Health Research Policy and Systems最新文献

{"title":"Health evidence meets politics: informing the development and evaluation of electoral platforms in Lebanon.","authors":"Fadi El-Jardali, Lama Bou-Karroum, Sabine Salameh, Racha Fadlallah, Rajaa Charif, Michelle Assal","doi":"10.1186/s12961-025-01357-1","DOIUrl":"10.1186/s12961-025-01357-1","url":null,"abstract":"<p><strong>Background: </strong>Whilst significant efforts have been undertaken to strengthen the role of evidence in policymaking, there is still limited work aiming to strengthen the role of evidence in electoral platforms, which are provided to inform citizens' voting decisions in democratic systems. This study aims to develop a guide targeted at political parties and candidates to support them in developing and communicating electoral platforms that are action-oriented, evidence-based and responsive to people needs. It also aims to pilot test and apply an evaluation tool to understand how political platforms are developed in Lebanon, a sectarian-based country, including main gaps, areas for improvement and use of evidence.</p><p><strong>Methods: </strong>To develop the guide, we searched electronic databases and websites to identify documents on the development and evaluation of electoral platforms. We also mapped a sample of existing electoral platforms from democratic countries. Building on the guide, we generated a standard evaluation tool - referred to as K2Platform tool - for scoring electoral platforms. The tool was first pilot tested and then used to evaluate electoral platforms of candidates running for the 2022 Lebanese Parliamentary elections.</p><p><strong>Results: </strong>We included 25 relevant articles that informed the development of the guide and evaluation tool. The guide presents the main phases and criteria involved in planning, designing and communicating electoral platforms. The K2Platform evaluation tool incorporates a set of 12 criteria and was used to evaluate 20 electoral platforms. The evaluation identified shortcomings in the electoral platforms, mainly the limited use of evidence and the absence of timelines and measurable indicators.</p><p><strong>Conclusions: </strong>The guide and K2Platform evaluation tool will make a breakthrough in how electoral platforms are designed to ensure they are transparent, action-oriented and responsive to people's needs. They provide essential criteria for political parties and other candidates to develop evidence-informed electoral platforms that can be translated into effective laws and policies. Our work supports evidence-informed policymaking and contributes to the science of knowledge translation by examining the use of evidence in informing electoral platforms.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"97"},"PeriodicalIF":3.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759955","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":"How can health be further integrated in urban development policymaking in the United Kingdom? A systems mapping approach.","authors":"Geoff Bates, Pablo Newberry, Rachael McClatchey, Jack Newman, Sarah Ayres","doi":"10.1186/s12961-025-01379-9","DOIUrl":"10.1186/s12961-025-01379-9","url":null,"abstract":"<p><strong>Background: </strong>In the United Kingdom the government's new health mission aims to reduce the burden on healthcare services by shifting from treating poor health to prevention. Delivering this requires action on health in policy arenas outside of the health sector such as urban development, as urban environments are key health determinants. However, change is challenging in complex and long-established policy systems and structures. Systems methods can enhance research into such contexts and demonstrate opportunities for delivering cross-cutting preventative health agendas.</p><p><strong>Methods: </strong>This study aimed to enhance understanding of how health is integrated in urban development policymaking, and how to bring about change to support healthier development. It was undertaken over two stages. Firstly, a thematic analysis of data from interviews with 37 United Kingdom policy officials exploring urban development decision-making in central government. Secondly, the development of a causal loop diagram based on the variables and connections between them, identified in the interview data.</p><p><strong>Results: </strong>Analysis revealed how health is not well integrated in urban development policymaking. Through mapping 15 important influencing variables, we identified four main areas where change can be delivered: senior leadership on preventative health, responsibility in urban development teams for health, opportunities in urban development for health experts to promote ideas, and the capacity and capability of officials to act. Addressing any of the factors identified will likely have benefits, but it is by bringing change to multiple highlighted areas that health integration will be maximized.