Health Policy Open最新文献

{"title":"Closing the equity gap: A call for policy and programmatic reforms to ensure inclusive and effective HIV prevention, treatment and care for persons with disabilities in Eastern and Southern Africa","authors":"","doi":"10.1016/j.hpopen.2024.100131","DOIUrl":"10.1016/j.hpopen.2024.100131","url":null,"abstract":"<div><div>In this paper, we explore the critical barriers that persons with disabilities face in accessing HIV services in the Eastern and Southern Africa (ESA) region, despite significant advancements in overall accessibility. We highlight the intersectional challenges experienced by individuals with disabilities, particularly women, and outline a comprehensive approach to bridge the existing gaps in policy and programmatic efforts. Specifically, we aim to address the exclusion of persons with disabilities from essential HIV prevention, treatment, and care services, a situation that has profound implications for their health, social inclusion, and economic productivity. In this discussion, we examine the current landscape, identify specific policy and programmatic hurdles, and propose targeted reforms, in an effort to contribute to the ongoing discourse on health equity and inclusivity.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient’s willingness to pay for improved community health insurance in Tanzania","authors":"","doi":"10.1016/j.hpopen.2024.100130","DOIUrl":"10.1016/j.hpopen.2024.100130","url":null,"abstract":"<div><div>Globally, achieving universal health coverage remains significant challenge. Health insurance coverage in low- and middle-income countries is still low with only a few African countries managed to reach 50% coverage. This study aimed to investigate the factors influencing patients’ willingness to pay (WTP) for medication and various versions of the improved Community Health Insurance Fund (iCHF) in Tanzania. A facility-based cross-sectional study was conducted in all hospitals, health centres, and eight randomly sampled dispensaries, sampling participant from the queue, one out of every three patient based on their order of entry into consultation room, and interviewed 1,748 patients in Kilombero and Same districts in Tanzania. We used multi-stage Contingent Valuation Methods exploring data collected during client exit interviews. We employed a random utility model and estimated WTP through an ordered logit model. The independent variables were; patient’s gender, age, marital status, education, employment status, Non-Communicable Disease (NCD) status, health insurance status, and the type of healthcare facility level. Our findings revealed that most patients exhibited a WTP of an amount equivalent to the current iCHF premiums and would also be willing to pay for an augmented iCHF premium inclusive of additional medication coverage. Upon adjusting for demographic characteristics, we observed that patients enrolled in an insurance program or benefiting from user fee waivers demonstrated a lower WTP for medication, while those with non-communicable diseases (NCDs) and seeking care in private facilities exhibited a higher WTP. Furthermore, patients with a secondary education level or above generally displayed higher WTP for premiums. Conversely, patients enrolled in private insurance and availing user fee waivers, along with those accessing care in public facilities, demonstrated a lowered WTP for iCHF premiums. These results highlight the need for targeted interventions to address systemic deficiencies and improve access to medicines. Our conclusions is that policies considering NCD status, education levels and income status are important when designing health insurance schemes for the informal sector in Tanzania, with the goal of increasing uptake of CHF.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving antibiotic prescribing – Recommendations for funding and pricing policies to enhance use of point-of-care tests","authors":"","doi":"10.1016/j.hpopen.2024.100129","DOIUrl":"10.1016/j.hpopen.2024.100129","url":null,"abstract":"<div><h3>Introduction</h3><div>Diagnostics can contribute to the improved quality of antibiotic prescribing. However, there is potential to enhance the use of point-of-care tests (POCTs) in general practice. This paper presents fit-for-purpose policy recommendations related to funding and pricing for POCTs applied for community-acquired acute respiratory tract infections (CA-ARTIs).</div></div><div><h3>Methods</h3><div>The development of the recommendations was informed by an analysis of the current status of funding and pricing policy frameworks for CA-ARTI POCTs in European countries, and an identification of barriers and facilitators for their uptake. Draft recommendations were developed and subsequently revised based on written and verbal feedback from meetings with experts.</div></div><div><h3>Results</h3><div>The proposal includes four recommendations for policy interventions related to funding and three recommendations regarding pricing policies. Two of the funding policy-related recommendations concern physicians’ remuneration, and two relate to product-specific reimbursement (public coverage) of the CA-ARTI POCTs. The pricing-related recommendations include a proposal to explore the introduction of price regulation, to pilot subscription-fee procurement models and to enhance more strategic approaches in public procurement of CA-ARTI POCTs.