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During the past 30 years, research on policy analytical capacity's multidimensional nature and the evolution of policy advisory systems (PASs) has both increased knowledge of these processes and structures and opened new avenues of inquiry. While it is clear that changes in PASs in many countries have occurred ‐ featuring processes such as the increased externalisation and politicisation of policy advice ‐ studies of changes among the roles played by core policy professionals in advice provision have lagged. One aspect of this question concerns the nature and extent of changes in this 'forgotten fundamental' of advice systems related to how these professionals are arrayed within 'policy shops'—that is organisational units identified in the 1960s and 1970s as the main organisational home of policy professionals in government. Whether or not such shops have changed from the central‐integrated model identified in early studies and, if so, how, remain outstanding and foundational questions. Recent research in Canada has mapped the distribution of policy professionals at the central and provincial level and found more types of analysts and venues than in earlier eras— which range from the 'classical' integrated policy shops of the 1960s and 1970s which remain in central agencies and single‐purpose line departments to the much more 'distributed' patterns found in many departments dealing with multiple or complex controversial issues. Using Canadian data, this study outlines the development of these organisational types and their distribution in government and discusses the implications of these changes for better understanding the work, and needs, of core professionals in policy advice systems.. Points for practitioners: 'Policy professionals' or public employees specifically tasked with policy analysis in government are key players in policy advisory systems despite the addition of more external and internal actors in policy advice systems in recent years.How these advisors and analysts are organised in government, whether they work in clusters or small groups, and how they interact with other civil servants and policy‐makers are a key determinant of their activities and influence in policy‐making.In the policy sciences, work in the 1960s and 1970s established 'the policy shop', that is relatively small centrally located organisational units employing mainly policy analysts, as the main home of policy professionals in government. These units often enjoyed a monopoly in analysis and played a key role in policy‐making. However, research on these organisations has not kept up with changes in advisory relations within and outside of governments and the impact such changes have had on the influence and activities of core professionals.Recent work by the authors looking at the large Canadian province of Ontario has identified more than a single type of arrangement of analysts in the current era. This paper expands this analysis to both small and large jurisdictions in Canada, including the federal government, and develops two detailed case studies of the current organisation of policy professionals in smaller central agencies like Ministries of Justice as well as in larger omnibus Ministries of the Environment.The study finds a 'distributed' model of policy shops—in which multiple policy units exist throughout the agency—to be dominant in both cases and in all the governments examined and suggests this is now the new normal, replacing the dominance of the older more integrated central shop model. The predominance of the distributed model contributes to the fragmentation of policy advice already underway in government due to the growth in the number of external advisors such as consultants and think tanks, and internal ones such as political staffers. [ABSTRACT FROM AUTHOR]

The American eel (Anguilla rostrata) has long been regarded as a panmictic fish and has been confirmed as such in the northern part of its range. In this paper, we tested for the first time whether panmixia extends to the tropical range of the species. To do so, we first assembled a reference genome (975 Mbp, 19 chromosomes) combining long (PacBio and Nanopore and short (Illumina paired‐end) reads technologies to support both this study and future research. To test for population structure, we estimated genotype likelihoods from low‐coverage whole‐genome sequencing of 460 American eels, collected at 21 sampling sites (in seven geographic regions) ranging from Canada to Trinidad and Tobago. We estimated genetic distance between regions, performed ADMIXTURE‐like clustering analysis and multivariate analysis, and found no evidence of population structure, thus confirming that panmixia extends to the tropical range of the species. In addition, two genomic regions with putative inversions were observed, both geographically widespread and present at similar frequencies in all regions. We discuss the implications of lack of genetic population structure for the species. Our results are key for the future genomic research in the American eel and the implementation of conservation measures throughout its geographic range. Additionally, our results can be applied to fisheries management and aquaculture of the species. [ABSTRACT FROM AUTHOR]

This paper explores how politicians respond to the public salience of policy issues when determining which topics to publicly address. Using new data and state-of-the-art methodology, our study provides a fresh perspective on this fundamental question. We focus on a multi-party parliamentary system, specifically the Canadian House of Commons, with a specific emphasis on the issue of climate change. To assess the attention given by political parties to various policy issues, we analyze transcripts from the Question Period spanning from April 2006 to June 2021. To gauge the public's level of concern for these issues, we incorporate data obtained from Google Trends. Employing an instrumental variable estimation strategy, our study causally estimates the extent to which the public salience of climate change influences elite attention. Our findings reveal that the public salience of climate change significantly influences the attention given to this issue by parties, albeit with noticeable partisan variations. Moreover, our research highlights the effectiveness of the Question Period in compelling the government to address challenging or potentially embarrassing issues. Lastly, we uncover evidence suggesting that the Liberal Party of Canada successfully increased the public salience of climate change during its tenure in government. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has challenged nations states across the world. They have implemented lockdown and social distancing and with the development of vaccines have gone to great lengths to build herd immunity for their populations. As place managers, local government has played a variety of roles supporting central government edicts related to social distancing and supporting local businesses impacted by lockdowns. The research reported here comparing the role local government has played in Australia, Canada, Italy, and New Zealand shows that they have at different times and for different issues been policy takers from central government, policy shapers, and policy makers adapting national strategies. Local government plays an important complementary role with central governments in both unitary and federal systems of government. The paper contributes to the literature on multi‐level governance, place‐based decision‐making, and disaster and emergency management by offering a framework for analysing municipal roles in crises management both in their relationship with higher layers of government and in their acting as locally placed organisations. Points for practitioners: Cross‐national study: Australia, Canada, Italy, and New Zealand.Examination of local government responses to COVID‐19 pandemic as policy makers, takers, or shapers.Comparison of federal and unitary states. [ABSTRACT FROM AUTHOR]

Canada and Australia, two liberal welfare states whose market-based ECEC systems consistently rank poorly on international measures, embraced similar short-term childcare policy responses to the onset of the COVID-19 pandemic: widespread closures, reduced capacity of centers, establishment of publicly funded emergency childcare programs for essential workers, and short-term wage subsidies for essential workers (sometimes including educators). Rooted in a feminist political economy (FPE) theoretical framework and using a what-is-the-problem-represented-to-be (WPR) methodological approach, this article explores the extent to which the first and second "waves" of the COVID-19 pandemic policy responses in Canada and Australia framed childcare as a concern about gendered, reproductive labor within political representations of the policy problems to be solved. [ABSTRACT FROM AUTHOR]

