Health Research Policy and Systems最新文献

{"title":"Opening the black box of health systems performance management using the behaviour change techniques taxonomy: implications for health research and practice.","authors":"Jenna M Evans, Sarah M Wheeler","doi":"10.1186/s12961-025-01284-1","DOIUrl":"10.1186/s12961-025-01284-1","url":null,"abstract":"<p><strong>Background: </strong>Performance management (PM) systems in healthcare consist of many interacting interventions, such as contracts, scorecards and incentives. The diversity, complexity and poor description of PM interventions hampers replication in research, standardized comparative analysis and accumulation of evidence. Specifying PM systems and interventions in terms of their behaviour change techniques (BCTs) using standardized language can address these challenges and clarify the mechanisms linking system-level PM with individual behaviours.</p><p><strong>Methods: </strong>We conducted an analysis of BCTs in a PM system in Ontario, Canada using a modified behaviour change technique taxonomy (BCTT). We reviewed 64 documents, observed 15 meetings and conducted 4 semi-structured interviews with key informants to map the PM interventions on to the taxonomy.</p><p><strong>Results: </strong>We identified 54 BCTs spanning 13 taxonomy domains in the PM system. BCTs were concentrated in four domains: (1) goals and planning, (2) reward and threat, (3) feedback and monitoring and (4) identity. The BCTs coded most often included: (1) discrepancy between current behaviour and goal, (2) feedback on outcome(s) of behaviour, (3) social comparison and (4) social incentive/reward. These BCTs suggest that this PM system seeks to change behaviour primarily by directing programme attention to their current performance in relation to the target and in relation to other programs across the province, and by acknowledging good performance with praise or recognition. A total of five PM interventions accounted for 58% of identified BCTs - the scorecard, quarterly performance review reports, quarterly performance review meetings, escalation letter for poor or declining performance and the improvement action plan.</p><p><strong>Conclusions: </strong>The results provide a unique analytical and evaluative characterization of the PM system, revealing how a behaviour-change lens on health systems PM can support the (re)design, standardized comparison, and evaluation of PM systems in research and in practice.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"17"},"PeriodicalIF":3.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122716","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 role of mass media in the translation of evidence from health policy and systems research in Nigeria.","authors":"Prince Agwu, Chinyere Mbachu, Obinna Onwujekwe","doi":"10.1186/s12961-024-01267-8","DOIUrl":"10.1186/s12961-024-01267-8","url":null,"abstract":"<p><strong>Background: </strong>There are massive gaps in communication between health researchers and policy-makers in Nigeria, which constrains the use of research evidence for policy-making. Mass media can help in bridging the gaps, especially since the media has the reach and a reputation for presenting information in ways that elicit actions from the public and policy-makers.</p><p><strong>Objective: </strong>There is a small body of emerging literature from Nigeria and sub-Saharan Africa, evidencing the usefulness of the media to encourage evidence translation in the health sector; and even evidence translation theories are light on dissemination. This paper adds to knowledge on how academia and media can be linked for effective dissemination of evidence for policy impact.</p><p><strong>Method: </strong>Data were sourced from group discussions in a communications workshop with 27 participants comprising researchers in health systems and policy and media professionals with several years of experience.</p><p><strong>Results: </strong>It was found that health research evidence conducted using quality procedures and published in quality academic journals barely make it to public and policy-making conversations because of the restrictiveness that characterizes academic outputs in traditional academic dissemination outlets. On the basis of the cultivation theory, the media was found instrumental in feedback of research results to communities, securing policy-makers' reactions and stimulating policy actions.</p><p><strong>Conclusions: </strong>In line with message system analysis, researchers must be strategic in the use of mass media, and our results showed how it can be done. In all, media usage for evidence translation has enormous potential to strengthen the health system.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"16"},"PeriodicalIF":3.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065185","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":"Evaluating the impact, implementation experience and political economy of primary care networks in Kenya: protocol for a mixed methods study.","authors":"Beatrice Amboko, Jacinta Nzinga, Benjamin Tsofa, Peter Mugo, Anita Musiega, Beryl Maritim, Ethan Wong, Caitlin Mazzilli, Wangari Ng'ang'a, Brittany Hagedorn, Gillian Turner, Anne Musuva, Felix Murira, Nirmala Ravishankar, Salim Hussein, Edwine Barasa","doi":"10.1186/s12961-024-01273-w","DOIUrl":"10.1186/s12961-024-01273-w","url":null,"abstract":"<p><strong>Background: </strong>Primary care networks (PCNs) are increasingly being adopted in low- and middle-income countries (LMICs) to improve the delivery of primary health care (PHC). Kenya has identified PCNs as a key reform to strengthen PHC delivery and has passed a law to guide its implementation. PCNs were piloted in two counties in Kenya in 2020 and implemented nationally in October 2023. This protocol outlines methods for a study that examines the impact, implementation experience and political economy of the PCN reform in Kenya.