</div></div><div><h3>Conclusions</h3><div>Optimised pricing and funding policies could make a difference in enhancing uptake of CA-ARTI POCTs. It is crucial for the successful implementation of policies to consider country settings. Additionally, supportive policy action is recommended, including the systematic use of health technology assessment, stakeholder communication, and monitoring and evaluation.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From theory to practice: Harmonizing taxonomies of trustworthy AI","authors":"","doi":"10.1016/j.hpopen.2024.100128","DOIUrl":"10.1016/j.hpopen.2024.100128","url":null,"abstract":"<div><div>The increasing capabilities of AI pose new risks and vulnerabilities for organizations and decision makers. Several trustworthy AI frameworks have been created by U.S. federal agencies and international organizations to outline the principles to which AI systems must adhere for their use to be considered responsible. Different trustworthy AI frameworks reflect the priorities and perspectives of different stakeholders, and there is no consensus on a single framework yet. We evaluate the leading frameworks and provide a holistic perspective on trustworthy AI values, allowing federal agencies to create agency-specific trustworthy AI strategies that account for unique institutional needs and priorities. We apply this approach to the Department of Veterans Affairs, an entity with largest health care system in US. Further, we contextualize our framework from the perspective of the federal government on how to leverage existing trustworthy AI frameworks to develop a set of guiding principles that can provide the foundation for an agency to design, develop, acquire, and use AI systems in a manner that simultaneously fosters trust and confidence and meets the requirements of established laws and regulations.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How firearm legislation impacts firearm mortality internationally: A scoping review","authors":"","doi":"10.1016/j.hpopen.2024.100127","DOIUrl":"10.1016/j.hpopen.2024.100127","url":null,"abstract":"<div><h3>Background</h3><p>The literature on gun violence is broad and variable, describing multiple legislation types and outcomes in observational studies. Our objective was to document the extent and nature of evidence on the impact of firearm legislation on mortality from firearm violence.</p></div><div><h3>Methods</h3><p>A scoping review was conducted under PRISMA-ScR guidance. A comprehensive peer-reviewed search strategy was executed in several electronic databases from inception to March 2024. Grey literature was searched for unpublished sources. Data were extracted on study design, country, population, type of legislation, and overall study conclusions on legislation impact on mortality from suicide, homicide, femicide, and domestic violence. Critical appraisal for a sample of articles with the same study design (ecological studies) was conducted for quality assessment.</p></div><div><h3>Findings</h3><p>5057 titles and abstracts and 651 full-text articles were reviewed. Following full-text review and grey literature search, 202 articles satisfied our eligibility criteria. Federal legislation was identified from all included countries, while state-specific laws were only reported in studies from the U.S. Numerous legislative approaches were identified including preventative, prohibitive, and more tailored strategies focused on identifying high risk individuals. Law types had various effects on rates of firearm homicide, suicide, and femicide. Lack of robust design, uneven implementation, and poor evaluation of legislation may contribute to these differences.</p></div><div><h3>Interpretation</h3><p>We found that national, restrictive laws reduce population-level firearm mortality. These findings can inform policy makers, public health researchers, and governments when designing and implementing legislation to reduce injury and death from firearms.</p></div><div><h3>Funding</h3><p>Funding is provided by the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance and in part by St. Michael’s Hospital, University of Toronto.</p></div><div><h3>Scoping review registration:</h3><p>Open Science Framework (OSF): <span><span>https://osf.io/sf38n</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000121/pdfft?md5=966efb0375d3f282c3458a484d95fcac&pid=1-s2.0-S2590229624000121-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on conflict and health system–related violent events in Libya: An interrupted time series analysis","authors":"","doi":"10.1016/j.hpopen.2024.100126","DOIUrl":"10.1016/j.hpopen.2024.100126","url":null,"abstract":"<div><p>As a response to the COVID-19 pandemic, the United Nations Security Council passed resolution S/RES2532 (2020), requesting the cessation of hostilities. Despite ceasefire initiatives, evidence suggests that both conflict and violent events remained unabated—and, in some cases, escalated during the first months of the pandemic. This study uses interrupted time series analyses to examine the impact of the pandemic on violent and non-violent political events—including health system-related violence—in Libya, which has been experiencing a protracted conflict since 2014. We find a reduction of approximately 21 battles (<em>p</em> &lt; 0.001) only during the first month of the pandemic. However, overall, throughout the pandemic, there was an increase of roughly one battle per month (<em>p</em> &lt; 0.001). The violence that affected healthcare workers decreased during the first year of the pandemic (<em>p</em> &lt; 0.001); but by the second year the reduction in healthcare worker–related violence had dissipated. While the pandemic seems to have mitigated the level of violence experience by healthcare workers, the overall pattern of violence is a troubling one, particularly since they were observed while there is an international agreement for a ceasefire in place and a specific peace agreement occurring in Libya. The pattern suggests that policy to protect healthcare workers may need to be enhanced even more during crisis settings.