Journal of Public Health Policy最新文献

Chagas disease (Trypanosoma cruzi infection) affects ~ 290,000 USA residents and is included in routine blood donation screening panels. Donors are notified of positive T. cruzi-screening results, deferred from donation, and given limited information for next steps. Individuals living with undiagnosed, uncommon infections often face substantial barriers in accessing physicians with infectious disease competency, confirmatory testing, and continuum of care after the point of blood donor deferral. We assessed 46 T. cruzi-deferred donors' experience following deferral, highlight donor challenges, and provide public health institution opportunities to support cases of rare transfusion-transmitted infections in the USA.

Evidence-informed policymaking emphasizes that policy decisions should be informed by the best available evidence from research and follow a systematic and transparent approach. For public health policymaking we can learn from existing practices of transparent, evidence-informed decision-making for clinical practice, medicines, and medical technology. We review existing evidence-to-decision frameworks, as well as frameworks and theories for policymaking to address the political dimension of policymaking, and use this analysis to propose an integrated framework to guide evidence-informed policymaking. The framework includes nine decision-making criteria and allows for the addition of other context-specific criteria. It also emphasizes elements of the decision-making process that can give greater legitimacy, fairness, and transparency to the policy decision, such as the use of deliberative processes and assessment of conflicts of interest. We offer the framework as a tool to help government policy makers use evidence in a structured and transparent way when making decisions about public health policy options.

In the United States, there are nearly 53 million informal or unpaid caregivers, many of whom experience mental and physical stress related to their caregiving duties and increased financial responsibility. We identified federal and state informal caregiver support policies authorized by specific legislation along with their key provisions and conducted a systematic review of the academic literature related to quantitative evaluations of these policies. Twenty policies, eight academic studies, and four gray literature reports were included in the study, with half of the policies introduced since 2000. Our study criteria yielded few academic valuations tied to caregiver policies and few policies including research provisions. Of the provision areas identified in policies, respite services, caregiver training, and workplace protections appeared the most. Future policies and the studies examining them should incorporate cost outcomes and equity as focus areas and disaggregate data by vulnerable groups to ensure value and equity in caregiver support legislation. KEY MESSAGES: Increased legislation to support informal caregivers may be warranted. The limited academic research examining existing caregiver policies identifies mixed outcomes for caregivers. Prioritizing vulnerable populations in such policy research examining outcomes could help improve caregiver support efforts. The included studies investigated the outcomes of three policies and identified more negative than positive outcomes for caregivers.

This study investigates the prevalence and determinants of readiness for quality antenatal care (ANC) services in Bangladesh using data from the 2017 Bangladesh Health Facility Survey (BHFS). We assessed the association between selected factors and the readiness index using multinomial logistic regression. We identified a significant gap in the availability and quality of ANC services, only 4.26% of health facilities provide quality ANC services, with rural facilities showing lower readiness compared to urban facilities (RRR:0.13; 95% CI: 0.06-0.31; p < 0.001). Community clinics and private hospitals have a lower likelihood of medium or high readiness compared to public hospitals or clinics. Health facilities with specialized care are more likely to demonstrate readiness for quality ANC services. Policy recommendations include increased healthcare funding, implementation of ANC guidelines, strengthened monitoring and evaluation of health facilities, and heightened community awareness. These measures should improve ANC, overall health outcomes, and public health policies.

Many countries are experiencing a post-pandemic surge in hospital utilization along with accelerating population aging. Maximal hospital efficiency is required, with utilization evidence essential for identifying appropriate hospital or broader health system reforms. We offer an investigation of the most recent pre-COVID year (2019-2020) of complete population-based hospital utilization data to describe and compare the use of hospitals by older (65+) and younger (0-64) people admitted for inpatient services in Canada. We found that 35.7% of all 1,888,133 admitted individuals and 39.8% of all 2,543,227 hospital episodes involved people aged 65+, representing 4,963,766 or 17.1% of the study population. This study, as do previous Canadian and other ones, found hospitals admit more younger people than older people. The admission and care patterns of both younger and older patients reveal a need for more community-based services to shorten older patient hospitalizations and prevent avoidable hospitalizations by both younger and older people.

Migrants living in large urban areas are disproportionately impacted by health crises such as pandemics. This policy brief explores how urban areas mitigate and/or exacerbate the impact of COVID-19 on migrant groups and provides policy recommendations. We conducted a policy review to focus on the effects of COVID-19 on migrants living in cities with > 500,000 residents. We found that structural inequity, lack of migrants' inclusion in as relief programs, and residential segregation exacerbated COVID-19 impacts. Engagement of Civil Society Organizations (CSOs) and e-governance showed promising effects mitigating the impact of COVID-19 on these groups; yet the use of technology introduced additional barriers such as access to devices and internet connection. We recommend increasing policy attention to systemic social inequities faced by migrant groups in urban areas and supporting innovative and inclusive implementation of public health policies, urban design, and greater engagement of CSOs in the delivery of services to migrants.

The dramatic growth in the rate of diabetes prompts serious debates about awareness, early diagnosis, and care interventions. This Viewpoint aims to explore, from the perspectives of healthcare sector representatives, what challenges and difficulties they face in dealing with diabetes and how these can be overcome. We applied the World Café method for group discussions, which enabled us to bring together 50 stakeholders. They identified challenges at institutional and structural levels under the concepts of awareness, digitalisation, and new forms of care and shared their suggestions for feasible solutions. We learned there is a need for a diabetes map of Germany to identify risk groups and that hybrid solutions should be implemented for treatment, care, prevention, and early diagnosis, considering digital infrastructure. Also, the demand for digital innovation in the healthcare system raised concerns about information transparency and data management.

There is a need for careful examination of large volumes of collected (structured and unstructured) information related to school-based evaluation. There is also no published, comprehensive framework/s for evaluating complex interventions in Irish primary schools. The aim of this paper is to outline a methodology for process evaluation of an Irish primary school-based physical activity (PA) and nutrition intervention. Evaluation followed the three themes outlined by the British Medical Research Council: implementation, context, and mechanism of impact that we further divided into six dimensions. Methodological tools included questionnaires, PA logs, reflective journals, write and draw, and semi-structured interviews. We triangulated findings across these multiple tools to assess each dimension. We designed a unique framework to enable comparisons and offer researchers a template for evaluating complex health promotion interventions in primary schools. We present a methodology for evaluating a complex school-based health promotion intervention. The framework we propose integrates process and outcome data. It aims to enhance future result interpretation and facilitate informed comparisons among intervention schools.