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AIDS and Behavior Dec 2017One of the four national HIV prevention goals is to incorporate combinations of effective, evidence-based approaches to prevent HIV infection. In fields of public... (Review)
Review
One of the four national HIV prevention goals is to incorporate combinations of effective, evidence-based approaches to prevent HIV infection. In fields of public health, techniques that alter environment and affect choice options are effective. Structural approaches may be effective in preventing HIV infection. Existing frameworks for structural interventions were lacking in breadth and/or depth. We conducted a systematic review and searched CDC's HIV/AIDS Prevention Research Synthesis Project's database for relevant interventions during 1988-2013. We used an iterative process to develop the taxonomy. We identified 213 structural interventions: Access (65%), Policy/Procedure (32%), Mass Media (29%), Physical Structure (27%), Capacity Building (24%), Community Mobilization (9%), and Social Determinants of Health (8%). Forty percent targeted high-risk populations (e.g., people who inject drugs [12%]). This paper describes a comprehensive, well-defined taxonomy of structural interventions with 7 categories and 20 subcategories. The taxonomy accommodated all interventions identified.
Topics: Capacity Building; Centers for Disease Control and Prevention, U.S.; HIV Infections; Health Policy; Humans; Public Health; Social Determinants of Health; United States
PubMed: 29159594
DOI: 10.1007/s10461-017-1965-5 -
Prevention Science : the Official... Feb 2018Problems related to high levels of gaming and Internet usage are increasingly recognized as a potential public health burden across the developed world. The aim of this...
Problems related to high levels of gaming and Internet usage are increasingly recognized as a potential public health burden across the developed world. The aim of this review was to present an international perspective on prevention strategies for Internet gaming disorder and related health conditions (e.g., Internet addiction), as well as hazardous gaming and Internet use. A systematic review of quantitative research evidence was conducted, followed by a search of governmental reports, policy and position statements, and health guidelines in the last decade. The regional scope included the USA, UK, Australia, China, Germany, Japan, and South Korea. Prevention studies have mainly involved school-based programs to train healthier Internet use habits in adolescents. The efficacy of selective prevention is promising but warrants further empirical attention. On an international scale, the formal recognition of gaming or Internet use as a disorder or as having quantifiable harms at certain levels of usage has been foundational to developing structured prevention responses. The South Korean model, in particular, is an exemplar of a coordinated response to a public health threat, with extensive government initiatives and long-term strategic plans at all three levels of prevention (i.e., universal, selective, and indicated). Western regions, by comparison, are dominated by prevention approaches led by non-profit organizations and private enterprise. The future of prevention of gaming and Internet problems ultimately relies upon all stakeholders working collaboratively in the public interest, confronting the reality of the evidence base and developing practical, ethical, and sustainable countermeasures.
Topics: Behavior, Addictive; Child; Developed Countries; Diagnostic and Statistical Manual of Mental Disorders; Female; Health Policy; Humans; Internationality; Internet; Male; Public Health; Video Games
PubMed: 28677089
DOI: 10.1007/s11121-017-0813-1 -
Perspectives in Public Health Mar 2012There is no evidence that previous Olympic Games have raised physical activity levels in adult populations. However, it may be premature to assume that this lack of... (Review)
Review
AIMS
There is no evidence that previous Olympic Games have raised physical activity levels in adult populations. However, it may be premature to assume that this lack of previous evidence for an inherent effect is an indication that there is no potential to proactively harness the Games to generate a physical activity or sport legacy. Given that the political goal of achieving a physical activity legacy had already been set, the policy-led aim of this systematic review was to examine the processes by which the London 2012 Olympic and Paralympic Games might deliver a physical activity (as opposed to sport) legacy.
METHODS
Searches were conducted on five databases: SPORTS DISCUS, CINAHL, PsychLNFO, MEDLINE and Web of Knowledge.
