scholarly journals Making evidence and policy in public health emergencies: lessons from COVID-19 for adaptive evidence-making and intervention

2020 ◽  
Vol 16 (3) ◽  
pp. 477-490 ◽  
Author(s):  
Kari Lancaster ◽  
Tim Rhodes ◽  
Marsha Rosengarten
Keyword(s):  
Public Health ◽  
Rapid Assessment ◽  
Social Practices ◽  
Knowledge Generation ◽  
Evidence Based ◽  
Multiple Forms ◽  
Policy And Practice ◽  
Public Health Emergencies ◽  
Key Points ◽  
Speed Up

Background:In public health emergencies, evidence, intervention, decisions and translation proceed simultaneously, in greatly compressed timeframes, with knowledge and advice constantly in flux. Idealised approaches to evidence-based policy and practice are ill equipped to deal with the uncertainties arising in evolving situations of need. Key points for discussion:There is much to learn from rapid assessment and outbreak science approaches. These emphasise methodological pluralism, adaptive knowledge generation, intervention pragmatism, and an understanding of health and intervention as situated in their practices of implementation. The unprecedented challenges of novel viral outbreaks like COVID-19 do not simply require us to speed up existing evidence-based approaches, but necessitate new ways of thinking about how a more emergent and adaptive evidence-making might be done. The COVID-19 pandemic requires us to appraise critically what constitutes ‘evidence-enough’ for iterative rapid decisions in-the-now. There are important lessons for how evidence and intervention co-emerge in social practices, and for how evidence-making and intervening proceeds through dialogue incorporating multiple forms of evidence and expertise. Conclusions and implications:Rather than treating adaptive evidence-making and decision making as a break from the routine, we argue that this should be a defining feature of an ‘evidence-making intervention’ approach to health.

scholarly journals Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Christine W. Hartmann ◽  
Ryann L. Engle ◽  
Camilla B. Pimentel ◽  
Whitney L. Mills ◽  
Valerie A. Clark ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Evidence Based ◽  
National Program ◽  
Extensive Experience ◽  
Evidence Based Practices ◽  
Team Members ◽  
Virtual Experience ◽  
Key Points ◽  
Program Content

Abstract Background Relatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasingly common. They have potentially wider reach, emergent public health situations necessitate their use, and restrictions on resources can make them more attractive. We therefore outline a set of principles for virtual external implementation facilitation and a series of recommendations based on extensive experience successfully using virtual external implementation facilitation in a national program. Model and recommendations Success in virtual external implementation facilitation may be achieved by facilitators applying three overarching principles: pilot everything, incorporate a model, and prioritize metacognition. Five practical principles also help: plan in advance, communicate in real time, build relationships, engage participants, and construct a virtual room for participants. We present eight concrete suggestions for enacting the practical principles: (1) assign key facilitation roles to facilitation team members to ensure the program runs smoothly; (2) create small cohorts of participants so they can have meaningful interactions; (3) provide clarity and structure for all participant interactions; (4) structure program content to ensure key points are described, reinforced, and practiced; (5) use visuals to supplement audio content; (6) build activities into the agenda that enable participants to immediately apply knowledge at their own sites, separate from the virtual experience; (7) create backup plans whenever possible; and (8) engage all participants in the program. Summary These principles represent a novel conceptualization of virtual external implementation facilitation, giving structure to a process that has been, to date, inadequately described. The associated actions are demonstrably useful in supporting the principles and offer teams interested in virtual external implementation facilitation concrete methods by which to ensure success. Our examples stem from experiences in healthcare. But the principles can, in theory, be applied to virtual external implementation facilitation regardless of setting, as they and the associated actions are not setting specific.