This paper examines how policymakers interpret and deploy cultural economy approaches within municipal economic development strategies and cultural plans. Focusing on the 33 largest municipalities in Ontario, Canada, we conduct a keyword analysis of 63 municipal planning documents, supplemented with key informant interviews with economic development and cultural planning staff. Our analysis reveals that the use of cultural economy approaches in economic development and cultural plans varies depending upon city size, municipal governance structure and municipal organizational structure. However, despite the widespread use of cultural economy ideas in planning documents, we conclude that its uptake in municipal policymaking fails to reflect its professional and scholarly popularity. [ABSTRACT FROM AUTHOR]

Background: The value of a life is regularly monetised by government departments for informing resource allocation. Guidance documents indicate how economic evaluation should be conducted, often specifying precise values for different impacts. However, we find different values of life and health are used in analyses by departments within the same government despite commonality in desired outcomes. This creates potential inconsistencies in considering trade-offs within a broader public sector spending budget. We provide evidence to better inform the political process and to raise important issues in assessing the value of public expenditure across different sectors. Methods: Our document analysis identifies thresholds, explicitly or implicitly, as observed in government-related publications in the following public sectors: health, social care, transport, and environment. We include both demand-side and supply-side thresholds, understood as societies' and governments' willingness to pay for health gains. We look at key countries that introduced formal economic evaluation processes early on and have impacted other countries' policy development: Australia, Canada, Japan, New Zealand, the Netherlands, and the United Kingdom. We also present a framework to consider how governments allocate resources across different public services. Results: Our analysis supports that identifying and describing the Value of a Life from disparate public sector activities in a manner that facilitates comparison is theoretically meaningful. The optimal allocation of resources across sectors depends on the relative position of benefits across different attributes, weighted by the social value that society puts on them. The value of a Quality-Adjusted Life Year is generally used as a demand-side threshold by Departments of transport and environment. It exceeds those used in health, often by a large enough proportion to be a multiple thereof. Decisions made across departments are generally based on an unspecified rationing rule. Conclusions: Comparing government expenditure across different public sector departments, in terms of the value of each department outcome, is not only possible but also desirable. It is essential for an optimal resource allocation to identify the relevant social attributes and to quantify the value of these attributes for each department. [ABSTRACT FROM AUTHOR]

Background: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). Methods: Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. Results: From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. Conclusions: Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities. [ABSTRACT FROM AUTHOR]

Background Generic drugs have been seen as a potentially powerful way to alleviate the financial burden on patients and health care systems. Two strategies for achieving rational prices of generic drugs are tiered pricing framework and pooled purchasing power. We compare the pan-Canadian Tiered Pricing Framework (TPF) and the Chinese National Volume-Based Procurement (NVBP) as comparators to explore the similarities and differences between the two mechanisms and summarise lessons for other jurisdictions. Methods This comparative study applies Donabedian's structure-process-outcome framework to systematically analyse the macro contexts, procedures, and long- and short-term results of each pricing mechanism, and the interactions between them. Results Structure: TPF is an upstream initiative aimed at lowering the prices of generic drugs and increasing coverage and price consistency. NVBP is a downstream national initiative prioritised for reducing drug prices to achieve value-based purchasing. Process: By associating the number of manufacturers with price cuts, TPF leaves the choice to manufacturers to decide if they want to enter a specific market. In contrast, the Chinese government determines NVBP list and has the authority to choose manufacturer(s) with the lowest price(s). TPF provides clear price information to potential suppliers with unclear order quantity. The NVBP drug price is determined by tendering, while procurement volume is clear and massive. Outcome: The effectiveness of TPF and NVBP is similar, with both achieving a 53% price cut. Both TPF and NVBP experienced efficiency improvement since their establishment, with 98 and 86 drugs priced per year. By comparing 60 drugs covered by both programmes, the NVBP price is 57% of that of the TPF counterpart on average (1.1 to 301.6%), by purchase power parity. Conclusions The tiered pricing scheme is feasible in regions with a stable and mature pharmaceutical market, typically seen in high-income countries, while tendering is more workable in low- and middle-income countries where the pharmaceutical market is weak and unstable. Experience in the two countries shows that a coordinated pricing mechanism involves many piecemeal interactive problems, which a sophisticated system with a robust long-range plan may address better. [ABSTRACT FROM AUTHOR]

Aims: In 2014, in response to evidence that Canada's tobacco use would lead, inexorably, to substantial morbidity and mortality for the foreseeable future, a group of experts convened to consider the development of a "Tobacco Endgame" for Canada. The "Tobacco Endgame" defines a time frame in which to eliminate structural, political, and social dynamics that sustain tobacco use, leading to improved population health. Strategies: A series of Background Papers describing possible measures that could contribute to the creation of a comprehensive endgame strategy for Canada was prepared in advance of the National Tobacco Endgame Summit hosted at Queen's University in 2016. At the summit, agreement was reached to work together to achieve <5% tobacco use by 2035 (<5 by '35). A report of the proceedings was shared widely. Achievements: Progress since 2016 has been mixed. The Summit report was followed by a national forum convened by Health Canada in March 2017, and in 2018, the Canadian Government adopted "<5 × '35" tobacco use target in a renewed Canadian tobacco reduction strategy. Tobacco use has declined in the last 5 years, but at a rate slower than that which will be needed to achieve the <5 by '35 goal. There remain > 5 million smokers in Canada, signaling that smoking-related diseases will continue to be an enormous health burden. Furthermore, the landscape of new products (e-cigarettes and cannabis) has created additional risks and opportunities. Future directions: A bold, reinvigorated tobacco control strategy is needed that significantly advances ongoing policy developments, including full implementation of the key demand-reduction policies of the WHO Framework Convention on Tobacco Control. Formidable, new disruptive policies and regulations will be needed to achieve Canada's Endgame goal. [ABSTRACT FROM AUTHOR]

