scholarly journals Unstandard Deviation: The Untapped Value of Positive Deviance for Reducing Inequalities

2021 ◽  
pp. 174569162110178
Author(s):  
Kai Ruggeri ◽  
Tomas Folke
Keyword(s):  
Public Policy ◽  
Real World ◽  
Behavioral Science ◽  
Public Policies ◽  
Population Level ◽  
Positive Deviance ◽  
Positive Outcomes ◽  
Effective Population ◽  
Over Time

Behavioral science is increasingly used in public policy to understand and address various manifestations of inequalities. Yet evidence from effective population-level interventions is limited. One framework, known as positive deviance, emphasizes individuals from disadvantaged circumstances who have significantly better outcomes than are typical for their group. Studying their behaviors and outcomes helps to understand what might explain their overall success. These insights could also be used to help others from these circumstances experience positive outcomes. Because positive deviance has been markedly understudied, we present a framework for doing so specifically within behavioral science for public policies aimed at reducing inequalities. Using examples from real-world and experimental insights on choices and outcomes of positive deviants, we encourage further study of their choices and trajectories over time to produce valuable insights. We propose that leveraging those findings would inform public policy by introducing interventions that are more ecologically sound and population-relevant and thus have a better chance at benefiting those who start off under adverse circumstances.

scholarly journals Unstandard deviation: The untapped value of positive deviance for reducing inequalities

2020 ◽  
Author(s):  
Kai Ruggeri ◽  
Tomas Folke
Keyword(s):  
Public Policy ◽  
Real World ◽  
Behavioral Science ◽  
Public Policies ◽  
Population Level ◽  
Positive Deviance ◽  
Positive Outcomes ◽  
Effective Population ◽  
Over Time

Behavioral science is increasingly used in public policy to understand and address various manifestations of inequalities. Yet evidence from effective population-level interventions is limited. One framework, known as positive deviance, emphasizes individuals from disadvantaged circumstances who have significantly better outcomes than are typical for their group. Studying their behaviors and outcomes helps to understand what might explain their overall success. It can also help to incorporate those insights in such a way that would facilitate others from these circumstances to experience positive outcomes. Because positive deviance has been markedly understudied, we present a framework for doing so specifically within behavioral science for public policies aimed at reducing inequalities. Using examples from real-world and experimental insights on choices and outcomes of positive deviants, we encourage further study of their choices and trajectories over time to produce valuable insights. We propose that leveraging those findings would inform public policy by introducing interventions that are more ecologically sound and population relevant, and consequently have a better chance at benefiting those who start off under adverse circumstances.

scholarly journals The stewardship deficit in New Zealand health policymaking

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Verna Smith
Keyword(s):  
Public Policy ◽  
New Zealand ◽  
Interest Groups ◽  
Public Policies ◽  
Fundamental Characteristic ◽  
Social Conflicts ◽  
Government Institutions ◽  
Health Policymaking ◽  
Over Time

The autonomy and capacity of a state to make and implement public policy (or to exercise its ‘stewardship’ functions) (WHO, 2000, p.122) is a fundamental characteristic of statehood. ‘Autonomy’ for a state is defined as ‘the ability of government institutions to resist being captured by interest groups and to act fairly as an arbiter of social conflicts’ (ibid.). ‘Capacity’ refers to the ability of government systems to make and implement policy and ‘springs from the expertise, resources and coherence of the machinery of government’ (Buse, Mays and Walt, 2007, p.81). Understanding the nature of autonomy and capacity in a particular state and how well that state is able to maintain or extend its autonomy or capacity to develop effective public policies is important because this enables states to strengthen these characteristics over time. 

Abstract 362: National Trends in Use of Sacubitril/valsartan

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Aya Ozaki ◽  
Harlan M Krumholz ◽  
Freny V Mody ◽  
Cynthia Jackevicius
Keyword(s):  
Real World ◽  
Population Level ◽  
The Elderly ◽  
Target Dose ◽  
The Real ◽  
Reduced Ejection Fraction ◽  
Real World Setting ◽  
Clinical Benefits ◽  
Higher Doses ◽  
Over Time

