Health Research Policy and Systems最新文献

{"title":"Understanding adverse childhood experiences and the call for trauma-informed healthcare system in Turkey: a review.","authors":"Nadire Gülçin Yildiz, Halide Z Aydin, Kemal Aydin, Hatice Yildiz, Grace Sambo, Bwanalori Mwamulima, Joe Maganga Zonda, Doreen Phiri, Yohane Vincent Abero Phiri","doi":"10.1186/s12961-024-01137-3","DOIUrl":"10.1186/s12961-024-01137-3","url":null,"abstract":"<p><p>Over the past four decades, research has underscored the significance of approaching and preventing trauma from a systemic standpoint. Trauma-informed care (TIC) methodologies offer a structure for healthcare practices, striving to convert organizations into trauma-informed systems that employ trauma-specific interventions. This review employs epidemiological and household data from Turkey to underscore the importance of integrating trauma-informed care as a means of prevention and intervention. Through a desk review, the study examines the role of adverse childhood experiences (ACEs), delving into their origin from family dynamics, migration, violence, exposure to violence, juvenile delinquency, and child maltreatment. The research highlights innovative healthcare approaches that leverage data to address complex patient health issues while considering mental health needs. In contemporary times, healthcare organizations acknowledge the value of a data-driven approach to make informed clinical decisions, enhance treatment procedures, and improve overall healthcare outcomes. The reviewed research and empirical data furnish proof of the importance of effective and efficient treatment methods that prioritize trauma prevention and treatment, integrating the role of ACEs. This paper seeks to contribute to discussions on transforming the healthcare system to meet the healthcare needs of Turkish households, all the while taking into account the evolving sociopolitical factors that shape Turkey's population characteristics.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"63"},"PeriodicalIF":4.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11140905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of health service-based research to health service organisations: a qualitative study with senior health service executives.","authors":"Angela L Todd, Nicholas Petrunoff, Michael Frommer, Don Nutbeam","doi":"10.1186/s12961-024-01149-z","DOIUrl":"10.1186/s12961-024-01149-z","url":null,"abstract":"<p><strong>Background: </strong>Research evidence has demonstrably improved health care practices and patient outcomes. However, systemic translation of evidence into practice is far from optimal. The reasons are complex, but often because research is not well aligned with health service priorities. The aim of this study was to explore the experiences and perspectives of senior health service executives on two issues: (1) the alignment between local research activity and the needs and priorities of their health services, and (2) the extent to which research is or can be integrated as part of usual health care practice.</p><p><strong>Methods: </strong>In this qualitative study, semi-structured interviews were conducted with senior health leaders from four large health service organisations that are members of Sydney Health Partners (SHP), one of Australia's nationally accredited research translation centres committed to accelerating the translation of research findings into evidence-based health care. The interviews were conducted between November 2022 and January 2023, and were either audio-recorded and transcribed verbatim or recorded in the interviewer field notes. A thematic analysis of the interview data was conducted by two researchers, using the framework method to identify common themes.</p><p><strong>Results: </strong>Seventeen health executives were interviewed, including chief executives, directors of medical services, nursing, allied health, research, and others in executive leadership roles. Responses to issue (1) included themes on re-balancing curiosity- and priority-driven research; providing more support for research activity within health organisations; and helping health professionals and researchers discuss researchable priorities. Responses to issue (2) included identification of elements considered essential for embedding research in health care; and the need to break down silos between research and health care, as well as within health organisations.</p><p><strong>Conclusions: </strong>Health service leaders value research but want more research that aligns with their needs and priorities. Discussions with researchers about those priorities may need some facilitation. Making research a more integrated part of health care will require strong and broad executive leadership, resources and infrastructure, and investing in capacity- and capability-building across health clinicians, managers and executive staff.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"65"},"PeriodicalIF":4.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141185771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explore the practice and barriers of collaborative health policy and system research-priority setting exercise in Ethiopia.","authors":"Binyam Tilahun, Getasew Amare, Berhanu Fikadie Endehabtu, Asmamaw Atnafu, Lemma Derseh, Kassu Ketema Gurmu, Endalkachew Delllie, Adane Nigusie","doi":"10.1186/s12961-024-01151-5","DOIUrl":"10.1186/s12961-024-01151-5","url":null,"abstract":"<p><strong>Introduction: </strong>Collaboration is gaining prominence in the priority setting of Health Policy And System Research (HPSR). However, its practice and challenges are not well explored in Ethiopia. Understanding the practice and barriers of collaborative Health Policy and System Research will help design approaches and platforms for setting inclusive and participatory policy and system-level health research topics. This paper explores the practice and barriers of collaborative HPSR-priority setting exercise in Ethiopia.