Health Research Policy and Systems最新文献

{"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}

{"title":"An evaluation of the feasibility, value and impact of using participatory modelling to inform the development of a regional system dynamics model for youth suicide prevention.","authors":"Maria Michail, Justin Waring, Jo-An Occhipinti, Katrina Witt, Adam Skinner, Michelle Lamblin, Maria Veresova, Dzenana Kartal, Jo Robinson","doi":"10.1186/s12961-025-01360-6","DOIUrl":"10.1186/s12961-025-01360-6","url":null,"abstract":"<p><strong>Background: </strong>Suicide remains a leading cause of death for young Australians. We need robust analytical tools to help us understand and respond to the dynamic complexity underlying suicide and suicidal behaviour. Participatory systems modelling leverages empirical data together with the experiential knowledge of stakeholders to inform model building, evaluation, and implementation. Efforts to evaluate collaborative deliberative processes such as participatory system modelling remain sparse. The aim of this study was to evaluate the feasibility, value and impact of adopting a participatory systems modelling approach for developing a youth suicide prevention system dynamics model in North-West Melbourne, Australia.</p><p><strong>Methods: </strong>Three participatory workshops were conducted with an expert stakeholder group including young people with lived and living experience of self-harm/suicidal behaviour, family members, healthcare professionals, and policy-makers. Data collection was informed by an evaluation framework, including (i) briefing questionnaires, (ii) workshop recordings and field notes and (iii) evaluation questionnaires. Data from each source were analysed separately, using codebook and reflexive thematic analysis, and synthesized to identify patterns in meaning and broad concepts under the evaluation categories of feasibility, value and impact.</p><p><strong>Results: </strong>We found that the feasibility of undertaking an inclusive and accessible participatory systems modelling project was influenced by stakeholder cultural diversity, meaningful involvement of those with lived and living experience, accessibility of technical aspects of modelling and managing group dynamics. The value of adopting a participatory approach in developing a complex systems model was demonstrated in the collaborative learning that took place between the expert stakeholder group and the research team. Central to this was the experiential knowledge of young people who helped shape our understanding of the contextual drivers of self-harm and suicidal behaviour. Stakeholders' knowledge of the regional health system informed the structure, logic and assumptions of the systems model.</p><p><strong>Conclusions: </strong>This is one of very few evaluations of a participatory systems modelling project involving young people with lived and living experience of self-harm/suicidal behaviour and bereaved families. Our study offers novel theoretical and practical insights into the processes adopted to ensure the safe and inclusive involvement of diverse perspectives in developing a youth suicide prevention system dynamics model.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"88"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540035","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 economic and health impact of substandard uterotonic use for prevention of postpartum hemorrhage in three Sub-Saharan African countries: a comparative analysis.","authors":"Petra Procter, Sara Rushwan, Yi-Fang Ashley Lee, Colleen R Higgins, A Metin Gülmezoglu, Lester Chinery, Sachiko Ozawa","doi":"10.1186/s12961-025-01322-y","DOIUrl":"10.1186/s12961-025-01322-y","url":null,"abstract":"<p><strong>Background: </strong>Uterotonics are essential in reducing the risk of postpartum haemorrhage (PPH) and saving mothers' lives. However, numerous quality-testing studies have found that uterotonics in many low- and middle-income countries are substandard. This study compares the economic, health, and policy implications of poor-quality uterotonics in three West African countries: Ghana, Nigeria, and Senegal. The economic impact of poor-quality uterotonics has not been previously compared.</p><p><strong>Methods: </strong>We utilized a decision-tree model to examine the implications of using substandard uterotonics (oxytocin and misoprostol) in three countries. The model simulated the place and mode of delivery, use and quality of uterotonics, risk and diagnosis of PPH and resulting economic and health outcomes. Country-specific inputs were derived from demographic and health surveys and published literature. Given large variations in population size, results were compared across 100 000 women giving birth.</p><p><strong>Results: </strong>Ghana demonstrated the greatest benefit from improvements in uterotonic quality, with US $2 million (13%) in annual cost savings and 2200 (11%) cases of PPH avoided per 100 000 women giving birth. Comparatively, annual cost savings were estimated at US $1.1 million (7%) and US $224,000 (7%) per 100 000 birthing women in Nigeria and Senegal, respectively. The yearly reduction in PPH cases per 100 000 birthing women was projected at 875 (6%) for Senegal and 944 (4%) for Nigeria. Taking varying population sizes into account, we saw that improvement in uterotonic quality could annually save US $89 million in Nigeria, US $18.8 million in Ghana and US $1.3 million in Senegal, leading to 100 000 fewer PPH cases per year overall. These simulated results were primarily driven by high proportions of substandard uterotonics and high facility use in Ghana, high numbers of home births in Nigeria and substandard misoprostol use in Senegal.