Background: Sacubitril/valsartan (Entresto ® ), available since 07/2015 to treat heart failure (HF) with reduced ejection fraction, reduced HF morbidity and mortality in the PARADIGM-HF trial at a mean daily dose of 375mg. The recommended starting dose is 49/51mg BID with up-titration to the target maintenance dose of 97/103mg BID. The uptake and pattern of dosage up-titration of sacubitril/valsartan in the real-world setting is understudied. Therefore, we characterize sacubitril/valsartan utilization patterns over time. Methods: We conducted a population-level cohort study using the IQVIA National Prescription Audit database from 08/2016-07/2019. Primary variables included the number of prescriptions (Rx) dispensed over a 3-year period and the proportion of Rx in the most recent 1-year period by dose, Rx types, prescriber and patient. Results: Over 3-years, 3.3 million sacubitril/valsartan Rx were dispensed. The number of Rx/month increased 5.6-fold, from 30,454 Rx to 175,605 Rx. Cardiologists prescribed 59% of Rx. However, non-cardiologists had a greater increase (7.5-fold) in prescribing over time than cardiologists (4.9-fold). During the most recent year, 49% of Rx were for the lowest dose of 24/26mg, followed by 31% for the intermediate 49/51mg dose, and 21% for the highest 97/103mg dose. There were more refill Rx than new Rx for all doses. For higher doses, more Rx were written by cardiologists than non-cardiologists (49/51mg: 59% vs. 41%; 97/103mg: 59% vs 41%, for cardiologists vs. non-cardiologists, respectively) (p<0.0001). There were fewer Rx for the target dose (97/103mg) in the oldest age than the youngest age category (11% for age 85+ vs. 24% for age 40-64 years). Conclusions: In the real-world setting, only 1 in 5 sacubitril/valsartan Rx dispensed in 2018/19 were for the target dose of 97/103mg with even lower use in the elderly population. The number of Rx prescribed by non-cardiologists has increased steeply, yet higher doses were prescribed more often by cardiologists. Given that these lower doses may not provide the same clinical benefits shown with higher doses in the PARADIGM-HF trial, identification of barriers or risk factors for underdosing of sacubitril/valsartan and its clinical implications warrants further evaluation.

Design as an Agent for Public Policy Innovation

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Federico VAZ ◽  
Sharon PRENDEVILLE
Keyword(s):  
Public Policy ◽  
Process Model ◽  
Public Policies ◽  
Policy Innovation ◽  
Design Methods ◽  
Policy Effectiveness ◽  
The Public ◽  
Dependent Activity ◽  
Effectiveness And Efficiency ◽  
Context Dependent

Described as units developing public policies in a design-oriented manner, Policy Labs are tasked to innovate to gain in policy effectiveness and efficiency. However, as public policymaking is a context-dependent activity, the way in which these novel organisations operate significantly differs. This study discusses the emergence of design approaches for policy innovation. The purpose is to map how Policy Labs in Europe introduce design approaches at distinct stages of the policymaking cycle. For this study, 30 organisations in Europe operating at various levels of government were surveyed. Based on the public policymaking process model, it investigates which design methods are Policy Labs deploying to innovate public policies. The study exposed a gap in the awareness of the utilised methods' nature. It also showed that the use of design methods is of less importance than the introduction of design mindsets for public policy innovation, namely ‘user-centredness’, ‘co-creation’, and ‘exploration’.

Investigating the President

2016 ◽  
Author(s):  
Douglas L. Kriner ◽  
Eric Schickler
Keyword(s):  
Public Policy ◽  
Political Theater ◽  
Policy Outcomes ◽  
Presidential Power ◽  
Political Pressure ◽  
Comprehensive Overview ◽  
Partisan Polarization ◽  
Approval Rating ◽  
Congressional Investigations ◽  
Over Time

Although congressional investigations have provided some of the most dramatic moments in American political history, they have often been dismissed as mere political theater. But these investigations are far more than grandstanding. This book shows that congressional investigations are a powerful tool for members of Congress to counter presidential aggrandizement. By shining a light on alleged executive wrongdoing, investigations can exert significant pressure on the president and materially affect policy outcomes. This book constructs the most comprehensive overview of congressional investigative oversight to date, analyzing nearly 13,000 days of hearings, spanning more than a century, from 1898 through 2014. The book examines the forces driving investigative power over time and across chambers, and identifies how hearings might influence the president’s strategic calculations through the erosion of the president’s public approval rating, and uncover the pathways through which investigations have shaped public policy. Put simply, by bringing significant political pressure to bear on the president, investigations often afford Congress a blunt, but effective check on presidential power—without the need to worry about veto threats or other hurdles such as Senate filibusters. In an era of intense partisan polarization and institutional dysfunction, the book delves into the dynamics of congressional investigations and how Congress leverages this tool to counterbalance presidential power.