</p><p><strong>Methods: </strong>We will adopt the parallel databases variant of convergent mixed methods study design to concurrently but separately collect quantitative and qualitative data. The two strands will be mixed during data collection to refine questions, with findings triangulated during analysis and interpretation to provide a comprehensive understanding of PCN implementation. The quantitative study will use a controlled before and after study design and collect data using health facility and client exit surveys. The primary outcome measure will be the service delivery readiness of PHC facilities. We will use a random sample of 228 health facilities and 2560 clients in four currently implementing PCNs, four planning to implement and four control counties at baseline and post-implementation. We shall undertake a preliminary cross-sectional analysis of the data at baseline from October to December 2023, followed by a difference-in-difference analysis at the endline from October to December 2024 to compare the outcome differences between the intervention and control counties over a 12-month period. The qualitative study will include a cross-sectional process evaluation and political economy analysis (PEA) using document reviews and approximately 80 in-depth interviews with national and sub-national stakeholders. The process evaluation will assess the emergence of PCN reforms, the implementation experience, the mechanism of impact and how the context affects implementation and outcomes. The PEA will examine the interaction of structural factors, institutions and actors/stakeholders' interests and power relations in implementing PCNs. We will also examine the gendered effects of the PCNs, including power relations and norms, and their implications on PHC from the supply and demand sides. We shall undertake a thematic analysis of the qualitative data.</p><p><strong>Discussion: </strong>This evaluation will contribute robust evidence on the impact, implementation experience, political economy and gendered implications of PCNs in a LMIC setting, as well as guide the refining of PCN implementation in Kenya and other LMICs implementing or planning to implement PCNs to enhance their effectiveness.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"14"},"PeriodicalIF":3.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052224","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":"Facilitators and barriers in the implementation of patient-centred care interventions among general practitioners: a systematic review protocol.","authors":"Wenhui Li, Min Su, Zhengrong Li, Xiaojing Fan","doi":"10.1186/s12961-024-01277-6","DOIUrl":"10.1186/s12961-024-01277-6","url":null,"abstract":"<p><strong>Background: </strong>Challenges in the patient-provider relationship are prevalent, underscoring the importance of patient-centred care, which is respectful and responsive to patients' needs. General practitioners (GPs), also known as family doctors, serve as gatekeepers in primary care and are well positioned to deliver this type of care. However, effectively implementing patient-centred care remains a challenge. While behaviour change interventions have been developed to enhance patient-centred care in general practices, a comprehensive understanding of the facilitators and barriers to their implementation is lacking. This review aims to examine contextual factors of implementing interventions for patient-centred care by GPs. Implementation research analyses all aspects of application, including factors influencing it, processes involved and outcomes achieved within different contexts. The review will use the updated Consolidated Framework for Implementation Research (CFIR 2.0) to analyse influential factors and the Behaviour Change Wheel (BCW) to define interventions to promote behaviour change in patient-centred care.</p><p><strong>Methods: </strong>This systematic literature review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of five databases (Ovid MEDLINE, CINAHL, EMBASE, Cochrane Library and Web of Science) will be conducted to identify barriers and facilitators for implementing interventions in promoting patient-centred care by GPs. The CFIR 2.0 framework will guide the categorization and synthesis of barriers and facilitators, while the BCW will be employed to define the interventions. Two independent reviewers will conduct study screening, data extraction, quality appraisal and data analysis. Any disagreements between the reviewers will be resolved through the involvement of additional reviewers.</p><p><strong>Discussion: </strong>This protocol outlines a systematic review utilizing an updated framework-based approach to identify and synthesize evidence on barriers and facilitators to implementing behaviour change interventions by GPs. The findings will provide insights into the effectiveness of these interventions in enhancing patient-centred care and will inform future research and clinical practice. This review will identify gaps and challenges in existing studies and propose strategies for the effective implementation of behavior change interventions among GPs. Additionally, it will inform clinical practice by refining behaviour change interventions to enhance the delivery of patient-centred care by GPs.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42023485014.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"15"},"PeriodicalIF":3.