scholarly journals Using stated preference methods to inform public health decision making

2021 ◽  
Vol 26 (2) ◽  
pp. 23-41
Author(s):  
Nikolina Dukić Samaržija

Croatia has recognised the importance of prevention programmes in the field of public health, although their effectiveness is not satisfactory due to the low population response, which has a negative impact on the rationalisation of public spending. One of the possible solutions is to consider the stated preferences of the target population. Therefore, the main objective of this study is to evaluate the use of stated preference methods in improving public health prevention programmes. For the purpose of the study, a questionnaire was designed using three different methods - Discrete Choice Experiment (DCE), Contingent Rating method (CR) and Best-Worst Scaling method (BWS). This study shows that the attributes of the Croatian cervical cancer screening programme are significantly associated with the respondents' utility level, which in turn is related to women's response. Since BWS, DCE, and CR measure the same construct - utility - we can say that convergent validity partially confirms the external validity of the methods. The author concludes that it is necessary to implement market principles, i.e. the demand-side analysis using stated preference methods, in the planning, implementation and re-evaluation of public health programmes.

2003 ◽  
Vol 131 (2) ◽  
pp. 849-857 ◽  
Author(s):  
R. F. GRAIS ◽  
J. H. ELLIS ◽  
G. E. GLASS

Instituting air travel restrictions to slow the geographical spread of smallpox cases would have significant consequences and present serious logistical concerns. Public health decision makers must weigh the potential benefits of such restrictions against their negative impact. The goal of this research is to provide a basic analytical framework to explore some of the issues surrounding the use of air travel restrictions as a part of an overall containment strategy. We report preliminary results of a compartmental model for the inter-city spread of smallpox cases resulting from US domestic air travel. Although air traffic can be halted within hours as was shown following the terrorist attacks of 11 September 2001, these results suggest that the consequences of halting domestic air travel may not be outweighed by public health benefits.


Author(s):  
Monika Mitra ◽  
Linda Long-Bellil ◽  
Robyn Powell

This chapter draws on medical, social, and legal perspectives to identify and highlight ethical issues pertaining to the treatment, representation, and inclusion of persons with disabilities in public health policy and practice. A brief history of disability in the United States is provided as a context for examining the key ethical issues related to public health policy and practice. Conceptual frameworks and approaches to disability are then described and applied. The chapter then discusses the imperativeness of expanding access to public health programs by persons with disabilities, the need to address implicit and structural biases, and the importance of including persons with disabilities in public health decision-making.


2021 ◽  
Vol 7 (3) ◽  
pp. e001051
Author(s):  
Caio Sain Vallio ◽  
Gabriela Martins de Oliveira ◽  
Giovana Araujo Kretli Mota ◽  
Alexandre Dias Lopes ◽  
Luiz Hespanhol

BackgroundRunning is an important type of exercise to keep people physically active. However, running also carries a risk of developing running-related injuries (RRI). Therefore, effective and evidence-based RRI prevention programmes are desirable, but are scarce in practice. An approach to face this problem might be the application of methods to develop RRI prevention programmes based on theories of behaviour change.ObjectiveThe purpose of the study was to develop an RRI prevention programme based on perspectives of behavioural and social science theories, as well as taking a framework development approach.MethodsThis was a qualitative study using the Intervention Mapping (IM) framework held between February and March 2018 in São Paulo, Brazil. The participants were involved in running practice. The data collection was conducted during focus group meetings. The data analysis was based on semantic thematic approach using a content analysis orientation based on inductive reasoning.ResultsThe target population of the RRI prevention programme identified was ‘adult recreational runners’. The objectives of the RRI prevention programme were established in two broad actions: (1) to provide feedback on individual training characteristics and RRI risk; and (2) provide/enhance knowledge, skills and self-efficacy on RRI preventive behaviours. The programme is aimed to be delivered through an online system.ConclusionAn RRI prevention programme was developed using the IM framework and a participatory approach. The programme was named ‘RunIn3’, and it is based on providing feedback on running volume and RRI risk, as well as providing knowledge, skills and self-efficacy on RRI preventive behaviours.


Author(s):  
Ernest Osei ◽  
Ruth Francis ◽  
Ayan Mohamed ◽  
Lyba Sheraz ◽  
Fariba Soltani-Mayvan

Abstract Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.


Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 629
Author(s):  
António Teixeira Rodrigues ◽  
João C. F. Nunes ◽  
Marta Estrela ◽  
Adolfo Figueiras ◽  
Fátima Roque ◽  
...  

