ETHICAL ANALYSIS IN PUBLIC HEALTH PRACTICE: A MULTI-SECTORAL MIXED-METHODS STUDY

2008 ◽  
Vol 31 (4) ◽  
pp. 19
Author(s):  
Pakes B Upshur
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
Health Practice ◽  
Structured Interviews ◽  
Ethical Awareness ◽  
Public Health Decision ◽  
Health Practitioners ◽  
Value Judgements ◽  
Health Decision ◽  
Public Health Practitioners

Rationale: All decisions in public health practice involve implicit value judgements, and many involve explicit reference to ethical principles. Despite the increased awareness, interest and literature in Public Health Ethics in the past decade, there remains little understanding of what public health practitioners or trainees mean by ethics, what meta-ethical foundations shape their approach to ethical dilemmas, and what prior training in ethics they have had or wish to have. This study aims to answer some of these questions and will serve as the basis for the development of resources to aid public health decision-making. Method: Qualitative and quantitative data were collected from public health practitioners by means of paper and web-based surveys, as well as structured interviews. Data was coded and analysed using SPSS 15. Results: 16/20 trainees, 70/150 Canadian practitioners, and 508/2058 American practitioners responded to the survey; 10 interviews were conducted. There was remarkable heterogeneity of responses regarding prioritization of values and meta-ethical justification of ethical norms. Respondents reported little training in ethics and considerable in enhancing their skills. Conflict between ethical imperatives and the law were a prominent feature of American, but not Canadian respondents. Conclusions: Public Health practitioners hold a variety of disparate views regarding ethics in public health. These translate into different understandings of the goals and means of public health, with far reaching implications in all spheres of practice. A Public Health Ethical Reflection tool was developed to enhance ethical awareness in goal setting, planning and implementation of public health interventions.

scholarly journals Novel Tools Supporting Knowledge Translation for Public Health Practice in British Columbia, Canada

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Joanne Stares ◽  
Jenny Sutherland
Keyword(s):  
Public Health ◽  
Health Care ◽  
Air Quality ◽  
Public Health Practice ◽  
Secondary Data ◽  
Data Sets ◽  
Health Practice ◽  
Notifiable Diseases ◽  
Health Practitioners ◽  
Public Health Practitioners

ABSTRACT ObjectivesUnderlying the delivery of services by the universal Canadian health care system are a number of rich secondary administrative health data sets which contain information on persons who are registered for care and details on their contacts with the system. These datasets are powerful sources of information for investigation of non-notifiable diseases and as an adjunct to traditional communicable disease surveillance. However, there are gaps between public health practitioners, access to these data, and access to experts in the use of these secondary data. The data linkage requires in-depth knowledge of these data including usages, limitations and data quality issues and also the skills to extract data to support secondary usage. OLAP reports have been developed to support operation needs but not on advanced analytics reports for surveillance and cohort study. To fill these gaps, we developed a set of web-based modular, parameterized, extraction and reporting tools for the purpose of: 1) decreasing the time and resources necessary to fill general secondary data requests for public health audiences; 2) quickly providing information from descriptive analysis of secondary data to public health practitioners; 3) informing the development of data feeds for continued enhanced surveillance or further data access requests; 4) assisting in preliminary stages of epidemiological investigations of non-notifiable diseases; and, 5) facilitating access to information from secondary data for evidence-based decision making in public health. ApproachWe intend to present these tools by case study of their application to small area analysis of secondary data in the context of air quality concerns. Data sources include individuals registered for health care coverage in BC, hospital separations, physician consultations, chronic disease registries, and drugs dispensation. Data sets contain complete information from 1992. Data were extracted and analyzed to describe the occurrence of health service utilization for cardiovascular and respiratory morbidity. Analysis was undertaken for BC residents in areas identified by local public health as priorities for monitoring. Health outcomes were directly standardized by age and compared to provincial trends by use of the comparative morbidity figure. ResultsResults will include descriptive epidemiological analysis of secondary data relating to respiratory and cardiovascular morbidity in the context of air quality concerns, summary of next steps, as well as an assessment of tool performance. ConclusionsWhere adopted tools such as these can make information from secondary data more accessible to support public health practice, particularly in regions with low analytical or epidemiological capacity.

scholarly journals Knowledge brokering on infectious diseases for public health

2021 ◽  
Vol 47 (3) ◽  
pp. 161-165
Author(s):  
Margaret Haworth-Brockman ◽  
Yoav Keynan
Keyword(s):  
Public Health ◽  
Severe Acute Respiratory Syndrome ◽  
Infectious Diseases ◽  
Knowledge Translation ◽  
Public Health Practice ◽  
Health Practice ◽  
Knowledge Brokering ◽  
Health Practitioners ◽  
Set Up ◽  
Public Health Practitioners

