Unpacking ‘the cloud’: a framework for implementing public health approaches to palliative care

2019 ◽  
Vol 35 (1) ◽  
pp. 160-170 ◽  
Author(s):  
Kathryn A Pfaff ◽  
Lisa Dolovich ◽  
Michelle Howard ◽  
Deborah Sattler ◽  
Merrick Zwarenstein ◽  
...  

Summary Designing and implementing population-based systems of care that address the social determinants of health, take action on multiple levels, and are guided by evidence-based principles is a pressing priority, and an international challenge. Aging persons are a priority demographic whose health needs span physical, psychosocial and existential care domains, increase in the last year of life, are often poorly coordinated and therefore remain unmet. Compassionate communities (CCs) are an example of a public health approach that fully addresses the holistic healthcare needs of those who are aging and nearing end of life. The sharing of resources, tools, and innovations among implementers of CCs is occurring globally. Although this can increase impact, it also generates complexity that can complicate robust evaluation. When initiating population health level projects, it is important to clearly define and organize concepts and processes that are proposed to influence the health outcomes. The Health Impact Change Model (HICM) was developed to unpack the complexities associated with the implementation and evaluation of a Canadian CC intervention. The HICM offers utility for citizens, leaders and decision-makers who are engaged in the implementation of population health level strategies or other social approaches to care, such as compassionate cities and age or dementia-friendly communities. The HICM’s concepts can be adapted to address a community’s healthcare context, needs, and goals for change. We share examples of how the model’s major concepts have been applied in the development, evaluation and spread of a complex CC approach.

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anita Mallon ◽  
Felicity Hasson ◽  
Karen Casson ◽  
Paul Slater ◽  
Sonja McIlfatrick

Abstract Background Moving palliative care from a solely clinical focus to a more population based and community orientated approach is the hallmark of a much advocated public health approach to palliative care. Young adults are a vital cohort of the public, yet their understanding of palliative care has not been investigated. This study aimed to explore young adults’ understanding of palliative care and identify factors that influence their engagement. Methods A purposive sample of young adults (n = 24) aged 18–29 years were recruited from one UK University. Semi-structured interviews were undertaken face to face or via telephone or Skype between November 2017 and February 2018. Thematic analysis using a framework approach and underpinned by a socioecological perspective was used to analyse the interviews. Results Three thematic categories were identified relating to intrapersonal and interpersonal influences, cultural and social influences and organisational and public policy influences. Palliative care was understood as supportive comfort care, delivered in the absence of cure, associated with the end of life and specifically focused on death and dying. Negative attitudes related to the context of care, which represented a static and hopeless situation. Whilst some reported positive attitudes, potential engagement was seen to be governed by a lack of knowledge and protective cultural norms. In terms of demonstrating readiness to engage with palliative care, participants requested clear information and suggested a normalising of palliative care through the education system. Conclusion Young adults in this study were ready to find out more about palliative care and identified social media as a platform upon which to engage this population. However, their perception of a society that views palliative care as a subject for those directly affected, creates a barrier to engagement. This study identified the ingredients of a public health message and mediums for disseminating the message. However, findings also suggest that a cultural shift is required to recognise the potential of engaging young adults in health issues that cross the life span, empowering them not only as individuals but as vital members of community and society.


2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 187-192
Author(s):  
Megan C. Roberts ◽  
George A. Mensah ◽  
Muin J. Khoury

The integration of genomic data into screen­ing, prevention, diagnosis, and treatment for clinical and public health practices has been slow and challenging. Implementa­tion science can be applied in tackling the barriers and challenges as well as exploring opportunities and best practices for integrat­ing genomic data into routine clinical and public health practice. In this article, we de­fine the state of disparities in genomic medi­cine and focus predominantly on late-stage research findings. We use case studies from genetic testing for cardiovascular diseases (familial hypercholesterolemia) and cancer (Lynch syndrome and hereditary breast and ovarian cancer syndrome) in high-risk populations to consider current disparities and related barriers in turning genomic advances into population health impact to advance health equity. Finally, we address how implementation science can address these translational barriers and we discuss the strategic importance of collaborative multi-stakeholder approaches that engage public health agencies, professional societ­ies, academic health and research centers, community clinics, and patients and their families to work collectively to improve population health and reduce or eliminate health inequities.Ethn Dis. 2019;29(Suppl 1):187-192; doi:10.18865/ed.29.S1.187.


2020 ◽  
pp. 089011712091422
Author(s):  
Tyler J. VanderWeele ◽  
Arthur C. Brooks

There is clear evidence that the prevalence of negative media reporting has increased substantially over the past years. There is evidence that this negative reporting adversely affects social interactions, and thereby also health and well-being outcomes. Given the wide reach of negative media reporting and the contagion of such reporting and the resulting interactions, the effects on health are arguably substantial. Moreover, there is little incentive at present for media outlets to change practices. A commitment of news outlets to report one positive story for every 3 negative stories, and of news consumers to restrict attention to outlets that do, could dramatically alter practices and, consequently, population health.


