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Ciencia & Saude Coletiva May 2019The 1988 Constitution increased the Public Prosecutor's Office attributions and facilitated social participation through management councils in the construction of...
The 1988 Constitution increased the Public Prosecutor's Office attributions and facilitated social participation through management councils in the construction of public policies and in the implementation of social control. In this context, it is necessary to reflect critically on the Public Prosecutor's Office work and its interaction with Health Councils to strengthen social control in the National Unified Health System. We conducted a systematic literature review to identify the national panorama of the relationship between the Public Prosecutor's Office and Health Councils with a view to providing answers on this institution's contributions toward effective social control in the National Unified Health System (SUS). The following databases were consulted: PubMed, BVS, CAPES Journals and BDTD. We included 17 studies, papers and dissertations, which were selected in the period 2006-2015. Results summarize that the Public Prosecutor's Office should focus its activities on health, especially on the operative and extrajudicial matrix, in order to boost popular participation and overcome Health Councils' shortcomings. An essential dialogue between the Public Prosecutor's Office and Health Councils is in place and mutually benefits the strengthening and effectiveness of social control in the SUS.
Topics: Brazil; Humans; Jurisprudence; National Health Programs; Public Policy; Social Control, Formal; Social Participation
PubMed: 31166511
DOI: 10.1590/1413-81232018245.16552017 -
Perspectives in Public Health Mar 2018There is limited evidence on what behavioural economics strategies are effective and can be used to inform non-communicable diseases (NCDs) public health policies... (Review)
Review
AIM
There is limited evidence on what behavioural economics strategies are effective and can be used to inform non-communicable diseases (NCDs) public health policies designed to reduce overeating, excessive drinking, smoking, and physical inactivity. The aim of the review is to examine the evidence on the use and effectiveness of behavioural economics insights on reducing NCDs lifestyle risk factors.
METHODS
Medline, Embase, PsycINFO, and EconLit were searched for studies published between January 2002 and July 2016 and reporting empirical, non-pharmacological, interventional research focusing on reducing at least one NCDs lifestyle risk factor by employing a behavioural economics perspective.
RESULTS
We included 117 studies in the review; 67 studies had a low risk of bias and were classified as strong or very strong, 37 were moderate, and 13 were weak. We grouped studies by NCDs risk factors and conducted a narrative synthesis. The most frequent behavioural economics precepts used were incentives, framing, and choice architecture. We found inconclusive evidence regarding the success of behavioural economics strategies to reduce alcohol consumption, but we identified several strategies with policy-level implications which could be used to reduce smoking, improve nutrition, and increase physical activity.
CONCLUSION
Most studies targeting tobacco consumption, physical activity levels, and eating behaviours from a behavioural economics perspective had promising results with potential impact on NCDs health policies. We recommend future studies to be implemented in real-life settings and on large samples from diverse populations.
Topics: Alcohol Drinking; Diet, Healthy; Economics, Behavioral; Exercise; Health Promotion; Humans; Life Style; Noncommunicable Diseases; Risk Factors; Smoking Prevention
PubMed: 28715989
DOI: 10.1177/1757913917720233 -
Current Nutrition Reports Dec 2019Update the state of evidence on the effectiveness of retail food environment interventions in influencing diet and explore the underlying role of public policy, through...
PURPOSE OF REVIEW
Update the state of evidence on the effectiveness of retail food environment interventions in influencing diet and explore the underlying role of public policy, through a systematic review of population-level interventions to promote health in the retail food environment, including community and consumer environments. Diet-related outcomes included purchasing, dietary intakes, diet quality, and health including weight. We coded studies for enabling public policy levers underpinning the intervention, using two widely used conceptual frameworks.
RECENT FINDINGS
Of 86 articles (1974-2018), the majority (58 articles, 67%) showed at least one positive effect on diet. Thirteen articles (15%) discussed natural experiments, 27 articles (31%) used a design involving comparison groups including 23 articles (27%) specifically describing randomized controlled trials, and 46 (53%) were quasi-experimental (cross-sectional) evaluations. Across the "4Ps" of marketing (product, promotion, placement, and price), promotion comprised the greatest proportion of intervention strategies, especially in earlier literature (pre-2008). Few studies combined geographic access interventions with 4P strategies, and few used robust dietary intake assessments. Behavior change communication remains an intervention mainstay, but recent work has also incorporated environmental and social planning, and fiscal strategies. More recent interventions were multi-component. The retail food environment intervention literature continues to grow and has become more robust overall, with clearer evidence of the effect of interventions on diet-related outcomes, including consumer purchasing, dietary intakes, and health. There is still much scope for development in the field. Attention to enabling public policy could help to strengthen intervention implementation and evaluation in the retail food environment.
