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1.  Practice-Based Teaching for Health Policy Action and Advocacy 
Public Health Reports  2008;123(Suppl 2):65-70.
SYNOPSIS
The Institute of Medicine has issued numerous reports calling for the public health workforce to be adept in policy-making, communication, science translation, and other advocacy skills. Public health competencies include advocacy capabilities, but few public health graduate institutions provide systematic training for translating public health science into policy action. Specialized health-advocacy training is needed to provide future leaders with policy-making knowledge and skills in generating public support, policy-maker communications, and policy campaign operations that could lead to improvements in the outcomes of public health initiatives. Advocacy training should draw on nonprofit and government practitioners who have a range of advocacy experiences and skills. This article describes a potential model curriculum for introductory health-advocacy theory and skills based on the course, Health Advocacy, a winner of the Delta Omega Innovative Public Health Curriculum Award, at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.
PMCID: PMC2431098  PMID: 18770919
2.  Strengthening the policy setting process for global malaria control and elimination 
Malaria Journal  2012;11:28.
The scale-up of malaria control efforts in recent years, coupled with major investments in malaria research, has produced impressive public health impact in a number of countries and has led to the development of new tools and strategies aimed at further consolidating malaria control goals. As a result, there is a growing need for the malaria policy setting process to rapidly review increasing amounts of evidence.
The World Health Organization Global Malaria Programme, in keeping with its mandate to set evidence-informed policies for malaria control, has convened the Malaria Policy Advisory Committee as a mechanism to increase the timeliness, transparency, independence and relevance of its recommendations to World Health Organization member states in relation to malaria control and elimination.
The Malaria Policy Advisory Committee, composed of 15 world-renowned malaria experts, will meet in full twice a year, with the inaugural meeting scheduled for 31 January to 2 February 2012 in Geneva. Policy recommendations, and the evidence to support them, will be published within two months of every meeting as part of an open access Malaria Journal thematic series. This article is a prelude to that series and provides the global malaria community with the background and overview of the Committee and its terms of reference.
doi:10.1186/1475-2875-11-28
PMCID: PMC3283447  PMID: 22284049
global; malaria; policy recommendations; WHO
3.  Youth Advocacy as a Tool for Environmental and Policy Changes That Support Physical Activity and Nutrition: An Evaluation Study in San Diego County 
Background
As evidence grows about the benefits of policy and environmental changes to support active living and healthy eating, effective tools for implementing change must be developed. Youth advocacy, a successful strategy in the field of tobacco control, should be evaluated for its potential in the field of obesity prevention.
Community Context
San Diego State University collaborated with the San Diego County Childhood Obesity Initiative to evaluate Youth Engagement and Action for Health! (YEAH!), a youth advocacy project to engage youth and adult mentors in advocating for neighborhood improvements in physical activity and healthy eating opportunities. Study objectives included documenting group process and success of groups in engaging in community advocacy with decision makers.
Methods
In 2011 and 2012, YEAH! group leaders were recruited from the San Diego County Childhood Obesity Initiative’s half-day train-the-trainer seminars for adult leaders. Evaluators collected baseline and postproject survey data from youth participants and adult group leaders and interviewed decision makers.
Outcomes
Of the 21 groups formed, 20 completed the evaluation, conducted community assessments, and advocated with decision makers. Various types of decision makers were engaged, including school principals, food service personnel, city council members, and parks and recreation officials. Eleven groups reported change(s) implemented as a result of their advocacy, 4 groups reported changes pending, and 5 groups reported no change as a result of their efforts.