</p><p><strong>Methods: </strong>This study investigates the practice and barriers of collaborative health policy and system research priority-setting exercises in Ethiopia. Utilizing a mixed-methods approach, we conducted Key Informant Interviews (KIIs) and an online self-administered survey with open-ended questionnaires to capture diverse perspectives from stakeholders involved in the research priority-setting process. Through conventional content analysis, we identified key contents related to current practices, challenges, and opportunities for enhancing collaboration in health policy and system research prioritization.</p><p><strong>Results: </strong>Our findings reveal a complex landscape characterized by varying levels of stakeholder engagement, institutional capacity constraints, and competing priorities within the health research ecosystem. Despite notable efforts to foster collaboration, stakeholders identified persistent challenges such as limited resources, institutional fragmentation, and inadequate coordination mechanisms as barriers to effective priority-setting processes. The implications of our research extend beyond academic discourse, with direct relevance to health policy and system research practice in Ethiopia. By shedding light on the dynamics of collaborative priority-setting exercises, our findings offer valuable insights for policymakers, researchers, and practitioners seeking to enhance the effectiveness and inclusivity of health research prioritization processes. Addressing the identified barriers and leveraging existing strengths in the research ecosystem can contribute to more evidence-informed health policies and programs, ultimately improving health outcomes for Ethiopian populations.</p><p><strong>Conclusions: </strong>Most institutions do not apply health policy and system research-priority setting to conduct informed decision-making. The barriers explored were weak integration, lack of knowledge, system, and platforms for the priority setting of Health Policy and System Resreach. So, it is recommended to build skills of different actors in the Health Policy and System Research-priority setting exercise and design a system and platform to integrate different stakeholders for collaborative research topics priority setting.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"64"},"PeriodicalIF":4.0,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11138033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the delivery of comprehensive care for people living with HIV in Canada: insights from citizen panels and a national stakeholder dialogue.","authors":"Michael G Wilson, Cristina Mattison, Kerry Waddell, Jean Bacon, Marissa Becker, Christine Bibeau, John N Lavis, Ron Rosenes, Claire E Kendall","doi":"10.1186/s12961-024-01147-1","DOIUrl":"10.1186/s12961-024-01147-1","url":null,"abstract":"<p><strong>Background: </strong>People living with human immunodeficiency virus (HIV) are living longer with health-related disability associated with ageing, including complex conditions. However, health systems in Canada have not adapted to meet these comprehensive care needs.</p><p><strong>Methods: </strong>We convened three citizen panels and a national stakeholder dialogue. The panels were informed by a plain-language citizen brief that outlined data and evidence about the challenge/problem, elements of an approach for addressing it and implementation considerations. The national dialogue was informed by a more detailed version of the same brief that included a thematic analysis of the findings from the panels.</p><p><strong>Results: </strong>The 31 citizen panel participants emphasized the need for more prevention, testing and social supports, increased public education to address stigma and access to more timely data to inform system changes. The 21 system leaders emphasized the need to enhance person-centred care and for implementing learning and improvement across provinces, territories and Indigenous communities. Citizens and system leaders highlighted that policy actions need to acknowledge that HIV remains unique among conditions faced by Canadians.</p><p><strong>Conclusions: </strong>Action will require a national learning collaborative to support spread and scale of successful prevention, care and support initiatives. Such a collaborative should be grounded in a rapid-learning and improvement approach that is anchored on the needs, perspectives and aspirations of people living with HIV; driven by timely data and evidence; supported by appropriate decision supports and aligned governance, financial and delivery arrangements; and enabled with a culture of and competencies for rapid learning and improvement.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"62"},"PeriodicalIF":4.