa South of the Sahara
PubMed: 36455987
DOI: 10.1136/bmjgh-2022-010228 -
Journal of Dental Research Dec 2021Sugar consumption is on the rise globally with detrimental (oral) health effects. There is ample evidence that sugar-sweetened beverage (SSB) taxes can efficiently...
Sugar consumption is on the rise globally with detrimental (oral) health effects. There is ample evidence that sugar-sweetened beverage (SSB) taxes can efficiently reduce sugar consumption. However, evidence alone is seldom enough to implement a policy. In this article, we present a narrative synthesis of evidence, based on real-world SSB tax evaluations, and we combine this with lessons from policy development case studies. This article is structured according to the Health Policy Analysis Triangle, which identifies a policy's content and process and important contextual factors. SSB tax policy content needs to be coupled to existing problems and public sentiment, which depend on more aspects than aspects related to (oral) health alone. Whether or not to include artificially sweetened beverages, therefore, is not solely a matter of showing the evidence of their oral health impact but also dependent on the stated aim of a tax and public sentiment toward tax policies in general. SSB taxes also need to be in line with existing tax and decision-making rules. Earmarking revenue for specific (health promotion) purposes may therefore be less straightforward as it might appear. The policy process of creating context-sensitive SSB tax policy content is not easy either. Advocacy coalitions need to be formed early in the process, and stamina, expertise, and flexibility are required to get a SSB tax adopted in a specific community. This requires a meticulously considered SSB tax structure implementation process. Oral health professionals who want to lead the way in advocating for SSB taxes should realize that evidence-based arguments on potential effectiveness alone will not be enough to realize change. The oral health community can learn important lessons from other "doctor-activists" such as pulmonologists, who have successfully advocated for higher tobacco taxes by being visible in the public debate with clear messaging and robust policy proposals.
Topics: Beverages; Health Policy; Sugar-Sweetened Beverages; Sweetening Agents; Taxes
PubMed: 34034538
DOI: 10.1177/00220345211014463 -
International Journal of Environmental... Mar 2023Environmental regulation faces theoretical and practical research challenges on global scale, due to differences such as language and policy environment. Research...
Environmental regulation faces theoretical and practical research challenges on global scale, due to differences such as language and policy environment. Research reflects the beneficial exploration of scholars, policymakers, and enterprises in the cognitive and behavioural norms of economic development, environmental protection, and social governance. This study demonstrated that the relevant research is motivated by the enaction of environmental regulations and discussed the influence of relevant research on the evolution of environmental regulations. Under the assumption that environmental regulations are consistent with related research, this study used 9185 papers in the field of environmental regulation from 2000 to 2019 to construct a research network panorama and explored the development and revelation of environmental regulation. The results revealed that environmental regulation research is motivated by the introduction of policies, and regulation is influenced by research evolution with the path of 'competitiveness-technological change-innovation.' In addition, after the twenty-first session of the Conference of the Parties (COP21), the number of studies increased significantly, with the USA in the leading position in the research field. Furthermore, governance strategies were inspired by real events, including the increasing concern with climate change, regional research preferences, and the promotion of information disclosure. These results suggest that environmental governors should focus on climate change, localisation, and mechanisms of information disclosure.