This article analyses and compares disability policies for working-age individuals in Canada with a focus on the mode of policy provision and type of measure to determine the degree to which direct funding is used in this country. To consider policy diversity in this federal system, policies are compared using a mixed-methods approach. Using quantitative methods, federal, provincial and territorial policies are first compared using hierarchical cluster analysis. This provides evidence of three distinct clusters in Canada according to policy provision and measure type. In a second, qualitative analysis, the disability strategies of four provinces' (British Columbia, Ontario, Newfoundland and Labrador and Quebec) are compared, to determine over arching policy orientations. Findings indicate that policy provision in Canada largely favours money over services. Furthermore, most provinces emphasize either health or integration measures over substantive measures. Despite these commonalities, significant variation persists across Canada. This extends to poverty and disability reduction strategies with two of the four provinces having a broader orientation while the other two provinces focus specifically on employment as a means of social inclusion. The article concludes with a discussion on the state of employment policies for individuals with a disability in Canada. [ABSTRACT FROM AUTHOR]

Background: In this paper we assess the quality of six deliberative stakeholder consultations regarding the implementation of a precision diagnostic for life-threatening pediatric brain tumors. Decision makers who base policy recommendations on the outputs of consultative exercises can presuppose that all deliberants are well informed of the policy issue, that participation in the deliberative process was fair, and that overcoming implementation barriers will necessarily result in practice change. Additional evidence is therefore needed to substantiate the informational quality of the deliberation, measure the equality of participation and study the effects on stakeholder reasoning to appropriately guide uptake of proposed recommendation(s). Methods: Using the DeVries framework for assessing the deliberative quality, we analyzed data from 44 post-consultation evaluation surveys completed by pediatric oncology and palliative care teams at two tertiary pediatric healthcare centers in Canada. We also conducted turn-taking and word-contribution analyses from the text transcriptions of each deliberation to assess equality of participation using descriptive statistics. Results: Deliberants agreed the quality of the deliberative process was fair (median ratings ranging from 9–10 out of 10) and the opportunities to receive expert information and discuss with others about the implementation of a new LDT were helpful (9.5 out of 10). While the session improved understanding of the implementation barriers and opportunities, it had marginal effects on deliberants' reasoning about whether LDTs would change their own clinical practice (3–10 out of 10). Participation was proportionate in at least four of the six deliberations, where no deliberant took more than 20% of total turns and contributed equal to, or less than 20% of total words. Conclusion: The quality assessment we performed demonstrates high informational value and perceived fairness of two deliberative stakeholder consultations involving pediatric palliative care and oncology teams in Canada. Quality assessments can reveal how the process of deliberation unfolds, whether deliberative outputs are the result of equitable participation among deliberants and what, if any, stakeholder voices may be missing. Such assessments should be routinely reported as a condition of methodological rigor and trustworthiness of deliberative stakeholder engagement research. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore 232 service providers' and policymakers' experiences of supporting children's well-being during the pandemic, across sectors, in 22 countries – including Kenya, the Philippines, South Africa, India, Scotland, Sweden, Canada and the USA, in the last quarter of 2020. Design/methodology/approach: A smartphone survey delivered via a custom-built app containing mostly open-ended questions was used. Respondents were recruited via professional networks, newsletters and social media. Qualitative content analysis was used. Findings: The findings reveal numerous system-level challenges to supporting children's well-being, particularly virus containment measures, resource deficiencies and inadequate governance and stakeholder coordination. Those challenges compounded preexisting inequalities and poorly affected the quality, effectiveness and reach of services. As a result, children's rights to an adequate standard of living; protection from violence; education; play; and right to be heard were impinged upon. Concurrently, the findings illustrate a range of adaptive and innovative practices in humanitarian and subsistence support; child protection; capacity-building; advocacy; digitalisation; and psychosocial and educational support. Respondents identified several priority areas – increasing service capacity and equity; expanding technology use; mobilising cross-sectoral partnerships; involving children in decision-making; and ensuring more effective child protection mechanisms. Practical implications: This study seeks to inform resilience-enabling policies and practices that foster equity, child and community empowerment and organisational resilience and innovation, particularly in anticipation of future crises. Originality/value: Using a novel approach to gather in-the-moment insights remotely, this study offers a unique international and multi-sectoral perspective, particularly from low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Abstract Increases in youth vaping rates and concerns of a new generation of nicotine addicts recently prompted an increase in the federal minimum legal purchase age (MLPA) for tobacco products, including e-cigarettes, to 21 years. This study presents the first regression discontinuity evidence on the effectiveness of e-cigarette MLPA laws. Using data on 12th graders from Monitoring the Future, we obtain robust evidence that federal and state age 18 MLPAs decreased underage e-cigarette use by 15–20 percent and frequent use by 20–40 percent. These findings suggest that the age 21 federal MLPA could meaningfully reduce e-cigarette use among 18- to 20-year-olds. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is twofold: to introduce scholars and practitioners of foresight to the emerging Canadian foresight ecosystem, and to provide lessons learned on developing policy foresight from the Government of Canada context. Design/methodology/approach: The paper provides a series of lessons based in part on informal and indirect observations and engagement with established Canadian foresight entities, including Policy Horizons Canada, and numerous newly established foresight initiatives at Global Affairs Canada, Standards Council of Canada and the Canadian Forest Service. Findings: The paper finds that Canada's newly emerging foresight units and initiatives face structural, institutional and organizational challenges to their long-term success, including in concretely measuring foresight outcome (rather than simply output) in policy making. Originality/value: The paper provides a unique and empirically driven perspective of the foresight ecosystem that has emerged within the Canadian federal public service since 2015. Lessons are culled from this emerging network of Canadian foresight practitioners for international application. [ABSTRACT FROM AUTHOR]

Purpose: In Canada, community engagement and accountability are a political imperative, resulting in an omnipresent program with varied opportunities for public participation. The purpose of this paper is to promote leadership and commitment for health system transformation that truly benefits communities. Design/methodology/approach: This paper is based on the author's experience with many engagement and accountability activities, applied in varied settings, for purposes such as evaluation, planning, policy making and system transformation. The specific context is generalized with international experiences and references. Findings: The "lessons learned" are based on practical considerations with relevance for both novice and experienced practitioners: clarifying principles, processes and purposes at the outset; using effective leadership to achieve the desired impact; using a variety of methods to engage communities; clarifying engagement and accountability roles precisely; measuring things that are meaningful; and consulting with internal as well as external communities. Also, community leaders should recognize effort as well as results. Research limitations/implications: Commitment to engagement and accountability is commendable – but is it enough? The paper concludes by looking beyond health system impacts to propose a broader systems perspective. If clinical governors want to use engagement and accountability to achieve "total value" for their communities, they will need to demonstrate as leaders that they are committed to long-term thinking and broad social goals. Originality/value: Too much focus on the process of care may mask accountability for reporting outcomes or systemic impact. The sustainable development goals highlight the need for systems thinking and public expectations include corporate social responsibility. As shown in the examples cited, a deeper commitment to engagement and accountability requires looking beyond care delivery to social determinants and to systemic impacts of the health care industry itself. [ABSTRACT FROM AUTHOR]