2020 ◽  
Vol 14 ◽  
pp. 263235242097504
Author(s):  
Sally Paul ◽  
Nina Vaswani

Background and Method: There is an absence of research on the prevalence of bereavement during early childhood and the relationship between childhood bereavement and socioeconomic status (SES) and this poses a challenge in both understanding and supporting children’s bereavement experiences. Using longitudinal data from the Growing Up in Scotland study, which tracks the lives of three nationally representative cohorts of children, this paper aimed to address these gaps in research. It specifically drew on data from Birth Cohort 1 to document the recorded bereavements of 2,815 children who completed all 8 sweeps of data collection, from age 10 months to 10 years. Findings: The study found that 50.8% of all children are bereaved of a parent, sibling, grandparent or other close family member by age 8 and this rises to 62% by age 10. The most common death experienced was that of a grandparent or other close relative. The study also found that children born into the lowest income households are at greater risk of being bereaved of a parent or sibling than those born into the highest income households. Discussion and Conclusion: Given the prevalence of childhood bereavement and its relationship with disadvantage, this paper argues that there is an important need to understand bereavement as a universal issue that is affected by the social conditions in which a child becomes bereaved, as well as an individual experience potentially requiring specialist support. This paper thus seeks to position childhood bereavement more firmly within the public health approach to palliative and bereavement care discourse and contends that doing so provides a unique and comprehensive opportunity to better understand and holistically respond to the experience of bereavement during childhood.


2020 ◽  
Vol 23 (4) ◽  
pp. 802-812
Author(s):  
Catherine A. Sharp ◽  
Mark A. Bellis ◽  
Karen Hughes ◽  
Kat Ford ◽  
Lisa C. G. Di Lemma

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 187-192 ◽  
Author(s):  
Megan C. Roberts ◽  
George A. Mensah ◽  
Muin J. Khoury

The integration of genomic data into screen­ing, prevention, diagnosis, and treatment for clinical and public health practices has been slow and challenging. Implementa­tion science can be applied in tackling the barriers and challenges as well as exploring opportunities and best practices for integrat­ing genomic data into routine clinical and public health practice. In this article, we de­fine the state of disparities in genomic medi­cine and focus predominantly on late-stage research findings. We use case studies from genetic testing for cardiovascular diseases (familial hypercholesterolemia) and cancer (Lynch syndrome and hereditary breast and ovarian cancer syndrome) in high-risk populations to consider current disparities and related barriers in turning genomic advances into population health impact to advance health equity. Finally, we address how implementation science can address these translational barriers and we discuss the strategic importance of collaborative multi-stakeholder approaches that engage public health agencies, professional societ­ies, academic health and research centers, community clinics, and patients and their families to work collectively to improve population health and reduce or eliminate health inequities.Ethn Dis. 2019;29(Suppl 1):187-192; doi:10.18865/ed.29.S1.187.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Teresa Burdett ◽  
Joanne Inman

PurposeDue to the need for the development of person-centred integrated models of care with a population health approach, this paper explored contemporary literature in this arena.Design/methodology/approachA systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Papers included in this review focused upon person-centred integrated care and a health promotion/public health approach (January 2018–October 2020). Papers were excluded due to not being written in English, not fitting the age criteria and not being peer reviewed.FindingsEight studies met the inclusion criteria and three overarching themes were identified with regards to person-centred integrated care as a health promotion/public health approach: Core components; Development, implementation, and evaluation of models of care and relationship to population health and wellbeing outcomes.Research limitations/implicationsThe need for person-centred integrated care as a health promotion/public health approach, to enhance population health and well-being outcomes requires further research to continue to develop, implement and evaluate models of care.Originality/valueThe international scope of this contemporary review brought together the three concepts of person-centred integrated care and public health, exploring the translation of policy into practice (WHO, 2016). The juxtaposition of public health approaches in the background/consequential or foreground/active agent demonstrates how promotion, prevention and population health can be re-valued in integrated people-centred health services (WHO, 2016).


2006 ◽  
Vol 1 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Sandro Galea, MD, DrPH ◽  
Craig Hadley, PhD ◽  
Sasha Rudenstine, BA

Disasters have been and will continue to be relatively common events in the human experience, and they make important contributions to variations in population health. There is a need, therefore, for conceptual models that identify the social and ecological factors influencing post-disaster consequences on population health. This article presents one such conceptual model which links the health consequences of natural, technological, and human-made disasters to a set of nested socioecological factors. Specifically, we attempt to link post-disaster consequences to aspects of the global and local environment and to highlight the roles played by social and ecological factors, including the social infrastructure, cultural beliefs, demography, and underlying historical and geographical circumstances. Examples from existing population-based health and disaster research are used to illustrate and amplify connections drawn from the model. From an applied standpoint, the model suggests that the role of multiple contextual determinants in shaping population health is likely to be complex. Practitioners interested in mitigating the consequences of disasters should pursue strategies that improve the underlying determinants of health, as well as practicable population- based interventions that could be implemented rapidly.


2016 ◽  
Vol 51 (7) ◽  
pp. 576-580 ◽  
Author(s):  
Mark Hoffman ◽  
Viktor Bovbjerg ◽  
Kim Hannigan ◽  
Jennifer M. Hootman ◽  
Sam T. Johnson ◽  
...  

Objective: To introduce athletic trainers to the benefits of using a population-based approach to injury and illness prevention and to explore opportunities for partnering with public health professionals on these initiatives. Background: Athletic trainers play leading roles in individual injury and illness prevention but are less familiar with policy development, evaluation, and implementation from a population-level standpoint. The Athletic Training and Public Health Summit was convened to understand, explore, and develop the intersection of athletic training and public health. Conclusions: To further the integration of athletic training within the public health arena, athletic trainers must expand their professional focus beyond the individual to the population level.


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