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Frontiers in Public Health 2022Syphilis is one of the most common sexually transmitted infections (STIs) worldwide and has shown a rising trend in recent years, according to a report published by the...
UNLABELLED
Syphilis is one of the most common sexually transmitted infections (STIs) worldwide and has shown a rising trend in recent years, according to a report published by the World Health Organization (WHO) in 2021. Given this problem, the present study aims to develop a scoping review of what has been done in the world after the publication of the global strategy for the elimination of STIs, with a specific focus on syphilis. Thus, we searched for papers on health policies in response to syphilis in Pubmed, Scopus, ScienceDirect, and EBSCO by CINAHL, as well as in official documents from international health organizations. The period from January 1, 2016, to August 14, 2022 was considered. Our search returned 880 papers addressing "Syphilis," "Health Policy," and "Health Policies" combined. Twenty-three papers fulfilled the inclusion and exclusion criteria according to two research questions set out for this scoping review. Our findings suggest that Brazil and Peru presented the greatest adequacy of the strategies provided by WHO in 2016 and the Pan American Health Organization (PAHO) in 2017, aiming tothe goals set out in the UN's 2030 Agenda for sustainable development. Among the studies found, six countries (Cuba, Thailand, Belarus, Armenia, Moldova, and Puerto Rico) reported the elimination of mother-to-child transmission (MTCT) of syphilis, but the most recent data are from 2016. Furthermore, it is essential to mention that no country has been found that has presented a comprehensive response to syphilis, noting the control or elimination of the disease in all key populations. Thus, it is necessary to constantly monitor national policies based on in-depth studies on the quality of the response, the challenges, and the national, regional, and global perspectives for the control of the disease until 2030, the year in which the SDGs will be reviewed.
SYSTEMATIC REVIEW REGISTRATION
https://osf.io/x9er5/?view_only=0cc0062222ec45dcb2f4d41484d285b6, identifier: 10.17605/OSF.IO/X9ER5.
Topics: Female; Health Policy; Humans; Infectious Disease Transmission, Vertical; Sexually Transmitted Diseases; Syphilis; World Health Organization
PubMed: 36187663
DOI: 10.3389/fpubh.2022.1002245 -
PLoS Medicine Jun 2019Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR...
BACKGROUND
Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidence map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS
Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS
To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
PROTOCOL REGISTRATION
PROSPERO CRD42017067514.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Drug Resistance, Microbial; Evidence-Based Medicine; Health Policy; Humans; Randomized Controlled Trials as Topic
PubMed: 31185011
DOI: 10.1371/journal.pmed.1002819 -
PloS One 2016Translational research is central to international health policy, research and funding initiatives. Despite increasing use of the term, the translation of basic science... (Review)
Review
Optimising Translational Research Opportunities: A Systematic Review and Narrative Synthesis of Basic and Clinician Scientists' Perspectives of Factors Which Enable or Hinder Translational Research.
INTRODUCTION
Translational research is central to international health policy, research and funding initiatives. Despite increasing use of the term, the translation of basic science discoveries into clinical practice is not straightforward. This systematic search and narrative synthesis aimed to examine factors enabling or hindering translational research from the perspective of basic and clinician scientists, a key stakeholder group in translational research, and to draw policy-relevant implications for organisations seeking to optimise translational research opportunities.
METHODS AND RESULTS
We searched SCOPUS and Web of Science from inception until April 2015 for papers reporting scientists' views of the factors they perceive as enabling or hindering the conduct of translational research. We screened 8,295 papers from electronic database searches and 20 papers from hand searches and citation tracking, identifying 26 studies of qualitative, quantitative or mixed method designs. We used a narrative synthesis approach and identified the following themes: 1) differing concepts of translational research 2) research processes as a barrier to translational research; 3) perceived cultural divide between research and clinical care; 4) interdisciplinary collaboration as enabling translation research, but dependent on the quality of prior and current social relationships; 5) translational research as entrepreneurial science. Across all five themes, factors enabling or hindering translational research were largely shaped by wider social, organisational, and structural factors.
CONCLUSION
To optimise translational research, policy could consider refining translational research models to better reflect scientists' experiences, fostering greater collaboration and buy in from all types of scientists. Organisations could foster cultural change, ensuring that organisational practices and systems keep pace with the change in knowledge production brought about by the translational research agenda.