Interpretation
Even a brief training session, paired with a practical manual, technical assistance, and commitment of adult leaders and youth may successfully engage decision makers and, ultimately, bring about change.
doi:10.5888/pcd11.130321
PMCID: PMC3970770  PMID: 24674636
4.  Neighborhood Eating and Activity Advocacy Teams (NEAAT): engaging older adults in policy activities to improve food and physical environments 
ABSTRACT
Local food and physical activity environments are known to impact health, and older adults are generally more vulnerable to health-related environmental impacts due to poorer physical function and mobility impairments. There is a need to develop cost-conscious, community-focused strategies that impact local food and physical activity environment policies. Engaging older adult community residents in assessment and advocacy activities is one avenue to address this need. We describe the Neighborhood Eating and Activity Advocacy Team project, a community-based participatory project in low-income communal housing settings in San Mateo County, CA, as one method for engaging older adults in food and physical activity environment and policy change. Methods and strategies used by the “community action teams” to generate relevant neighborhood environmental data, build coalitions, prioritize complex issues, and advocate for change are presented. Advocacy groups are feasible among older adults to improve food and physical activity environments.
doi:10.1007/s13142-011-0100-9
PMCID: PMC3717885  PMID: 24073118
Food environment; Physical activity environment; Advocacy; Neighborhood assessment; Seniors; Participatory research
5.  Building Alliances in Unlikely Places: Progressive Allies and the Tobacco Institute’s Coalition Strategy on Cigarette Excise Taxes 
American journal of public health  2009;99(7):1188-1196.
The tobacco industry utilizes third parties to advance its policy agenda. On excise taxes, the industry identified organized labor and progressive groups as potential allies whose advocacy could undermine public support for tax increases. To attract such collaboration, the industry framed the issue as one of tax fairness, creating a labor management committee to provide distance from tobacco companies and furthering progressive allies’ interests through financial and logistical support. Internal industry documents indicate that this strategic use of ideas, institutions, and interests facilitated the recruitment of leading progressive organizations as allies. By placing excise taxes within a strategic policy nexus that promotes mutual public interest goals, public health advocates may use a similar strategy in forging their own excise tax coalitions.
doi:10.2105/AJPH.2008.143131
PMCID: PMC2696666  PMID: 19443832
6.  Corporate Externalities: A Challenge to the Further Success of Prevention Science 
The full benefit of prevention science will not be realized until we learn how to influence organizational practices. The marketing of tobacco, alcohol, and food and corporate advocacy for economic policies that maintain family poverty are examples of practices we must influence. This paper analyzes the evolution of such practices in terms of their selection by economic consequences. A strategy for addressing these critical risk factors should include: (a) systematic research on the impact of corporate practices on each of the most common and costly psychological and behavior problems; (b) empirical analyses of the consequences that select harmful corporate practices; (c) assessment of the impact of policies that could affect problematic corporate practices; and (d) research on advocacy organizations to understand the factors that influence their growth and to help them develop effective strategies for influencing corporate externalities.
doi:10.1007/s11121-010-0190-5
PMCID: PMC3042055  PMID: 21225461
Prevention; Intervention; Policymakers; Organizational practices; Advocacy
7.  A rapid assessment and response approach to review and enhance Advocacy, Communication and Social Mobilisation for Tuberculosis control in Odisha state, India 
BMC Public Health  2011;11:463.
Background
Tuberculosis remains a major public health problem in India with the country accounting for 1 in 5 of all TB cases reported globally. An advocacy, communication and social mobilisation project for Tuberculosis control was implemented and evaluated in Odisha state of India. The purpose of the study was to identify the impact of project interventions including the use of 'Interface NGOs' and involvement of community groups such as women's self-help groups, local government bodies, village health sanitation committees, and general health staff in promoting TB control efforts.
Methods
The study utilized a rapid assessment and response (RAR) methodology. The approach combined both qualitative field work approaches, including semi-structured interviews and focus group discussions with empirical data collection and desk research.
Results
Results revealed that a combination of factors including the involvement of Interface NGOs, coupled with increased training and engagement of front line health workers and community groups, and dissemination of community based resources, contributed to improved awareness and knowledge about TB in the targeted districts. Project activities also contributed towards improving health worker and community effectiveness to raise the TB agenda, and improved TB literacy and treatment adherence. Engagement of successfully treated patients also assisted in reducing community stigma and discrimination.