RESULTS
There are two key findings: first, that communities that are not positively engaged with hosting the 2012 Games in London are likely to be beyond the reach of any initiatives seeking to harness the Games to develop legacies in any area; second, major events such as London 2012 can, if promoted in the right way, generate a 'festival effect' that may have the potential to be harnessed to promote physical activity among the least active. The 'festival effect' derives from the promotion of the 2012 Games as a national festival that is bigger than and beyond sport, but that is also rooted in the lives of local and cultural communities, thus creating a strong desire to participate in some way in an event that is both nationally significant and locally or culturally relevant.
CONCLUSIONS
Physical activity policy makers and professionals should seek to satisfy this desire to participate through providing physical activity (rather than sport) opportunities presented as fun community events or programmes. The key to generating a physical activity legacy among the least active adults through this process is to de-emphasise the sporting element of the 2012 Games and promote the festival element.
Topics: Exercise; Health Policy; Holidays; Humans; London; Public Health; Sports
PubMed: 22616427
DOI: 10.1177/1757913911435758 -
Environmental Health : a Global Access... Jan 2011Continuous exposure to many chemicals, including through air, water, food, or other media and products results in health impacts which have been well assessed, however... (Review)
Review
BACKGROUND
Continuous exposure to many chemicals, including through air, water, food, or other media and products results in health impacts which have been well assessed, however little is known about the total disease burden related to chemicals. This is important to know for overall policy actions and priorities. In this article the known burden related to selected chemicals or their mixtures, main data gaps, and the link to public health policy are reviewed.
METHODS
A systematic review of the literature for global burden of disease estimates from chemicals was conducted. Global disease due to chemicals was estimated using standard methodology of the Global Burden of Disease.
RESULTS
In total, 4.9 million deaths (8.3% of total) and 86 million Disability-Adjusted Life Years (DALYs) (5.7% of total) were attributable to environmental exposure and management of selected chemicals in 2004. The largest contributors include indoor smoke from solid fuel use, outdoor air pollution and second-hand smoke, with 2.0, 1.2 and 0.6 million deaths annually. These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively.
CONCLUSIONS
The known burden due to chemicals is considerable. This information supports decision-making in programmes having a role to play in reducing human exposure to toxic chemicals. These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden. Chemicals with known health effects, such as dioxins, cadmium, mercury or chronic exposure to pesticides could not be included in this article due to incomplete data and information. Effective public health interventions are known to manage chemicals and limit their public health impacts and should be implemented at national and international levels.
Topics: Disease; Environmental Pollutants; Environmental Pollution; Epidemiology; Humans; Mortality; Occupational Exposure; Public Health; Public Policy; Risk Assessment
PubMed: 21255392
DOI: 10.1186/1476-069X-10-9 -
Health Research Policy and Systems Mar 2015Burden of disease (BoD) studies have been conducted in numerous international settings since the early 1990's. Two national BoD studies have been undertaken in... (Review)
Review
BACKGROUND
Burden of disease (BoD) studies have been conducted in numerous international settings since the early 1990's. Two national BoD studies have been undertaken in Australia, in 1998 and 2003, although neither study estimated the BoD specifically for Indigenous Australians. In 2005 the Australian Government Department of Health and Ageing Office for Aboriginal and Torres Strait Islander Health formally commissioned the University of Queensland to undertake, in parallel with the second national BoD study, the "Burden of Disease and Injury in Aboriginal and Torres Strait Islander Peoples" study, drawing on available data up to 2003. This paper aims to explore the policy context and narrative in the lead up to commissioning the Indigenous BoD (IBoD) study, focusing on relevant contextual factors and insights regarding the perspectives of key stakeholders and their anticipated value of the study. It is part of a broader project that examines the uptake of evidence to policy, using the IBoD study as a case study.
METHODS
A systematic review of the literature was undertaken in late 2013 and early 2014, and the findings triangulated with 38 key informant interviews with Indigenous and non-Indigenous academics, researchers, statisticians, policy advisors, and policymakers, conducted between 2011 and 2013.
FINDINGS
Contextual features which led to commissioning the IBoD study included widespread recognition of longstanding Indigenous disadvantage, lower life expectancy than non-Indigenous Australians, and the lack of an adequate evidence base upon which to determine priorities for interventions. Several anticipated benefits and expectations of key stakeholders were identified. Most informants held at least one of the following expectations of the study: that it would inform the evidence base, contribute to priority setting, and/or inform policy. There were differing or entirely contrasting views to this however, with some sharing concerns about the study being undertaken at all.