Environmentalists, Nuclear Waste, and the Politics of Passive Exclusion in Germany

2001 ◽  
Vol 19 (4) ◽  
pp. 43-63 ◽  
Author(s):  
Christian Hunold
Keyword(s):  
Public Policy ◽  
Public Sphere ◽  
Nuclear Waste ◽  
Environmental Movement ◽  
The State ◽  
Radioactive Wastes ◽  
Liberal Democratic ◽  
Democratic State ◽  
Ecological Democracy ◽  
Over Time

In this essay I examine the dispute between the German GreenParty and some of the country’s environmental nongovernmentalorganizations (NGOs) over the March 2001 renewal of rail shipmentsof highly radioactive wastes to Gorleben. My purpose indoing so is to test John Dryzek’s 1996 claim that environmentalistsought to beware of what they wish for concerning inclusion in theliberal democratic state. Inclusion on the wrong terms, arguesDryzek, may prove detrimental to the goals of greening and democratizingpublic policy because such inclusion may compromise thesurvival of a green public sphere that is vital to both. Prospects forecological democracy, understood in terms of strong ecologicalmodernization here, depend on historically conditioned relationshipsbetween the state and the environmental movement that fosterthe emergence and persistence over time of such a public sphere.

scholarly journals Evidence for Designing Public Policies Aimed at Reducing Food Waste and Food Insecurity in Mexico

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1727-1727
Author(s):  
Verónica Mundo-Rosas
Keyword(s):  
Public Policy ◽  
Food Insecurity ◽  
Food Waste ◽  
Scientific Evidence ◽  
Public Policies ◽  
Southern Mexico ◽  
Funding Sources ◽  
National Production ◽  
Development Goals ◽  
Food Residues

Abstract Objectives To analyze the magnitude and distribution of food waste and insecurity in Mexico as a first step in designing public policies to counteract these problems. Methods Based on methodology proposed by Subirats et al. (2008), we analyzed the magnitude and distribution of food waste and insecurity in Mexico. Using scientific evidence and official data, we responded to the following guiding questions: What is the problem? What is the magnitude of the problem? Who are the population groups most affected by the problem and where do they reside? To what extent does coverage under current public policies address these problems? Results Problem: By 2050, the Mexican population will have grown by 22.9 million with respect to 2015. The country's capacity to produce the amount of food required in the future will depend largely on what proportion of the population has the necessary financial resources to acquire the food it needs, and whether food is equitably distributed. Magnitude of the problem: Mexico loses and wastes approximately 34% of the national production of items in the basic food basket while 26.4 million Mexicans lack sufficient income to acquire the quantity and quality of food they need. Those affected the most: From an environmental viewpoint, the larger cities in Mexico constitute the principal production centers of food waste, among other residues. This causes air, land and water pollution at the regional level, as well as serious health problems in the population. From an ethical and nutritional perspective, food waste indirectly affects those experiencing food insecurity. Location of the affected population: In 2012, central Mexico was the largest generator of urban solid waste including organic and, specifically, food residues. Conversely, southern Mexico was the region most affected by food insecurity. Public policy coverage: Despite the magnitude of the problem, several Mexican states have no public policy in place to combat food waste or insecurity. Conclusions The evidence provided by our study contributes to decision making in the formulation of public policies aimed at reducing food loss and waste as well as food insecurity. It also serves to monitor progress towards the 2030 Sustainable Development Goals. Funding Sources None.

scholarly journals Recomposing persons: Scavenging and storytelling in a birth cohort archive

2021 ◽  
pp. 095269512199539
Author(s):  
Penny Tinkler ◽  
Resto Cruz ◽  
Laura Fenton
Keyword(s):  
Life Course ◽  
Cohort Studies ◽  
Birth Cohort ◽  
Quantitative Data ◽  
Population Level ◽  
Relational Embeddedness ◽  
The Life Course ◽  
Over Time

Birth cohort studies can be used not only to generate population-level quantitative data, but also to recompose persons. The crux is how we understand data and persons. Recomposition entails scavenging for various (including unrecognised) data. It foregrounds the perspective and subjectivity of survey participants, but without forgetting the partiality and incompleteness of the accounts that it may generate. Although interested in the singularity of individuals, it attends to the historical and relational embeddedness of personhood. It examines the multiple and complex temporalities that suffuse people’s lives, hence departing from linear notions of the life course. It implies involvement, as well as reflexivity, on the part of researchers. It embraces the heterogeneity and transformations over time of scientific archives and the interpretive possibilities, as well as incompleteness, of birth cohort studies data. Interested in the unfolding of lives over time, it also shines light on meaningful biographical moments.

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