Conclusion
The expanded use of advocacy, communication and social mobilisation activities in TB control has resulted in a number of benefits. These include bridging pre-existing gaps between the health system and the community through support and coordination of general health services stakeholders, NGOs and the community. The strategic use of 'tailored messages' to address specific TB problems in low performing areas also led to more positive behavioural outcomes and improved efficiencies in service delivery. Implications for future studies are that a comprehensive and well planned range of ACSM activities can enhance TB knowledge, attitudes and behaviours while also mobilising specific community groups to build community efficacy to combat TB. The use of rapid assessments combined with other complementary evaluation approaches can be effective when reviewing the impact of TB advocacy, communication and social mobilisation activities.
doi:10.1186/1471-2458-11-463
PMCID: PMC3141449  PMID: 21663623
tuberculosis; advocacy; communication; social mobilisation; rapid assessment and review
8.  Toxic ignorance and right-to-know in biomonitoring results communication: a survey of scientists and study participants 
Background
Exposure assessment has shifted from pollutant monitoring in air, soil, and water toward personal exposure measurements and biomonitoring. This trend along with the paucity of health effect data for many of the pollutants studied raise ethical and scientific challenges for reporting results to study participants.
Methods
We interviewed 26 individuals involved in biomonitoring studies, including academic scientists, scientists from environmental advocacy organizations, IRB officials, and study participants; observed meetings where stakeholders discussed these issues; and reviewed the relevant literature to assess emerging ethical, scientific, and policy debates about personal exposure assessment and biomonitoring, including public demand for information on the human health effects of chemical body burdens.
Results
We identify three frameworks for report-back in personal exposure studies: clinical ethics; community-based participatory research; and citizen science 'data judo.' The first approach emphasizes reporting results only when the health significance of exposures is known, while the latter two represent new communication strategies where study participants play a role in interpreting, disseminating, and leveraging results to promote community health. We identify five critical areas to consider in planning future biomonitoring studies.
Conclusion
Public deliberation about communication in personal exposure assessment research suggests that new forms of community-based research ethics and participatory scientific practice are emerging.
doi:10.1186/1476-069X-8-6
PMCID: PMC2654440  PMID: 19250551
9.  MADD rates the states: a media advocacy event to advance the agenda against alcohol-impaired driving. 
Public Health Reports  1995;110(3):240-245.
The "Rating the States" (RTS) Program of Mothers Against Drunk Driving (MADD) is designed to bring public attention to the status of State government efforts to combat alcohol-impaired driving. MADD's 1993 report, which evaluated each State with a grade from A to D, brought renewed visibility to MADD's fight for new prevention policies and helped to advance key State legislation. Because of MADD's national press conference and other media activities, more than 60 million Americans saw or heard a news story related to the program. This article outlines the program's objectives and methodology, efforts to publicize the results, and what was achieved in terms of news media coverage and in advancing public policy change. The RTS Program is a proven media advocacy strategy for prompting State legislatures and Governors to enact new policies. The article concludes with guidelines for other public health advocacy groups that may want to emulate this strategy.
PMCID: PMC1382113  PMID: 7610210
10.  Community advocacy groups as a means to address the social environment of female sex workers: a case study in Andhra Pradesh, India 
Journal of Epidemiology and Community Health  2012;66(Suppl_2):ii87-ii94.
Background
To examine the association between the presence of community advocacy groups (CAGs) and female sex workers' (FSWs) access to social entitlements and outcomes of police advocacy.
Methods
Data were used from a cross-sectional survey conducted in 2010–2011 among 1986 FSWs and 104 NGO outreach workers from five districts of Andhra Pradesh. FSWs were recruited using a probability-based sampling from 104 primary sampling units (PSUs). A PSU is a geographical area covered by one outreach worker and is expected to have an active CAG as per community mobilisation efforts. The presence of active CAGs was defined as the presence of an active committee or advocacy group in the area (PSU). Outcome indicators included acquisition of different social entitlements and measures of police response as reported by FSWs. Multivariate linear and logistic regression analyses were used to examine the associations.
Results
Areas with active CAGs compared with their counterparts had a significantly higher mean number of FSWs linked to ration cards (12.8 vs 6.8; p<0.01), bank accounts (9.3 vs 5.9; p=0.05) and health insurance (13.1 vs 7.0; p=0.02). A significantly higher percentage of FSWs from areas with active CAGs as compared with others reported that the police treat them more fairly now than a year before (79.7% vs 70.3%; p<0.05) and the police explained the reasons for arrest when arrested the last time (95.7% vs 87%; p<0.05).