One of harm reduction's most salient features is its pragmatism. Harm reduction purports to distinguish itself from dominant prohibitionist and abstinence-based policy paradigms by being grounded in what is realistic, in contrast with the moralism or puritanism of prohibition and abstention. This is reflected in the meme "harm reduction works", popular both in institutional and grassroots settings. The idea that harm reduction is realistic and effective has meant different things among the main actors who seek to shape harm reduction policy. Drawing on scholarly literature about harm reduction, as well as examples from recent harm reduction advocacy efforts in relation to drug policy in Canada, this paper argues that harm reduction distinguishes itself through a unique "way of knowing". Grassroots harm reduction advocates, particularly as they argue through human rights frameworks, do more than simply make claims for the provision of particular services—like needle exchange, safe consumption sites, safe supply and the like—on the basis that these are realistic paths toward the health and well-being of people who use drugs. Rather, as they marshal lived experience in support of these policy changes through peer-driven initiatives in contexts of prohibition, they make particular claims about what constitute valid, methodologically rigorous evidence bases for action in contexts where policies to date have been driven by ideology and have developed in ways that have excluded and marginalized those most affected from policymaking. In doing so, they advocate for the centrality of people who use drugs not only in policy-making processes, but in evidence production itself. [ABSTRACT FROM AUTHOR]

Accessible housing is an urgent issue for countries experiencing rapid population aging. For over 20 years the United Kingdom's (UK) building code (Part M) and Lifetime Homes Standard have been researched as leading practices to increase accessible housing stock and allow older adults to stay in their communities. This review compiles key stakeholder groups' perspectives on these regulatory tools. Five main themes and 'lessons learned' were derived to anticipate potential challenges and inform proactive response for planners and policy makers in Canada and other countries when developing their own accessible housing regulation. [ABSTRACT FROM AUTHOR]

Background: Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians' (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning. Methods: As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis approach was employed to identify recurring themes. For the current study, we examined themes related to PPE. Results: A total of 68 FPs were interviewed across the four regions. Four overarching themes were identified: 1) factors associated with good PPE access, 2) managing PPE shortages, 3) impact of PPE shortages on practice and providers, and 4) symbolism of PPE in primary care. There was a wide discrepancy in access to PPE both within and across regions, and integration with hospital or regional health authorities often resulted in better access than community-based practices. When PPE was limited, FPs described rationing and reusing these resources in an effort to conserve, which often resulted in anxiety and personal safety concerns. Many FPs expressed that PPE shortages had come to symbolize neglect and a lack of concern for the primary care sector in the pandemic response. Conclusions: During the COVID-19 pandemic response, hospital-centric plans and a lack of prioritization for primary care led to shortages of PPE for family physicians. This study highlights the need to consider primary care in PPE conservation and allocation strategies and to examine the influence of the underlying organization of primary care on PPE distribution during the pandemic. [ABSTRACT FROM AUTHOR]

Aims: To explore nurse practitioners' experiences of medication abortion implementation in Canada and to identify ways to further support the implementation of medication abortion by nurse practitioners in Canada. Design: A qualitative approach informed by feminist theory and integrated knowledge translation. Methods: Qualitative interviews with stakeholders and nurse practitioners between January 2020 and May 2021. Data were analysed using critical feminist theory. Results: Participants included 20 stakeholders, 16 nurse practitioner abortion providers, and seven nurse practitioners who did not provide abortions. We found that nurse practitioners conduct educational, communication and networking activities in the implementation of medication abortion in their communities. Nurse practitioners navigated resistance to abortion care in the health system from employers, colleagues and funders. Participants valued making abortion care more accessible to their patients and indicated that normalizing medication abortion in primary care was important to them. Conclusion: When trained in abortion care and supported by employers, nurse practitioners are leaders of abortion care in their communities and want to provide accessible, inclusive services to their patients. We recommend nursing curricula integrate abortion services in education, and that policymakers and health administrators partner with nurses, physicians, midwives, social workers and pharmacists, for comprehensive provincial/territorial sexual and reproductive health strategies for primary care. Impact The findings from this study may inform future policy, health administration and curriculum decisions related to reproductive health, and raise awareness about the crucial role of nurse practitioners in abortion care and contributions to reproductive health equity. Patient or Public Contribution: This study focused on provider experiences. In‐kind support was provided by Action Canada for Sexual Health & Rights, an organization that provides direct support and resources to the public and is committed to advocating on behalf of patients and the public seeking sexual and reproductive health services. [ABSTRACT FROM AUTHOR]

The need for leadership in nursing is well-documented and Domain Six of the doctoral section of the National Nursing Education Framework of the Canadian Association of Schools of Nursing (CASN) is Leadership. While there are likely many paths to achievement of these leadership components, the intent of this paper is to share my journey through iteration of and reflection on my PhD dissertation research focused on a four-cycle community-based participatory action research study (CBPR) related to clinical teaching in Ghana. The focus of CBPR is to engage the researcher and the participant group (community) in collaborative, and egalitarian processes to assess and problem solve an issue in the community. Similarly, leadership promotes collaborative interpersonal relationships among leaders and followers to address issues and institutes change strategies in policies. This paper presents my experiences in building leadership capacity through this scholarly endeavor (PhD thesis) in relation to the CASN guideline. [ABSTRACT FROM AUTHOR]