Topics: Cooperative Behavior; Databases, Factual; Health Policy; Patient Care; Professional Role; Translational Research, Biomedical
PubMed: 27490373
DOI: 10.1371/journal.pone.0160475 -
Bulletin of the World Health... Aug 2010To assess the effect of food taxes and subsidies on diet, body weight and health through a systematic review of the literature. (Review)
Review
OBJECTIVE
To assess the effect of food taxes and subsidies on diet, body weight and health through a systematic review of the literature.
METHODS
We searched the English-language published and grey literature for empirical and modelling studies on the effects of monetary subsidies or taxes levied on specific food products on consumption habits, body weight and chronic conditions. Empirical studies were dealing with an actual tax, while modelling studies predicted outcomes based on a hypothetical tax or subsidy.
FINDINGS
Twenty-four studies met the inclusion criteria: 13 were from the peer-reviewed literature and 11 were published on line. There were 8 empirical and 16 modelling studies. Nine studies assessed the impact of taxes on food consumption only, 5 on consumption and body weight, 4 on consumption and disease and 6 on body weight only. In general, taxes and subsidies influenced consumption in the desired direction, with larger taxes being associated with more significant changes in consumption, body weight and disease incidence. However, studies that focused on a single target food or nutrient may have overestimated the impact of taxes by failing to take into account shifts in consumption to other foods. The quality of the evidence was generally low. Almost all studies were conducted in high-income countries.
CONCLUSION
Food taxes and subsidies have the potential to contribute to healthy consumption patterns at the population level. However, current evidence is generally of low quality and the empirical evaluation of existing taxes is a research priority, along with research into the effectiveness and differential impact of food taxes in developing countries.
Topics: Body Weight; Chronic Disease; Diet; Food; Humans; Obesity; Public Policy; Taxes; United States
PubMed: 20680126
DOI: 10.2471/BLT.09.070987 -
Annals of Internal Medicine Jan 2013Although there is broad policy consensus that both cost containment and quality improvement are critical, the association between costs and quality is poorly understood. (Review)
Review
BACKGROUND
Although there is broad policy consensus that both cost containment and quality improvement are critical, the association between costs and quality is poorly understood.
PURPOSE
To systematically review evidence of the association between health care quality and cost.
DATA SOURCES
Electronic literature search of PubMed, EconLit, and EMBASE databases for U.S.-based studies published between 1990 and 2012.
STUDY SELECTION
Title, abstract, and full-text review to identify relevant studies.
DATA EXTRACTION
Two reviewers independently abstracted data with differences reconciled by consensus. Studies were categorized by level of analysis, type of quality measure, type of cost measure, and method of addressing confounders.
DATA SYNTHESIS
Of 61 included studies, 21 (34%) reported a positive or mixed-positive association (higher cost associated with higher quality); 18 (30%) reported a negative or mixed-negative association; and 22 (36%) reported no difference, an imprecise or indeterminate association, or a mixed association. The associations were of low to moderate clinical significance in many studies. Of 9 studies using instrumental variables analysis to address confounding by unobserved patient health status, 7 (78%) reported a positive association, but other characteristics of these studies may have affected their findings.
LIMITATIONS
Studies used widely heterogeneous methods and measures. The review is limited by the quality of underlying studies.
CONCLUSION
Evidence of the direction of association between health care cost and quality is inconsistent. Most studies have found that the association between cost and quality is small to moderate, regardless of whether the direction is positive or negative. Future studies should focus on what types of spending are most effective in improving quality and what types of spending represent waste.
PRIMARY FUNDING SOURCE
Robert Wood Johnson Foundation.
