Search

Background It has been suggested that to meet information needs of multiple stakeholders, evaluation of public health interventions should specify a broader range of outcomes, evaluate a wider range of interventions and use more varied methods, in particular for dealing with complexity. Current outcomes approaches in public policy are potentially fertile ground for addressing these challenges and embedding evaluation in processes for reporting on public health outcomes. This paper describes work by NHS Health Scotland to realize this potential. Methods Development of outcomes frameworks containing logic models which link actions to outcomes and specify outcome indicators for monitoring progress. Group processes to inform and help create shared ownership of models across key stakeholders. Creation of web-based resources to host outcomes frameworks with hyperlinks connecting logic models to evidence and outcome indicators. Results The outcomes frameworks have been used in various ways by policy-makers and practitioners to shape policy, planning and monitoring and evaluation. A range of additional challenges that need to be overcome in developing and using the outcomes frameworks has been identified. Conclusions Logic model-based outcomes frameworks are useful tools for supporting outcome-based planning and evaluation of public health interventions. [ABSTRACT FROM AUTHOR]

As policy-makers search for signposts to guide the design and implementation of successful public policies, international benchmarking is increasingly viewed as an attractive source of inspiration and policy learning. Yet, despite its popularity, its claims as a technique for policy learning are surprisingly understudied. This paper critically examines the use of international benchmarking as a policy-making tool and draws insights from structured interviews with a diverse range of policy-makers, researchers, and academics. First, the study found that rather than being used as a tool for policy learning, international benchmarking is more often employed to steer political agendas. Second, there is a notable resistance on the part of policy-makers to adopt the ‘lessons’ of international comparisons, often on the basis of claims of ‘exceptionalism’. Finally, the appeal of rankings, league tables, and best practices can gloss over important contextual factors that inform the policy learning process, crowding out other valuable modes of policy learning. [ABSTRACT FROM AUTHOR]

Background: In the Netherlands, municipal health assessments are carried out by 28 Regional Health Services, serving 418 municipalities. In the absence of guidelines, regional public health reports were developed in two pilot regions on the basis of the model and experience of national health reporting. Though they were well received and positively evaluated, it was not clear which specific characteristics determined ‘good public health reporting’. Therefore, this study was set up to develop a theoretical framework for the quality of regional public health reporting in The Netherlands. Methods: Using concept mapping as a standardized tool for conceptualization, 35 relevant reporting experts formulated short statements in two different brainstorming sessions, describing specific quality criteria of regional public health reports. After the removal of duplicates, the list was supplemented with international criteria, and the statements were sent to each participant for rating and sorting. The results were processed statistically and represented graphically. The output was discussed and interpreted, leading to the final concept map. Results: The final concept map consisted of 97 criteria, grouped into 13 clusters, and plotted in two dimensions: a ‘product’ dimension, ranging from ‘production’ to ‘content’, and a ‘context’ dimension, ranging from ‘science’ to ‘policy’. The three most important clusters were: (i) ‘solution orientation’, (ii) ‘policy relevance’ and (iii) ‘policy impact’. Conclusion: This study provided a theoretical framework for the quality of regional public health reporting, indicating relevant domains and criteria. Further work should translate domains and criteria into operational indicators for evaluating regional public health reports. [ABSTRACT FROM AUTHOR]

Background: Mortality and morbidity rates, traditionally used indicators for child injury, are limited in their ability to explain differences in child injury between countries, are inadequate in capturing actions to address the problem of child injury and do not adequately identify progress made within countries. There is a need for a broader set of indicators to help better understand the success of countries with low rates of child injury, provide guidance and benchmarks for policy makers looking to make investments to reduce their rates of fatal and non-fatal child injury and allow monitoring of progress towards achieving these goals. This article describes an assessment of national leadership, infrastructure and capacity in the context of child injury prevention in 18 countries in Europe and explores the potential of these to be used as additional indicators to support child injury prevention practice. Methods: Partners in 18 countries coordinated data collection on 21 items relating to leadership, infrastructure and capacity. Responses were coded into an overall score and scores for each of the three areas and were compared with child injury mortality rankings using Spearman’s rank correlation. Results: Overall score and scores for leadership and capacity were significantly negatively correlated to child injury mortality ranking. Conclusions: Findings of this preliminary work suggest that these three policy areas may provide important guidance for the types of commitments that are needed in the policy arena to support advances in child safety and their assessment a way to measure progress. [ABSTRACT FROM PUBLISHER]

