scholarly journals Aligning diagnostics to the point-of-care: lessons for innovators, evaluators and decision-makers from tuberculosis and HIV

2020 ◽  
Vol 5 (11) ◽  
pp. e003457
Author(s):  
Nora Engel ◽  
Petra F G Wolffs
Keyword(s):  
Public Health ◽  
Business Models ◽  
Point Of Care ◽  
Decision Makers ◽  
Research Needs ◽  
Ethnographic Fieldwork ◽  
Evaluation Procedures ◽  
Semistructured Interviews ◽  
Intended Use ◽  
Global Stakeholders

Diagnostics, including those that work at point-of-care, are an essential part of successful public health responses to infectious diseases and pandemics. Yet, they are not always used or fit intended use settings. This paper reports on key insights from a qualitative study on how those engaged with developing and implementing new point-of-care (POC) diagnostics for tuberculosis (TB) and HIV ensure these technologies work at POC. Ethnographic fieldwork between 2015 and 2017 consisting of 53 semistructured interviews with global stakeholders and visits to workshops, companies, and conferences was combined with 15 semistructured interviews with stakeholders in India including providers, decision-makers, scientists and developers and visits to companies, clinics and laboratories. Our results show how developers and implementer of HIV and TB POC diagnostics aim to know and align their diagnostics to elements in more settings than just intended use, but also the setting of the developer, the global intermediaries, the bug/disease and the competitor. Actors and elements across these five settings define what a good diagnostic is, yet their needs might conflict or change and they are difficult to access. Aligning diagnostics to the POC requires continuous needs assessment throughout development and implementation phases as well as substantive, ongoing investment in relationships with users. The flexibility required for such continuous realigning and iteration clashes with established evaluation procedures and business models in global health and risks favouring certain products over others. The paper concludes with suggestions to strengthen this alignment work and applies this framework to research needs in the wake of COVID-19.

“PHONE-CONNECT” - A Pilot Program Prescribing Phones to Address Digital Health Equity Needs in the COVID-19 Era (Preprint)

2020 ◽  
Author(s):  
Gill Kazevman ◽  
Marck Mercado ◽  
Jennifer Hulme ◽  
Andrea Somers
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Services ◽  
Access To Health Care ◽  
Health Care Services ◽  
Point Of Care ◽  
Digital Health ◽  
Contact Tracing ◽  
Health Care Intervention ◽  
Care Intervention

UNSTRUCTURED Vulnerable populations have been identified as having higher infection rates and poorer COVID-19 related outcomes, likely due to their inability to readily access primary care, follow public health directives and adhere to self-isolation guidelines. As a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, relying on phone and internet connectivity. Yet, persons who are digitally inaccessible, such as those struggling with poverty or homelessness, are often unable to utilize these services. In response to this newly highlighted social disparity known as “digital health inequity”, emergency physicians at the University Health Network, Toronto, initiated a program called “PHONE CONNECT”. This novel approach attempts to improve patients’ access to health care, information and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing). While similar programs addressing the same emerging issues have been recently described in the media, this is the first time phones are provided as a health care intervention in an emergency department. This innovative ED point-of-care intervention may have a significant impact on improving the health outcomes for vulnerable people during the COVID-19 pandemic, and even beyond it.

scholarly journals Expert Advisory Groups: Exploring the Sensemaking Proces s During a Public Health C risis R esponse

2018 ◽  
Author(s):  
Iva Seto ◽  
David Johnstone ◽  
Jennifer Campbell-Meier
Keyword(s):  
Public Health ◽  
Decision Makers ◽  
Process Information ◽  
Unexpected Event ◽  
Health Crisis ◽  
Creation Process ◽  
Public Health Crisis ◽  
Advisory Groups ◽  
Expert Advisory ◽  
Meaning Creation

In a public health crisis, experts (such as epidemiologists, public health officers, physicians and virologists) support key decision  makers with advice in a highly dynamic, pressured,  and time-sensitive context. Experts must process information (to provide advice) as quickly as possible, yet this must be balanced with ensuring the information is credible, reliable,  and relevant. When an unexpected event occurs, it may lead to a gap between what is  experienced and what was expected; sensemaking is a meaning creation process which is engaged to fill the gap. This research explores how experts engage in sensemaking during a  public health crisis.