</p><p><strong>Conclusions: </strong>If the United Kingdom Government's health mission is to be effective, policymakers must be empowered and incentivized to act on health in areas such as urban development. There is recent evidence of enhanced leadership on health prevention, but this must be supported in in several ways simultaneously, with increased funding, facilitating joined up working across sectors, and enhancing the use of tools and evidence to understand and promote health outcomes. By taking a systems approach this study adds value to existing understandings by going beyond isolated challenges and opportunities, to illustrate the connections between them and, therefore, how any changes are likely to have wider effects.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"96"},"PeriodicalIF":3.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742018","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":"Health research versus the virus: strengthening systems, saving lives.","authors":"Stephen Robert Hanney, Bahareh Yazdizadeh","doi":"10.1186/s12961-025-01354-4","DOIUrl":"10.1186/s12961-025-01354-4","url":null,"abstract":"<p><p>For this Commentary, we selected papers from those in this journal's Thematic Series on health research systems' pandemic response. The calling notice for papers suggested possible use of a WHO framework for analysing health research systems (HRSs). Whilst it was not widely used in the reported studies, it did provide the basis for the two main, overlapping, topics for analysis in this Commentary. These, in turn, informed the selection criteria for papers. First, we selected papers that described the contributions made towards meeting the needs for pandemic-related research in at least one area we could classify as being one of the nine components of a HRS, and did so in at least one jurisdiction. Second, we identified papers that could contribute to an analysis of how comprehensive HRSs facilitated progress in meeting the needs for pandemic-related research.Using the selection criteria, we included 13 papers in the Commentary covering research in 22 named countries, and many others unnamed. For the first topic, we found that for each of the nine components, we could identify at least two of the included papers, usually more, as having in some ways analysed the contributions made towards meeting the needs for pandemic-related research. Examples included, for coordination, the first HRS component, a paper describing a pandemic preparedness program in Australia. For other HRS components, some papers analysed prioritization systems in the United Kingdom and Iran, and another, research ethics governance across Central American countries. For the finance component, a US paper covered Operation Warp Speed's substantial funding. Papers showed existing capacity for conducting trials contributed to rapid progress on new drugs and vaccines in Brazil, the United Kingdom and the United States. Included papers showed how capacity was mobilized for knowledge production and how evidence, often locally produced, was used in many countries across the income range. Papers cited studies showing pandemic research had saved millions of lives through vaccines and repurposed drugs. For the second topic, evidence suggested that where there was a comprehensive HRS, especially with an overall strategy, considerable progress was made.The Commentary's added value lies in it extracting, collating and organizing data from the 13 papers to facilitate analysis of HRSs. Collectively, the papers provide evidence about the benefits of strengthening HRSs, and challenges (including resource waste) when HRSs were not well developed. This can justify a recommendation to give serious consideration to WHO's call in 2013 for a comprehensive approach to developing health research systems as fully as possible, in as many countries as possible. This could be particularly important before any future pandemics.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"95"},"PeriodicalIF":3.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717769","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":"Policy to practice: insights from implementation of a school-based sanitary napkin distribution programme in Odisha, India.","authors":"Shyama Desaraju, Nishisipa Panda, Rudra Prasad Panigrahy, Bhuputra Panda","doi":"10.1186/s12961-025-01316-w","DOIUrl":"10.1186/s12961-025-01316-w","url":null,"abstract":"<p><strong>Background: </strong>Recognizing the importance of menstrual health and hygiene, governments worldwide, including India, are working towards improving awareness, infrastructure and access to essential products and services. Odisha's state-led \"Khushi\" programme, launched in 2018, is one such initiative providing free sanitary napkins to schoolgirls in government and government-aided schools to improve menstrual hygiene and reduce dropouts. Our study aims to explore the perspectives and barriers in the implementation of the Khushi programme in Odisha.