Background: Antibiotic resistance is a worldwide public health problem, leading to longer hospital stays, raising medical costs and mortality levels. As physicians’ attitudes are key factors to antibiotic prescribing, this study sought to explore their differences between primary care and hospital settings. Methods: A survey was conducted between September 2011 and February 2012 in the center region of Portugal in the form of a questionnaire to compare hospital (n = 154) and primary care (n = 421) physicians’ attitudes and knowledge regarding antibiotic prescribing. Results: More than 70% of the attitudes were statistically different (p < 0.05) between hospital physicians (HPs) and primary care physicians (PCPs). When compared to PCPs, HPs showed higher agreement with antibiotic resistances being a public health problem and ascribed more importance to microbiological tests and to the influence of prescription on the development of resistances. On the other hand, PCPs tended to agree more regarding the negative impact of self-medication with antibiotics dispensed without medical prescription and the need for rapid diagnostic tests. Seven out of nine sources of knowledge’s usefulness were statistically different between both settings, with HPs considering most of the knowledge sources to be more useful than PCPs. Conclusions: Besides the efforts made to improve both antibiotic prescribing and use, there are differences in the opinions between physicians working in different settings that might impact the quality of antibiotic prescribing. In the future, these differences must be considered to develop more appropriate interventions.


Author(s):  
Zuzana Škodová ◽  
Ľubica Bánovčinová ◽  
Eva Urbanová ◽  
Marián Grendár ◽  
Martina Bašková

Background: Postpartum depression has a negative impact on quality of life. The aim of this study was to examine the factor structure and psychometric properties of the Slovak version of the Edinburgh Postnatal Depression Scale (EPDS). Methods: A paper and pencil version of the 10-item EPDS questionnaire was administered personally to 577 women at baseline during their stay in hospital on the second to fourth day postpartum (age, 30.6 ± 4.9 years; 73.5% vaginal births vs. 26.5% operative births; 59.4% primiparas). A total of 198 women participated in the online follow-up 6–8 weeks postpartum (questionnaire sent via e-mail). Results: The Slovak version of the EPDS had Cronbach’s coefficients of 0.84 and 0.88 at baseline (T1) and follow-up, respectively. The three-dimensional model of the scale offered good fit for both the baseline (χ2(df = 28) = 1339.38, p < 0.001; CFI = 0.99, RMSEA = 0.02, and TLI = 0.99) and follow-up (χ2(df = 45) = 908.06, p < 0.001, CFI = 0.93, RMSEA = 0.09, and TL = 0.90). A risk of major depression (EPDS score ≥ 13) was identified in 6.1% in T1 and 11.6% in the follow-up. Elevated levels of depression symptoms (EPDS score ≥ 10) were identified in 16.7% and 22.7% of the respondents at baseline and follow-up, respectively. Conclusions: The Slovak translation of the EPDS showed good consistency, convergent validity, and model characteristics. The routine use of EPDS can contribute to improving the quality of postnatal health care.


2021 ◽  
Vol 6 (3) ◽  
pp. e005207
Author(s):  
Keyrellous Adib ◽  
Penelope A Hancock ◽  
Aysel Rahimli ◽  
Bridget Mugisa ◽  
Fayez Abdulrazeq ◽  
...  

Early on in the COVID-19 pandemic, the WHO Eastern Mediterranean Regional Office recognised the importance of epidemiological modelling to forecast the progression of the COVID-19 pandemic to support decisions guiding the implementation of response measures. We established a modelling support team to facilitate the application of epidemiological modelling analyses in the Eastern Mediterranean Region (EMR) countries. Here, we present an innovative, stepwise approach to participatory modelling of the COVID-19 pandemic that engaged decision-makers and public health professionals from countries throughout all stages of the modelling process. Our approach consisted of first identifying the relevant policy questions, collecting country-specific data and interpreting model findings from a decision-maker’s perspective, as well as communicating model uncertainty. We used a simple modelling methodology that was adaptable to the shortage of epidemiological data, and the limited modelling capacity, in our region. We discuss the benefits of using models to produce rapid decision-making guidance for COVID-19 control in the WHO EMR, as well as challenges that we have experienced regarding conveying uncertainty associated with model results, synthesising and comparing results across multiple modelling approaches, and modelling fragile and conflict-affected states.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Clark ◽  
S Neil-Sztramko ◽  
M Dobbins

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.


Author(s):  
Eric Emerson ◽  
Allison Milner ◽  
Zoe Aitken ◽  
Lauren Krnjacki ◽  
Cathy Vaughan ◽  
...  

Abstract Background Exposure to discrimination can have a negative impact on health. There is little robust evidence on the prevalence of exposure of people with disabilities to discrimination, the sources and nature of discrimination they face, and the personal and contextual factors associated with increased risk of exposure. Methods Secondary analysis of de-identified cross-sectional data from the three waves of the UK’s ‘Life Opportunities Survey’. Results In the UK (i) adults with disabilities were over three times more likely than their peers to be exposed to discrimination, (ii) the two most common sources of discrimination were strangers in the street and health staff and (iii) discrimination was more likely to be reported by participants who were younger, more highly educated, who were unemployed or economically inactive, who reported financial stress or material hardship and who had impairments associated with hearing, memory/speaking, dexterity, behavioural/mental health, intellectual/learning difficulties and breathing. Conclusions Discrimination faced by people with disabilities is an under-recognised public health problem that is likely to contribute to disability-based health inequities. Public health policy, research and practice needs to concentrate efforts on developing programs that reduce discrimination experienced by people with disabilities.


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