scholarly journals Working towards evidence-informed policy: Public health report Stockholm

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Bartelink ◽  
D Yacaman Mendez ◽  
A Lager
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Scientific Literature ◽  
Decision Makers ◽  
High Quality ◽  
Public Health Report ◽  
The Public ◽  
Health Report ◽  
High Quality Evidence ◽  
Quality Evidence

Abstract Issue Public health problems and interventions are often addressed in sub-optimal ways by not prioritizing them based on the best available evidence. Description of the Problem The public health report 2019 for the Stockholm region aims to inform decision makers, politicians, and public health workers about the risk factors and diseases that account for the biggest part of the burden of disease with a clear focus on high quality evidence and communication of main messages. How did the public health report 2019 affect public health policy in the Stockholm region? Results The public health report 2019 influenced agenda setting, resource allocation and priority setting in the Stockholm region. Lessons We identified the following facilitating factors in the process, of which most also are supported in scientific literature, in chronological order: 1) understanding the policymaking context to be aware of windows of opportunity, 2) establishing relationships with relevant policymakers, engage with them routinely in the decision-making process, and being accessible for questions, 3) doing high-quality research by considering the latest scientific literature, multiple data sources and involving academic experts in the field, 4) communicating clear and relevant messages for generalists by translating research into easy-understandable texts and attractive figures, and 5) active dissemination of the report through multiple channels. In addition, the following barriers were identified: 1) the timeframe of the policymaking process was not in line with the research process, and 2) involving politicians in an early stage can potentially harm the objectivity of research in media messages. Key messages By focussing on major problems, high quality evidence and clear messages a public health report can contribute to more evidence-informed policy making. Engaging decision makers in the process of public health reporting is critical for the impact on agenda setting, resource allocation, and priority setting.

scholarly journals An evaluation of the Victorian Salt Reduction Partnership’s advocacy strategy for policy change

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Emalie Rosewarne ◽  
Michael Moore ◽  
Wai-Kwan Chislett ◽  
Alexandra Jones ◽  
Kathy Trieu ◽  
...  
Keyword(s):  
Public Health ◽  
Policy Change ◽  
Action Plan ◽  
Evaluation Framework ◽  
Decision Makers ◽  
Health Advocacy ◽  
Salt Reduction ◽  
Public Health Advocacy ◽  
The Creation ◽  
The Impact

Abstract Background Public health advocacy strategies facilitate policy change by bringing key health issues to the forefront of public and political discourse, influencing decision-makers and public opinion, and increasing policy demand. The Victorian Salt Reduction Partnership (VSRP) was established in 2014 in response to inadequate government action to improve population diets in Australia. This study aimed to evaluate the success of the VSRP’s advocacy strategy in achieving policy change. Methods Documentation of VSRP activities and outputs were collected, and semi-structured interviews conducted as part of a comprehensive process evaluation. For this study, the Kotter Plus 10-step public health advocacy evaluation framework was used to guide data extraction, analysis, and synthesis. Results A sense of urgency for salt reduction was generated by producing evidence and outlining the potential impact of a state-based salt reduction programme. This enabled the creation of a coalition with diverse skills and expertise, which facilitated the development of an innovative and collaborative advocacy action plan. A clear change vision was established, but communication of the vision to decision-makers was lacking, which reduced the impact of the programme as decision-makers were not provided with a clear incentive for policy change. As a result, while programme outputs were achieved, these did not translate to achieving broader strategic goals during a limited-term intervention in a political climate unconcerned with salt. Conclusions The Kotter Plus 10-step framework was a useful tool for evaluating the success of the VSRP advocacy strategy. The framework enabled the identification of key strengths, including the creation of the guiding coalition, and areas where efforts could be improved in future similar strategies, such as effective communication within partnerships and to decision-makers, to better influence policy and improve public health impact.

scholarly journals The NCCMT’s dynamic model for evidence-informed public health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Clark ◽  
S Neil-Sztramko ◽  
M Dobbins
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Research Evidence ◽  
Decision Makers ◽  
Local Data ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Political Preferences ◽  
Health Decision ◽  
Structured Approach