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259022962400011X/pdfft?md5=5fc25f12eec83da1ece2b29aeddabb38&pid=1-s2.0-S259022962400011X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The doctor vote: Interactions between political ideological preferences and healthcare reform strategies among U.S. physicians","authors":"","doi":"10.1016/j.hpopen.2024.100123","DOIUrl":"10.1016/j.hpopen.2024.100123","url":null,"abstract":"<div><h3>Intro</h3><p>Improving the American healthcare system has consistently predominated the domestic policy agenda in the United States for decades. However, physicians have traditionally played a small role in the U.S. legislative process despite their direct observations of the obstacles that cost, access, and quality can have on their patients and their care. The goal of this study was to examine the relationship between physician political ideological preferences and health policy reform options.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional survey of 3,001 currently practicing U.S. physicians to predict how self-identification as liberal, moderate, or conservative impacted a physician’s policy preferences under the domains of cost, access, and quality.</p></div><div><h3>Results</h3><p>A total of 536 (18.8%) out of 3,001 physicians responded to the survey. Overall, 32% of physicians identified as liberal, 43% as moderate, and 22% as conservative.</p></div><div><h3>Conclusion</h3><p>Liberal-identifying physicians favored traditionally liberal reform ideas (a national health plan or public option), while conservative physicians preferred conservative policies (free market optimization). However, variation within political groups and domains of healthcare suggest that no single reform policy will be unanimously supported by every physician within a political group. Nonetheless, physicians are unanimously dissatisfied with the state of our current system, and physician-supported healthcare reform should be a national priority.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259022962400008X/pdfft?md5=2448f279323a90a68152b2152924df5d&pid=1-s2.0-S259022962400008X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141960353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Was priority setting considered in COVID-19 response planning? A global comparative analysis","authors":"","doi":"10.1016/j.hpopen.2024.100125","DOIUrl":"10.1016/j.hpopen.2024.100125","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic forced governments across the world to consider how to prioritize resource allocation. Most countries produced pandemic preparedness plans that guide and coordinate healthcare, including how to allocate scarce resources such as ventilators, human resources, and therapeutics. The objective of this study was to compare and contrast the extent to which established parameters for effective priority setting (PS) were incorporated into COVID-19 pandemic response planning in several countries around the world.</p></div><div><h3>Methods</h3><p>We used the Kapriri and Martin framework for effective priority setting and performed a quantitative descriptive analysis to explore whether and how countries’ type of health system, political, and economic contexts impacted the inclusion of those parameters in their COVID-19 pandemic plans. We analyzed 86 country plans across six regions of the World Health Organization.</p></div><div><h3>Results</h3><p>The countries sampled represent 40% of nations in AFRO, 54.5% of EMRO, 45% of EURO, 46% of PAHO, 64% of SEARO, and 41% of WPRO. They also represent 39% of all HICs in the world, 39% of Upper-Middle, 54% of Lower-Middle, and 48% of LICs. No pattern in attention to parameters of PS emerged by WHO region or country income levels. The parameters: evidence of political will, stakeholder participation, and use of scientific evidence/ adoption of WHO recommendations were each found in over 80% of plans. We identified a description of a specific PS process in 7% of the plans; explicit criteria for PS in 36.5%; inclusion of publicity strategies in 65%; mention of mechanisms for appealing decisions or implementing procedures to improve internal accountability and reduce corruption in 20%; explicit reference to public values in 15%; and a description of means for enhancing compliance with the decisions in 5%.</p></div><div><h3>Conclusion</h3><p>The findings provide a basis for policymakers to reflect on their prioritization plans and identify areas that need to be strengthened. Overall, there is little consideration for explicit prioritization processes and tools and restricted attention to equity considerations; this may be a starting point for policymakers interested in improving future preparedness and response planning. Although the study focused on the COVID-19 pandemic, priority setting remains one of the policymakers’ most prominent challenges. Policymakers should consider integrating systematic priority setting in their routine decision-making processes.