Background: Debates surrounding the use of conventional approaches in public health and the existence of perceived barriers to using the results of economic evaluations have led to questions posed as to how to establish priorities within public health schemes. The aims of this study were therefore to explore the feasibility and validity of economic evaluation techniques in developing priorities within public health programmes and consider the extent to which different presentational approaches are likely to be incorporated into decision-making, from perspectives of relevant stakeholders. Methods: An advisory board, representative of potential users of economic evaluations, was set up to identify preferences for how findings from economic evaluations might be presented to decision makers and to test the impact of different approaches, different outputs and different presentational styles. The board was divided into two groups, each of which was given three hypothetical ‘scenarios’ to consider. The scenarios comprised descriptions of methods and outputs, with costs, effects, target population and context of intervention constant across all scenarios. Results: The perceived validity of estimates of effectiveness was vitally important, along with sufficient information to gauge whether designs were appropriate and to assess implementation practicalities. Cost–benefit analysis and cost–utility analysis were the preferred approaches despite their complexity, although participants required benchmarks to place net-benefit estimates from cost–benefit analyses into context. Conclusion: Further research is required to substantiate and build on these preliminary findings and collaborations between economists and policy makers are needed to develop clear, rigorous and standard guidance relating to economic evaluation, recognizing the diversity of public health strategies. [ABSTRACT FROM AUTHOR]

Current international attention to Health in all policies (HiAP) has its origins in a more sophisticated understanding of the impact of public policies on health, and a recognition that policies across government have an impact on the social and environmental determinants of health and related inequalities in health. As an emerging field, there has been limited attention focused on comprehensive approaches to the evaluation of HiAP to date, and the research focus around HiAP has mainly examined the processes of cross-sectoral policy development, rather than their health-related impacts or outcomes. The purpose of this paper is to explore issues in assessing the implementation of HiAP and describe an expanded evaluation framework for assessing the potential intermediate and end-point effects of HiAP actions, using a planning logic model for ‘complex programs’. This meets the needs of public sector policy-makers who express an interest in understanding the relationship between HiAP and health-related and social outcomes. The paper proposes applying a contribution analysis method to estimate and model the anticipated impacts of HiAP policies on intermediate and longer term outcomes, in advance of empirical studies of these outcomes, and as an innovative input into HiAP and evaluation planning. A broader long-term evaluation framework will enhance the political saliency of HiAP initiatives, especially from governments considering HiAP approaches in financially constrained environments. [ABSTRACT FROM PUBLISHER]

The Ottawa Charter both gave health promotion a solid framework and health promoters an identity. Yet, health promotion has far from reached its potential in being internalized in public health politics. Advocacy for health is one of the core missions for health promotion and the 25-year celebration of the Ottawa Charter offers a free ride, instead of being a missed opportunity. WHO has not met the expectations in taking advantage of the momentum and outcomes from the long series of global health promotion conferences. The series represents a lifeline for health promotion. Concepts like healthy public policy, supportive environments, social determinants, health and human rights, whole of government, globalization and others have been elaborated and framed in a health promoting context. The downside is that the footprints have not been bold, in particular not internationally. An upside is the development of research and science, underscored by a rapid development of scientific journals, textbooks, academic institutions and posts. A question arising is whether practise and policy making are left behind, since implementation on a grand scale still is lacking? Further and future efforts must be devoted to explore the processes and art of policy making. There is a need for more narratives and more health promoters involving themselves in policy making and politics. Health promotion is as relevant for the twenty-first century as ever. The challenges and opportunities are evident; the increasing global burden of non-communicable diseases, ageing populations, harmful use of alcohol, social determinants and fair societies improved governance and more. Health promotion can add value and WHO can step up its engagement. [ABSTRACT FROM PUBLISHER]