The National Collaborating Centres (NCCs) for Public Health (NCCPH) were established in 2005 as part of the federal government’s commitment to renew and strengthen public health following the severe acute respiratory syndrome (SARS) epidemic. They were set up to support knowledge translation for more timely use of scientific research and other knowledges in public health practice, programs and policies in Canada. Six centres comprise the NCCPH, including the National Collaborating Centre for Infectious Diseases (NCCID). The NCCID works with public health practitioners to find, understand and use research and evidence on infectious diseases and related determinants of health. The NCCID has a mandate to forge connections between those who generate and those who use infectious diseases knowledge. As the first article in a series on the NCCPH, we describe our role in knowledge brokering and the numerous methods and products that we have developed. In addition, we illustrate how NCCID has been able to work with public health to generate and share knowledge during the coronavirus disease 2019 (COVID-19) pandemic.

scholarly journals Assessing Laws and Legal Authorities for Public Health Emergency Legal Preparedness

2008 ◽  
Vol 36 (S1) ◽  
pp. 23-27 ◽  
Author(s):  
Brian Kamoie ◽  
Robert M. Pestronk ◽  
Peter Baldridge ◽  
David Fidler ◽  
Leah Devlin ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
The United States ◽  
Health Practice ◽  
Public Health Agencies ◽  
State Constitutions ◽  
Public Health Infrastructure ◽  
Health Agencies ◽  
Health Practitioners ◽  
Public Health Practitioners

Public health legal preparedness begins with effective legal authorities, and law provides a key foundation for public health practice in the United States. Laws not only create public health agencies and fund them, but also authorize and impose duties upon government to protect the public's health while preserving individual liberties. As a result, law is an essential tool in public health practice and is one element of public health infrastructure, as it defines the systems and relationships within which public health practitioners operate.For purposes of this paper, law can be defined as a rule of conduct derived from federal or state constitutions, statutes, local laws, judicial opinions, administrative rules and regulations, international codes, or other pronouncements by entities authorized to prescribe conduct in a legally binding manner. Public health legal preparedness, a subset of public health preparedness, is defined as attainment of legal benchmarks within a public health system.

scholarly journals A new tool to assess community-level evidence to inform public health decision making

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Clark ◽  
S Snelling ◽  
J Beyers ◽  
C Howarth ◽  
S Neil-Sztramko ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Quality Assessment ◽  
Community Level ◽  
Public Health Decision ◽  
Political Preferences ◽  
Health Practitioners ◽  
Health Decision ◽  
Public Health Practitioners

Abstract Background As public health responds to evolving challenges around the globe, it is critical to draw on community-level evidence to inform decisions on emerging needs. There are existing tools for assessing the quality of research evidence, but none that explicitly focus on quality assessment of evidence from community sources, including local health status and ever-changing community and political preferences and actions. Methods The National Collaborating Centre for Methods and Tools (NCCMT) in Canada has developed new tools, called Quality Assessment of Community Evidence (QACE), to help public health decision makers assess the quality of community evidence. The QACE tools were drafted through extensive review of existing frameworks, tools and measures for appraising population health and community evidence, and diverse key informants. We identified three consistent themes that became the core dimensions in these tools. By using the QACE tools, practitioners can answer the question: “Is the quality of this evidence about local context, community needs and political preferences good enough to influence decision making?” Results The QACE tools provide probing questions for each of three dimensions: relevant, trustworthy and equity-informed. Supplementary resources help users delve more deeply into different aspects of quality assessment. The QACE tools are intended for public health practitioners who provide and use evidence to support or make decisions about public health practice and policy, including public health practitioners, senior leaders, policy makers and funders. Conclusions The QACE tool is a new addition to the public health toolbox for evidence-informed decision making, providing questions to ask about evidence from community sources. By using the tool as part of a decision-making process, public health practitioners can be assured that their decisions are based on the best-available evidence for their communities. Key messages The new Quality Assessment of Community Evidence (QACE) tools fill the gap in assessing quality of community-level evidence for public health decision-makers. Community evidence, including local health status and needs and community and political preferences and actions, should be assessed for quality in three critical domains.

scholarly journals What makes a ‘successful’ collaborative research project between public health practitioners and academics? A mixed-methods review of funding applications submitted to a local intervention evaluation scheme

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peter van der Graaf ◽  
Lindsay Blank ◽  
Eleanor Holding ◽  
Elizabeth Goyder
Keyword(s):  
Public Health ◽  
Health Research ◽  
Collaborative Research ◽  
Online Survey ◽  
Public Health Practice ◽  
Rapid Review ◽  
Success Rates ◽  
Evaluation Scheme ◽  
Health Practitioners ◽  
Public Health Practitioners