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decentralization of the health system - experiences from Pakistan, Portugal and Brazil.","authors":"Shafaq Mahmood, Rita Sequeira, Muhammad Muneeb Ullah Siddiqui, Marcos Batista Araujo Herkenhoff, Patrícia Pita Ferreira, Adalberto Campos Fernandes, Paulo Sousa","doi":"10.1186/s12961-024-01145-3","DOIUrl":"10.1186/s12961-024-01145-3","url":null,"abstract":"<p><strong>Background: </strong>Decentralization of a health system is a complex and multidimensional phenomenon that demands thorough investigation of its process logistics, predisposing factors and implementation mechanisms, within the broader socio-political environment of each nation. Despite its wide adoption across both high-income countries (HICs) and low-and-middle-income countries (LMICs), empirical evidence of whether decentralization actually translates into improved health system performance remains inconclusive and controversial. This paper aims to provide a comprehensive description of the decentralization processes in three countries at different stages of their decentralization strategies - Pakistan, Brazil and Portugal.</p><p><strong>Main body: </strong>This study employed a systematic analysis of peer-reviewed academic journals, official government reports, policy documents and publications from international organizations related to health system decentralization. A comprehensive search was conducted using reputable databases such as PubMed, Google Scholar, the WHO repository and other relevant databases, covering the period up to the knowledge cutoff date in June 2023. Information was systematically extracted and organized into the determinants, process mechanics and challenges encountered during the planning, implementation and post-decentralization phases. Although decentralization reforms have achieved some success, challenges persist in their implementation. Comparing all three countries, it was evident that all three have prioritized health in their decentralization reforms and aimed to enhance local decision-making power. Brazil has made significant progress in implementing decentralization reforms, while Portugal and Pakistan are still in the process. Pakistan has faced significant implementation challenges, including capacity-building, resource allocation, resistance to change and inequity in access to care. Brazil and Portugal have also faced challenges, but to a lesser extent. The extent, progress and challenges in the decentralization processes vary among the three countries, each requiring ongoing evaluation and improvement to achieve the desired outcomes.</p><p><strong>Conclusion: </strong>Notable differences exist in the extent of decentralization, the challenges faced during implementation and inequality in access to care between the three countries. It is important for Portugal, Brazil and Pakistan to address these through reinforcing implementation strategies, tackling inequalities in access to care and enhancing monitoring and evaluation mechanism. Additionally, fostering knowledge sharing among these different countries will be instrumental in facilitating mutual learning.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"61"},"PeriodicalIF":4.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the nexus between British Columbia's public consumption and decriminalization policies of illegal drugs.","authors":"Farihah Ali, Justine Law, Cayley Russell, Jean-Francois Crépault, João Castel-Branco Goulão, Kurt Lock, Jürgen Rehm","doi":"10.1186/s12961-024-01150-6","DOIUrl":"10.1186/s12961-024-01150-6","url":null,"abstract":"<p><p>In January 2023, the province of British Columbia (BC) decriminalized the possession of certain illegal drugs for personal use. The province's primary intent was to reduce the stigma associated with drug use, as well as barriers for people who use drugs (PWUD) to access treatment and supports. However, less than ten months into the decriminalization policy, due to growing concerns about public safety voiced by municipal governments and communities, the provincial government made amendments to the policy to ban the public consumption of illicit drugs in additional locations, and subsequently introduced additional legislation, Bill 34, aimed at regulating public consumption of drugs in public spaces. Some communities have also implemented local bylaws similarly regulating public drug use. Bill 34 and local bylaws may serve as tools to promote community health and safety and minimize direct and indirect harms associated with public drug use. However, such legislation may re-criminalize PWUD and reinforce negative perceptions surrounding drug use, especially if these policies are not paired with strategies to expand the availability and accessibility of critical harm reduction and housing services. Without ample access to these services, limitations on public drug use can potentially displace individuals to areas where they are more likely to use alone, further exposing them to substance use-related harms, and undermining the goals of decriminalization. The potential effects of these restrictions may also disproportionately impact marginalized populations. As of April 2024, Bill 34 remains on hold. Moving forward, it will be important to monitor this bill, as well as other public consumption bylaws and legislation, and their impact on BC's overall decriminalization initiative. Decision-makers are urged to increase engagement with PWUD and relevant stakeholders in the design and implementation of policies pertaining to public consumption to ensure that they effectively address the evolving needs and realities of PWUD, and align with decriminalization goals.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"60"},"PeriodicalIF":4.