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.

scholarly journals The challenge of bringing evidence in decision-making for public health emergencies: can preparedness reach out to HTA?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C E Chronaki ◽  
A Miglietta
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Policy Development ◽  
Digital Health ◽  
Resource Planning ◽  
Public Health Emergency ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
The Impact ◽  
Evidence Based Decision Making

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 reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. 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 to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.

scholarly journals Managing Borders During Public Health Emergencies of International Concern: A Proposed Typology of Cross-border Health Measures

2021 ◽  
Author(s):  
Kelley Lee ◽  
Karen A Grépin ◽  
Catherine Worsnop ◽  
Summer Marion ◽  
Julianne Piper ◽  
...  
Keyword(s):  
Public Health ◽  
Research Policy ◽  
Grey Literature ◽  
World Health ◽  
Border Health ◽  
Policy And Practice ◽  
Public Health Emergencies ◽  
Cross Border ◽  
Health Measures ◽  
Starting Point

Abstract BackgroundThe near universal adoption of cross-border health measures during the COVID-19 pandemic worldwide has prompted significant debate about their effectiveness and compliance with international law. The number of measures used, and the range of measures applied, have far exceeded previous public health emergencies of international concern. However, efforts to advance research, policy and practice to support their effective use has been hindered by a lack of clear and consistent definition. ResultsBased on a review of existing datasets for cross-border health measures, such as the Oxford Coronavirus Government Response Tracker and World Health Organization Public Health and Social Measures, along with analysis of secondary and grey literature, we propose six categories to define measures more clearly and consistently – type of movement (travel and trade), policy goal, level of jurisdiction, use by public versus private sector, stage of journey, and degree of restrictiveness. These categories are then be brought together into a proposed typology that can support research with generalizable findings and comparative analyses across jurisdictions. The typology facilitates evidence-informed decision-making which takes account of policy complexity including trade-offs and externalities. Finally, the typology can support efforts to strengthen coordinated global responses to outbreaks and inform future efforts to revise the WHO International Health Regulations (2005). ConclusionsThe widespread use of cross-border health measures during the COVID-19 pandemic has prompted significant reflection on available evidence, previous practice and existing legal frameworks. The typology put forth in this paper aims to provide a starting point for strengthening research, policy and practice.

Evidence-Based Approach for Disaster Preparedness Authorities to Inform the Contents of Repositories for Prescription Medications for Chronic Disease Management and Control

2008 ◽  
Vol 23 (5) ◽  
pp. 447-457 ◽  
Author(s):  
David W. Brown ◽  
Stacy L. Young ◽  
Michael M. Engelgau ◽  
George A. Mensah
Keyword(s):  
Public Health ◽  
Chronic Disease ◽  
Chronic Conditions ◽  
Causes Of Death ◽  
Prescription Medication ◽  
Evidence Based ◽  
Narcotic Analgesics ◽  
Public Health Emergencies ◽  
Drug Classes ◽  
And Control

AbstractIntroduction:Chronic diseases are major causes of death and disability and often require multiple prescribed medications for treatment and control. Public health emergencies (e.g., disasters due to natural hazards) that disrupt the availability or supply of these medications may exacerbate chronic disease or even cause death.Problem:A repository of chronic disease pharmaceuticals and medical supplies organized for rapid response in the event of a public health emergency is desirable. However, there is no science base for determining the contents of such a repository. This study provides the first step in an evidence-based approach to inform the planning, periodic review, and revision of repositories of chronic disease medications.Methods:Data from the 2004 National Hospital Ambulatory Medical Care Survey (NHAMCS) were used to examine the prescription medication needs of persons presenting to US hospital emergency departments for chronic disease exacerbations. It was assumed that the typical distribution of cases for an emergency department will reflect the patient population treated in the days after a public health emergency. The estimated numbers of prescribed drugs for chronic conditions that represent the five leading causes of death, the five leading primary diagnoses for physician office visits, and the five leading causes of disease burden assessed by disability-adjusted life years are presented.Results:The 2004 NHAMCS collected data on 36,589 patient visits that were provided by 376 emergency departments. Overall, the five drug classes mentioned most frequently for emergency department visits during 2004 were narcotic analgesics (30.7 million), non-steroidal anti-inflammatory drugs (25.2 million), non-narcotic analgesics (15.2 million), sedatives and hypnotics (10.4 million), and cephalosporins (8.2 million). The drug classes mentioned most frequently for chronic conditions were: (1) for heart disease, antianginal agents/vasodilators (715,000); (2) for cancer, narcotic analgesics (53,000); (3) for stroke, non-narcotic analgesics (138,000); (4) for chronic obstructive pulmonary disease, anti-asthmatics/bronchodilators (3.2 million); and (5) for diabetes, hypoglycemic agents (261,000). Ten medication categories were common across four or more chronic conditions.Conclusions:Persons with chronic diseases have an urgent need for ongoing care and medical support after public health emergencies. These findings provide one evidence-based approach for informing public health preparedness in terms of planning for and review of the prescription medication needs of clinically vulnerable populations with prevalent chronic disease.