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000108/pdfft?md5=37508f8fbc04b3bec6643a7f4534472b&pid=1-s2.0-S2590229624000108-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Puerto Rican physician’s recommendations to mitigate medical migration from Puerto Rico to the mainland United States","authors":"Adrián J. Santiago-Santiago ,&nbsp;Joshua Rivera-Custodio ,&nbsp;Claudia A. Mercado-Ríos ,&nbsp;Yoymar González-Font ,&nbsp;Sheilla R. Madera ,&nbsp;Nelson Varas-Díaz ,&nbsp;Mark Padilla ,&nbsp;Alíxida Ramos-Pibernus ,&nbsp;Kariela Rivera-Bustelo ,&nbsp;John Vertovec ,&nbsp;Armando Matiz-Reyes ,&nbsp;Kevin Grove","doi":"10.1016/j.hpopen.2024.100124","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100124","url":null,"abstract":"<div><p>Puerto Rico (PR) is a United States (US) territory with a history of colonial violence, poverty, and government corruption. Due to these sociopolitical factors and natural disasters (e.g., hurricanes and earthquakes), there has been a sharp increase in PR residents migrating to the mainland US. Local media and professional health organizations focus on the impact of medical migration on the PR health system (e.g., health personnel shortages and long waiting periods for critical care). According to the PR College of Physicians and Surgeons, 365–500 physicians have left annually since 2014, which represents a crisis of access to health services. However, few studies have focused on ways to mitigate medical migration from PR to the US mainland. This article describes the recommendations provided by migrating and non-migrating Puerto Rican Physicians (PRPs) to mitigate medical migration from PR to the US mainland. We focus on qualitative data from a mixed-methods NIH-funded study (1R01MD014188) to explore factors that motivate or mitigate migration among migrating (n = 26) and non-migrating (n = 24) PRPs. Interviews were analyzed following thematic analysis guidelines. Results show the following themes: 1) strategies to retain early-career medical residents living in PR; 2) recommendations for local government on future health policy; and 3) work environment initiatives for health institutions to mitigate physician migration. Findings suggest multilevel efforts are required to mitigate medical migration in PR.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000091/pdfft?md5=8879cc103e2da7d8d30b9284b91d22dc&pid=1-s2.0-S2590229624000091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do social protection programmes affect the burden of breast and cervical cancer? A systematic review","authors":"Ligia Gabrielli ,&nbsp;Sheila M. Alvim Matos ,&nbsp;Ana Luísa Patrão ,&nbsp;Emanuelle F. Góes ,&nbsp;Maria da Conceição C. Almeida ,&nbsp;Greice M.S. Menezes ,&nbsp;Isabel dos-Santos-Silva ,&nbsp;Gulnar Azevedo e Silva ,&nbsp;Maria Teresa Bustamante-Teixeira ,&nbsp;Mauricio L. Barreto ,&nbsp;Srinivasa Vittal Katikireddi ,&nbsp;Alastair H. Leyland ,&nbsp;Luana Ferreira Campos ,&nbsp;Ester Maria Dias Fernandes de Novaes ,&nbsp;Daniela de Almeida Pereira ,&nbsp;Elvira Rodrigues Santana ,&nbsp;Fernanda Rodrigues Gonçalves Zeferino ,&nbsp;Ana Cleide da Silva Dias ,&nbsp;Fábio G. Fernandes ,&nbsp;Ana Cristina de Oliveira Costa ,&nbsp;Estela M.L. Aquino","doi":"10.1016/j.hpopen.2024.100122","DOIUrl":"https://doi.org/10.1016/j.hpopen.2024.100122","url":null,"abstract":"<div><h3>Background</h3><p>Socioeconomic conditions are strongly associated with breast and cervical cancer incidence and mortality patterns; therefore, social protection programmes (SPPs) might impact these cancers. This study aimed to evaluate the effect of SPPs on breast and cervical cancer outcomes and their risk/protective factors.</p></div><div><h3>Methods</h3><p>Five databases were searched for articles that assessed participation in PPS and the incidence, survival, mortality (primary outcomes), screening, staging at diagnosis and risk/protective factors (secondary outcomes) for these cancers. Only peer-reviewed quantitative studies of women receiving SPPs compared to eligible women not receiving benefits were included. Independent reviewers selected articles, assessed eligibility, extracted data, and assessed the risk of bias. A harvest plot represents the included studies and shows the direction of effect, sample size and risk of bias.</p></div><div><h3>Findings</h3><p>Of 17,080 documents retrieved, 43 studies were included in the review. No studies evaluated the primary outcomes. They all examined the relationship between SPPs and screening, as well as risk and protective factors. The harvest plot showed that in lower risk of bias studies, participants of SPPs had lower weight and fertility, were older at sexual debut, and breastfed their infants for longer.</p></div><div><h3>Interpretation</h3><p>No studies have yet assessed the effect of SPPs on breast and cervical cancer incidence, survival, or mortality; nevertheless, the existing evidence suggests positive impacts on risk and protective factors.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000078/pdfft?md5=6c2f8be0bcd84bf92f179eab98d77eef&pid=1-s2.0-S2590229624000078-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140948113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}