scholarly journals Local Government Stakeholder Perceptions of Legitimacy and Conflict of Interest: The Alcohol Industry and the "Drink Free Days" Campaign in England

2021 ◽  
Author(s):  
Helen Walls ◽  
Benjamin Hawkins ◽  
Anna Durrance-Bagale
Keyword(s):  
Public Health ◽  
Online Survey ◽  
Local Authority ◽  
Conflicts Of Interest ◽  
Alcohol Policy ◽  
Free Text ◽  
Structured Interviews ◽  
Alcohol Education ◽  
Alcohol Industry ◽  
Survey Responses

Background: Industry involvement in alcohol policy is highly contentious. The Drink Free Days (DFD) campaign (2018- 2019) run by Public Health England (PHE), an executive agency of government, and Drinkaware, an industry-funded ‘alcohol education charity’ to encourage middle-aged drinkers to abstain from drinking on some days was criticised for perceived industry involvement. We examine the extent to which the DFD campaign was supported by local-authority Directors of Public Health (DPHs) in England – which have a statutory remit for promoting population health within their locality – and their reasons for this. Methods: Our mixed-methods approach included a stakeholder mapping, online survey, and semi-structured interviews. The stakeholder mapping provided the basis for sampling survey and interview respondents. In total, 25 respondents completed the survey, and we conducted 21 interviews with DPHs and their local authority (LA) representatives. We examined survey responses, and coded free-text survey and interview responses to identify key themes. Results: While some respondents supported the DFD campaign, others did not promote it, or actively opposed it, due mainly to concerns about conflicts of interest and the legitimacy of industry involvement in the campaign. These were considered to undermine PHE’s independence and deflect attention from more important, evidence-based policy interventions such as alcohol pricing while conferring vicarious credibility on Drinkaware. We also found low levels of knowledge about alcohol-related harm, the effectiveness of different policies to address these and the policy-influencing strategies used by the alcohol industry. Conclusion: The findings highlight the dangers of industry partnership and potential conflicts of interest for government agencies and the ineffectiveness of the campaigns they run at local and national levels. They demonstrate the need for caution in engaging with industry-associated bodies at all levels of government and are thus of potential relevance to studies of other health-harming industries and policy contexts.

scholarly journals Public-private partnerships and the politics of alcohol policy in England: the Coalition Government’s Public Health ‘Responsibility Deal’

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Benjamin Hawkins ◽  
Jim McCambridge
Keyword(s):  
Public Health ◽  
Policy Development ◽  
Conflicts Of Interest ◽  
Policy Decision ◽  
Alcohol Policy ◽  
Relationship Building ◽  
Regulatory Regime ◽  
Evidence Based ◽  
Structured Interviews ◽  
Health Responsibility

Abstract Background The 2010–2015 Conservative-led Coalition Government launched their flagship Public Health Responsibility Deal (PHRD) for England in 2011; a year before their alcohol strategy. This co-regulatory regime placed alcohol industry actors at the heart of policy-making, but was viewed with scepticism by public health actors. This article examines the ways in which the PHRD structured the alcohol policy environment throughout this period, which included the rejection of evidence-based policies such as minimum unit pricing. Methods This article draws on 26 semi-structured interviews with policy actors (parliamentarians, civil servants, civil society actors and academics) in 2018. Respondents were identified and recruited using purposive sampling. Interviews were recorded, transcribed and analysed using thematic coding. Results The PHRD shaped the context of alcohol policy development at Westminster throughout this period. It circumscribed the policy space by taking evidence-based measures not amenable to industry partnership off the agenda. While the PHRD created important opportunities for industry engagement with policy-makers, it undermined public health actors’ access to government, particularly following their withdrawal from the process. Moreover, the PHRD demonstrates the enduring appeal of partnership as a policy idea for governments, despite a lack of evidence of their effectiveness. Conclusions This study of the PHRD demonstrates the ways in which industry actors are able to influence policy through long-term relationship building and partnership working on policy decision-making. Whilst such partnership approaches may appear to have the potential to mitigate some of alcohol harms, they create fundamental conflicts of interest, and may undermine the very causes they seek to further.

scholarly journals Are public health measures and individualised care compatible in the face of a pandemic? A national observational study of bereaved relatives’ experiences during the COVID-19 pandemic