</p><p><strong>Methodology: </strong>This paper emanates from a larger study on menstrual health in Odisha, conducted from September 2021 to December 2022, focussing on qualitative insights into the implementation challenges of the Khushi programme. It examines stakeholder perspectives through in-depth interviews with key officials from health and education departments and focus group discussions with schoolgirls. In addition, relevant programme documents and government policies were reviewed.</p><p><strong>Results: </strong>Our study findings related to the systemic bottlenecks in the implementation of the Khushi programme have been summarized under key thematic domains: (1) approach to micro-planning; (2) interdepartmental convergence; (3) indenting and supply chain; (4) capacity building; and (5) monitoring and supervision. This study underscores the importance of designing and implementing a comprehensive behaviour-change strategy that should capitalize on the existing collaboration between the health and education departments, while addressing identified weaknesses.</p><p><strong>Conclusions: </strong>The Khushi programme has the potential to bring about a paradigm shift in menstrual health behaviour among schoolgirls. To maximize its impact, the government may adopt a comprehensive strategy, including strengthening menstrual-hygiene-compliant school infrastructure, providing education and sensitization for both implementers and beneficiaries, and integrating environment-friendly menstrual hygiene products in the programme.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"94"},"PeriodicalIF":3.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649349","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":"Understanding policy commitments for universal health coverage: a framework for analysis.","authors":"Andréa Williams, Jesper Sundewall","doi":"10.1186/s12961-025-01370-4","DOIUrl":"10.1186/s12961-025-01370-4","url":null,"abstract":"<p><strong>Background: </strong>Countries around the world have committed to universal health coverage (UHC), a global vision that affirms the right for all people to access essential healthcare, when and where they need it and regardless of their ability to pay. UHC, as a political commitment, developed as part of the Sustainable Development Agenda in 2015 and, more recently, at the United Nations High-Level meeting on UHC in 2019. A policy commitment to UHC means translating the broad vision of UHC into nationally appropriate, locally relevant health policies. The aim of this work is to develop an analytical framework for describing the key features of UHC to assess how UHC is conceptualised and translated at the national health policy level.</p><p><strong>Methods: </strong>We analysed purposively collected documents on UHC and conducted case studies of relevant health policies in three countries: South Africa, Botswana, and Kenya.</p><p><strong>Results: </strong>We propose a framework that includes five components we consider central to a UHC approach, namely: population coverage, healthcare service provision, health financing, health equity, and leadership and governance. The framework was applied to health policies in three countries in Africa (Botswana, Kenya, and South Africa) to test its relevance and applicability.</p><p><strong>Conclusions: </strong>Analysing policy commitments for UHC is central to understanding how countries are translating the broad aspiration into action. Our framework provides a useful tool by breaking down UHC into five core components and proposes questions to guide how policy commitments can be identified.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"93"},"PeriodicalIF":3.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649350","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":"Assessing the potential for scaling evidence-based interventions in African health systems: A deliberate dialogue.","authors":"Humphrey Cyprian Karamagi, Ali Ben Charif, Hillary Kipchumba Kipruto, Sokona Sy, Jacinta Nzinga, Araia Berhane, Tewelde Yohannes, Stephen Senkomago Musoke, Kyuree Kim, Kristina Tunheim, Solyana Ngusbrhan Kidane","doi":"10.1186/s12961-025-01369-x","DOIUrl":"10.1186/s12961-025-01369-x","url":null,"abstract":"<p><strong>Background: </strong>The WHO Regional Office for Africa reviewed evidence-based interventions designed to enhance health systems outputs: access, quality, demand and resilience. Although there is eagerness to expand interventions, the extent to which they can be successfully scaled remains mostly unknown. This study evaluated their potential for scaling to enhance system outputs.