Topics: Confounding Factors, Epidemiologic; Cost Control; Health Care Costs; Health Policy; Quality Improvement; Quality of Health Care; United States
PubMed: 23277898
DOI: 10.7326/0003-4819-158-1-201301010-00006 -
Journal of Health Care For the Poor and... 2013The rapidly rising rate of obesity has prompted a variety of policy responses at national, regional, and local levels. Yet, many have expressed concern that these policy... (Review)
Review
The rapidly rising rate of obesity has prompted a variety of policy responses at national, regional, and local levels. Yet, many have expressed concern that these policy responses have a limited evidence base, are overly paternalistic, and have the potential to increase rather than shrink obesity-related disparities. The purpose of this article is to evaluate obesity policies in terms of the adequacy of evidence for action and along two ethical dimensions: their potential effect on liberty and equity. To evaluate evidence, we engage in a systematic review of reviews and rate policies in terms of the sufficiency of evidence of effectiveness at combating obesity. We then apply a libertarian-paternalist framework to assess policies in terms of their impact on liberty and inverse-equity theory to assess impact on disparities. This article provides a framework to assist decision-makers in assessing best practices in obesity using a more multi-faceted set of dimensions.
Topics: Freedom; Health Policy; Humans; Obesity; Paternalism
PubMed: 23727973
DOI: 10.1353/hpu.2013.0097 -
Canadian Journal of Psychiatry. Revue... Jul 2021Concerns surrounding the mental health and well-being of Canadian postsecondary students have increased in recent years, with data suggesting increases in the prevalence... (Review)
Review
Postsecondary Mental Health Policy in Canada: A Scoping Review of the Grey Literature: Politique de santé mentale post-secondaire au Canada: un examen de la portée de la littérature grise.
OBJECTIVE
Concerns surrounding the mental health and well-being of Canadian postsecondary students have increased in recent years, with data suggesting increases in the prevalence of self-reported stress and psychological distress. Strategies to address postsecondary mental health have emerged at the national, provincial, and institutional levels. While reviews of the academic literature on the subject have been conducted, a detailed review of the grey literature has not. The objective of this study was to map the current state of grey literature related to current or recommended action supporting postsecondary mental health and well-being in Canada, with a focus on policy documents and guiding frameworks.
METHODS
We conducted a review following Arksey and O'Malley's 5-step framework for scoping reviews, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Our search was restricted to documents with a primary focus on postsecondary mental health, a national or provincial scope, and publication date between 2000 and 2019.
RESULTS
While a national policy or guiding framework applicable to all postsecondary institutions across Canada does not yet exist, recommendations for policy at both the national and provincial levels were well aligned, emphasizing the need for a comprehensive approach to addressing mental health services through the use of a whole-campus approach that encompasses both upstream and downstream services.
CONCLUSION
Postsecondary sector stakeholders should consider how existing policy documents and guiding frameworks can be used to inform evidence-based, institutionally specific action on postsecondary mental health. More work is required to align the fragmented action occurring across Canada and incentivize postsecondary institutions to create a sustainable, effective strategy to address the increasingly complex and unique mental health needs of their students, staff, and faculty.
Topics: Canada; Health Policy; Humans; Mental Health Services
PubMed: 33016127
DOI: 10.1177/0706743720961733 -
PharmacoEconomics Aug 2017Policies such as the Cancer Drugs Fund in England assumed a societal preference to fund cancer care relative to other conditions, even if that resulted in lower health... (Review)
Review
BACKGROUND
Policies such as the Cancer Drugs Fund in England assumed a societal preference to fund cancer care relative to other conditions, even if that resulted in lower health gain for the population overall.
OBJECTIVE
The aim of this study was to investigate the evidence for such a preference among the UK public.
METHODS
The MEDLINE, PubMed and Econlit electronic databases were searched for studies relating to preferences for prioritising cancer treatment, as well as studies relating to preferences for the characteristics of cancer (severity of disease, end-of-life). The searches were run in November 2015 and updated in March 2017. Empirical preference studies, studies of public views, and studies in English were included.
RESULTS
We identified 24 studies relating to cancer preferences. Two directly addressed health trade-offs in the UK-one showed a preference for health gain in cancer, while the other found no such preference but provided results consistent with population health maximisation. Other studies mostly showed support for cancer but did not require a direct health trade-off. Severity and end-of-life searches identified 12 and 6 papers, respectively, which were additional to existing reviews. There is consistent evidence that people give priority to severe illness, while results for end-of-life are mixed.
CONCLUSION
We did not find consistent support for a preference for health gains to cancer patients in the context of health maximisation. The evidence base is small and the results are highly sensitive to study design. There remains a contradiction between these findings and the popular view of cancer, and further work is required to determine the features of cancer which contribute to that view.