Abstract Background The national Public Health Practice Evaluation Scheme (PHPES) is a response-mode funded evaluation programme operated by the National Institute for Health Research School for Public Health Research (NIHR SPHR). The scheme enables public health professionals to work in partnership with SPHR researchers to conduct rigorous evaluations of their interventions. Our evaluation reviewed the learning from the first five years of PHPES (2013–2017) and how this was used to implement a revised scheme within the School. Methods We conducted a rapid review of applications and reports from 81 PHPES projects and sampled eight projects (including unfunded) to interview one researcher and one practitioner involved in each sampled project (n = 16) in order to identify factors that influence success of applications and effective delivery and dissemination of evaluations. Findings from the review and interviews were tested in an online survey with practitioners (applicants), researchers (principal investigators [PIs]) and PHPES panel members (n = 19) to explore the relative importance of these factors. Findings from the survey were synthesised and discussed for implications at a national workshop with wider stakeholders, including public members (n = 20). Results Strengths: PHPES provides much needed resources for evaluation which often are not available locally, and produces useful evidence to understand where a programme is not delivering, which can be used to formatively develop interventions. Weaknesses: Objectives of PHPES were too narrowly focused on (cost-)effectiveness of interventions, while practitioners also valued implementation studies and process evaluations. Opportunities: PHPES provided opportunities for novel/promising but less developed ideas. More funded time to develop a protocol and ensure feasibility of the intervention prior to application could increase intervention delivery success rates. Threats: There can be tensions between researchers and practitioners, for example, on the need to show the 'success’ of the intervention, on the use of existing research evidence, and the importance of generalisability of findings and of generating peer-reviewed publications. Conclusions The success of collaborative research projects between public health practitioners (PHP) and researchers can be improved by funders being mindful of tensions related to (1) the scope of collaborations, (2) local versus national impact, and (3) increasing inequalities in access to funding. Our study and comparisons with related funding schemes demonstrate how these tensions can be successfully resolved.

scholarly journals Improving Public Health Policy through Infection Transmission Modelling: Guidelines for Creating a Community of Practice

2015 ◽  
Vol 26 (4) ◽  
pp. 191-195 ◽  
Author(s):  
Seyed M Moghadas ◽  
Margaret Haworth-Brockman ◽  
Harpa Isfeld-Kiely ◽  
Joel Kettner
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Infectious Diseases ◽  
Collaborative Work ◽  
Public Health Practice ◽  
Model Parameters ◽  
Full Potential ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Decision

BACKGROUND: Despite significant research efforts in Canada, real application of modelling in public health decision making and practice has not yet met its full potential. There is still room to better address the diversity of the Canadian population and ensure that research outcomes are translated for use within their relevant contexts.OBJECTIVES: To strengthen connections to public health practice and to broaden its scope, the Pandemic Influenza Outbreak Research Modelling team partnered with the National Collaborating Centre for Infectious Diseases to hold a national workshop. Its objectives were to: understand areas where modelling terms, methods and results are unclear; share information on how modelling can best be used in informing policy and improving practice, particularly regarding the ways to integrate a focus on health equity considerations; and sustain and advance collaborative work in the development and application of modelling in public health.METHOD: The Use of Mathematical Modelling in Public Health Decision Making for Infectious Diseases workshop brought together research modellers, public health professionals, policymakers and other experts from across the country. Invited presentations set the context for topical discussions in three sessions. A final session generated reflections and recommendations for new opportunities and tasks.CONCLUSIONS: Gaps in content and research include the lack of standard frameworks and a glossary for infectious disease modelling. Consistency in terminology, clear articulation of model parameters and assumptions, and sustained collaboration will help to bridge the divide between research and practice.

scholarly journals How can we support best practice? A situational assessment of injury prevention practice in public health.

2019 ◽  
Author(s):  
Sarah A. Richmond ◽  
Sarah Carsley ◽  
Rachel Prowse ◽  
Heather Manson ◽  
Brent Moloughney
Keyword(s):  
Public Health ◽  
Injury Prevention ◽  
Best Practice ◽  
Resource Constraints ◽  
Public Health Practice ◽  
System Level ◽  
Health Practice ◽  
Structured Interviews ◽  
Situational Assessment ◽  
Access To Data