</p><p><strong>Methods: </strong>Underpinned by two frameworks for knowledge transfer, the study utilized a deliberative dialogue approach and an integrated knowledge translation strategy. A steering committee of 8 men and women oversaw the process, and 25 experts from across Africa were invited to participate. Data collection employed the African Scalability Assessment Framework (AFROSAF), consisting of 15 attributes grouped into nine scalability components: health need (three attributes), development process (three), intervention content (one), political context (one), evidence for impact (two), resource availability (one), target unit (one), scaling setting (one) and sustainability at scale (one). The scoring was on a 4-point Likert scale. Intervention scores ranged from 0 to 100, where higher scores indicated a greater potential for successful scaling. Data analysis included frequency counts, arithmetic mean, standard deviation (SD), 95% confidence interval (CI) and hierarchical cluster analysis.</p><p><strong>Results: </strong>A total of 288 health services interventions were rated for scalability, with most focusing on disease prevention (n = 114; 39.6%) and newborn age group (n = 70; 24.3%). The scalability scores averaged 79.2 (SD 17.5). The highest component score was evidence for impact [mean (CI 95%) 87.9 (85.7, 90.2)] and lowest for health security [61.9 (58.0, 65.8)]. The scalability scores varied across public health functions and age cohorts. Interventions were clustered into three groups based on their scalability score: high (n = 185; 64.2%; mean 89.5; SD 6.1; range 78.7-100), medium (n = 77; 26.7%; mean 68.6; SD 5.3; range 58.3-76.9) and low (n = 26; 9.0%; mean 37.4; SD 14.2; range 3.7-55.6). Most high-scoring interventions focused on disease prevention, 78 (42.2%) and reproductive and newborn age groups 59 (31.9%).</p><p><strong>Conclusions: </strong>This study rated public health interventions for their scalability in African health systems. Disease prevention interventions for pregnancy women and newborns were most likely to be scaled. However, health security remained largely unexplored, and further investigation remains pivotal.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"91"},"PeriodicalIF":3.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636896","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":"Serbian Health Information System (HIS) improvements 2021-2024: comparison study using stages of continuous improvement (SOCI) methodology.","authors":"Bosiljka Djikanovic, Milan Kovacevic, Isidora Smigic, Marija Cvejic, Emilija Nicic, Caitlin Madevu-Matson, Steve Ollis, Vasa Curcin, Alimou Barry, Stephanie Watson-Grant","doi":"10.1186/s12961-025-01337-5","DOIUrl":"10.1186/s12961-025-01337-5","url":null,"abstract":"<p><strong>Background: </strong>The Health Information System (HIS) in public healthcare services in Serbia was introduced in 2008, with the first comprehensive evaluation of its maturity conducted in 2021. Since then, several improvement initiatives have been implemented. This study aimed to assess the extent of HIS advancement between 2021 and 2024 and to identify both the desirable and realistic future maturity status.</p><p><strong>Methods: </strong>The maturity assessment of the Serbian HIS in 2024 was conducted using the same tool as in 2021: The Health Information Systems Stages of Continuous Improvement (SOCI), enabling direct comparison between the two periods. Progress was measured across five domains: Leadership and Governance, Management and Workforce, Information and Communication Technologies (ICT), Standards and Interoperability, and Data Quality and Use. These domains covered 13 components and 39 single subcomponents, with their maturity stages being assessed on a 5-point Likert scale on the basis of the opinions of key informants and documented through a desk review. Higher scores indicate a higher level of development. Along with a current assessment of maturity, key informants identified desired maturity levels for the future, using the same scale. Data were presented as comparisons in total scores per domain in 2024 versus 2021, for both current and projected statuses.</p><p><strong>Results: </strong>Between 2021 and 2024, the overall maturity of the Serbian HIS improved by nearly 1 point (from 1.6/5 to 2.5/5). The same difference of 0.9 was observed between the current 2024 status and the future desired status (2.5 versus 3.4). The most notable improvements were observed in the HIS Strategic Plan under Leadership and Governance (2.5-point increase) and Business Continuity under ICT Infrastructure (2-point increase). The primary driver of progress over the past 3 years was the adoption of the national Program for Digitalization in the Health System of Serbia (eHealth Strategy) and its corresponding Action Plan, which served as a development blueprint.</p><p><strong>Conclusions: </strong>Substantial progress in HIS maturity was achieved between 2021 and 2024, driven by strong governmental commitment, international donor support, and the engagement of dedicated national professionals. If current momentum and resourcing are sustained, the projected maturity levels are likely to be attainable in the near future.