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052243","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":"Involving national stakeholders in a systems approach to map drivers of childhood obesity and actions to prevent childhood obesity in Denmark: the Generation Healthy Kids Study.","authors":"Knud Ryom, Paul Bloch, Ulla Toft, Didde Høeg, Louise T Thomsen, Steven Allender, Harry Rutter, Adrian Bauman, Rikke Fredenslund Krølner, Anders Blædel Gottlieb Hansen","doi":"10.1186/s12961-024-01279-4","DOIUrl":"10.1186/s12961-024-01279-4","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is a preventable global public health challenge, increasingly recognized as a complex problem, stemming from complex drivers. Obesity is characterized by multiple interdependencies and diverse influences at different societal levels. Tackling childhood obesity calls for a holistic approach that engages with complexity and recognizes that there is no single \"magic bullet\" intervention to prevent obesity. To facilitate a shared understanding of the complex structures and relationships that determine children's weight development, systems approaches have shown promising potential. However, systems approaches require more development and research in public health.</p><p><strong>Aim: </strong>This paper describes the processes of gathering national stakeholders to create a system map of childhood obesity drivers in Denmark to map existing obesity prevention initiatives and define real-world actions to prevent childhood obesity in local communities in Denmark. The system map and action ideas will inform the development of community-based activities in a large-scale national study, the Generation Healthy Kids Study.</p><p><strong>Methods: </strong>During two workshops in the autumn of 2022, national stakeholders (n = 45) were involved in generating and revising a system map. We used a scripted approach inspired by group model building and community-based systems dynamics methods to engage stakeholders, collect and visualize their knowledge on childhood obesity, create consensus on the drivers of childhood health, identify local and national intervention opportunities for prevention of childhood obesity and develop actions to create system changes.</p><p><strong>Results: </strong>The study identified the following six sub-systems of factors influencing childhood obesity: (1) family; (2) diet and dietary habits; (3) physical activity and active living; (4) mental health and wellbeing; (5) screen, media and sleep; and (6) competencies of professionals.</p><p><strong>Conclusions: </strong>A systems approach to childhood obesity was useful to generate a shared understanding of the underlying drivers of childhood overweight and obesity and has potential for informing initiatives at local and national level in Denmark. However, challenges were experienced regarding the usefulness of the system mapping process, with a tension between the map as a step in a shared process towards actions and the map as means to gain a deeper understanding of the complex system of childhood overweight and obesity and how to change the system.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"13"},"PeriodicalIF":3.6,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028646","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":"Translation of oral health research priorities into research topics in an equity-based priority setting exercise.","authors":"Sumanth Nagraj Kumbargere, Cath Quinn, Lynne Callaghan, Martha Paisi, Mona Nasser","doi":"10.1186/s12961-024-01261-0","DOIUrl":"10.1186/s12961-024-01261-0","url":null,"abstract":"<p><strong>Background: </strong>In the context of research priority-setting, participants express their research priorities and ideas in various forms, ranging from narratives to explicit topics or questions. However, the transition from these expressions to well-structured research topics or questions is not always straightforward. Challenges intensify when research priorities pertain to interventions or diagnostic accuracy, requiring the conversion of narratives into the Participant, Intervention, Comparator, Outcome (PICO) format.</p><p><strong>Scope and findings: </strong>This project aimed to understand the challenges of engaging a diverse, multilingual population in setting oral health research priorities. While not a comprehensive priority-setting effort, we modified James Lind Alliance's (JLA) methods and used thematic analysis to establish a list of priority research topics and questions. This was accomplished by conducting interviews with 40 community participants and 14 dentists from various ethnic backgrounds in Malaysia. The interview language depended on participant preferences, including English, Malay, and Mandarin, with translations handled collaboratively by bilingual research assistants. The process involved thematic analysis, discussion with a research committee, and necessary modifications. Our interpretations revealed distinct categories of participant statements: explicit, complicated, implicit and incomplete. In this study, we identified a three-step approach to translate research ideas that are presented either as explicit statements or as complicated narratives.</p><p><strong>Conclusions: </strong>Translating community research priorities poses inherent challenges. Our model, although not exhaustive, provides a valuable tool to assist research priority-setting groups in translating these priorities into meaningful research topics and questions, facilitating the equitable inclusion of diverse perspectives. Future research priority-setting endeavours should document their translation processes, thus aiding researchers in understanding and tackling the intricacies of this task.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"12"},"PeriodicalIF":3.