Conclusion
FSWs from areas with active CAGs were more likely to access certain social entitlements and to receive a fair response from the police, highlighting the contributions of CAGs in community mobilisation.
doi:10.1136/jech-2011-200478
PMCID: PMC3433220  PMID: 22495774
Structural interventions; sex workers; HIV prevention intervention; community advocacy; social capital; empowerment; HIV; AIDS; public health; violence; epidemiology; statistics
11.  Toward Reproducible Computational Research: An Empirical Analysis of Data and Code Policy Adoption by Journals 
PLoS ONE  2013;8(6):e67111.
Journal policy on research data and code availability is an important part of the ongoing shift toward publishing reproducible computational science. This article extends the literature by studying journal data sharing policies by year (for both 2011 and 2012) for a referent set of 170 journals. We make a further contribution by evaluating code sharing policies, supplemental materials policies, and open access status for these 170 journals for each of 2011 and 2012. We build a predictive model of open data and code policy adoption as a function of impact factor and publisher and find higher impact journals more likely to have open data and code policies and scientific societies more likely to have open data and code policies than commercial publishers. We also find open data policies tend to lead open code policies, and we find no relationship between open data and code policies and either supplemental material policies or open access journal status. Of the journals in this study, 38% had a data policy, 22% had a code policy, and 66% had a supplemental materials policy as of June 2012. This reflects a striking one year increase of 16% in the number of data policies, a 30% increase in code policies, and a 7% increase in the number of supplemental materials policies. We introduce a new dataset to the community that categorizes data and code sharing, supplemental materials, and open access policies in 2011 and 2012 for these 170 journals.
doi:10.1371/journal.pone.0067111
PMCID: PMC3689732  PMID: 23805293
12.  Performance Reporting to Help Organizations Promote Quality Improvement 
Healthcare Policy  2008;4(2):70-74.
In healthcare, a great deal of time, money and energy go into producing public reports for a wide range of audiences. Reporting strategies often target audiences like the general public, whose behaviour is not readily changed by the information in report cards. However, when it comes to effectively targeting groups that can actually use the data to achieve significant impacts, one audience stands out from the rest: health system managers and providers, who can interpret and apply performance data to improve the quality of care their organizations deliver. The evidence behind performance reports was recently summarized in Evidence Boost for Quality, a special subseries of Evidence Boost, produced by the Canadian Health Services Research Foundation to showcase healthcare issues where research indicates a preferred course of action in health services management and policy. To access archived issues of Evidence Boost, visit .
PMCID: PMC2645213  PMID: 19377371
13.  Scientific Support by the BONUS+ Projects for the Sustainability of the Baltic Sea Region: The Case of the HELCOM Baltic Sea Action Plan 
Ambio  2014;43(1):1-10.
The synthesis of the BONUS+ research is introduced. The HELCOM Baltic Sea Action Plan is examined as a case to illustrate the potentials and challenges in building the science–policymaking interface on a macroregional level. The projects address environmental challenges in the Baltic Sea as defined by the Baltic Sea Action Plan, or consider the environmental governance and decision making within the Baltic Sea context in general. Eutrophication, biodiversity, hazardous substances, maritime activities, and the environment governance are addressed, as are crosscutting issues, such as the impact of climate change, maritime spatial planning and impacts of future development on ecosystem services. The projects contributed to relevant policy developments: 37 consultations carried out at EU level, 49 modifications to policy documents and action plans, 153 suggestions for the efficacy of pertinent public policies and governance, and in 570 occasions, scientists working in BONUS+ projects served as members or observers in scientific and stakeholder committees.
doi:10.1007/s13280-013-0472-9
PMCID: PMC3888661  PMID: 24414800
Baltic Sea; HELCOM; The joint Baltic Sea research and development programme; Linking science and policy; Sustainable ecosystem services
14.  Assessing and Forecasting Population Health: Integrating Knowledge and Beliefs in a Comprehensive Framework 
Public Health Reports  2009;124(6):778-789.
