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Health Research Policy and Systems Oct 2017In order to understand and measure the policy impact of research we need a definition of research impact that is suited to the task. This article systematically reviewed... (Review)
Review
BACKGROUND
In order to understand and measure the policy impact of research we need a definition of research impact that is suited to the task. This article systematically reviewed both peer-reviewed and grey literature for definitions of research impact to develop a definition of research impact that can be used to investigate how public health research influences policy.
METHOD
Keyword searches of the electronic databases Web of Science, ProQuest, PubMed, EMBASE, CINAHL, Informit, PsycINFO, The Cochrane Database of Systematic Reviews and Google Scholar were conducted between August 2015 and April 2016. Keywords included 'definition' and 'policy' and 'research impact' or 'research evidence'. The search terms 'health', public health' or 'mental health' and 'knowledge transfer' or 'research translation' were used to focus the search on relevant health discipline approaches. Studies included in the review described processes, theories or frameworks associated with public health, health services or mental health policy.
RESULTS
We identified 108 definitions in 83 publications. The key findings were that literature on research impact is growing, but only 23% of peer-reviewed publications on the topic explicitly defined the term and that the majority (76%) of definitions were derived from research organisations and funding institutions. We identified four main types of definition, namely (1) definitions that conceptualise research impacts in terms of positive changes or effects that evidence can bring about when transferred into policies (example Research Excellence Framework definition), (2) definitions that interpret research impacts as measurable outcomes (Research Councils UK), and (3) bibliometric and (4) use-based definitions. We identified four constructs underpinning these definitions that related to concepts of contribution, change, avenues and levels of impact.
CONCLUSION
The dominance of bureaucratic definitions, the tendency to discuss but not define the concept of research impact, and the heterogeneity of definitions confirm the need for conceptual clarity in this area. We propose a working definition of research impact that can be used in a range of health policy contexts.
Topics: Health Policy; Health Services; Humans; Peer Review, Health Care; Public Health; Serial Publications
PubMed: 28969650
DOI: 10.1186/s12961-017-0247-z -
Implementation Science : IS Nov 2017It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve... (Review)
Review
BACKGROUND
It is widely acknowledged that health policy and management decisions rarely reflect research evidence. Therefore, it is important to determine how to improve evidence-informed decision-making. The primary aim of this systematic review was to evaluate the effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The secondary aim of the review was to describe factors perceived to be associated with effective strategies and the inter-relationship between these factors.
METHODS
An electronic search was developed to identify studies published between January 01, 2000, and February 02, 2016. This was supplemented by checking the reference list of included articles, systematic reviews, and hand-searching publication lists from prominent authors. Two reviewers independently screened studies for inclusion, assessed methodological quality, and extracted data.
RESULTS
After duplicate removal, the search strategy identified 3830 titles. Following title and abstract screening, 96 full-text articles were reviewed, of which 19 studies (21 articles) met all inclusion criteria. Three studies were included in the narrative synthesis, finding policy briefs including expert opinion might affect intended actions, and intentions persisting to actions for public health policy in developing nations. Workshops, ongoing technical assistance, and distribution of instructional digital materials may improve knowledge and skills around evidence-informed decision-making in US public health departments. Tailored, targeted messages were more effective in increasing public health policies and programs in Canadian public health departments compared to messages and a knowledge broker. Sixteen studies (18 articles) were included in the thematic synthesis, leading to a conceptualisation of inter-relating factors perceived to be associated with effective research implementation strategies. A unidirectional, hierarchal flow was described from (1) establishing an imperative for practice change, (2) building trust between implementation stakeholders and (3) developing a shared vision, to (4) actioning change mechanisms. This was underpinned by the (5) employment of effective communication strategies and (6) provision of resources to support change.
CONCLUSIONS
Evidence is developing to support the use of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare. The design of future implementation strategies should be based on the inter-relating factors perceived to be associated with effective strategies.
TRIAL REGISTRATION
This systematic review was registered with Prospero (record number: 42016032947).
Topics: Canada; Communication; Decision Making; Evidence-Based Practice; Health Policy; Humans; Leadership; Organizational Innovation; Policy Making; Public Health Administration; Trust; United States
PubMed: 29137659
DOI: 10.1186/s13012-017-0662-0 -
International Journal of Environmental... Jan 2022Active ageing is defined as the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. The design...