The scholarship on state-building has devoted a significant amount of attention to the role of taxation in building state institutions and capacities. It has also emphasised the crucial role of taxation in driving state-society relations. Scholars have argued that the linkage between taxation and state building also applies to the area of social policy. In this paper, we draw on a fiscal-centred perspective on welfare state development that highlights the fiscal policy role of social insurance as a revenue raising institution to study the fiscal relationship between social insurance and state-building in Israel and Canada – two 'most dissimilar cases' that nonetheless feature strikingly similar patterns with regard to this relationship. As our findings show, in both cases, social insurance programmes were introduced, designed, and utilized to advance fiscal and economic policy capacity and thereby promote state building. Using these programmes and the commitments they created, political actors could legitimize the generation of revenues, build institutional infrastructure for tax collection, and create capital reserves for investing in the economy. [ABSTRACT FROM AUTHOR]

The Canadian government recently sanctioned a supervised consumption site (SCS) that is currently in Vancouver, British Columbia. The government is open to sanctioning more sites across the country; however, by law the federal health minister must consider whether such facilities are supported by local governments representing the cities where the sites are proposed to be located. Until 2016, the government of Canada's largest city, Toronto, did not support SCSs. Drawing on Lenton cannabis policy research, this study analyses government documents, policy papers, scientific reports, and newspaper articles and secondary literature to identify some of the significant barriers that minimised the likelihood that Toronto's council would support SCSs between 2003 and 2016. The report compares conditions in Toronto to those of Vancouver where SCSs have enjoyed council support since 2001. This study find that three conditions play an important role in explaining why SCSs were supported in Vancouver 14 years before they were endorsed in Toronto: (1) Strong public support; (2) Favourable electoral conditions; and (3) Law enforcement support. Changes in Toronto surrounding these conditions help explain why its council endorsed SCSs in 2016. This study concludes that Lenton's research holds utility as a socio-legal theory of municipal drug policy change. [ABSTRACT FROM AUTHOR]

Canada has been discussing whether to implement an orphan drug policy for more than 25 years. Recently, the federal government announced funding for orphan drugs starting in 2022, and the Canadian Senate has recommended that the country develop an orphan drug policy. This paper uses a list of orphan drugs approved by the United States Food and Drug Administration between 2008 and 2017, inclusive. It then compares Canada, which has no orphan drug policy, and Australia, which has had such a policy since 1997. There was no difference between the countries in the proportion of orphan drugs approved, the time drugs spent in the regulatory review process, and any delay in marketing the drugs in the respective countries compared to the United States. Both Canada and Australia approved virtually all of the drugs that offered a moderate to significant therapeutic improvement. If Canada hopes to provide faster access to orphan drugs, especially those that are therapeutically innovative, it will need to develop a policy that is significantly different from that in Australia. [ABSTRACT FROM AUTHOR]

In an era which marks an exceptional phase of growth in science and technology, the acute disparities in access to healthcare still persist. So where on one hand scientific advancement in medicine aims at increasing life expectancy, on the other hand there are millions who are denied access to existing medicines. Patents on medicines also pose a significant barrier to access new drugs, especially in low and middle income countries which already suffer from poor health financing mechanisms. The patent laws were built on the assumption of incentivizing the innovators by rewarding them with the exclusive right to produce, sell or market the innovation. The basic premise for granting patents was based on the thought that it would increase investment in research and development promoting dynamic gains through newer innovations. However, evidence found to support this justification is meager. So in a situation where the drug gap still persists and we aim to achieve sustainable development goals by 2030, this paper attempts to focus on understanding how compulsory licensing has been used in selected cases to alleviate the major legal and political barriers to access medicines. The methodology comprises of cross-country comparison of patent framework and compulsory licensing cases. The sample selected for study includes both developed as well as developing countries. The aim is to evaluate the policy approaches used by selected countries to grant compulsory licenses and to identify the best practices for evidence-based policy making on international issues related to pharmaceutical patents. In each case, a driving factor has been the international extension of patent laws through trade agreements; first bilaterally (US-Canada) and subsequently internationally (1995 Uruguay round, under which low- and middle-income countries were granted a grace period until 2005 to comply). [ABSTRACT FROM AUTHOR]

The authors comment on an article by W. Hall and colleagues on regulating delta-9-tetrahydrocannabinol (THC) content in cannabis products. Topics include policy options discussed by W. Hall and colleagues with a view to reduce cannabis-related harm, the introduction by Quebec and Uruguay of caps on THC levels for the products supplied through the legal market, and possible impact of accommodating different THC concentrations among different legal supply options.

When individuals evaluate policies, they consider both the policy's content and its endorsers. In this study, we investigate the conditions under which these sometimes competing factors guide preferences. In an effort to combat the spread of COVID-19, American President Trump and Canadian Prime Minister Trudeau bilaterally agreed to close their shared border to refugee claimants and asylum seekers. These ideologically opposed leaders endorsing a common policy allows us to test the influence of a well-known foreign neighbor on domestic policy evaluations. With a large cross-national survey experiment, we first find that Canadians and Americans follow ideological positions in evaluating the policy, with right-leaning respondents offering the most support. With an experiment, we reveal how both populations shift their views when told about their neighboring leader's endorsement. Our findings highlight ideologically motivated reasoning across an international border, with broad implications for understanding how individuals weigh a policy's content against its political cues. [ABSTRACT FROM AUTHOR]

This paper analyzes the nature of the debate generated prior to the implementation of the Act Respecting End-of-Life Care in 2015 in Québec (Canada). Including medical assistance in dying (MAID) along existing palliative care services, the act is an important policy change on a very sensitive issue. As such, MAID could be categorized as a morality policy issue, the latter being defined as a particular category of policy because of its specific features (issues of first principle, technical simplicity, high salience, public interest, and public participation). In line with Mucciaroni’s proposition, we rather analyze this issue by understanding morality policy as one of two framing strategies (moral and/or rational-instrumental frame). Our research reconstructs four public opinion framings as advanced and transmitted through the media between 2005 and 2015. It shows that although opponents to the bill unsurprisingly framed the debate in deontological terms, mostly referring to sanctity of life as one of the most important values in society, they also framed it on rational-instrumental grounds in a similar proportion, alleging the danger of a slippery slope and potential abuse. As well, if some of the proponents favored a moral framing centered on the argument that dignity and individual autonomy take precedence over all other values, others put forward a rational-instrumental one, where the slippery slope/abuse argument is used as a cautionary statement against the artificial prolongation of life. Our analysis reinforces Mucciaroni’s and Ferraiolo’s assertions that sensitive issues classified as morality policy cannot be apprehended solely through the unidimensional frame of morality. [ABSTRACT FROM AUTHOR]