CONCLUSIONS
The IBoD study, in concept, offered the potential to generate much desired 'answers', in the form of a quantified ranking of health risks and disease burden, and it was hoped by many that the results of the study would feed into determining priorities and informing Indigenous health policy.
Topics: Australia; Cost of Illness; Health Policy; Humans; Interviews as Topic; Native Hawaiian or Other Pacific Islander; Research
PubMed: 25890380
DOI: 10.1186/s12961-015-0004-0 -
Journal of Public Health Policy Dec 2020A policy proposal to ban public housing smoking indoors has received support, but it is unclear how certain affected groups, specifically smokers in housing units,...
A policy proposal to ban public housing smoking indoors has received support, but it is unclear how certain affected groups, specifically smokers in housing units, perceive such a policy. To review the literature on attitudes and perceptions of housing unit tenants towards an indoor smoke-free housing policy, using various databases, we searched articles for attitudes towards smoking ban enforcement in housing units. We identified fourteen articles. Non-smokers heavily favored indoor policies and current smokers heavily opposed them. Current smokers represented a substantial minority in the reviewed articles, resulting in overall outcomes of the surveys driven by non-smokers. Studies investigating attitudes about housing smoking bans largely represent the views of non-smokers and lack data about barriers and concerns of tenants who do not support a smoke-free policy. Future studies should investigate if such a discrepancy impacts the efficacy of smoke-free housing policies.
Topics: Attitude; Housing; Humans; Public Housing; Smoke-Free Policy; Surveys and Questionnaires; Tobacco Smoke Pollution
PubMed: 32620837
DOI: 10.1057/s41271-020-00236-z -
Trauma, Violence & Abuse Apr 2024Community management policies for individuals convicted of sexual offenses (ICSO) are controversial, mainly because the effectiveness of these policies in reducing... (Meta-Analysis)
Meta-Analysis Review
Community management policies for individuals convicted of sexual offenses (ICSO) are controversial, mainly because the effectiveness of these policies in reducing recidivism is limited and appear to have some collateral effects. Despite this, the current meta-analysis found the public highly support these policies. Studies examining public perceptions regarding community management policies for ICSO to understand levels of support, misconceptions about the policies, and factors affecting the views of the public were reviewed. After searching 7 electronic databases, 43 studies, both quantitative and qualitative, were included in the systematic review and 31 in the meta-analysis. Studies could be longitudinal or cross-sectional, needed to include public attitudes, opinions, and perceptions about ICSO community management policies and could include standardized or non-standardized measures, indirect assessments of attitudes, along with interviews and focus groups. Results suggest that overall, policies were supported by 76% of the public, 61% believed in their effectiveness, and 63% felt safer because of the policies. However, only 36% accessed the registry, 38% took preventive actions, and 40% were aware/concerned about the collateral consequences. All analyses yielded high levels of heterogeneity. Misconceptions about policies and ICSO were moderate. Finally, 36 studies explored factors that affected the public's attitudes and perceptions of policies with a variety of significant associations and predictors. The findings provide comprehensive evidence that while these policies are supported by the public, the public have less belief in the effectiveness of them in protecting children and reducing recidivism. Implications for public policy and future research are discussed.
Topics: Humans; Attitude; Cross-Sectional Studies; Public Opinion; Public Policy; Sex Offenses
PubMed: 37199477
DOI: 10.1177/15248380231174695 -
The Milbank Quarterly Jun 2015POLICY POINTS: Many barriers hamper advocacy for health equity, including the contemporary economic zeitgeist, the biomedical health perspective, and difficulties... (Review)
Review
UNLABELLED
POLICY POINTS: Many barriers hamper advocacy for health equity, including the contemporary economic zeitgeist, the biomedical health perspective, and difficulties cooperating across policy sectors on the issue. Effective advocacy should include persistent efforts to raise awareness and understanding of the social determinants of health. Education on the social determinants as part of medical training should be encouraged, including professional training within disadvantaged communities. Advocacy organizations have a central role in advocating for health equity given the challenges bridging the worlds of civil society, research, and policy.