Topics: Antineoplastic Agents; Financial Management; Health Policy; Humans; Neoplasms; Public Opinion; Research Design; Severity of Illness Index; United Kingdom
PubMed: 28455834
DOI: 10.1007/s40273-017-0511-7 -
European Journal of Public Health Nov 2022Successful implementation of health policies require acceptance from the public and policy-makers. This review aimed to identify tools used to assess the acceptability...
BACKGROUND
Successful implementation of health policies require acceptance from the public and policy-makers. This review aimed to identify tools used to assess the acceptability of policies targeting physical activity and dietary behaviour, and examine if acceptability differs depending on characteristics of the policy and of the respondents.
METHODS
A systematic review (PROSPERO: CRD42021232326) was conducted using three databases (Science Direct, PubMed and Web of Science).
RESULTS
Of the initial 7780 hits, we included 48 eligible studies (n = 32 on dietary behaviour, n = 11 on physical activity and n = 5 on both), using qualitative and quantitative designs (n = 25 cross-sectional, quantitative; n = 15 qualitative; n = 5 randomized controlled trials; n = 3 mixed-methods design). Acceptability was analysed through online surveys (n = 24), interviews (n = 10), focus groups (n = 10), retrospective textual analysis (n = 3) and a taste-test experiment (n = 1). Notably, only 3 (out of 48) studies applied a theoretical foundation for their assessment. Less intrusive policies such as food labels and policies in a later stage of the implementation process received higher levels of acceptability. Women, older participants and respondents who rated policies as appropriate and effective showed the highest levels of acceptability.
CONCLUSION
Highly intrusive policies such as taxations or restrictions are the least accepted when first implemented, but respondents' confidence in the relevance and effectiveness of the policy may boost acceptability over the course of implementation. Studies using validated tools and a theoretical foundation are needed to further examine opportunities to increase acceptability.
Topics: Humans; Female; Cross-Sectional Studies; Retrospective Studies; Diet; Exercise; Health Policy
PubMed: 36444105
DOI: 10.1093/eurpub/ckac053 -
BMJ Open Jan 2022Assessing the impact of COVID-19 policy is critical for informing future policies. However, there are concerns about the overall strength of COVID-19 impact evaluation...
INTRODUCTION
Assessing the impact of COVID-19 policy is critical for informing future policies. However, there are concerns about the overall strength of COVID-19 impact evaluation studies given the circumstances for evaluation and concerns about the publication environment.
METHODS
We included studies that were primarily designed to estimate the quantitative impact of one or more implemented COVID-19 policies on direct SARS-CoV-2 and COVID-19 outcomes. After searching PubMed for peer-reviewed articles published on 26 November 2020 or earlier and screening, all studies were reviewed by three reviewers first independently and then to consensus. The review tool was based on previously developed and released review guidance for COVID-19 policy impact evaluation.
RESULTS
After 102 articles were identified as potentially meeting inclusion criteria, we identified 36 published articles that evaluated the quantitative impact of COVID-19 policies on direct COVID-19 outcomes. Nine studies were set aside because the study design was considered inappropriate for COVID-19 policy impact evaluation (n=8 pre/post; n=1 cross-sectional), and 27 articles were given a full consensus assessment. 20/27 met criteria for graphical display of data, 5/27 for functional form, 19/27 for timing between policy implementation and impact, and only 3/27 for concurrent changes to the outcomes. Only 4/27 were rated as overall appropriate. Including the 9 studies set aside, reviewers found that only four of the 36 identified published and peer-reviewed health policy impact evaluation studies passed a set of key design checks for identifying the causal impact of policies on COVID-19 outcomes.
DISCUSSION
The reviewed literature directly evaluating the impact of COVID-19 policies largely failed to meet key design criteria for inference of sufficient rigour to be actionable by policy-makers. More reliable evidence review is needed to both identify and produce policy-actionable evidence, alongside the recognition that actionable evidence is often unlikely to be feasible.
Topics: COVID-19; Cross-Sectional Studies; Health Policy; Humans; Research Design; SARS-CoV-2
PubMed: 35017250
DOI: 10.1136/bmjopen-2021-053820