2021 ◽  
pp. 026921632110198
Author(s):  
Catriona R Mayland ◽  
Rosemary Hughes ◽  
Steven Lane ◽  
Tamsin McGlinchey ◽  
Warren Donnellan ◽  
...  
Keyword(s):  
Public Health ◽  
Family Support ◽  
Online Survey ◽  
Free Text ◽  
Professional Networks ◽  
Dying Patients ◽  
The Face ◽  
Individualised Care ◽  
The Impact ◽  
Informative Communication

Background: COVID-19 public health restrictions have affected end-of-life care experiences for dying patients and their families. Aim: To explore bereaved relatives’ experiences of quality of care and family support provided during the last days of life; to identify the impact of factors associated with perceived support. Design: A national, observational, open online survey was developed and disseminated via social media, public fora and professional networks (June–September 2020). Validated instruments and purposively designed questions assessed experiences. Analysis used descriptive statistics, logistic regression and thematic analysis of free-text responses. Participants: Individuals (⩾18 years) who had experienced the death of a relative/friend (all care settings) within the United Kingdome during the COVID-19 pandemic. Results: Respondents ( n = 278, mean 53.4 years) tended to be female ( n = 216, 78%); over half were ‘son/daughter’ (174, 62.6%) to the deceased. Deceased individuals (mean 81.6 years) most frequently died in their ‘usual place of care’ ( n = 192, 69.3%). Analysis established five conceptual themes affecting individualised care: (1) public health restrictions compounding the distress of ‘not knowing’; (2) disparate views about support from doctors and nurses; (3) challenges in communication and level of preparedness for the death; (4) delivery of compassionate care; (5) emotional needs and potential impact on grief. Male respondents (OR 2.9, p = 0.03) and those able to visit (OR 2.2, p = 0.04) were independently associated with good perceptions of family support. Conclusion: Despite public health restrictions, individualised care can be enabled by proactive, informative communication; recognising dying in a timely manner and facilitating the ability to be present before death.

Exposing the tactics of alcohol companies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Moore AM
Keyword(s):  
Public Health ◽  
Tobacco Industry ◽  
Self Regulation ◽  
World Market ◽  
Alcohol Policy ◽  
Alcohol Industry ◽  
Members Of Parliament ◽  
The World ◽  
Prime Objective ◽  
Insight Into

Abstract Background The alcohol industry has taken a page from the tobacco industry play book in an attempt to resist regulation through delay, self-regulation and effective lobbying. The global alcohol industry is constantly seeking to increase sales of harmful products through widespread marketing, the targeting of young people, and resisting regulatory action. Methods An assessment of the number of lobbyists engaged in one form of another to influence members of Parliament in Australia is being conducted to provide an insight into the attempts to influence alcohol policy. This follows a scan of the lobbyists' register by Daube et al in 2018 that found the while the tobacco industry had 20 direct lobbyists and 14 indirect, the junk food industry 33 direct and 13 indirect, the most dominant was the alcohol industry with 43 direct and 23 indirect. A careful re-examination of the register in 2020 is expected to reveal an increase in these numbers. There will also be an examination of the State and Territory registers in an attempt to understand the overall numbers of people specifically attempting to influence governments. Discussion This particular examination is focussed on the Australian Parliament/s. However, the message will be similar world-wide. Companies such as Diageo have a significant share of the world market with net sales, for example, being 25% of scotch, 16% of beer and 11% of vodka. Their “Drinkiq” website claims “Diageo is committed to preventing and reducing alcohol abuse around the world”. However, other business websites illustrate that their prime objective is to sell more alcohol. Presentation The presentation will focus on the importance of countering the efforts of industry in increasing availability of alcohol. It will also provide a series of steps that public health advocates can take in order to persuade governments of the importance of protecting community health through appropriate regulation of the marketing and sales of alcohol. Key messages The alcohol industry seeks to increase sales while arguing it is protecting health. Public health advocates do have the tools to counter approaches by alcohol companies.

Management of Conflicts of Interest in WHO’s Consultative Processes on Global Alcohol Policy

2021 ◽  
Author(s):  
June YY Leung ◽  
Sally Casswell
Keyword(s):  
Policy Development ◽  
Tobacco Industry ◽  
Conflicts Of Interest ◽  
Action Plan ◽  
Global Strategy ◽  
Alcohol Policy ◽  
World Health ◽  
Web Based ◽  
Alcohol Industry ◽  
State Actors

