International Journal of Health Policy and Management最新文献

{"title":"Reflections on the Health System Impact Fellowship and the Future of Embedded Research Comment on \"Early Career Outcomes of Embedded Research Fellows: An Analysis of the Health System Impact Fellowship Program\".","authors":"Elena Lopatina, Deepa Singal, Kiran Pohar Manhas","doi":"10.34172/ijhpm.8615","DOIUrl":"https://doi.org/10.34172/ijhpm.8615","url":null,"abstract":"<p><p>The Health System Impact (HSI) Fellowship program in Canada offers a transformative approach to health services and policy research (HSPR) training, preparing PhD graduates for diverse career pathways and leadership roles within learning health systems. This commentary builds on Kasaai and colleagues' evaluation of the HSI Fellowship to discuss the diverse career paths of alumni and highlight the multifaceted benefits of the program. Further, we emphasize the need for future research and knowledge mobilization to better understand and evaluate embedded research roles. Developing a robust evaluation framework is essential to capture the unique impacts of embedded research, fostering a culture that prioritizes and integrates it, thereby driving the transformation towards learning health systems.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8615"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retailer Responses to Public Consultations on the Adoption of Takeaway Management Zones Around Schools: A Longitudinal Qualitative Analysis.","authors":"Matthew Keeble, Michael Chang, Daniel Derbyshire, Martin White, Jean Adams, Ben Amies-Cull, Steven Cummins, Suzan Hassan, Bochu Liu, Antonieta Medina-Lara, Oliver Mytton, Tarra L Penney, John Rahilly, Nina Rogers, Bea Savory, Annie Schiff, Richard Smith, Claire Thompson, Thomas Burgoine","doi":"10.34172/ijhpm.8294","DOIUrl":"https://doi.org/10.34172/ijhpm.8294","url":null,"abstract":"<p><strong>Background: </strong>Takeaway food is often high in calories and served in portion sizes that exceed public health recommendations for fat, salt and sugar. This food is widely accessible in the neighbourhood food environment. As of 2019, of all local authorities in England (n=325), 41 had adopted urban planning interventions that can allow them to manage the opening of new takeaway outlets in \"takeaway management zones around schools\" (known elsewhere as \"exclusion zones\"). Before adoption, local authorities undertake mandatory public consultation where responses objecting to proposals can be submitted. Evidence on common objections could be insightful for practitioners and policy-makers considering this intervention.</p><p><strong>Methods: </strong>We included 41 local authorities that adopted a takeaway management zone around schools between 2009 and 2019. We identified and analysed objections to proposals submitted by or on behalf of food retailers and local authority responses to these. We used reflexive thematic analysis with a commercial determinants of health lens to generate themes, and investigated if and how objections and responses changed over time.</p><p><strong>Results: </strong>We generated four themes: The role of takeaways in obesity, Takeaway management zone adoption, Use and interpretation of evidence, and managing external opinions. Despite not being implicated by the adoption of takeaway management zones around schools, planning consultants objected to proposals on behalf of transnational food retailers, however, independent takeaways did not respond. Objections attempted to determine the causes of poor diet and obesity, suggest alternative interventions to address them, undermine evidence justifying proposals, and influence perspectives about local authorities and their intervention. Objections consistently raised the same arguments, but over time became less explicit and expressed a willingness to partner with local authorities to develop alternative solutions.</p><p><strong>Conclusion: </strong>Objections to local authority proposals to adopt an urban planning intervention that can stop new takeaways opening near schools featured strategies used by other industries to delay or prevent population health intervention adoption. Practitioners and policy-makers can use our findings when developing proposals for new takeaway management zones around schools. By using knowledge about their local context and addressing arguments against specific aspects of the intervention, they can pre-empt common objections.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8294"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organizational Culture Relation With Innovation Comment on \"Employee-Driven Innovation in Health Organizations: Insights From a Scoping Review\".","authors":"Hatem H Alsaqqa","doi":"10.34172/ijhpm.8583","DOIUrl":"10.34172/ijhpm.8583","url":null,"abstract":"<p><p>This commentary article is important and relevant, as organizational culture and innovation are essential to health organization's performance and viability in a dynamic and competitive setting. Organizational culture is the unquenchable drive that propels an organization's growth and serves as its soul. However, effective internal innovation management is one way that managers and organizations may foster innovation. Health organizations that prioritize service and technological innovation while simultaneously cultivating an appropriate innovation culture to establish a sustainable internal consensus that stimulates innovation are the most inventive. Individuals as well as groups have a deeply ingrained culture that influences how they think and behave, causing health organizations to operate in a way that is rational and consistent.