Topics: Body Weight; Commerce; Consumer Behavior; Databases, Factual; Diet; Environment; Feeding Behavior; Food; Health Promotion; Humans; Marketing; Public Health; Public Policy
PubMed: 31797233
DOI: 10.1007/s13668-019-00295-z -
Public Health Nutrition Aug 2016Poor dietary intake is the most important behavioural risk factor affecting health globally. Despite this, there has been little investment in public health nutrition... (Review)
Review
OBJECTIVE
Poor dietary intake is the most important behavioural risk factor affecting health globally. Despite this, there has been little investment in public health nutrition policy actions. Policy process theories from the field of political science can aid understanding why policy decisions have occurred and identify how to influence ongoing or future initiatives. The present review aims to examine public health nutrition policy literature and identify whether a policy process theory has been used to analyse the process.
DESIGN
Electronic databases were searched systematically for studies examining policy making in public health nutrition in high-income, democratic countries.
SETTING
International, national, state and local government jurisdictions within high-income, democratic countries.
SUBJECTS
Individuals and organisations involved in the nutrition policy-making process.
RESULTS
Sixty-three studies met the eligibility criteria, most were conducted in the USA and a majority focused on obesity. The analysis demonstrates an accelerating trend in the number of nutrition policy papers published annually and an increase in the diversity of nutrition topics examined. The use of policy process theory was observed from 2003; however, it was utilised by only 14 % of the reviewed papers.
CONCLUSIONS
There is limited research into the nutrition policy process in high-income countries. While there has been a small increase in the use of policy process theory from 2003, an opportunity to expand its use is evident. We suggest that nutrition policy making would benefit from a pragmatic approach that ensures those trying to influence or understand the policy-making process are equipped with basic knowledge around these theories.
Topics: Humans; Nutrition Policy; Nutritional Status; Policy Making; Politics; Public Health
PubMed: 26443533
DOI: 10.1017/S1368980015002712 -
Health Policy and Planning Jul 2020Because health systems are conceptualized as social systems, embedded in social contexts and shaped by human agency, values are a key factor in health system change. As...
Because health systems are conceptualized as social systems, embedded in social contexts and shaped by human agency, values are a key factor in health system change. As such, health systems software-including values, norms, ideas and relationships-is considered a foundational focus of the field of health policy and systems research (HPSR). A substantive evidence-base exploring the influence of software factors on system functioning has developed but remains fragmented, with a lack of conceptual clarity and theoretical coherence. This is especially true for work on 'social values' within health systems-for which there is currently no substantive review available. This study reports on a systematic mixed-methods evidence mapping review on social values within HPSR. The study reaffirms the centrality of social values within HPSR and highlights significant evidence gaps. Research on social values in low- and middle-income country contexts is exceedingly rare (and mostly produced by authors in high-income countries), particularly within the limited body of empirical studies on the subject. In addition, few HPS researchers are drawing on available social science methodologies that would enable more in-depth empirical work on social values. This combination (over-representation of high-income country perspectives and little empirical work) suggests that the field of HPSR is at risk of developing theoretical foundations that are not supported by empirical evidence nor broadly generalizable. Strategies for future work on social values in HPSR are suggested, including: countering pervasive ideas about research hierarchies that prize positivist paradigms and systems hardware-focused studies as more rigorous and relevant to policy-makers; utilizing available social science theories and methodologies; conceptual development to build common framings of key concepts to guide future research, founded on quality empirical research from diverse contexts; and using empirical evidence to inform the development of operationalizable frameworks that will support rigorous future research on social values in health systems.
Topics: Developing Countries; Empirical Research; Health Policy; Health Services; Health Services Research; Humans; Social Values
PubMed: 32374881
DOI: 10.1093/heapol/czaa038 -
Annual Review of Public Health 2006The systematic review "movement" that has transformed medical journal reports of clinical trials and reviews of clinical trials has taken hold in public health, with the... (Review)
Review
The systematic review "movement" that has transformed medical journal reports of clinical trials and reviews of clinical trials has taken hold in public health, with the most recent milestone, the publication of the first edition of The Guide to Community Health Services in 2005. In this paper we define and distinguish current terms, point out important resources for systematic reviews, describe the impact of systematic review on the quality of primary studies and summaries of the evidence, and provide perspectives on the promise of systematic reviews for shaping the agenda for public health research. Several pitfalls are discussed, including a false sense of rigor implied by the terms "systematic review" and "meta-analysis" and substantial variation in the validity of claims that a particular intervention is "evidence based," and the difficulty of translating conclusions from systematic reviews into public health advocacy and practice.
Topics: Evidence-Based Medicine; Health Knowledge, Attitudes, Practice; Health Policy; Humans; Journalism, Medical; Meta-Analysis as Topic; Public Health; Public Health Practice; Review Literature as Topic; United States
PubMed: 16533110
DOI: 10.1146/annurev.publhealth.27.021405.102239 -
Journal of Urban Health : Bulletin of... Jun 2020Global initiatives have raised awareness of the need for cross-departmental and cross-sectoral activities to support urban health, sustainability, and equity, with...