CONTEXT
Health inequalities are systematic differences in health among social groups that are caused by unequal exposure to-and distributions of-the social determinants of health (SDH). They are persistent between and within countries despite action to reduce them. Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts.
METHODS
This article is a systematic review of the academic literature and a fixed-length systematic search of the gray literature. After applying our inclusion criteria, we analyzed our findings according to our predefined dimensions of advocacy for health equity. Last, we synthesized our findings and made a critical appraisal of the literature.
FINDINGS
The policy world is complex, and scientific evidence is unlikely to be conclusive in making decisions. Timely qualitative, interdisciplinary, and mixed-methods research may be valuable in advocacy efforts. The potential impact of evidence can be increased by "packaging" it as part of knowledge transfer and translation. Increased contact between researchers and policymakers could improve the uptake of research in policy processes. Researchers can play a role in advocacy efforts, although health professionals and disadvantaged people, who have direct contact with or experience of hardship, can be particularly persuasive in advocacy efforts. Different types of advocacy messages can accompany evidence, but messages should be tailored to advocacy target. Several barriers hamper advocacy efforts. The most frequently cited in the academic literature are the current political and economic zeitgeist and related public opinion, which tend to blame disadvantaged people for their ill health, even though biomedical approaches to health and political short-termism also act as barriers. These barriers could be tackled through long-term actions to raise public awareness and understanding of the SDH and through training of health professionals in advocacy. Advocates need to take advantage of "windows of opportunity," which open and close quickly, and demonstrate expertise and credibility.
CONCLUSIONS
This article brings together for the first time evidence from the academic and the gray literature and provides a building block for efforts to advocate for health equity. Evidence regarding many of the dimensions is scant, and additional research is merited, particularly concerning the applicability of findings outside the English-speaking world. Advocacy organizations have a central role in advocating for health equity, given the challenges bridging the worlds of civil society, research, and policy.
Topics: Cost-Benefit Analysis; Global Health; Health Policy; Health Status Disparities; Human Rights; Humans; International Agencies; Patient Advocacy; Politics; Social Determinants of Health; Social Justice
PubMed: 26044634
DOI: 10.1111/1468-0009.12112 -
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 -
Nutrition (Burbank, Los Angeles County,... Jun 2015The Global Burden of Disease Study and related studies report unhealthy diet is the leading risk for death and disability globally. Given the evidence associating diet... (Review)
Review
The Global Burden of Disease Study and related studies report unhealthy diet is the leading risk for death and disability globally. Given the evidence associating diet and non-communicable diseases (NCDs), international and national health bodies including the World Health Organization and United Nations have called for population health interventions to improve diet as a means to target NCDs. One of the proposed interventions is to ensure healthy foods/beverages are more accessible to purchasers and unhealthy ones less accessible via fiscal policy, namely taxation and subsidies. The objective of this systematic review was to evaluate the evidence base to assess the effect of healthy food/beverage subsidies and unhealthy food/beverage taxation. A comprehensive review was conducted by searching PubMed, Medline, and Google Scholar for peer-reviewed publications and seventy-eight studies were identified for inclusion in this review. This review was performed in keeping with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Although moderate in quality, there was consistent evidence that taxation and subsidy intervention influenced dietary behaviors. The quality, level and strength of evidence along with identified gaps in research support the need for further policies and ongoing evaluation of population-wide food/beverage subsidies and taxation. To maximize success and effect, this review suggests that food taxes and subsidies should be a minimum of 10 to 15% and preferably used in tandem. Implementation of population-wide polices for taxation and subsides with ongoing evaluation of intended and unintended effects are supported by this review.
Topics: Diet; Feeding Behavior; Food Assistance; Food Supply; Health; Health Promotion; Humans; Nutrition Policy; Taxes
PubMed: 25933484
DOI: 10.1016/j.nut.2014.12.010