Topics: Inventions; Environmental Policy; Conservation of Natural Resources; Policy; Climate Change; China
PubMed: 36981813
DOI: 10.3390/ijerph20064906 -
Neotropical Entomology Jun 2023Emerging evidence suggests that insect populations may be declining at local and global scales, threatening the sustainability of the ecosystem services that insects... (Review)
Review
Emerging evidence suggests that insect populations may be declining at local and global scales, threatening the sustainability of the ecosystem services that insects provide. Insect declines are of particular concern in the Neotropics, which holds several of the world's hotspots of insect endemism and diversity. Conservation policies are one way to prevent and mitigate insect declines, yet these policies are usually biased toward vertebrate species. Here, we outline some key policy instruments for biodiversity conservation in the Neotropics and discuss their potential contribution and shortcomings for insect biodiversity conservation. These include species-specific action policies, protected areas and Indigenous and Community Conserved Areas (ICCAs), sectoral policies, biodiversity offsetting, market-based mechanisms, and the international policy instruments that underpin these efforts. We highlight that although these policies can potentially benefit insect biodiversity indirectly, there are avenues in which we could better incorporate the specific needs of insects into policy to mitigate the declines mentioned above. We propose several areas of improvement. Firstly, evaluating the extinction risk of more Neotropical insects to better target at-risk species with species-specific policies and conserve their habitats within area-based interventions. Secondly, alternative pest control methods and enhanced monitoring of insects in a range of land-based production sectors. Thirdly, incorporating measurable and achievable insect conservation targets into international policies and conventions. Finally, we emphasise the important roles of community engagement and enhanced public awareness in achieving these improvements to insect conservation policies.
Topics: Animals; Ecosystem; Conservation of Natural Resources; Biodiversity; Insecta; Policy
PubMed: 36918492
DOI: 10.1007/s13744-023-01031-7 -
Bulletin of the World Health... Apr 2022Preventing noncommunicable diseases is a global priority, for which the World Health Organization has recommended policies to reduce the consumption of tobacco products,...
Preventing noncommunicable diseases is a global priority, for which the World Health Organization has recommended policies to reduce the consumption of tobacco products, alcohol and unhealthy foods. However, regulation has been strongly opposed by affected industries, who have invoked the provisions of legally binding trade and investment agreements. The aim of this analysis of the legal, economic and public health literature was to present a short primer on the relationship between noncommunicable disease prevention policy and trade and investment agreements to help public health policy-makers safeguard public health policies. The analysis identified opportunities for protecting, and even promoting, public health in trade and investment agreements, including: (i) ensuring exceptions for public health measures are included in agreements; (ii) committing to good regulatory practice that balances transparency and cooperation with the need for governments to limit the influence of vested interests; (iii) ensuring trade and investment agreement preambles acknowledge the importance of public health; (iv) excluding investor-state dispute settlement mechanisms from agreements; and (v) limiting the scope and definition of key provisions on investor protection to reduce the risk of investment disputes. This synthesis of the multidisciplinary literature also provides support for greater strategic and informed engagement between the health and trade policy sectors. In addition, ensuring a high level of health protection in trade and investment agreements requires cooperation between disciplines, engagement with experts in law, economics and public health policy, and fully transparent policy processes and governance structures.
Topics: Commerce; Health Policy; Humans; Investments; Noncommunicable Diseases; Public Health; Public Policy
PubMed: 35386551
DOI: 10.2471/BLT.21.287395 -
Frontiers in Public Health 2021In 2018, the government of China decided to develop Hainan Province as the country's first free trade port operating within the country's socialist system. Based on this...
In 2018, the government of China decided to develop Hainan Province as the country's first free trade port operating within the country's socialist system. Based on this strategy, Hainan reformed its medical laws and policies to make it freer and more open. For example, Hainan formulated policies for more rapid and convenient access of foreign medicine and sanitary equipment (MSE), allowed manufacturers to register MSE in China with real-world data (RWD), and provided legal and visa conveniences for international medical teams to carry out various activities, including: diagnosis, treatment and scientific research. Hainan's reforms are not only conducive to the improvement of local medical and public health levels, but also provide opportunities for international MSE manufacturers and medical research institutions swiftly to enter China's huge medical market. However, with opportunity comes risk: Hainan should be on guard against public health risks associated with medical tourism, and decide how to strike a reasonable balance between protecting local MSE enterprises and improving the accessibility of imported MSE through policies and legislation. Finally, the paper recommends that Hainan should improve the regulatory system as soon as possible to ensure the quality of diagnosis and treatment in its new hospitals, and deal with data and information security risks in the RWD research.
Topics: China; Health Care Reform; Policy; Public Health
PubMed: 34869178
DOI: 10.3389/fpubh.2021.764977