Active ageing is defined as the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. The design of active ageing policies intersects with different overarching societal challenges, especially ageing populations, social rights and sustainability. However, there are no previous attempts to review active ageing policies in the light of these challenges and the international policy objectives and targets that are guiding the international community. The aim of this study is to systematically identify, review and analyse all national and regional policies on active ageing adopted in Italy, by applying a conceptual framework derived from main international policy initiatives in the three areas. The research was conducted in two stages. First, a case study analysis was carried out per each relevant national institution and regional government. Standardised interviews were combined with policy document search, selection and analysis. Second, we performed a policy analysis in the light of a conceptual framework adopted. This latter was composed by nine policy domains, selected and integrated from principles and objectives of three overarching international frameworks on ageing-i.e., the Regional Implementation Strategy (RIS) commitments of the Madrid International Plan of Action on Ageing (MIPAA), social rights-i.e., the European Pillar of Social Rights and sustainability-i.e., the Sustainable Development Goals (SDGs) of the Agenda 2030 for Sustainable Development. Results pointed out that out of the identified nine policy fields, the major intervention areas by Italian policy makers concerned labour market participation, life-long learning, social and economic inequalities, health and well-being. Less attention had been given to issues such as gender and equal opportunities and sustainable cities. This systematic policy review is a milestone for understanding how active ageing policies contribute to address major societal challenges and what domains need further policy development.
Topics: Aging; Humans; Italy; Public Policy; Quality of Life; Sustainable Development
PubMed: 35010853
DOI: 10.3390/ijerph19010600 -
BMC Psychiatry May 2018Mental 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...
BACKGROUND
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).
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
Topics: Budgets; Developed Countries; Developing Countries; Global Health; Health Policy; Humans; Income; Mental Health; Policy Making
PubMed: 29776356
DOI: 10.1186/s12888-018-1711-1 -
Midwifery Aug 2022Policy implementation can be affected by what individuals believe to be right and wrong. When implementing abortion policies, providers' moral beliefs can be relevant in... (Review)
Review
INTRODUCTION
Policy implementation can be affected by what individuals believe to be right and wrong. When implementing abortion policies, providers' moral beliefs can be relevant in the success of the implementation process. Considering that midwives and nurses are direct providers of abortion care, exploring their experiences related to abortion policy implementation could provide helpful information to prevent policy failure.
METHODS
Systematic integrative review. The studies were identified through an electronic search strategy and the screening of the reference lists of all selected articles. Studies were retrieved from eight medical and social sciences databases. Thirty-one studies focused on midwives' and nurses' experiences of implementing abortion policies, irrespective of setting or age of study were included in this review. Studies included used qualitative, quantitative and mixed methods. Study quality was appraised using the Mixed Method Appraisal Tool version 2018. No study was excluded from this review based on its quality appraisal.
RESULTS
In terms of their quality, most studies included in this review were conducted appropriately. Three superordinate themes represent the main elements that challenge midwives and nurses when providing abortion care. The first superordinate theme identified that many midwives and nurses believed fetuses are sentient beings, making them worthy of compassionate treatment. The next superordinate theme was focused on preferences and expectations about abortion care. Finally, the third superordinate theme illustrates midwives' and nurses' experiences with other team members, highlights their creativity when challenged with insufficient resources and provides a glimpse of the numerous techniques used for coping with work-related stress.
CONCLUSION
Midwives and nurses worldwide face multiple challenges when providing abortion care. Guidelines aiming to support policy implementation should consider how abortion affects healthcare providers and suggest appropriate measures to reduce these and other barriers. Midwives and nurses technical and ethical competencies for abortion provision should be strengthened.
Topics: Abortion, Induced; Attitude of Health Personnel; Female; Health Personnel; Humans; Midwifery; Nurses; Policy; Pregnancy; Qualitative Research
PubMed: 35613486
DOI: 10.1016/j.midw.2022.103363 -
BMJ Open Jul 2014Pharmaceutical company representatives likely influence the prescribing habits and professional behaviour of physicians. (Review)
Review
BACKGROUND
Pharmaceutical company representatives likely influence the prescribing habits and professional behaviour of physicians.
OBJECTIVE
The objective of this study was to systematically review the effects of interventions targeting practising physicians' interactions with pharmaceutical companies.