Abstract Background : To effectively impact the significant population burden of injury, we completed a situational assessment of injury prevention practice within a provincial public health system to identify system-wide priorities for capacity-building to advance injury prevention in public health. Methods : Data was collected through semi-structured interviews (n=20) and focus groups (n=19). Participants included a cross-section of injury prevention practitioners and leadership from public health units reflecting different population sizes and geographic characteristics, in addition to public health researchers and experts from academia, public health and not-for-profit organizations. Thematic analysis was used to code all of the data by one reviewer, followed by a second independent reviewer who coded a random selection of interview notes. Major codes and sub codes were identified and final themes were decided through iterations of coding comparisons and categorization. Once data were analysed, we confirmed the findings with the field, in addition to participating in a prioritization exercise to surface the top three needs for support. Results : Major themes that emerged from the data included: current public health practice challenges; capacity and resource constraints, and; injury as a low priority area. Overall, injury prevention is a broad, complex topic that competes with other areas of public health. Best practices are challenged by system-wide factors related to resources, direction, coordination, collaboration, and emerging injury public health issues. Injury is a reportedly under prioritized and under resourced public health area of practice. Practitioners believe that increasing access to data and evidence, and improving collaboration and networking is required to promote best practice. Conclusions : The results of this study suggest that there are several system level needs to support best practice in public health injury prevention in Ontario including reducing research to practice gaps and supporting opportunities for collaboration. Our research contributes to the literature of the complexity of public health practice, and presents several mechanisms of support to increase capacity at a system level to improve injury prevention practice, and eventually lessen the population burden of injury.

scholarly journals Example C: Using online respondent-driven detection for communicable disease control

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y B Helms ◽  
N Hamdiui ◽  
R Eilers ◽  
C J P A Hoebe ◽  
N Dukers ◽  
...  
Keyword(s):  
Public Health ◽  
Mixed Methods Research ◽  
Time Pressure ◽  
Communicable Disease ◽  
Public Health Practice ◽  
Contact Tracing ◽  
Personal Contact ◽  
Health Practice ◽  
Structured Interviews ◽  
Online Questionnaire

Abstract Online respondent-driven detection (online-RDD) is a novel method of case-finding that may enhance contact tracing (CT). However, the opportunities and barriers of online-RDD for public health practice have not yet been investigated from the perspective of public health professionals (PHPs). Therefore, it is unclear what the potential strengths and limitations of online-RDD for CT are. We conducted a sequential exploratory mixed methods research. First, we conducted semi-structured interviews with Dutch PHPs involved in CT. Questions were derived from the diffusion of innovations theory. Second, we distributed an online-questionnaire to 260 Dutch PHPs to study the main findings in a larger population. We used hypothetical scenario’s (scabies, shigella, and mumps) to elicit PHPs’ perceptions of online-RDD. Twelve interviews were held. Response rate to the online-questionnaire was 31% (n = 70). Four themes related to characteristics of online-RDD that influenced PHPs’ intention to adopt online-RDD emerged: advantages over traditional CT, task conflicts and opportunity costs, public health risks, and situational compatibility. PHPs believed online-RDD may enhance CT through increased reach, low-key communication options, and saving time. Limitations were foreseen in the delivery of measures, supporting patients and contacts, missing information and contacts, and causing unrest. Online-RDD may be particularly applicable in situations with digitally skilled and literate target populations, low urgency, low time-pressure, and a simple perspective for action. A majority of PHPs (70%) had a positive adoption intention towards online-RDD. PHPs perceived online-RDD as beneficial to public health practice. Further development of online-RDD should focus on facilitating opportunities for personal contact between PHPs, patients and contacts. A comparative study of ‘traditional’ CT and online-RDD could yield further insights in the potential of online-RDD for public health practice.

Glossary of health equity in the context of environmental public health practice

2019 ◽  
Vol 73 (9) ◽  
pp. 806-809 ◽  
Author(s):  
Karen Rideout ◽  
Dianne Oickle
Keyword(s):  
Public Health ◽  
Health Equity ◽  
Public Health Practice ◽  
Health Sector ◽  
Health Inequities ◽  
Environmental Public Health ◽  
The Social ◽  
Health Practitioners ◽  
Canadian Context ◽  
Public Health Practitioners

Health equity is increasingly present as an overarching goal in public health policy frameworks across the globe. Public health actions to support health equity are challenging because solutions to the root causes of health inequities often lie outside of the health sector, and a specific role for environmental public health practitioners has not been clearly articulated. The regulatory nature of the environmental public health profession means that their role is particularly ambiguous. Still, environmental public health practitioners are well situated to identify and respond to factors that contribute to health inequities because of their role as front-line professionals who interact with a wide cross-sector of the population. This Glossary, rooted primarily in the Canadian context but drawing on lessons from elsewhere, describes environmental public health regulatory practice in relation to health equity, including approaches that practitioners can use to contribute to addressing the social determinants of health.

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