Aims and objectives: This scoping review explored: (i) the role of unregulated care providers in the healthcare system; (ii) their potential role on interprofessional teams; (iii) the impact of unregulated care provider’s role on quality of care and patient safety; and (iv) education and employment standards. Background: Unregulated care providers in Canada assist older adults with personal support and activities of daily living in a variety of care settings. As the care needs of an aging population become increasingly complex, the role of unregulated care providers in healthcare delivery has also evolved. Currently, many unregulated care providers are performing tasks previously performed by regulated health professionals, with potential implications for quality of care and patient safety. Information is fragmented on the role, education and employment standards of unregulated care providers. Methods: A scoping review was conducted following the methods outlined by Arksey and O'Malley (International Journal of Social Research Methodology, 8, 2005, 19) and Levac, Colquhoun, and O'Brien (Implementation Science, 5, 2010, 69). An iterative search of published and grey literature was conducted from January 2000 to September 2016 using Medline, CINAHL, SCOPUS and Google. Inclusion and exclusion criteria were applied to identify relevant studies published in English. Results: The search yielded 63 papers for review. Results highlight the evolving role of unregulated care providers, a lack of recognition and a lack of authority for unregulated care provider decision‐making in patient care. Unregulated care providers do not have a defined scope of practice. However, their role has evolved to include activities previously performed by regulated professionals. Variations in education and employment standards have implications for quality of care and patient safety. Conclusions: Unregulated care providers are part of an important workforce in the long‐term care and community sectors in Canada. Their evolving role should be recognised and efforts made to leverage their experience on interprofessional teams and reduce variations in education and employment standards. Implications for practice: This study highlights the evolving role of unregulated care providers in Canada and presents a set of recommendations for implementation at micro, meso, and macro policy levels. [ABSTRACT FROM AUTHOR]

Nutrition guideline development is traditionally seen as a mechanism by which evidence is used to inform policy decisions. However, applying evidence in policy is a decidedly complex and politically embedded process, with no single universally agreed-upon body of evidence on which to base decisions, and multiple social concerns to address. Rather than simply calling for "evidence-based policy," an alternative is to look at the governing features of the evidence use system and reflect on what constitutes improved evidence use from a range of explicitly identified normative concerns. This study evaluated the use of evidence within the Canada Food Guide policy process by applying concepts of the "good governance of evidence" – an approach that incorporates multiple normative principles of scientific and democratic best practice to consider the structure and functioning of evidence advisory systems. The findings indicated that institutionalizing a process for evidence use grounded in democratic and scientific principles can improve evidence use in nutrition policy making. [ABSTRACT FROM AUTHOR]

Aim: This article aims to explore how policymakers conceptualise a person suitable for disability income support (DIS) and how this compares across two settings – Australia and Canada. Methods: A constructivist grounded theory approach was used; 45 policymakers in Australia and Canada were interviewed between March 2012 and September 2013. All policymakers are or were influential in the design or assessment of DIS. Results: Results found that the policymakers in both jurisdictions define a suitable person as having as an 'ideal type' of disability with five features – visibility, diagnostic proof, permanency, recognition as a medical illness and perceived as externally caused. Many of the policymakers described how mental illnesses are not an 'ideal type' of disability for DIS by juxtaposing the features of mental illnesses against physical illnesses. As such, mental illnesses were labelled imperfect disabilities and physical illnesses as 'ideal type' for DIS. Conclusions: The rise of DIS recipients has divided the once protected 'deserving' category of the disabled into more ('ideal type' of disability) and less deserving (imperfect disability). Such conceptualisations are important because these categories can influence the allocation of welfare resources. [ABSTRACT FROM AUTHOR]

The article presents a list of various papers on policy studies subjects that were presented at the 1977 annual meetings of the Midwest, New England, Northeastern, Southern, Southwestern, and Western Political Science Association. Philip Abbott of Wayne State University, Detroit, Michigan presented "Philosophy of Political Theory and Public Policy: The Abortion Question in the Classroom." John Shiry of University at Alberta, presented "Policy Type and the Political Process in a Canadian Province: A Test of the Lowi Model."

The main goal of this paper is to propose a dynamic mapping for knowledge and ignorance mobilization in science research and innovation. An underlying argument is that ‘knowledge mobilization’ science policy agendas in countries such as Canada and the United Kingdom fail to capture a critical element of science and innovation: ignorance mobilization. The latter draws attention to dynamicsupstreamof knowledge in science research and innovation. Although perhaps less visible, there is ample evidence that researchers value, actively produce, and thereby mobilize ignorance. For example, scientists and policymakers routinely mobilize knowledge gaps (cf. ignorance) in the process of establishing and securing research funding to argue the relevance of a scientific paper or a presentation, and to launch new research projects. Ignorance here is non-pejorative and by and large points to the borders and the limits of scientific knowing – what is known to be unknown. In addition, processes leading to the intentional or unintentional consideration or bracketing out of what is known to be unknown are intertwined with, yet remain distinct from, knowledge mobilization dynamics. The concepts of knowledge mobilization and of ignorance mobilization, respectively, are understood to be the use of knowledge or ignorance towards the achievement of goals. The value of this paper lies in its conceptualization of the mobilization of knowledge as related to the mobilization of ignorance within a complex, dynamic and symbiotic relationship in science research and innovation: it takes two to tango. [ABSTRACT FROM AUTHOR]