SYNOPSIS
A comprehensive population health-forecasting model has the potential to interject new and valuable information about the future health status of the population based on current conditions, socioeconomic and demographic trends, and potential changes in policies and programs. Our Health Forecasting Model uses a continuous-time microsimulation framework to simulate individuals' lifetime histories by using birth, risk exposures, disease incidence, and death rates to mark changes in the state of the individual. The model generates a reference forecast of future health in California, including details on physical activity, obesity, coronary heart disease, all-cause mortality, and medical expenditures. We use the model to answer specific research questions, inform debate on important policy issues in public health, support community advocacy, and provide analysis on the long-term impact of proposed changes in policies and programs, thus informing stakeholders at all levels and supporting decisions that can improve the health of populations.
PMCID: PMC2773940  PMID: 19894419
15.  The development of a strategy for tackling health inequalities in the Netherlands 
Over the past decade, the Dutch government has pursued a research-based approach to tackle socioeconomic inequalities in health. We report on the most recent phase in this approach: the development of a strategy to reduce health inequalities in the Netherlands by an independent committee. In addition, we will reflect on the way the report of this committee has influenced health policy and practice.
A 6-year research and development program was conducted which covered a number of different policy options and consisted of 12 intervention studies. The study results were discussed with experts and policy makers. A government advisory committee developed a comprehensive strategy that intends to reduce socioeconomic inequalities in disability-free life expectancy by 25% in 2020. The strategy covers 4 different entry-points for reducing socioeconomic inequalities in health, contains 26 specific recommendations, and includes 11 quantitative policy targets. Further research and development efforts are also recommended.
Although the Dutch approach has been influenced by similar efforts in other European countries, particularly the United Kingdom and Sweden, it is unique in terms of its emphasis on building a systematic evidence-base for interventions and policies to reduce health inequalities. Both researchers and policy-makers were involved in the process, and there are clear indications that some of the recommendations are being adopted by health policy-makers and health care practice, although more so at the local than at the national level.
doi:10.1186/1475-9276-3-11
PMCID: PMC529300  PMID: 15500696
16.  Strategic Priorities for Increasing Physical Activity Among Adults Age 50 and Older: The National Blueprint Consensus Conference Summary Report 
On May 1, 2001, a coalition of national organizations released a major planning document designed to develop a national strategy for the promotion of physically active lifestyles among the mid-life and older adult population. The National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older was developed with input from 46 organizations with expertise in health, medicine, social and behavioral sciences, epidemiology, gerontology/geriatrics, clinical science, public policy, marketing, medical systems, community organization, and environmental issues. The Blueprint notes that, despite a wealth of evidence about the benefits of physical activity for mid-life and older persons, there has been little success in convincing age 50+ Americans to adopt physically active lifestyles. The Blueprint identifies barriers in the areas of research, home and community programs, medical systems, public policy and advocacy, and marketing and communications. In addition to identifying barriers, the Blueprint proposes a number of concrete strategies that could be employed in order to overcome the barriers to physical activity in society at large. This report summarizes the outcome of the National Blueprint Consensus Conference that was held in October 2002. In this conference, representatives of more than 50 national organizations convened in Washington, D.C. with the goal of identifying high priority and high feasibility strategies which would advance the National Blueprint and which could be initiated within the next 12 to 24 months. Participants in the consensus conference were assigned to one of five breakout groups: home and community, marketing, medical systems, public policy, and research. Each breakout group was charged with identifying the three highest priority strategies within their area for effectively increasing physical activity levels in the mid-life and older adult population. In addition to the 15 strategies identified by the breakout groups, three "cross-cutting" strategies were added which were considered to be broad-based in scope and which applied to more than one of the breakout themes. A national organization was identified to take the lead in planning and implementing each strategy. A summary of the 18 strategies and lead organizations is presented. The National Blueprint Consensus Conference has identified an ambitious agenda of strategies and tactics that will need to be implemented in order to overcome societal barriers to physical activity among the mid-life and older adult population. More than 50 national organizations have expressed a commitment to work towards the implementation of the Blueprint agenda. Eighteen priority strategies have been identified in the areas of home and community, marketing, medical systems, public policy, and research. The organizations charged with the task of implementing the high priority strategies will use professional networks and established delivery channels and communication systems to translate this plan into action.