ELIGIBILITY CRITERIA
We included observational studies, non-randomised controlled trials (non-RCTs) and RCTs evaluating legislative, educational, policy or other interventions targeting the interactions between physicians and pharmaceutical companies.
DATA SOURCES
The search strategy included an electronic search of MEDLINE and EMBASE. Two reviewers performed duplicate and independent study selection, data abstraction and assessment of risk of bias.
APPRAISAL AND SYNTHESIS METHODS
We assessed the risk of bias in each included study. We summarised the findings narratively because the nature of the data did not allow a meta-analysis to be conducted. We assessed the quality of evidence by outcome using the GRADE methodology.
RESULTS
Of 11 189 identified citations, one RCT and three observational studies met the eligibility criteria. All four studies specifically targeted one type of interaction with pharmaceutical companies, that is, interactions with drug representatives. The RCT provided moderate quality evidence of no effect of a 'collaborative approach' between the pharmaceutical industry and a health authority. The three observational studies provided low quality evidence suggesting a positive effect of policies aiming to reduce interaction between physicians and pharmaceutical companies (by restricting free samples, promotional material, and meetings with pharmaceutical company representatives) on prescription behaviour.
LIMITATIONS
We identified too few studies to allow strong conclusions.
CONCLUSIONS
Available evidence suggests a potential impact of policies aiming to reduce interaction between physicians and drug representatives on physicians' prescription behaviour. We found no evidence concerning interventions affecting other types of interaction with pharmaceutical companies.
Topics: Drug Industry; Interprofessional Relations; Physicians; Policy
PubMed: 24989618
DOI: 10.1136/bmjopen-2014-004880 -
Journal of American College Health : J... 2015Systematically review studies of support for, and effectiveness of, university campuses' smoke-free policies. (Review)
Review
OBJECTIVE
Systematically review studies of support for, and effectiveness of, university campuses' smoke-free policies.
PARTICIPANTS/METHODS
A search was carried out for studies in English related to campus smoking bans through June 2013. Eligible studies had outcomes for student or faculty attitudes, or measures of smoking prevalence or secondhand smoke (SHS) exposure.
RESULTS
Nineteen eligible studies were identified, 18 from the United States and 1 from the United Kingdom. A meta-analysis found 58.94% (95% confidence interval [CI] [52.35%, 65.53%]) of students (12 studies) and 68.39% (95% CI [65.12%, 71.67%]) of faculty (7 studies) supported smoke-free policies. Both studies measuring student smoking prevalence indicated a postban reduction (16.5% to 12.8% after 1 year [p < .001] and 9.5% to 7.0% [p = .036] after 3 years). Only 5% of UK universities were smoke-free compared with 25% of US universities.
CONCLUSIONS
A majority of students and faculty support smoke-free campus policies, which may reduce smoking and SHS exposure.
Topics: Attitude; Humans; Organizational Policy; Prevalence; Program Evaluation; Smoke-Free Policy; Students; United States; Universities
PubMed: 25692536
DOI: 10.1080/07448481.2015.1015029 -
Health Research Policy and Systems Oct 2022The health research system (HRS) is an important national priority that requires a systematic and functional approach. Evaluating the HRS of Iran as a developing country...
BACKGROUND
The health research system (HRS) is an important national priority that requires a systematic and functional approach. Evaluating the HRS of Iran as a developing country and identifying its challenges reveals the stewardship-related role in how the whole system is operating well. This study aims to assess the HRS in terms of stewardship functions and highlight the enhancement points.
METHODS
This study was carried out between March 2020 and April 2021 using a systematic review and meta-synthesis of evidence to examine the Iranian HRS stewardship challenges and interview 32 stakeholders, using a critical case sampling and snowballing approach which included both semi-structured and in-depth interviews. The interviewees were selected based on criteria covering policy-makers, managers, research bodies and nongovernmental organizations (NGOs) in health research-related fields like higher education, research, technology, innovation and science. All data were analysed using content analysis to determine eight main groups of findings under three levels: macro, meso, and micro.
RESULTS
Analysis of the findings identified eight main themes. The most critical challenges were the lack of an integrated leadership model and a shared vision among different HRS stakeholders. Their scope and activities were often contradictory, and their role was not clarified in a predetermined big picture. The other challenges were legislation, priority-setting, monitoring and evaluation, networking, and using evidence as a decision support base.