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8583"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a Systems Map: Applying Systems Thinking to Unhealthy Commodity Industry Influence on Public Health Policy.","authors":"Adam Bertscher, James Nobles, Anna B Gilmore, Krista Bondy, Amber van den Akker, Sarah Dance, Michael Bloomfield, Mateusz Zatoński","doi":"10.34172/ijhpm.2024.7872","DOIUrl":"10.34172/ijhpm.2024.7872","url":null,"abstract":"<p><strong>Background: </strong>Unhealthy commodity industries (UCIs) engage in political practices to influence public health policy, which poses barriers to protecting and promoting public health. Such influence exhibits characteristics of a complex system. Systems thinking would therefore appear to be a useful lens through which to study this phenomenon, potentially deepening our understanding of how UCI influence are interconnected with one another through their underlying political, economic and social structures. As such this study developed a qualitative systems map to depict the complex pathways through which UCIs influence public health policy and how they are interconnected with underlying structures.</p><p><strong>Methods: </strong>Online participatory systems mapping workshops were conducted between November 2021 and February 2022. As a starting point for the workshops, a preliminary systems map was developed based on recent research. Twenty-three online workshops were conducted with 52 geographically diverse stakeholders representing academia, civil society (CS), public office, and global governance organisations (CGO). Analysis of workshop data in NVivo and feedback from participants resulted in a final systems map.</p><p><strong>Results: </strong>The preliminary systems map consisted of 40 elements across six interdependent themes. The final systems map consisted of 64 elements across five interdependent themes, representing key pathways through which UCIs impact health policy-making: (1) direct access to public sector decision-makers; (2) creation of confusion and doubt about policy decisions; (3) corporate prioritisation of commercial profits and growth; (4) industry leveraging the legal and dispute settlement processes; and (5) industry leveraging policy-making, norms, rules, and processes.</p><p><strong>Conclusion: </strong>UCI influence on public health policy is highly complex, involves interlinked practices, and is not reducible to a single point within the system. Instead, pathways to UCI influence emerge from the complex interactions between disparate national and global political, economic and social structures. These pathways provide numerous avenues for UCIs to influence public health policy, which poses challenges to formulating a singular intervention or limited set of interventions capable of effectively countering such influence. Using participatory methods, we made transparent the interconnections that could help identify interventions in future work.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"7872"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuing Education in Digital Skills for Healthcare Professionals - Mapping of the Current Situation in EU Member States.","authors":"Anu-Marja Kaihlanen, Lotta Virtanen, Emma Kainiemi, Virpi Sulosaari, Tarja Heponiemi","doi":"10.34172/ijhpm.8309","DOIUrl":"10.34172/ijhpm.8309","url":null,"abstract":"<p><p>The rapid advancement of technology in healthcare is creating new competency requirements for professionals, such as skills for data management and the adoption of new technologies, understanding the effect of digitalisation on clinical processes, and evaluating clinical safety and ethics within the context of digitalisation. These requirements call for improved educational curricula and ongoing continuing education in digital skills. This study, as part of the Digital Skills Training for Health Care Professionals in Oncology (DigiCanTrain) project, aims to map and describe the existing continuing education in digital skills for healthcare professionals (HCPs) in European Union (EU) Member States. Using a mapping study methodology, data was collected from experts in 25 EU countries through surveys and from online sources. Qualitative content analysis was used for categorising the data. The results show variations between countries in policy strategies, training organisation, and funding mechanisms. Educational institutions, employers, third parties, and national/regional authorities were found to be the main organisers of the digital skills training. Comprehensive accreditation systems seemed to be scarce, and practices also varied between countries. The study highlights the importance of adopting a systematic approach to enhancing continuous professional development in digital skills, which would ensure that professionals have equitable access to education, resulting in consistent, quality patient care across countries and regions. The findings offer valuable insights for policymakers, educators, healthcare institutions, and professionals.