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"92"},"PeriodicalIF":3.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636897","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":"Identifying key complex relations between education and healthcare in the Netherlands for future pandemic management.","authors":"Sophie Hadjisotiriou, Jannie Coenen, Etiënne A J A Rouwette, Vittorio Nespeca, Tom H Oreel, Vincent A W J Marchau, Vítor V Vasconcelos, Rick Quax, Heiman F L Wertheim, Marcel G M Olde Rikkert, Hubert P L M Korzilius","doi":"10.1186/s12961-025-01359-z","DOIUrl":"10.1186/s12961-025-01359-z","url":null,"abstract":"<p><strong>Background: </strong>The effects of the coronavirus disease 2019 (COVID-19) pandemic and subsequent policies in the Netherlands extended beyond healthcare, impacting other societal systems such as education. This study aims to conceptualize a coupled education-healthcare system during a pandemic and identify key variables and relations that affect the accessibility of both systems. This is essential to address the interconnected nature of pandemic policymaking and design policies that account for possible unintended consequences that interventions in healthcare may have on education and vice versa.</p><p><strong>Methods: </strong>Group model building and in-depth interviews with actors from healthcare and education were used to develop a coupled causal loop diagram of healthcare and education accessibility in the Netherlands during a pandemic. The causal loop diagram is analysed with cross-impact analysis to identify key leverage points, monitoring variables, feedback loops and relations between healthcare and education.</p><p><strong>Results: </strong>Six causal relations were identified between healthcare and education, indicating a relevant impact of healthcare on education during pandemics. Cross-impact analysis identified 24 leverage points, of which 10 were in healthcare, 11 in education and 4 in the contextual environment. During the COVID-19 pandemic in the Netherlands, healthcare utilized all these leverage points, education utilized six and two were used not pertaining to healthcare or education but the contextual environment. Leverage points included the availability and wellbeing of personnel, number of patients, progress of pupils/students and resources. Seven monitoring variables included the availability of personnel, resources in education and progress of pupils/students, and were utilized in healthcare and education during the pandemic. Four feedback loops were found, of which three are reinforcing. One large balancing feedback loop is situated between the healthcare and education system, indicating mutual dependency to maintain staff for the accessibility of healthcare and education.</p><p><strong>Conclusions: </strong>Group model building, in-depth interviews and cross-impact analysis identified key variables, causal relations and feedback loops illustrating the coupled nature of healthcare and education during pandemics. This highlights the need for integrated policymaking that addresses and considers coupled systems to ensure accessibility to both healthcare and education. The finalized model can serve as a tool to support such integrated policymaking.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"89"},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608229","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":"Demystifying programme theories of co-production in health and welfare: An interview study on new researchers' systems perspectives.","authors":"Annika Nordin, Sofia Kjellström, Ann-Christine Andersson","doi":"10.1186/s12961-025-01368-y","DOIUrl":"10.1186/s12961-025-01368-y","url":null,"abstract":"<p><strong>Background: </strong>Coproduction is an inclusive approach for improving health and social care services, and coproduction research mostly focuses on participating stakeholders who are not researchers. Programme theories are important for designing, evaluating and disseminating change initiatives; however, few empirical studies on quality improvement initiatives or coproduction projects include explicit programme theories. This study addresses these knowledge gaps by describing new researchers' initial implicit programme theories of coproduction from three different system perspectives.</p><p><strong>Methods: </strong>This is a cross-sectional interview substudy that includes 12 respondents. The respondents are new researchers (doctoral students) in Samskapa, an international research programme. The respondents conduct their studies in their own national contexts: Western Europe and North America. The interviews focus on their thoughts and experiences of coproduction, and the data are analysed using directed content analysis based on central concepts of programme theory. Coded statements are additionally coded for the system perspective they refer to. To describe programme theories of coproduction from micro-, meso- and macrosystem perspectives, a latent interpretation of the data is carried out. The consolidated criteria for reporting qualitative research (COREQ) checklist for qualitative studies was used to assure quality standards.