Background The World Health Organization (WHO) has engaged in consultations with the alcohol industry in global alcohol policy development, including currently a draft action plan to strengthen implementation of the Global strategy to reduce the harmful use of alcohol. WHO’s Framework for Engagement with Non-State Actors (FENSA) is an organization-wide policy that aims to manage potential conflicts of interest in WHO’s interactions with private sector entities, non-governmental institutions, philanthropic foundations and academic institutions. Methods We analysed the alignment of WHO’s consultative processes with non-state actors on "the way forward" for alcohol policy and a global alcohol action plan with FENSA. We referred to publicly accessible WHO documents, including the Alcohol, Drugs and Addictive Behaviours Unit website, records of relevant meetings, and other documents relevant to FENSA. We documented submissions to two web-based consultations held in 2019 and 2020 by type of organization and links to the alcohol industry. Results WHO’s processes to conduct due diligence, risk assessment and risk management as required by FENSA appeared to be inadequate. Limited information was published on nonstate actors, primarily the alcohol industry, that participated in the consultations, including their potential conflicts of interest. No minutes were published for WHO’s virtual meeting with the alcohol industry, suggesting a lack of transparency. Organizations with known links to the tobacco industry participated in both web-based consultations, despite FENSA’s principle of non-engagement with tobacco industry actors. Conclusion WHO’s consultative processes have not been adequate to address conflicts of interest in relation to the alcohol industry, violating the principles of FENSA. Member states must ensure that WHO has the resources to implement and is held accountable for appropriate and consistent safeguards against industry interference in the development of global alcohol policy.

scholarly journals P21 Feasibility of the Learning and Exercise to Avert Pain (LEAP) programme: an evaluation of a group therapy intervention for young people with chronic musculoskeletal pain

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_4) ◽  
Author(s):  
Hannah Wong ◽  
Margaret Wheeler ◽  
Jennifer Nisbet ◽  
Janet McDonagh ◽  
Verna Cuthbert
Keyword(s):  
Young People ◽  
Musculoskeletal Pain ◽  
Conflicts Of Interest ◽  
Outcome Data ◽  
Free Text ◽  
Electronic Patient Records ◽  
Structured Interviews ◽  
Group Setting ◽  
Adolescent Anxiety

Abstract Background Chronic idiopathic musculoskeletal pain (CIMSKP) has become increasingly recognised as a major cause of morbidity in adolescents. In view of increasing referrals to a paediatric rheumatology centre, the Learning and Exercise to Avert Pain (LEAP) intervention was designed as an approach to pain management within a group setting, led by an occupational therapist and a physiotherapist. It involves 2 hour weekly sessions for 6 weeks and includes education, gym activities and relaxation sessions with routine collection of Pain VAS, CHAQ, Bath Pain questionnaires (adolescent BAPQ and parent BAPQ-p forms) at baseline, end of LEAP and 3 months follow-up. We aim to assess the feasibility and impact of LEAP for adolescents with CIMSKP. Methods Young people who had been referred for the LEAP programme were identified (n = 46). Basic demographics and questionnaire scores were collected from electronic patient records and therapy notes. Feasibility was assessed by delivery of programme and percentage completion of questionnaires at three time-points. Semi-structured interviews were conducted with healthcare professionals involved in the programme and analysed using thematic analyses as were any free text comments on the BAPQ from adolescents and parents. Statistical analysis of the outcome data was performed using paired t-tests and SPSS software (v22). Results 46 adolescents were identified: 85% female, median age 16 years (range 10 to 19). 34 participated in LEAP, 12 received 1:1 therapy. Feasibility of programme delivery was achieved with completion of all six sessions. Completion rates for all 3 measures for adolescents/parents at baseline, end of programme review and follow up were 78.6/71.4%, 64.3/71.4%, and 45.5/36.4% respectively. Adolescent scores indicated a significant increase in impairment in the development subscale scores on BAPQ from baseline to programme end (p = 0.021) although not at follow up. Parent scores for adolescent anxiety and pain-specific anxiety on BAPQ-p increased significantly from end of programme to follow-up (p = 0.017, p = 0.034 respectively). Parents scored higher than adolescents for most outcomes. The qualitative data (available for 11 adolescents, 12 parents) revealed that parents and adolescents appreciated learning coping techniques and gaining a greater understanding of chronic pain. The intervention was perceived to be socially beneficial in particular but imperfect in terms of data collection by the professionals interviewed (n = 2). Conclusion Baseline demographics of the LEAP participants echoed current literature. Delivery of the programme was feasible and the programme was positively received by young people, their parents and professionals alike. The increase in adolescent development subscale scores following the programme could represent increased self-reflection and/or peer to peer observations as a result of the group setting but needs longer term follow-up data to clarify further. The increase in parental anxiety highlights the need for a concurrent session for parents. Routine collection of objective measures remains challenging in non-research setting. Conflicts of Interest The authors declare no conflicts of interest.

scholarly journals The New Zealand podiatry profession – a workforce in crisis?