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8309"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"System-Based Interventions to Address Physician Burnout: A Qualitative Study of Canadian Family Physicians' Experiences During the COVID-19 Pandemic.","authors":"Maria Mathews, Samina Idrees, Dana Ryan, Lindsay Hedden, Julia Lukewich, Emily Gard Marshall, Judith Belle Brown, Paul Gill, Madeleine McKay, Eric Wong, Leslie Meredith, Lauren Moritz, Sarah Spencer","doi":"10.34172/ijhpm.8166","DOIUrl":"10.34172/ijhpm.8166","url":null,"abstract":"<p><strong>Background: </strong>Medical professionals experienced high rates of burnout and moral distress during the COVID-19 pandemic. In Canada, burnout has been linked to a growing number of family physicians (FPs) leaving the workforce, increasing the number of patients without access to a regular doctor. This study explores the different factors that impacted FPs' experience with burnout and moral distress during the pandemic, with the goal of identifying system-based interventions aimed at supporting FP well-being and improving retention.</p><p><strong>Methods: </strong>We conducted semi-structured qualitative interviews with FPs across four health regions in Canada. Participants were asked about the roles they assumed during different stages of the pandemic, and they were also encouraged to describe their well-being, including relevant supports and barriers. We used thematic analysis to examine themes relating to FP mental health and well-being.</p><p><strong>Results: </strong>We interviewed 68 FPs across the four health regions. We identified two overarching themes related to moral distress and burnout: (1) inability to provide appropriate care, and (2) system-related stressors and buffers of burnout. FPs expressed concern about the quality of care their patients were able to receive during the pandemic, citing instances where pandemic restrictions limited their ability to access critical preventative and diagnostic services. Participants also described four factors that alleviated or exacerbated feelings of burnout, including: (1) workload, (2) payment model, (3) locum coverage, and (4) team and peer support.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic limited FPs' ability to provide quality care to patients, and contributed to increased moral distress and burnout. These findings highlight the importance of implementing system-wide interventions to improve FP well-being during public health emergencies. These could include the expansion of interprofessional team-based models of care, alternate remuneration models for primary care (ie, non-fee-for-service), organized locum programs, and the availability of short-term insurance programs to cover fixed practice operating costs.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8166"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Meso-Level in Quality Improvement: Perspectives From a Maternal-Neonatal Health Partnership in South Africa.","authors":"Helen Schneider, Solange Mianda","doi":"10.34172/ijhpm.2024.7948","DOIUrl":"10.34172/ijhpm.2024.7948","url":null,"abstract":"<p><strong>Background: </strong>Sustained implementation of facility-level quality improvement (QI) processes, such as plan-do-study-act cycles, requires enabling meso-level environments and supportive macro-level policies and strategies. Although this is well recognised, there is little systematic empirical evidence on roles and capacities, especially at the immediate meso-level of the system, that sustain QI strategies at the frontline.</p><p><strong>Methods: </strong>In this paper we report on qualitative research to characterize the elements of a quality and outcome-oriented meso-level, focused on sub/district health systems (DHSs), conducted within a multi-level initiative to improve maternal-newborn health (MNH) in three provinces of South Africa. Drawing on the embedded experience and tacit knowledge of core project partners, obtained through in-depth interviews (39) and project documentation, we analysed thematically the roles, capacities and systems required at the meso-level for sustained QI, and experiences with strengthening the meso-level.