Abstract Issue It is well accepted that public health decision makers should use the best available research evidence in their decision-making process. However, research evidence alone is insufficient to inform public health decision making. Description of the problem As new challenges to public health emerge, there can be a paucity of high quality research evidence to inform decisions on new topics. Public health decision makers must combine various sources of evidence with their public health expertise to make evidence-informed decisions. The National Collaborating Centre for Methods and Tools (NCCMT) has developed a model which combines research evidence with other critical sources of evidence that can help guide decision makers in evidence-informed decision making. Results The NCCMT's model for evidence-informed public health combines findings from research evidence with local data and context, community and political preferences and actions and evidence on available resources. The model has been widely used across Canada and worldwide, and has been integrated into many public health organizations' decision-making processes. The model is also used for teaching an evidence-informed public health approach in Masters of Public Health programs around the globe. The model provides a structured approach to integrating evidence from several critical sources into public health decision making. Use of the model helps ensure that important research, contextual and preference information is sought and incorporated. Lessons Next steps for the model include development of a tool to facilitate synthesis of evidence across all four domains. Although Indigenous knowledges are relevant for public health decision making and should be considered as part of a complete assessment the current model does not capture Indigenous knowledges. Key messages Decision making in public health requires integrating the best available evidence, including research findings, local data and context, community and political preferences and available resources. The NCCMT’s model for evidence-informed public health provides a structured approach to integrating evidence from several critical sources into public health decision making.

Alternative Workstations: Magic Pills for Office Worker Health?

2017 ◽  
Vol 61 (1) ◽  
pp. 460-464 ◽  
Author(s):  
Jia-Hua Lin ◽  
Carisa Harris-Adamson ◽  
Stephen Bao ◽  
David Rempel ◽  
Lora Cavuoto ◽  
...  
Keyword(s):  
Public Health ◽  
Computer Work ◽  
Musculoskeletal Symptoms ◽  
Office Worker ◽  
Audience Participation ◽  
Research Needs ◽  
Health Concerns ◽  
Research And Practice ◽  
Workplace Interventions ◽  
Worker Health

Routine office or computer work are of public health concerns due to their sedentary nature. Sit- stand desks may be prescribed for employees based on medical or ergonomic factors. Sit-stand or active workstations, either assigned to individual workers or made available in “unassigned” office areas are also making inroads into the workplace with the goal of reducing sedentary work, varying (alternating) work postures, improving productivity, or accommodating workers with musculoskeletal symptoms. This diverse panel will present recent research and practice findings and invite audience participation in a discussion of this trending topic. Studies examining the effects of sit-stand or active workstations on physiological and cardiovascular outcomes will be reported. The effects on movement patterns, performance and productivity will also be examined. Real workplace interventions and examples of practices will be presented. The goal is to provide a forum to share our understanding about the benefits and limitations of various office workstation designs and discuss research needs.

scholarly journals Exploring Factors Affecting the Emergency Specialists’ Decision-Making in Case of Emergencies in Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Abbasali Ebrahimian ◽  
Seyed-Hossein Hashemi-Amrei ◽  
Mohammadreza Monesan
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Qualitative Content Analysis ◽  
Decision Makers ◽  
Decision Making Process ◽  
Factors Affecting ◽  
Emergency Situations ◽  
The Core ◽  
Semistructured Interviews ◽  
Emergency Decision

Introduction. Appropriate decision-making is essential in emergency situations; however, little information is available on how emergency decision-makers decide on the emergency status of the patients shifted to the emergency department of the hospital. This study aimed at explaining the factors that influence the emergency specialists’ decision-making in case of emergency conditions in patients. Methods. This study was carried out with a qualitative content analysis approach. The participants were selected based on purposive sampling by the emergency specialists. The data were collected through semistructured interviews and were analyzed using the method proposed by Graneheim and Lundman. Results. The core theme of the study was “efforts to perceive the acute health threats of the patient.” This theme was derived from the main classes, including “the identification of the acute threats based on the patient’s condition” and “the identification of the acute threats based on peripheral conditions.” Conclusions. The conditions governing the decision-making process about patients in the emergency department differ from the conditions in other health-care departments at hospitals. Emergency specialists may have several approaches to decide about the patients’ emergency conditions. Therefore, notably, the emergency specialists’ working conditions and the others’ expectations from these specialists should be considered.