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Matthew Carroll ◽  
Hannah Jepson ◽  
Prue Molyneux ◽  
Angela Brenton-Rule
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Private Practice ◽  
Sports Medicine ◽  
Online Survey ◽  
Health Sector ◽  
New Graduates ◽  
The North ◽  
New Graduate ◽  
Survey Responses

Abstract Background This is the first study to explore workforce data from the Podiatrists Board of New Zealand. The study analysed data from an online survey which New Zealand podiatrists complete as part of their application for an Annual Practising Certificate. Methods Survey responses between 2015 and 2019 were analysed. Data was related to work setting, employment status, work hours, location, professional affiliations, and number of graduates entering practice. Survey data was downloaded by a second party who provide data security for the Podiatrists Board of New Zealand workforce data. All data supplied for analysis were deidentified and could not be re-linked to an individual practitioner. Results In 2019 there were 430 podiatrists who held an Annual Practising Certificate. Eighty percent of podiatrists who work in New Zealand are in private practice, with 8% employed in the public health sector. Podiatrist’s work is a mix of general podiatry, diabetes care and sports medicine. The majority are self-employed (40%) or business owners (19%). Approximately 40% work between 31 to 40 h per week and 46 to 50 weeks per year. The majority are female (67%) with most practising in the North Island (69%) and located in the Auckland region (33%). On average 76% of new graduates were issued an Annual Practising Certificate between 2015 and 2019. Conclusion The New Zealand podiatry profession is small and growing at a slow rate, consequently there is evidence of a workforce shortage. To maintain a per-capita ratio of podiatrists approximate to Australia and the United Kingdom an additional 578 podiatrists are required in the New Zealand workforce. There are not enough new graduate practitioners entering the workforce and once practising, the majority enter private practice in the face of limited public health employment opportunities.

scholarly journals Local Alcohol Policy Implementation in Scotland: Understanding the Role of Accountability within Licensing

2019 ◽  
Vol 16 (11) ◽  
pp. 1880 ◽  
Author(s):  
Alex Wright
Keyword(s):  
Public Health ◽  
Policy Implementation ◽  
National Level ◽  
Alcohol Policy ◽  
Structured Interviews ◽  
Public Health Perspective ◽  
Health Goals ◽  
Documentary Analysis ◽  
Guidance Documents ◽  
Specific Implementation

Scotland has been ambitious in its policy and legislative efforts to tackle alcohol-related harm, efforts which include the innovative feature of a ‘public health objective’ within local alcohol licensing. However, the persistence of alcohol-related harms and inequalities requires further examination of both the overarching Scottish alcohol strategy and its specific implementation. A qualitative case study was undertaken to explore how alcohol policy is implemented locally in Scotland, with data generated from (i) documentary analysis of 12 relevant policies, legislation, and guidance documents; and (ii) a thematic analysis of semi-structured interviews with 54 alcohol policy implementers in three Scottish localities and nine national-level stakeholders. The data suggest there is a tension between the intentions of licensing legislation and the way it is enacted in practice, and that accountability emerges as an important factor for understanding why this occurs. In particular, there are a lack of accountability mechanisms acting upon Scottish Licensing Boards to ensure they contribute to the public health goals of the Scottish alcohol strategy. From a public health perspective, this has perpetuated a system in which Licensing Boards continue to act with autonomy from the rest of the alcohol policy implementation system, creating a challenge to the achievement of public health goals. Alcohol policy in Scotland is likely to fall short of intended goals as long as the tension between licensing legislation and enacted licensing practices remains.