CONCLUSIONS
Stewardship functions are not appropriately performed and are considered the root causes of many other HRS challenges in Iran. Formulating a clear shared vision and a work scope for HRS actors is critical, along with integrating all efforts towards a unified strategy that assists in addressing many challenges of HRS, including developing strategic plans and future-oriented and systematic research, and evaluating performance. Policy-makers and senior managers need to embrace and use evidence, and effective networking and communication mechanisms among stakeholders need to be enhanced. An effective HRS can be achieved by redesigning the processes, regulations and rules to promote transparency and accountability within a well-organized and systematic framework.
Topics: Humans; Iran; Developing Countries; Government Programs; Qualitative Research; Policy; Health Policy
PubMed: 36307850
DOI: 10.1186/s12961-022-00905-3 -
Expert Review of Vaccines Mar 2022Numerous analyses demonstrate substantial health-economic impacts of primary vaccine effects (preventing or mitigating clinical manifestations of the diseases they...
INTRODUCTION
Numerous analyses demonstrate substantial health-economic impacts of primary vaccine effects (preventing or mitigating clinical manifestations of the diseases they target), but vaccines may also be associated with secondary effects, previously known as nonspecific, heterologous, or off-target effects.
AREAS COVERED
We define key concepts to distinguish primary and secondary vaccine effects for health economic analyses, summarized terminology used in different fields, and perform a systematic review of health economic analyses focused on secondary vaccine effects (SVEs).
EXPERT OPINION
Health economists integrate evidence from multiple fields, which often use incomplete or inconsistent definitions. Like regulators and policy makers, health economists require high-quality evidence of specific effects. Consistent with the limited evidence on mechanisms of action for SVEs, the associated health economic literature remains highly limited, with 4 studies identified by our systematic review. The lack of specific and well-controlled evidence that supports quantification of specific SVEs limits the consideration of these effects in vaccine research, development, regulatory, and recommendation decisions and health economic analyses.
Topics: Cost-Benefit Analysis; Health Policy; Humans; Immunization, Secondary; Policy; Vaccines
PubMed: 34927511
DOI: 10.1080/14760584.2022.2017287 -
Human Resources For Health Oct 2023The COVID-19 pandemic highlighted pre-existing weaknesses in health and care systems and services and shortages of health and care workers (HCWs). As a result,...
BACKGROUND
The COVID-19 pandemic highlighted pre-existing weaknesses in health and care systems and services and shortages of health and care workers (HCWs). As a result, policymakers needed to adopt measures to improve the health and care workforce (HCWF) capacity. This review aims to identify countries' range of policies and management interventions implemented to improve HCWs' capacity to address the COVID-19 pandemic response, synthesize their evidence on effectiveness, and identify gaps in the evidence.
METHODS
The literature was searched in PubMed, Embase, Scopus, LILACS-BVS, WHO's COVID-19 Research Database and the ILO, OECD and HSRM websites for literature and documents published between January 2020 and March 2022. Eligibility criteria were HCWs as participants and policy and management interventions aiming to improve HCWF capacity to address the COVID-19 pandemic response. Risk of bias was assessed with Joanna Briggs Institute (JBI) Critical Appraisal Tools (CAT) and certainty of the evidence in presented outcomes with GRADE.
RESULTS
The searches retrieved 3378 documents. A total of 69 were included, but only 8 presented outcomes of interventions implemented. Most of the selected documents described at least one intervention implemented by countries at the organizational environment level to increase the flexibility and capacity of the HCWF to respond to the pandemic, followed by interventions to attract and retain HCWs in safe and decent working environments. There was a lack of studies addressing social protection, human resources for health information systems, and regarding the role of community health workers and other community-based providers. Regarding the risk of bias, most of documents were rated as medium or high quality (JBI's CAT), while the evidence presented for the outcomes of interventions was classified as mostly low-certainty evidence (GRADE).
CONCLUSIONS
Countries have implemented various interventions, some innovative, in response to the pandemic, and others had their processes started earlier and accelerated by the pandemic. The evidence regarding the impact and efficacy of the strategies used by countries during the pandemic still requires further research.
Topics: Humans; COVID-19; Pandemics; Health Personnel; Policy; Workforce
PubMed: 37817165
DOI: 10.1186/s12960-023-00856-y