scholarly journals Addiction care in crisis: evidence should drive progressive policy and practice

2019 ◽  
Vol 215 (6) ◽  
pp. 702-703
Author(s):  
Kamaldeep S. Bhui ◽  
Peter Byrne ◽  
Diane Goslar ◽  
Julia Sinclair
Keyword(s):  
Public Health ◽  
Mental Health ◽  
National Government ◽  
Evidence Based ◽  
Policy And Practice ◽  
Good Mental Health ◽  
Specialist Services ◽  
Health Specialist ◽  
Progressive Policy ◽  
Addiction Care

SummaryAddictions are challenging health and social problems that need to be addressed to preserve and promote good mental health and ensure that individuals within society lead healthy and productive lives. Tackling addictions is complex and requires communities, public health, specialist services, and local and national government to act in unison and implement evidence-based interventions. This editorial raises systemic issues that need attention and proposes a range of systemic options.

Evidence-Based Public Health Policy and Practice: Promises and Limits

2005 ◽  
Vol 28 (5) ◽  
pp. 226-230 ◽  
Author(s):  
Laurie M. Anderson ◽  
Ross C. Brownson ◽  
Mindy T. Fullilove ◽  
Steven M. Teutsch ◽  
Lloyd F. Novick ◽  
...  
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Health Policy ◽  
Evidence Based ◽  
Policy And Practice ◽  
Health Policy And Practice

scholarly journals Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority

2021 ◽  
Vol 9 ◽  
Author(s):  
Lene E. Søvold ◽  
John A. Naslund ◽  
Antonis A. Kousoulis ◽  
Shekhar Saxena ◽  
M. Walid Qoronfleh ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Systems ◽  
Healthcare Workers ◽  
Well Being ◽  
Health Impacts ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
Healthcare Workforce ◽  
Health And Well Being

The COVID-19 pandemic has had an unprecedented impact on health systems in most countries, and in particular, on the mental health and well-being of health workers on the frontlines of pandemic response efforts. The purpose of this article is to provide an evidence-based overview of the adverse mental health impacts on healthcare workers during times of crisis and other challenging working conditions and to highlight the importance of prioritizing and protecting the mental health and well-being of the healthcare workforce, particularly in the context of the COVID-19 pandemic. First, we provide a broad overview of the elevated risk of stress, burnout, moral injury, depression, trauma, and other mental health challenges among healthcare workers. Second, we consider how public health emergencies exacerbate these concerns, as reflected in emerging research on the negative mental health impacts of the COVID-19 pandemic on healthcare workers. Further, we consider potential approaches for overcoming these threats to mental health by exploring the value of practicing self-care strategies, and implementing evidence based interventions and organizational measures to help protect and support the mental health and well-being of the healthcare workforce. Lastly, we highlight systemic changes to empower healthcare workers and protect their mental health and well-being in the long run, and propose policy recommendations to guide healthcare leaders and health systems in this endeavor. This paper acknowledges the stressors, burdens, and psychological needs of the healthcare workforce across health systems and disciplines, and calls for renewed efforts to mitigate these challenges among those working on the frontlines during public health emergencies such as the COVID-19 pandemic.

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