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysing the performance of a health innovation ecosystem in the COVID-19 crisis: complexity and chaos theory perspective.","authors":"Mehrnaz Moeenian, Sepehr Ghazinoory, Pegah Yaghmaie","doi":"10.1186/s12961-024-01136-4","DOIUrl":"10.1186/s12961-024-01136-4","url":null,"abstract":"<p><strong>Background: </strong>This research delves into the complexity management of collaborative networks and interorganizational systems in the health innovation ecosystem on the basis of a best practice in the coronavirus disease 2019 (COVID-19) crisis. The objective is to offer specific solutions and guidelines to stakeholders in the health innovation ecosystem to control the chaos resulting from unexpected events along the ecosystem development and evolution path.</p><p><strong>Methods: </strong>For this purpose, the performance of the Health Innovation Ecosystem in Iran (the Every Home is a Health Base plan) has been examined through a detailed and in-depth analysis of events and actions taken using documents, reports and interviews with experts. The practical application of chaos and complex adaptive system features (adaptation, time horizons, edge of chaos, sensitivity to initial conditions, state space and strange attractors) is introduced to identify and manage the transition from a state where the health innovation ecosystem is on the edge of chaos and prone to failure. Data were collected through studying documents, reports and interviews with experts, and then analysed using qualitative content analysis techniques, open and axial coding and metaphors derived from complexity and chaos theories.</p><p><strong>Results: </strong>The findings indicate that to understand and embrace the complexity of the health innovation ecosystem throughout its development and evolution and manage and lead it through the edge of chaos towards successful interorganizational systems performance, it is necessary to use gap analysis to achieve consensus, establish a highly interactive governance structure with key stakeholders of the ecosystem, maintain flexibility to control bifurcations (butterfly effect), prevent transforming emergency solutions into standard routines and ensure the sustainability of the ecosystem against future threats by long-term financial security.</p><p><strong>Conclusions: </strong>This research provides insights into the dynamics of complex health systems and offers strategies for promoting successful innovation through collaborative networks and interorganizational systems in the development and evolution of the health innovation ecosystem. By embracing complexity and chaos, healthcare professionals, policy-makers and researchers can collaboratively address complex challenges and improve outcomes in health network activities. The conclusion section provides guidelines for successfully managing the complexity of the ecosystem and offers suggestions for further research.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"59"},"PeriodicalIF":4.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11106938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research outcomes informing the selection of public health interventions and strategies to implement them: A cross-sectional survey of Australian policy-maker and practitioner preferences.","authors":"Luke Wolfenden, Alix Hall, Adrian Bauman, Andrew Milat, Rebecca Hodder, Emily Webb, Kaitlin Mooney, Serene Yoong, Rachel Sutherland, Sam McCrabb","doi":"10.1186/s12961-024-01144-4","DOIUrl":"10.1186/s12961-024-01144-4","url":null,"abstract":"<p><strong>Background: </strong>A key role of public health policy-makers and practitioners is to ensure beneficial interventions are implemented effectively enough to yield improvements in public health. The use of evidence to guide public health decision-making to achieve this is recommended. However, few studies have examined the relative value, as reported by policy-makers and practitioners, of different broad research outcomes (that is, measures of cost, acceptability, and effectiveness). To guide the conduct of research and better inform public health policy and practice, this study aimed at describing the research outcomes that Australian policy-makers and practitioners consider important for their decision-making when selecting: (a) public health interventions; (b) strategies to support their implementation; and (c) to assess the differences in research outcome preferences between policy-makers and practitioners.</p><p><strong>Method: </strong>An online value-weighting survey was conducted with Australian public health policy-makers and practitioners working in the field of non-communicable disease prevention. Participants were presented with a list of research outcomes and were asked to select up to five they considered most critical to their decision-making. They then allocated 100 points across these - allocating more points to outcomes perceived as more important. Outcome lists were derived from a review and consolidation of evaluation and outcome frameworks in the fields of public health knowledge translation and implementation. We used descriptive statistics to report relative preferences overall and for policy-makers and practitioners separately.</p><p><strong>Results: </strong>Of the 186 participants; 90 primarily identified as policy-makers and 96 as public health prevention practitioners. Overall, research outcomes of effectiveness, equity, feasibility, and sustainability were identified as the four most important outcomes when considering either interventions or strategies to implement them. Scores were similar for most outcomes between policy-makers and practitioners.