</p><p><strong>Conclusions: </strong>Improving uterotonic quality would bring significant cost savings and maternal health improvements across countries. Specific policies to improve uterotonic quality and bring about the economic and health benefits may need to be tailored by country. Ensuring the quality of uterotonics is essential in improving medicine equity and would contribute towards efforts to achieve universal health coverage by ensuring that medications adequately achieve their value for money.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"86"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540037","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 health system in Syria (2000-2024): assembling the pieces of a fragmented system-A scoping review.","authors":"Orwa Al-Abdulla, Maher Alaref, Agneta Kallström, Jussi Kauhanen","doi":"10.1186/s12961-025-01352-6","DOIUrl":"10.1186/s12961-025-01352-6","url":null,"abstract":"<p><p>This study provides a detailed overview of Syria's health system from 2000 to 2024 by synthesizing existing literature and data. Its goal is to inform the health sector recovery plan following recent political changes in Syria, detailing the health system's characteristics and evolution on the basis of the WHO's conceptual framework. A scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Data sources included PubMed, MEDLINE, Scopus, Google Scholar, grey literature and government reports. The analysis identified service delivery, financing, and governance as the most frequently discussed aspects of the health system. It revealed a distorted health system that retained aspects of the Semashko model whilst also incorporating elements of liberalization from the 2003 modernization program. The study underscores major challenges, including the politicization of healthcare, workforce shortages, fragmented financing, and disparities in access to healthcare services. The findings indicate that the Syrian health system has been characterized by centralized governance, inconsistent financing strategies, a fragmented health information system, and a growing dependence on the private sector. The post-conflict recovery phase offers a chance to rebuild a more equitable and resilient health system. Policymakers are urged to consider necessary reforms to the health system recovery plan in Syria.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"85"},"PeriodicalIF":3.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540038","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 impact assessment of a Canadian digital health funding program: a case study.","authors":"Jessica Nadigel, Bahar Kasaai, Halla Thorsteinsdóttir, Susan Rogers, Meghan McMahon, R Jane Rylett, Richard H Glazier","doi":"10.1186/s12961-025-01356-2","DOIUrl":"10.1186/s12961-025-01356-2","url":null,"abstract":"<p><strong>Background: </strong>Digital innovations have the potential to enhance equitable access to health systems, improve care integration and support learning health systems. Research funders make substantial investments in digital health research to advance the uptake of evidence-informed digital solutions within health systems, yet their impacts on health and health system outcomes, health equity, policy and practice remain poorly understood. Research impact assessments (RIAs) serve as a vital tool for funders to examine the links between research investments and real-world change. The Canadian Institutes of Health Research commissioned an RIA on its largest digital health program, the eHealth Innovations Partnership Program (eHIPP), to understand the program's outputs and impacts.</p><p><strong>Methods: </strong>This study applied two complementary frameworks, the Canadian Academy of Heath Science's (CAHS) Making an Impact Framework and the Canadian Health Services and Policy Research Alliance's (CHSPRA) Informing Decision-Making Framework, to assess the research impact of the eHIPP program, funded from 2015 to 2021. A mixed-methods approach was taken to collect and analyse data from eHIPP grant recipients and their partners.</p><p><strong>Results: </strong>The eHIPP program supported 22 research teams through a total investment of CAD$ 42M. The RIA revealed impacts in the areas of capacity development, knowledge creation, informing decision-making and health outcomes. The teams generated 36 co-designed, evidenced-informed solutions, 79 publications, 194 presentations and 38 media interviews or articles. Solutions were reported to influence health system practice (52%) and policy (33%), improve health outcomes (62%), enhance equitable access to care (62%), improve patient (62%) and provider experience (52%), increase cost-effectiveness (52%), enhance population health (48%) and improve health equity (43%).</p><p><strong>Conclusions: </strong>This RIA study highlights the importance of stakeholder collaboration, robust partnerships and co-design approaches in effectively integrating patient-centred digital health solutions into health systems. These elements are key to advancing the Quintuple Aim (improved cost, population health and equity and experience of patients and providers) and supporting evidence-informed decisions. This paper presents a first case study applying the CAHS and CHSPRA frameworks to assess the impacts of a large digital health funding program. Further, it explores the program's outcomes and impacts and highlights considerations, successes and challenges for funders when applying RIA.