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004259","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":"Lessons from the pandemic: Relationship between patient visits and patient length of stay in California's health system.","authors":"David D Cho, Yu Wang","doi":"10.1186/s12961-024-01283-8","DOIUrl":"10.1186/s12961-024-01283-8","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic placed a heavy strain on the United States healthcare system. Common hospital operational performances were impacted to varying degrees by the pandemic. This study examined the healthcare operational measures during COVID-19 pandemic.</p><p><strong>Methods: </strong>This cross-sectional study examined the COVID-19 cases and death counts of 56 California counties and hospital-level utilization data of 397 hospitals in California from January 2019 to March 2021.</p><p><strong>Results: </strong>A total of 56 California counties were analysed, of which 37 counties were urban and 19 counties were rural. Average patient length of stay was positively associated with the number of intensive care unit visits by COVID-19 patients for all counties, as well as urban and rural counties separately. However, average patient length of stay was negatively associated with the number of inpatient visits by COVID-19 patients for all counties and urban counties.</p><p><strong>Conclusions: </strong>The findings suggest that, while the need for additional beds and nursing staff in intensive care units exceeded initial estimates, there were also opportunities to streamline the care process for improved efficiency in regular acute care units. The understanding of factors impacting average patient length of stay would be valuable for hospital administrators in optimizing resource allocation and utilization to balance patient outcomes with financial sustainability during disruptive events.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"11"},"PeriodicalIF":3.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004340","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 health system, service and consumer representatives in the co-design of a multi-criteria decision-making framework for commissioning overweight and obesity programs and services.","authors":"Laura Thomas, Suzanne Robinson, Sharyn Burns, Helen Mitchell, Andrea Begley","doi":"10.1186/s12961-024-01263-y","DOIUrl":"10.1186/s12961-024-01263-y","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a multi-faceted problem that requires complex health system responses. While no single program or service is sufficient to meet every individual's needs, some criteria that increase the likelihood of program/service quality delivery to produce effective outcomes exist. However, although research on health commissioning is available internationally and is growing within the Australian context, no evidence exists of a multi-criteria decision-making framework to address the complexity required for effective commissioning of overweight and obesity early intervention and weight management programs or services. This study aimed to develop a set of criteria to support effective commissioning in this context.</p><p><strong>Methods: </strong>A mixed-methods co-design approach was used to develop a multi-criteria framework. A literature review informed a three-stage co-design consensus-gathering approach. Participants included Western Australian stakeholders from the Western Australian health system, services and consumers, who reviewed, ranked and validated responses and criteria through ongoing discussions. A deliberative forum was held between the two online, modified Delphi surveys to reach a consensus among stakeholders.</p><p><strong>Results: </strong>Through the co-design, a total of 63 stakeholders were identified: 24 completed the round 1 Delphi survey assessing 22 proposed criteria, 40 attended the deliberative forum and 30 completed the round 2 Delphi survey. A total of 4 themes arose from the co-design process: (1) reduce duplication, (2) demote criteria, (3) re-organize criteria and (4) simplify language, and 10 criteria were established: safety, collaboration and consultation, appropriateness, effectiveness, efficiency, equity, evidence-based, health service delivery model, sustainability and workforce capacity and competence. The criteria were underpinned by indicators highlighting relevant sub-themes.</p><p><strong>Conclusions: </strong>A multi-criteria framework was developed and its application to the commissioning process will enable the selection of programs and services that will likely have an impact on individuals' use of and satisfaction with programs and services, overweight and obesity-related outcomes and inter-agency collaborations to maximize economic and workforce resources.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"10"},"PeriodicalIF":3.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004338","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":"A systemic approach to identifying sustainable community-based interventions for improving adolescent mental health: a participatory group model building and design protocol.","authors":"Megan Keenan, Leanne Freeman, Ediane Santana de Lima, Katie Potter, Tim Hobbs, Ellis Ballard, Peter Fonagy","doi":"10.1186/s12961-024-01247-y","DOIUrl":"10.1186/s12961-024-01247-y","url":null,"abstract":"<p><strong>Background: </strong>The deteriorating mental health of children and young people in the United Kingdom poses a challenge that services and policy makers have found difficult to tackle. Kailo responds to this issue with a community-based participatory and systemically informed strategy, perceiving mental health and well-being as a dynamic state shaped by the interplay of broader health determinants. The initiative works to explore, define and implement locally relevant solutions to challenges shaping the mental health and well-being of young people. Kailo unfolds in three stages within each locale. These stages encompass: \"early discovery\", \"deeper discovery and co-design\" and \"implementation\". This document delves into the participatory group model building and design protocol occurring in the \"deeper discovery and co-design\" stage of the project.