</p><p><strong>Conclusion: </strong>For Australian policy-makers and practitioners working in the field of non-communicable disease prevention, outcomes related to effectiveness, equity, feasibility, and sustainability appear particularly important to their decisions about the interventions they select and the strategies they employ to implement them. The findings suggest researchers should seek to meet these information needs and prioritize the inclusion of such outcomes in their research and dissemination activities. The extent to which these outcomes are critical to informing the decision of policy-makers and practitioners working in other jurisdictions or contexts warrants further investigation.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"58"},"PeriodicalIF":4.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The TransFORmation of IndiGEnous PrimAry HEAlthcare Delivery (FORGE AHEAD): economic analysis.","authors":"Aleksandra Stanimirovic, Troy Francis, Susan Webster-Bogaert, Stewart Harris, Valeria Rac","doi":"10.1186/s12961-024-01135-5","DOIUrl":"10.1186/s12961-024-01135-5","url":null,"abstract":"<p><strong>Background: </strong>Indigenous populations have increased risk of developing diabetes and experience poorer treatment outcomes than the general population. The FORGE AHEAD program partnered with First Nations communities across Canada to improve access to resources by developing community-driven primary healthcare models.</p><p><strong>Methods: </strong>This was an economic assessment of FORGE AHEAD using a payer perspective. Costs of diabetes management and complications during the 18-month intervention were compared to the costs prior to intervention implementation. Cost-effectiveness of the program assessed incremental differences in cost and number of resources utilization events (pre and post). Primary outcome was all-cause hospitalizations. Secondary outcomes were specialist visits, clinic visits and community resource use. Data were obtained from a diabetes registry and published literature. Costs are expressed in 2023 Can$.</p><p><strong>Results: </strong>Study population was ~ 60.5 years old; 57.2% female; median duration of diabetes of 8 years; 87.5% residing in non-isolated communities; 75% residing in communities < 5000 members. Total cost of implementation was $1,221,413.60 and cost/person $27.89. There was increase in the number and cost of hospitalizations visits from 8/$68,765.85 (pre period) to 243/$2,735,612.37. Specialist visits, clinic visits and community resource use followed this trend.</p><p><strong>Conclusion: </strong>Considering the low cost of intervention and increased care access, FORGE AHEAD represents a successful community-driven partnership resulting in improved access to resources.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"57"},"PeriodicalIF":3.6,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging communities as partners in health crisis response: a realist-informed scoping review for research and policy.","authors":"Mateus Kambale Sahani, Harro Maat, Dina Balabanova, Mirkuzie Woldie, Paul Richards, Susannah Mayhew","doi":"10.1186/s12961-024-01139-1","DOIUrl":"10.1186/s12961-024-01139-1","url":null,"abstract":"<p><strong>Background: </strong>Health is increasingly affected by multiple types of crises. Community engagement is recognised as being a critical element in successful crisis response, and a number of conceptual frameworks and global guideline documents have been produced. However, little is known about the usefulness of such documents and whether they contain sufficient information to guide effective community engagement in crisis response. We undertake a scoping review to examine the usefulness of conceptual literature and official guidelines on community engagement in crisis response using a realist-informed analysis [exploring contexts, mechanisms, and outcomes(CMOs)]. Specifically, we assess the extent to which sufficient detail is provided on specific health crisis contexts, the range of mechanisms (actions) that are developed and employed to engage communities in crisis response and the outcomes achieved. We also consider the extent of analysis of interactions between the mechanisms and contexts which can explain whether successful outcomes are achieved or not.</p><p><strong>Scope and findings: </strong>We retained 30 documents from a total of 10,780 initially identified. Our analysis found that available evidence on context, mechanism and outcomes on community engagement in crisis response, or some of their elements, was promising, but few documents provided details on all three and even fewer were able to show evidence of the interactions between these categories, thus leaving gaps in understanding how to successfully engage communities in crisis response to secure impactful outcomes. There is evidence that involving community members in all the steps of response increases community resilience and helps to build trust. Consistent communication with the communities in time of crisis is the key for effective responses and helps to improve health indicators by avoiding preventable deaths.</p><p><strong>Conclusions: </strong>Our analysis confirms the complexity of successful community engagement and the need for strategies that help to deal with this complexity to achieve good health outcomes. Further primary research is needed to answer questions of how and why specific mechanisms, in particular contexts, can lead to positive outcomes, including what works and what does not work and how to measure these processes.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"22 1","pages":"56"},"PeriodicalIF":4.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}