scholarly journals 18.H. Workshop: Bringing evidence during public health emergencies: addressing the challenge through HTA

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Emergency Preparedness ◽  
Public Health Emergency ◽  
Decision Makers ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
Response Planning ◽  
Emergency Preparedness And Response ◽  
Public Health Emergency Preparedness

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and irrefutable evidence may be lacking. The process of including evidence in public health decision-making and for evidence-informed policy, in preparation, and during public health emergencies, is not systematic and is complicated by many barriers as the absences of shared tools and approaches for evidence-based preparedness and response planning. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability and to implement coordinated evidence-based response plans. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. As a multidisciplinary, standardized and evidence-based decision-making tool, Health Technology Assessment (HTA) represents and approach that can inform public health emergency preparedness and response planning processes; it can also provide meaningful insights on existing preparedness structures, working as bridge between scientists and decision-makers, easing knowledge transition and translation to ensure that evidence is effectively integrated into decision-making contexts. HTA can address the link between scientific evidence and decision-making in public health emergencies, and overcome the key challenges faced by public health experts when advising decision makers, including strengthening and accelerating knowledge transfer through rapid HTA, improving networking between actors and disciplines. It may allow a 360° perspective, providing a comprehensive view to decision-making in preparation and during public health emergencies. The objective of the workshop is to explore and present how HTA can be used as a shared and systematic evidence-based tool for Public Health Emergency Preparedness and Response, in order to enable stakeholders and decision makers taking actions based on the best available evidence through a process which is systematic and transparent. Key messages There are many barriers and no shared mechanisms to bring evidence in decision-making during public health emergencies. HTA can represent the tool to bring evidence-informed actions in public health emergency preparedness and response.

SERS Substrate Fabrication for Biochemical Sensing: towards Point-of-Care Diagnostics

2021 ◽  
Author(s):  
Xiaojia Liu ◽  
Jiuchuan Guo ◽  
Yang Li ◽  
Bo Wang ◽  
Shikun Yang ◽  
...  
Keyword(s):  
Public Health ◽  
Economic Growth ◽  
Food Safety ◽  
Technology Development ◽  
Point Of Care ◽  
Sers Substrate ◽  
Health Issues ◽  
Biochemical Sensing ◽  
Point Of Care Diagnostics ◽  
Increasing Demand

Rapid technology development and economic growth have brought attention to public health issues, such as food safety and environmental pollution, which creates an ever-increasing demand for fast and portable sensing...

Leveraging blockchain based decentralized apps for the Tokyo Olympics amid the COVID-19 pandemic

First Monday ◽  
2021 ◽  
Author(s):  
Rishi Sabarigirisan ◽  
Aditi Biswas ◽  
Ridhi Rohatgi ◽  
Shyam KC ◽  
Shekhar Shukla
Keyword(s):  
Public Health ◽  
Health And Safety ◽  
Well Being ◽  
Decision Makers ◽  
Contact Tracing ◽  
Strategic Objectives ◽  
Crowd Management ◽  
Blockchain Technology ◽  
Smooth Contact ◽  
Public Health And Safety

The COVID-19 pandemic has induced a cloud of uncertainty over the mega sports event, the 2021 Tokyo Olympics. Cancelling or re-scheduling the event could have serious repercussions on the economic, social and environmental well-being for the involved stakeholders. Thus, it becomes critical to conduct events of this magnitude by adopting appropriate public health measures. In this research, we primarily focus on two main premises relative to public health and safety, contact tracing and crowd management. We explore and evaluate the usability of blockchain based decentralized apps in crowd management and contact tracing for the Tokyo Olympics using value-focused thinking (VFT). A VFT framework aids in narrowing fundamental and strategic objectives that need to be addressed for smooth contact tracing and crowd management by understanding stakeholder viewpoints. We established an equivalence of the objectives identified through VFT with blockchain technology properties. Further, we also present a conceptual ideation of contact tracing and crowd management through blockchain based decentralized apps for the Tokyo Olympics. This work could potentially assist decision-makers, researchers and stakeholders involved in organizing the Tokyo Olympics in understanding and analysing the utility of blockchain based decentralized apps for crowd management and contact tracing.

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