</p><p><strong>Results: </strong>Meso-level QI roles identified included establishing and supporting QI systems and strengthening delivery networks. We propose three elements of system capacity as enabling these meso-level roles: (1) leadership stability and capacity, (2) the presence of formal mechanisms to coordinate service delivery processes at sub-district and district levels (including governance, referral and outreach systems), and (3) responsive district support systems (including quality oriented human resource, information, and emergency medical services [EMS] management), embedded within supportive relational eco-systems and appropriate decision-space. While respondents reported successes with system strengthening, overall, the meso-level was regarded as poorly oriented to and even disabling of quality at the frontline.</p><p><strong>Conclusion: </strong>We argue for a more explicit orientation to quality and outcomes as an essential district and sub-district function (which we refer to as meso-level stewardship), requiring appropriate structures, processes, and capacities.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"7948"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We Need a Combination of Approaches to Evaluate Health System Resilience Comment on \"Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic\".","authors":"Julia Zimmermann, Marina Karanikolos, Jonathan Cylus, Martin McKee","doi":"10.34172/ijhpm.8564","DOIUrl":"10.34172/ijhpm.8564","url":null,"abstract":"<p><p>Health system resilience has become a desirable health system attribute in the current permacrisis environment. The article by Saulnier and colleagues reviews the literature on health system resilience and refines the concept, pinpointing dimensions of resilience governance that have not reached consensus, or that are missing from the literature. In this commentary we complement the findings by discussing different conceptual frameworks for understanding resilience and introducing resilience testing, a method to assess health system resilience using a hypothetical shock scenario. Resilience testing is a mixed-methods approach that combines a review of existing data with a structured workshop, where health system experts collaboratively assess the resilience of their health system. The new method is proposed as a tool for policy-making, as the results can identify attributes of the current health system that may hinder or boost a resilient response to the next crisis.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8564"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Countering Coloniality in Global Health Comment on \"The Rhetoric of Decolonizing Global Health Fails to Address the Reality of Settler Colonialism: Gaza as a Case in Point\".","authors":"Autumn Asher BlackDeer","doi":"10.34172/ijhpm.8670","DOIUrl":"https://doi.org/10.34172/ijhpm.8670","url":null,"abstract":"<p><p>This commentary joins the chorus of rightful critiques of global health as it continues to further colonial agendas under the guise of supposed well-meaning efforts. Engebretsen and Baker rightfully call out the uptake of decolonial rhetoric in the field of global health, pointing out notable failures to actually challenge undergirding colonial structures and move beyond theory into meaningful action, using clear examples from the ongoing crisis in Gaza and global health's ongoing response (or lack thereof). In this work I bring together essential foundations of decolonial scholarship in order to further the work Engebretsen and Baker have defined as crucial reckoning points for the field of global health. This commentary will (1) ground our conversation by defining true decolonization, (2) delineate the coloniality of knowledge and its manifestations in global health, and (3) conclude with a call to develop a decolonial praxis.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8670"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generating \"Différance\" or an Ontology That Is Same Old Same Old Comment on \"The Generative Mechanisms of Financial Strain and Financial Well-Being: A Critical Realist Analysis of Ideology and Difference\".","authors":"Lynn McIntyre, Catherine L Mah","doi":"10.34172/ijhpm.8565","DOIUrl":"https://doi.org/10.34172/ijhpm.8565","url":null,"abstract":"<p><p>Glenn and colleagues carefully conducted a realist review of initiatives introduced in high-income countries intended to improve financial well-being (FWB) or reduce financial strain (FS) during the early days of the pandemic. They found that these initiatives were underpinned by either neoliberal or social equity ideologies, within which, social location acted on different groups. In this commentary, we suggest caution in applying labels such as neoliberalism and social equity when lumping social welfare policies; labour policies; housing and financial services policies; and service provision for health, seniors, childcare, and education across welfare state regimes. We also caution against aggregating equity-deserving groups from different contexts into a single otherness. We suggest a pragmatic reinterpretation of the study's findings and in future examinations of post-pandemic recovery in accordance with long-standing pragmatic methods of working in public health that seek to improve population health and well-being through collective action.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8565"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}