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"81"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474956","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":"Direct health facility financing and its influence on quality compliance in primary healthcare: evidence from Tanzania.","authors":"Syabo M Mwaisengela, Patricia A Materu, Chrisogone J German, Novatus Tesha, Raymond R Kiwesa, Joseph C Hokororo, Godfrey Kacholi, Henry A Mollel, Stephen Kibusi, Mackfallen G Anasel, Albino Kalolo, Ntuli A Kapologwe, Eliudi S Eliakimu, George M Ruhago","doi":"10.1186/s12961-025-01361-5","DOIUrl":"10.1186/s12961-025-01361-5","url":null,"abstract":"<p><strong>Background: </strong>Globally, health systems focus on improving the quality of healthcare services through policy changes. Sub-Saharan African countries have been enacting reforms to strengthen their primary healthcare and referral systems including devolution of authority to healthcare facilities. Devolving health facility financing to primary healthcare providers is a crucial strategy to enhance autonomy in planning, management and resource utilization. In Tanzania, this strategy is called Direct Health Facility Financing (DHFF), and is envisaged to impact on the quality of health services in primary healthcare facilities. This study aimed to determine the effect of DHFF on quality of health services after 3 years of its implementation.</p><p><strong>Methods: </strong>This study employed a before-after noncontrolled analysis of the quality scores by considering compliance of public primary health facilities with healthcare quality standards by using star rating assessment data before and after DHFF implementation. Quality scores were established by performance of service areas, namely organization of services, emergencies and referrals; infrastructure, infection prevention and control; clinical services; and clinical support services. Distribution normality of compliance scores was determined through the Shapiro-Wilk test for normal data and were observed to be non-normal. Median change in quality compliance scores were established, Wilcoxon matched pairs sum rank tests estimated probabilities of the change (α = 0.05) and Cohen's d estimator (d) calculated the effect size of DHFF.</p><p><strong>Findings: </strong>This study involved 1216 primary healthcare (PHC) facilities from 10 regions of Tanzania's mainland, the majority of which were dispensaries (88.8%) and rurally located (86.3%). Findings showed significant positive median change in compliance with quality standards from 0.53 to 0.57 (P < 0.001). However, effect size of DHFF as an intervention is small (d = 0.27).</p><p><strong>Conclusions: </strong>Direct health facility financing has impacted a small change in quality of health services. As evidenced by several studies, challenges regarding fidelity to its implementation process including lower spending on health commodities, dependence on and delayed disbursement of Health Sector Basket Funds (HSBF), poor facilities' planning capacity and shortage of human resources for health must be addressed for it to yield its intended outcome.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"83"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474954","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 challenges of primary healthcare financial resource allocation in Iran.","authors":"Somayeh Mahdiyan, Mostafa Amini-Rarani, Reza Rezayatmand, Nasrin Shaarbafchizadeh","doi":"10.1186/s12961-025-01331-x","DOIUrl":"10.1186/s12961-025-01331-x","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare (PHC) is essential for health systems worldwide, and resource allocation is vital for sustainability. However, various challenges hinder the allocation process, negatively affecting health outcomes. Therefore, this study explored the current challenges related to financial resource allocation within the PHC system in Iran.</p><p><strong>Materials and methods: </strong>This study is a qualitative descriptive study conducted on the basis of the guide provided by Villamin et al. Data were collected through semi-structured interviews. Accordingly, 20 interviewees were selected via a purposive and snowball sampling approach. The interviewees were experts in budgeting, primary healthcare, and health policies. This study was conducted in 2024. Data were collected between May 2024 and October 2024. The interviews continued until the saturation point was reached. The interview data were analysed via an inductive thematic analysis approach. MAXQDA version 2020 and Microsoft Excel were used for data extraction.</p><p><strong>Results: </strong>The challenges associated with financial resource allocation were categorized into five main themes, eight subthemes, and 25 codes. Themes (subthemes) included the population base (demographic and geographical), health needs (epidemiological), governance (policymaking and political), implementation (process-related and management) and impact (financial).</p><p><strong>Conclusions: </strong>The findings provide a comprehensive set of challenges for allocating financial resources to PHC. Addressing these challenges is essential for health system managers, policymakers and political leaders. Additionally, awareness of PHC financial resource allocation challenges and how to address them clearly demands a multifaceted approach. Successful outcomes depend on collaboration amongst managers at the health system's macro, meso, and micro levels. Such cooperation will be instrumental in creating an effective allocation of financial resources that supports the ongoing development and sustainability of PHC initiatives.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"82"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474957","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":"An exploratory study of context and factors shaping policies for integrated management of multimorbidity in Malawi.","authors":"Gift Treighcy Banda-Mtaula, Elias Rejoice Maynard Phiri, Miriam Taegtmeyer, Felix Limbani, Rhona Mijumbi, Multilink Consortium","doi":"10.1186/s12961-025-01358-0","DOIUrl":"10.1186/s12961-025-01358-0","url":null,"abstract":"<p><strong>Background: </strong>Malawi faces a high burden of chronic diseases. There is an increasing prevalence of multimorbidity, where individuals experience the coexistence of two or more chronic communicable and noncommunicable diseases. International organizations such as the WHO call for policy reforms that embrace integrated disease management. Our study explored the policy environment and decisions directly relevant to the delivery of integrated multimorbidity care in Malawi.