</p><p><strong>Methods: </strong>Participatory methods, such as group model building, are effective in articulating and building consensus on complex issues like the social determinants of adolescent mental health. This paper describes the protocol for application of group model building within the Kailo design process to develop causal loop diagrams and pinpoint leverage points for improving adolescent mental health. It also suggests a method for considering modifications to delivery within a unique project context and in alignment with participants' needs. This paper sets out to define the approach and clarify the objectives these engagements aim to fulfil. The method adapts existing group model building (GMB) protocols for use in a community setting. The engagements will involve groups of local young people and existing community members. To assess the success of the session's implementation post-delivery, the study utilizes existing frameworks for fidelity evaluations, which define a core and flex model.</p><p><strong>Discussion: </strong>The method described enables an integration of diverse local understandings of complex processes which provides a platform for creating co-designed interventions. This protocol can be used to further strengthen research and design through incorporating complexity and participation into the formulation of contextually relevant policies and practices. The strengths and limitations of the approach are discussed.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"9"},"PeriodicalIF":3.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978284","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":"Strengthening research preparedness for crises: lessons from Norwegian government agencies in using randomized trials and quasi-experimental methods to evaluate public policy interventions.","authors":"Unni Gopinathan, Ingeborg Elgersma, Therese Dalsbø, Mona Bjørbæk, Atle Fretheim","doi":"10.1186/s12961-024-01271-y","DOIUrl":"10.1186/s12961-024-01271-y","url":null,"abstract":"&lt;p&gt;&lt;p&gt;During public health crises such as pandemics, governments must rapidly adopt and implement wide-reaching policies and programs (\"public policy interventions\"). A key takeaway from the coronavirus disease 2019 (COVID-19) pandemic was that although numerous randomized controlled trials (RCTs) focussed on drugs and vaccines, few policy experiments were conducted to evaluate effects of public policy interventions across various sectors on viral transmission and other consequences. Moreover, many quasi-experimental studies were of spurious quality, thus proving unhelpful for informing public policy. The pandemic highlighted the need to continuously develop competence, capacity and a robust legal-ethical foundation for impact evaluations well before crises occur. It raised a crucial question: how can governments in non-crisis times develop capabilities to generate evidence on the effects of public policy interventions, thus enabling a rapid and effective research response during public health crises? We conducted a mapping to explore how government agencies in Norway use RCTs and quasi-experimental methods to strengthen the evidence base for public policy interventions and to identify barriers and facilitators to their use. Contributing to the study were 10 government agencies across sectors such as development assistance, education, health, social welfare, statistics and taxation. Many of these agencies have conducted or commissioned RCTs or quasi-experimental studies in the past 5 years, with evaluations ranging from 1 or 2 to more than 15 per agency. The measures evaluated included organizational, educational and financial interventions and interventions for oversight and sanctions. Some agencies have internal capabilities for designing and conducting evaluations, while others commissioned such studies to universities and other research institutions. Agencies reported examples where enhanced communication among implementers, researchers, ministries and political leaders facilitated impact evaluations, and these lessons offer opportunities for cross-sector knowledge-sharing to help strengthen rigorous evaluations of public policy interventions. Despite their potential, various government agencies report that randomized and quasi-experimental studies face legal, ethical, political and practical barriers that affect their use. For instance, the urgency of politicians to implement policies at scale has led to the discontinuation of trials and hindered learning from their effects. The surveyed agencies stressed the importance of legislation providing clear guidelines on when differential treatment can be justified and when informed consent requirements can be waived, as well as faster and clearer processes for managing privacy concerns related to data access. Crucially, greater political acceptance for systematically and gradually implementing reforms, including using randomization, could strengthen evidence-informed public policy, enhancing the s","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"8"},"PeriodicalIF":3.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978286","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}