Unmet needs for assistive technologies (ATs) exist and the need for ATs is growing owing to demographic changes worldwide. Little comprehensive research has examined equity of access to ATs in Canada. Our study elucidates perspectives of policymakers and stakeholders on challenges and solutions for enhancing equitable access to ATs to advance policy discussions. We conducted a qualitative interview study with a purposive sample of policymakers and stakeholders. Stakeholders were from non-profit organisations; private insurance companies; ageing or technology industries; and advocacy, consumer, and support groups. We used thematic analysis to develop themes that summarised and facilitated data interpretation. We conducted 24 interviews involving 32 participants. We present three themes: (1) User experiences, detailing challenges experienced by AT system users; (2) System characteristics: Challenges and solutions, outlining governance, financial, and delivery arrangements that create challenges for accessing AT, as well as participants' proposed solutions; and (3) Shifts in models and principles, for approaches that may foster equitable access to ATs. We consolidate results into a set of valued qualities of a system that can enhance equitable AT access, and relate results to relevant national and international activities. This is the most comprehensive study of Canadian policymaker and stakeholder views on AT access to date. Identified challenges and solutions point to opportunities for policy action and to support work to create a national vision for AT access that strengthens the potential for ATs to enable daily activity participation, independence, and societal inclusion of seniors and people with disabilities. AT use supports daily activity participation, independence, and societal inclusion of seniors and people with disabilities. There is an urgent need to ensure that those who need ATs have access to them, considering the benefits of their use, current unmet needs for ATs, and the anticipated demand for ATs because of the ageing population and increased prevalence of chronic disease and disability. A comprehensive understanding of policymakers' and stakeholders' perspectives on challenges and potential solutions for enhancing equitable access to ATs is critical to support development of evidence- and values-informed policies. Understanding challenges and solutions identified by diverse policymakers and stakeholders can lead to national and local opportunities for policy action and support work to create a national vision for enhancing equitable access to AT. [ABSTRACT FROM AUTHOR]

Progress in reducing health inequalities through public policy action is difficult in nations identified as liberal welfare states. In Canada, as elsewhere, researchers and advocates provide governing authorities with empirical findings on the sources of health inequalities and document the lived experiences of those encountering these adverse health outcomes with the hope of provoking public policy action. However, critical analysis of the societal structures and processes that make improving the sources of health inequalities difficult—the quality and distribution of living and working conditions, that is the social determinants of health—identifies limitations in these approaches. Within this latter critical tradition, we consider—using household food insecurity in Canada as an illustration—how polemics and anger mobilization, usually absent in health inequalities research and advocacy—could force Canadian governing authorities to reduce health inequalities through public policy action. We explore the potential of using high valence terms such as structural violence, social death and social murder, which make explicit the adverse outcomes of health‐threatening public policy to force government action. We conclude by outlining the potential benefits and threats posed by polemics and anger mobilization as means of promoting health equity. [ABSTRACT FROM AUTHOR]

The concept of autonomy is essential in the practice and study of gerontology and in long-term care policies. For older adults with expanding care needs, scores from tightly specified assessment instruments, which aim to measure the autonomy of service users, usually determine access to social services. These instruments emphasise functional independence in the performance of activities of daily living. In an effort to broaden the understanding of autonomy into needs assessment practice, the province of Québec (Canada) added social and relational elements into the assessment tool. In the wake of these changes, this article studies the interaction between the use of assessment instruments and the extent to which they alter how older adults define their autonomy as service users. This matters since the conceptualisation of autonomy shapes the formulation of long-term care policy problems, influencing both the demand and supply of services and the types of services that ought to be prioritised by governments. Relying on focus groups, this study shows that the functional autonomy frame dominates problem definitions, while social/relational framings are marginal. This reflects the more authoritative weight of functional autonomy within the assessment tool and contributes to the biomedicalisation of aging. [ABSTRACT FROM AUTHOR]

This article focuses on Canada's liberal welfare state and the COVID-19 pandemic, offering an overview of some of the unequal health and social effects of the crisis. It argues that the policy response to the pandemic should be situated within a broader pattern of welfare restructuring and organization that serves to instrumentalize economic insecurity and extend labor discipline. Without making firm predictions about the future, we argue that this is likely to reproduce increasingly unequal patterns of welfare access, providing benefits to some constituents while disciplining vulnerable groups to facilitate competitive gains. [ABSTRACT FROM AUTHOR]

Purpose:In this paper we examine how the intersection of various social and political influences shapes discharge planning and rehabilitation practices in ways that may not meet the espoused aims of rehabilitation programs or the preferences of older adults and their families. Methods:Taking a critical bioethics perspective, we used microethnographic case study methods to examine discharge-planning processes in a well-established older adult inpatient rehabilitation setting in Canada. The data included observations of discharge-planning family conferences and semi-structured interviews conducted with older adults facing discharge, their family members and rehabilitation professionals involved in discharge planning. Results:From the time of admission, a contextual push to focus on discharge superseded program aims of providing interventions to increase older adults’ functional capabilities. Professionals’ primary commitment to safety limited consideration of discharge options and resulted in costly and potentially unnecessary recommendations for 24-hour care. The resulting “rehabilitation” stay was more akin to an extended process of “destination triage” biased towards the promotion of physical safety than optimizing functioning. Conclusions:The resulting reduction of rehabilitation into “destination triage” has significant social, financial and occupational implications for older adults and their families, and broader implications for healthcare services and overarching healthcare systems. Implications for RehabilitationCurrent trends promoting consideration of discharge planning from the point of admission and prioritizing physical safety are shifting the focus of rehabilitation away from interventions to maximize recovery of function, which are the stated aims of rehabilitation.Such practices furthermore promote assessments to determine prognosis early in the rehabilitation stay when accurate prognosis is difficult, which can lead to overly conservative recommendations for discharge from rehabilitation services, thus further negating the impact of rehabilitation.Further work is required to examine the social, occupational and functional implications of superseding rehabilitation interventions to maximize capabilities with practices that prioritize safety over quality of life for older adults and their family members. [ABSTRACT FROM PUBLISHER]

Copyright of Canadian Public Administration is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Public Administration is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Social policy scholarship assumes that left-wing governments favour a stronger public provision of services, while right-wing politics promote privatization, largely as a matter of ideology. Yet the findings on Canadian provinces' market-based housing instruments suggest that alternative views are possible. Left-leaning governments introduced private delivery mechanisms for economic as well as non-economic reasons. The archival research and thematic analysis of interview responses with key actors (n = 56) suggest that the introduction of housing allowances in the policy toolbox largely results from bureaucratic initiatives, regardless of the party in power. Rather than political forces or advocacy by power interests, this policy change is mostly driven by considerations of equity and efficiency on the part of officials 'muddling through'. The concept is revisited in the final discussion, where important strands of the privatization literature are challenged, as well as the political assumptions associated with the notion of users' freedom. [ABSTRACT FROM AUTHOR]