Historical Context and Current Status of the Intersection of Physical Activity and Public Health: Results of the 2015 American Kinesiology Association’s Opportunities for Kinesiology Survey

2015 ◽  
Vol 4 (4) ◽  
pp. 329-345 ◽  
Author(s):  
Bradley J. Cardinal ◽  
Minsoo Kang ◽  
James L. Farnsworth ◽  
Gregory J. Welk
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Online Survey ◽  
Overall Response Rate ◽  
Historical Context ◽  
Community Outreach ◽  
Current Status ◽  
Survey Results ◽  
Survey Responses ◽  
Program Options

Kinesiology leaders were surveyed regarding their views of the (re)emergence of physical activity and public health. Their views were captured via a 25-item, online survey conducted in 2014. The survey focused on four areas: (a) types of affiliation with public health; (b) program options and course coverage; (c) outreach programming; and (d) perspectives on integration. Member and nonmember institutions of the American Kinesiology Association received the survey. Responses were received from 139 institutional leaders, resulting in an overall response rate of 21.4%. Key findings included that the combination of physical activity and public health was seen as both a stand-alone subdisciplinary area within kinesiology and also an area that has a great deal of potential for collaboration, the acquisition of external funding, and further strengthening of community outreach and engagement. The survey results are placed in historical context and interpreted with various caveats and limitations in mind.

scholarly journals The art and science of priority-setting: assessing the value of Public Health England’s Prioritization Framework

2020 ◽  
Author(s):  
G Maniatopoulos ◽  
D J Hunter ◽  
J Gray
Keyword(s):  
Public Health ◽  
Priority Setting ◽  
Local Authority ◽  
Participant Observation ◽  
Adoption Process ◽  
Early Adopter ◽  
Structured Interviews ◽  
Local Authorities ◽  
The Impact ◽  
Prioritization Framework

ABSTRACT Background Findings are presented from the evaluation of Public Health England’s (PHE) Prioritization Framework (PF) aimed to assist local authority commissioners with their public health investment and disinvestment decisions. The study explored the take up of the PF in three early adopter local authority settings. Methods Semi-structured interviews (n = 30) across three local authorities supplemented by participant observation of workshops. Results Participants acknowledged that the PF provided a systematic means of guiding priority-setting and one that encouraged transparency over investment and disinvestment decisions. The role performed by PHE and its regional teams in facilitating the process was especially welcomed and considered critical to the adoption process. However, uptake of the PF required a significant investment of time and commitment from public health teams at a time when resources were stretched. The impact of the political environment in the local government was a major factor determining the likely uptake of the PF. Ensuring committed leadership and engagement from senior politicians and officers was regarded as critical to success. Conclusions The study assessed the value and impact of PHE’s PF tool in three early adopter local authorities. Further research could explore the value of the tool in aiding investment and disinvestment decisions and its impact on spending.

Engaged, overextended, or burned out: What is the state of the disaster response workforce?

2021 ◽  
Vol 19 (9) ◽  
pp. 159-168
Author(s):  
Kelsey L. Merlo, PhD ◽  
Kayla C. Jones, MA ◽  
Katrina M. Conen, BA ◽  
Elizabeth A. Dunn, MPH, CPH ◽  
Blake L. Scott, MPH ◽  
...  
Keyword(s):  
Public Health ◽  
Cluster Analysis ◽  
Emotional Exhaustion ◽  
Disaster Response ◽  
Online Survey ◽  
Initial Study ◽  
System Level ◽  
Personal Efficacy ◽  
Study Results ◽  
Survey Responses

The prolonged coronavirus-2019 (COVID-19) pandemic and co-occurring disasters during 2020 took a toll on everyone, taxing public health and disaster management personnel particularly. This initial study evaluated levels of exhaustion, cynicism, and professional efficacy among a broad array of the disaster workforce responding to these events through an online survey. Responses were compared to normative standards from an international dataset using a one-sample t-test and described using k-means cluster analysis. Results from 111 emergency management and disaster services, public health, healthcare, first responders, and other professionals and volunteers indicated high levels of emotional exhaustion and cynicism, along with high levels of personal efficacy compared to normative samples. Perceptions of the heightened risk of contracting COVID-19 were significantly associated with increased emotional exhaustion and cynicism. Cluster analysis results indicated three different patterns of burnout: half of the respondents were overextended (high levels of emotional exhaustion, cynicism, and efficacy) or burned out (high emotional exhaustion and cynicism, low efficacy), while 50 percent were engaged (low emotional exhaustion, low cynicism, and high personal efficacy). This suggests that despite the COVID-19 pandemic, a substantial proportion of the disaster response workforce is still thriving. However, a large proportion is burned out or at high risk (overextended). Limitations of this study include a lack of diversity in the sample, which, although similar to the demographic characteristics of the emergency manager population, may limit the generalizability of the study results. System-level planners can use this information to develop comprehensive workforce approaches, policies, and procedures to prevent burnout for these essential personnel working behind the scenes.

Sign in / Sign up

Export Citation Format

Share Document