</p><p><strong>Methods: </strong>This was a cross-sectional qualitative study. We used a single case-study methodology combining two sources of data: a document review of policies published between 2000 and 2023 (N = 11) and key informant interviews with policymakers (N = 13). We used the policy triangle framework to examine the context in which the policies aimed at improving management of multimorbidity were formulated, the actors involved, the policy process and the contents of the policies. Additionally, we identified barriers to the implementation of these policies.</p><p><strong>Results: </strong>Malawi advocates for integrated health promotion, screening, treatment and management of chronic conditions across key policies, with a bias towards noncommunicable disease (NCD) + NCD and NCD + human immunodeficiency virus (HIV) integration. Integrated disease management was seen as a tool to accelerate achieving global and local goals such as the Sustainable Development Goals and universal health coverage. However, the formulation and implementation of these policies have been challenged by several factors including unclear burden of multimorbidity, donor-driven priorities through vertical disease funding and inadequate number and training of healthcare workers to manage multimorbidity.</p><p><strong>Conclusions: </strong>We suggest that the timely provision of resources, creation of guidelines for multimorbidity management, building clinicians' capacity and harmonization of donor-government goals should accompany policy rollout for integrated multimorbidity management.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"84"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474953","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 protocols: a template for empirical bioethics and other investigations.","authors":"Henri-Corto Stoeklé, Christian Hervé","doi":"10.1186/s12961-025-01362-4","DOIUrl":"10.1186/s12961-025-01362-4","url":null,"abstract":"<p><p>We have formalized a protocol template suitable for all types of humanities and social sciences investigations in the domain of health, including empirical bioethics in particular. To achieve this, we revisited the protocol template proposed by O'Brien et al. in Academic Medicine in 2014, better known as the \"Standards for Reporting Qualitative Research (SRQR)\". We reorganized, fused and/or renamed several of the sections, and partly or entirely rewrote several of the corresponding instructions. This made it possible to overcome the limitation of the initial protocol to qualitative approaches, and to render the resulting template equally suitable for quantitative and mixed approaches, and/or other approaches. This new protocol template should be seen as a highly adaptable base.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"80"},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474955","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":"Raising complex public health challenges on local government agendas: a Norwegian case study.","authors":"Kristine Løkås Vigsnes, Charlotte Kiland, Harry Rutter, Eirik Abildsnes","doi":"10.1186/s12961-025-01347-3","DOIUrl":"10.1186/s12961-025-01347-3","url":null,"abstract":"<p><strong>Background: </strong>Public health challenges, ranging from noncommunicable disease prevention to pandemic preparedness, involve both policymaking and the handling of complexity at local, national or global level. The complexity of public health challenges arises from uncertain knowledge, hidden mechanisms, differing conceptual models and multiple stakeholders, making it difficult to identify and agree on problem definitions and potential solutions. This case study aims to provide insights into how complex public health challenges are addressed within local government agendas. We use theories of policy entrepreneurs and agenda setting to explore the processes behind the agenda setting of a public health programme for work inclusion.</p><p><strong>Methods: </strong>We conducted an in-depth case study in a local government context. Data from interviews with key informants and political documents were triangulated and analysed using deductive thematic content analysis, framed within Kingdon's agenda-setting theory and theories of policy entrepreneurs.</p><p><strong>Results: </strong>We identified problem framing, the involvement of multiple actors, and turbulent surroundings as influential factors for agenda setting of complex public health challenges in local government. We further identified the significance of the level of influence of policy entrepreneurs' positions, their coalitions and maintaining agenda control as core mechanisms for enabling agenda setting. We found that strategic manoeuvres of policy entrepreneurs were crucial to handle and manoeuvre complexity within the multiple streams described by Kingdon.</p><p><strong>Conclusions: </strong>This article contributes knowledge of how complex public health problems receive attention and how these issues are shaped and defined, placed on governmental agendas, and paired with solutions. The article contributes important insights for understanding policy responses to complex public health problems and how policy entrepreneurs strategically manoeuvre within the streams of policy development to create windows of opportunity and maintain agenda control. This is important knowledge to support agenda setting for public health challenges and to realize policies to improve public health.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"79"},"PeriodicalIF":3.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325318","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}