Global initiatives have raised awareness of the need for cross-departmental and cross-sectoral activities to support urban health, sustainability, and equity, with respective indicators routinely used as a way to catalyze and monitor action toward pre-defined goals. Despite the existence of at least 145 urban health indicator (UHI) tools globally, there has been very little research on the use of indicators by policy- and decision-makers; more attention has been devoted to their development and validation. This paper describes the second part of a two-part systematic review of the characteristics (part A) and use (part B, this part) of UHI tools by municipal built environment policy- and decision-makers. Part B is a narrative synthesis of studies on the use of UHI tools. This PRISMA-P compliant review follows a mixed methods sequential explanatory design. The search was conducted using seven bibliographic databases, grey literature searches, and key journal hand searches. Ten studies describing the use of ten UHI tools in seven countries were included in the narrative synthesis, resulting in development of a theory of change (ToC). We found that both expert-led and participatory indicator projects can be underpinned by research evidence and residents' knowledge. Our findings contradict the dominant view of indicator use in policy-making as a linear process, highlighting a number of technical, organizational, political, knowledge, and contextual factors that affect their use. Participatory UHI tools with community involvement were generally more effective at supporting "health in all policies" and "whole-of-society" approaches to governing healthy cities than expert-led processes. UHI tool producers proposed a range of techniques to address urban health complexity characteristics. Finally, in combining data from both parts of the review, we found that potentially important UHI tool features, such as neighbourhood-scale data, were influential in the use of indicators by built environment policy- and decision-makers.
Topics: Built Environment; City Planning; Health Status Indicators; Humans; Policy Making; Public Policy; Urban Health
PubMed: 31482385
DOI: 10.1007/s11524-019-00378-w -
The Pan African Medical Journal 2017There is a need for interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Implementation of physical activity (PA) within the... (Review)
Review
INTRODUCTION
There is a need for interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Implementation of physical activity (PA) within the rehabilitation of people with mental health problems (PMHP) could reduce the burden and facilitate recovery. The objective of the current review was to explore (1) the role of PA within mental health policies of SSA countries, and (2) the current research evidence for PA to improve mental health in SSA.
METHODS
We screened the Mental Health Atlas and MiNDbank for mental health policies in SSA countries and searched PubMed for relevant studies on PA in PMHP in SSA.
RESULTS
Sixty-nine percent (=33/48) of SSA countries have a dedicated mental health policy. Two of 22 screened mental health policies included broad physical activity recommendations. There is clear evidence for the role of PA in the prevention and rehabilitation of depression in SSA.
CONCLUSION
Despite the existing evidence, PA is largely a neglected rehabilitation modality in the mental health care systems of SSA. Continued education of existing staff, training of specialized professionals and integration of PA for mental health in public health awareness programs are needed to initiate and improve PA programs within the mental health care systems of SSA.
Topics: Africa South of the Sahara; Depression; Exercise; Health Policy; Humans; Mental Disorders; Mental Health; Mental Health Services
PubMed: 28491235
DOI: 10.11604/pamj.2017.26.104.10051 -
American Journal of Public Health Jan 2017The production of systematic reviews is increasing, but their credibility is under threat. Although systematic reviews are an important tool for policymaking, their... (Review)
Review
The production of systematic reviews is increasing, but their credibility is under threat. Although systematic reviews are an important tool for policymaking, their influence can be weakened by methodological problems and poor policy relevance. Using Cochrane as an example, I address standards for systematic reviews, the influence of special interests on these reviews, and ways to increase their relevance for policymakers.
Topics: Evidence-Based Medicine; Health Policy; Humans; Policy Making; Research Design; Review Literature as Topic
PubMed: 27854519
DOI: 10.2105/AJPH.2016.303518 -
Implementation Science : IS Apr 2017Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media... (Review)
Review
INTRODUCTION
Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media interventions-including social media-on the health policy-making process.
METHODS
Eligible study designs included randomized and non-randomized designs, economic studies, process evaluation studies, stakeholder analyses, qualitative methods, and case studies. We electronically searched Medline, EMBASE, Communication and Mass Media Complete, Cochrane Central Register of Controlled Trials, and the WHO Global Health Library. We followed standard systematic review methodology for study selection, data abstraction, and risk of bias assessment.
RESULTS
Twenty-one studies met our eligibility criteria: 10 evaluation studies using either quantitative (n = 7) or qualitative (n = 3) designs and 11 case studies. None of the evaluation studies were on social media. The findings of the evaluation studies suggest that media interventions may have a positive impact when used as accountability tools leading to prioritizing and initiating policy discussions, as tools to increase policymakers' awareness, as tools to influence policy formulation, as awareness tools leading to policy adoption, and as awareness tools to improve compliance with laws and regulations. In one study, media-generated attention had a negative effect on policy advocacy as it mobilized opponents who defeated the passage of the bills that the media intervention advocated for. We judged the confidence in the available evidence as limited due to the risk of bias in the included studies and the indirectness of the evidence.
CONCLUSION
There is currently a lack of reliable evidence to guide decisions on the use of media interventions to influence health policy-making. Additional and better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and the circumstances under which media interventions are successful.
TRIAL REGISTRATION
PROSPERO 2015: CRD42015020243.
Topics: Health Policy; Humans; Mass Media; Policy Making; Social Media
PubMed: 28420401
DOI: 10.1186/s13012-017-0581-0