In light of recent interest in the theoretical foundations of policy paradigms, this paper aims to specify the qualities that differentiate paradigmatic from non-paradigmatic policy ideas. While the incommensurability thesis that underlies the concept of paradigms has been the target of much criticism, there is something intuitively appealing about the incommensurability of policy alternatives that is not yet fully understood. Hesitant to abandon completely the notion of incommensurability, this paper emphasizes the relative nature of ideational commensurability and provides an account of how the exclusivity of a paradigm may wither in relation to competing perspectives. The empirical section demonstrates this pattern of paradigmatic policy-making by examining solutions advanced to alleviate problems in Canadian trade-industrial policy between 1975 and 1995. Contrary to the popular perception that paradigmatic ideas yield policy stability, the findings suggest that even in areas where clearly articulated paradigms initially exist, strictly paradigmatic thinking is often fleeting. [ABSTRACT FROM AUTHOR]

Objective. The aim of the present study was to describe how policy makers (bureaucrats and politicians) in Australia and Ontario (Canada) perceive evidence provided by doctors to substantiate applications for disability income support (DIS) by their patients with mental illnesses. Because many mental illnesses (e.g. depression) lack diagnostic tests, their existence and effects are more difficult to demonstrate than most somatic illnesses. Methods. Semi-structured interviews were conducted with 45 informants, all influential in the design of the assessment of DIS programs. The informants were subcategorised into advocates, legal representatives, doctors (general practitioners (GPs) and specialists (e.g. psychiatrists)), policy insiders and researchers. Informants were found through snowball sampling. Following the principles of grounded theory, data collection and analysis occurred in tandem. Results. Informants expressed some scepticism about doctors' evidence. Informants perceived that doctors could, due to lack of diagnostic certainty, 'write these things [evidence] however [they] want to'. Psychiatrists, perceived as having more time and skills, were considered as providing more trustworthy evidence than GPs. Conclusion. Doctors, providing evidence to support applications, play an important role in determining disability. However, policy makers perceive doctors' evidence about mental illnesses as less trustworthy than evidence about somatic illnesses. This affects decisions by government adjudicators. [ABSTRACT FROM AUTHOR]

Aims: This study provides an examination of normalization trends associated with the use of cannabis and tobacco, and whether and to what extent health concerns and legal contexts appear to modify the tolerance displayed to users.Methods: Data for this paper are drawn from a mixed methods interview study involving 202 respondents who reported being regular users of cannabis (alonen = 100 or in conjunction with tobaccon = 67) or tobacco only users (n = 35), in four Canadian cities (Halifax, Montreal, Toronto and Vancouver).Findings: While participants commonly attributed serious health risks to the use of tobacco, cannabis was viewed as relatively low risk. All groups described cannabis laws as too punitive, while most agreed with the regulatory controls for tobacco. Drawing on norms around appropriate context for use, cannabis users illustrate the expansion of normalization, with varying degrees of acceptability in different spaces. In contrast, tobacco users’ heightened awareness of the dangers of smoking leads them to engage in a reflexive process-limiting appropriate venues and contexts for use.Conclusions: These findings suggest that perceptions of health risk shape users’ experience of normalization (and denormalization) and help to contextualize the larger societal processes where both drugs are in a stage of societal re-evaluation. Much can be learned about the cannabis future from the tobacco past. [ABSTRACT FROM PUBLISHER]

Background: Public health systems in Canada have undergone significant policy renewal over the last decade in response to threats to the public's health, such as severe acute respiratory syndrome. There is limited research on how public health policies have been implemented or what has influenced their implementation. This paper explores policy implementation in two exemplar public health programs -chronic disease prevention and sexually-transmitted infection prevention - in Ontario, Canada. It examines public health service providers', managers' and senior managements' perspectives on the process of implementation of the Ontario Public Health Standards 2008 and factors influencing implementation.Methods: Public health staff from six health units representing rural, remote, large and small urban settings were included. We conducted 21 focus groups and 18 interviews between 2010 (manager and staff focus groups) and 2011 (senior management interviews) involving 133 participants. Research assistants coded transcripts and researchers reviewed these; the research team discussed and resolved discrepancies. To facilitate a breadth of perspectives, several team members helped interpret the findings. An integrated knowledge translation approach was used, reflected by the inclusion of academics as well as decision-makers on the team and as co-authors.Results: Front line service providers often were unaware of the new policies but managers and senior management incorporated them in operational and program planning. Some participants were involved in policy development or provided feedback prior to their launch. Implementation was influenced by many factors that aligned with Greenhalgh and colleagues' empirically-based Diffusion of Innovations in Service Organizations Framework. Factors and related components that were most clearly linked to the OPHS policy implementation were: attributes of the innovation itself; adoption by individuals; diffusion and dissemination; the outer context - interorganizational networks and collaboration; the inner setting - implementation processes and routinization; and, linkage at the design and implementation stage.Conclusions: Multiple factors influenced public health policy implementation. Results provide empirical support for components of Greenhalgh et al's framework and suggest two additional components - the role of external organizational collaborations and partnerships as well as planning processes in influencing implementation. These are important to consider by government and public health organizations when promoting new or revised public health policies as they evolve over time. A successful policy implementation process in Ontario has helped to move public health towards the new vision. [ABSTRACT FROM AUTHOR]

The POpulation HEalth Model (POHEM) is a health microsimulation model that was developed at Statistics Canada in the early 1990s. POHEM draws together rich multivariate data from a wide range of sources to simulate the lifecycle of the Canadian population, specifically focusing on aspects of health. The model dynamically simulates individuals' disease states, risk factors, and health determinants, in order to describe and project health outcomes, including disease incidence, prevalence, life expectancy, health-adjusted life expectancy, quality of life, and healthcare costs. Additionally, POHEM was conceptualized and built with the ability to assess the impact of policy and program interventions, not limited to those taking place in the healthcare system, on the health status of Canadians. Internationally, POHEM and other microsimulation models have been used to inform clinical guidelines and health policies in relation to complex health and health system problems. This paper provides a high-level overview of the rationale, methodology, and applications of POHEM. Applications of POHEM to cardiovascular disease, physical activity, cancer, osteoarthritis, and neurological diseases are highlighted. [ABSTRACT FROM AUTHOR]

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Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)