</p><p><strong>Results: </strong>A generic programme theory of coproduction is suggested: If microsystem actors collaborate, facilitated by mesosystem mediators and supported by macrosystem managements' feedback and engagement, then coproduction will occur and health and welfare systems will improve.</p><p><strong>Conclusions: </strong>Coproduction projects are complex interventions that exhibit equifinality - a principle from open systems theory which posits that similar outcomes can be achieved through multiple, distinct pathways. Programme theories of coproduction from several system perspectives can be merged into a generic programme theory, which in turn can capture the interventions' complexity.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"90"},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608175","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":"Co-creating mental health promotion and prevention interventions with groups in vulnerable situations in Europe: a mixed-methods study protocol for co-creation implementation and participatory evaluation.","authors":"Raquel Teixeira, Cláudia de Freitas, Liuska Sanna, Eleonora Prina, Giulia Turrini, Amber S Brizar, Cătălin Gherdan, Evaldas Kazlauskas, Austėja Dumarkaitė, Henrik Wasmus, Leonie Fleck, Ulrich Reininghaus, Melanie Mack, Chiara Scarampi, Maritta Välimäki, Maija Satamo, Wietse A Tol","doi":"10.1186/s12961-025-01349-1","DOIUrl":"10.1186/s12961-025-01349-1","url":null,"abstract":"<p><strong>Background: </strong>Co-creation has emerged as a crucial strategy for addressing complex public health challenges, including promotion and prevention of mental health concerns. While the evidence base for effective interventions continues to grow, significant gaps remain in their implementation and integration into real-world settings. Co-creation offers a valuable tool for strengthening mental health promotion strategies, ensuring that interventions are evidence-based, contextually relevant, culturally sensitive, sustainable and acceptable to those directly affected. However, there is a paucity of studies examining the evaluation of co-creation research, particularly regarding how participatory methods foster adaptation and influence outcomes and long-term sustainability. This protocol outlines a study designed to implement, evaluate and strengthen co-creation methodologies through a participatory and formative evaluation approach.</p><p><strong>Methods: </strong>This study adopts a mixed-methods design within the ADVANCE project, a multi-country initiative focused on co-creating mental health promotion and prevention interventions with groups in vulnerable situations across seven European countries. End-users, healthcare professionals, and decision-makers will be engaged throughout the project in both intervention design and evaluation. Co-creation activities initiated with intervention scenario building and prioritization, drawing on desk reviews and online Delphi surveys co-developed with locally-set Society Advisory Groups (SAGs). The selection of intervention scenarios for implementation was performed using scenario-based workshops involving stakeholders in six partner countries. A second goal is to evaluate the co-creation process, which was co-designed in consultation with country teams and SAGs. A longitudinal qualitative study based on semistructured interviews with co-creators across two time points will be conducted, following the co-development of the interview guide through an online World Café.</p><p><strong>Discussion: </strong>This study introduces an innovative approach by embedding participatory and formative evaluation into the co-creation process, enabling ongoing adaptation of co-creation activities. Through continuous stakeholder engagement, the project seeks to address barriers deriving from power imbalances, conflicting priorities, and resource limitations. Qualitative and participatory methods will be combined to elicit stakeholders' views, identify drawbacks and promote adjustments to ensure meaningful collaboration and reduce participation fatigue. Expected outcomes include actionable recommendations to inform policy, reduce stigma and foster the co-creation of more inclusive, effective, sustainable and scalable mental health promotion and prevention strategies across Europe.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"87"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540036","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}