PMCID: PMC3963251
Physical activity; older adults; public policy; community; medical systems
17.  A Discussion of Exposure Science in the 21st Century: A Vision and a Strategy 
Environmental Health Perspectives  2013;121(4):405-409.
Background: The National Research Council (NRC) of the National Academy of Sciences recently published the report Exposure Science in the 21st Century: A Vision and a Strategy. The expert committee undertaking this report included expertise from ecology, chemistry, exposure science, toxicology, public health, bioethics, engineering, medicine, and policy.
Objective: Our aim is to inform members of the scientific community in fields aligned with environmental and public health so they are more able to appreciate the full breadth of the vision and understand the framework developed in order to move the vision forward.
Discussion: Although the NRC report was commissioned by the U.S. Environmental Protection Agency and the National Institute of Environmental Health Sciences, it is solely the consensus product of the independent volunteer committee, whose findings were subject to the rigorous peer-review procedures of the NRC. In addition to reviewing the history and current status of exposure science, the report lays out a vision for the future and makes recommendations that include both short-term and long-term milestones.
Conclusion: To accomplish the vision presented in the NRC report, resources will be needed to complete studies, develop and use analyses of exposure, and build databases associated with individual and population exposures, as well as to train the next generation of exposure scientists. Important excerpts as well as paraphrased statements from the report appear in this commentary; however, the general observations and comments are our own.
doi:10.1289/ehp.1206170
PMCID: PMC3620766  PMID: 23380895
eco-exposome; exposome; exposure assessment; exposure science; National Research Council
18.  Inaugural meeting of the malaria policy advisory committee to the WHO: conclusions and recommendations 
Malaria Journal  2012;11:137.
The Malaria Policy Advisory Committee to the World Health Organization met for the first time from 31 January to 2 February 2012 in Geneva, Switzerland. This article provides a summary of the discussions, conclusions and recommendations from that meeting, as part of the newly launched Malaria Journal thematic series “WHO Malaria Policy Advisory Committee: Reports and Recommendations”.
Summaries are provided, referencing the relevant background documents, for the meeting sessions on global malaria control, drug resistance and containment, rapid diagnostic test procurement criteria, larviciding, classification of countries for elimination, estimating malaria cases and deaths, and seasonal malaria chemoprevention. Policy statements, position statements, and guidelines that will arise from the MPAC meeting conclusions and recommendations will be formally issued and disseminated to World Health Organization member states by the World Health Organization Global Malaria Programme.
doi:10.1186/1475-2875-11-137
PMCID: PMC3364913  PMID: 22545931
Global; Malaria; Policy development; WHO; Drug resistance; Diagnostic tests; Mosquito control; Elimination; Surveillance; Chemoprevention
19.  Roadblocks to translational advances on metastasis research 
Nature medicine  2013;19(9):1104-1109.
Promising advances in cancer therapy stemming from an increasing understanding of the molecular and genetic underpinnings of the tumorigenic process have been fueled by a strong, determined scientific community, influential patient advocacy groups and committed funding bodies. Despite these efforts, the development of effective drugs to prevent systemic dissemination of cancer cells or to eliminate overt metastasis in secondary organs remains a challenge to both researchers and physicians. In an attempt to tackle the most relevant and timely translational issues, a meeting held in 2012 as a result of a successful partnership between the Volkswagen Foundation and Nature Medicine brought together a group of metastasis research experts to identify the most important hurdles and help create a framework for potential clinical and translational strategies.
doi:10.1038/nm.3327
PMCID: PMC3972758  PMID: 24013756
20.  Medicare Part D Research and Policy Highlights, 2012: Impact and Insights 
Clinical Therapeutics  2012;34(4):904-914.
Background
In the 6 years since the implementation of Medicare Part D in the United States, the program has been reported to improve quality, offer better beneficiary protections, and lower drug costs.
Objective
The purpose of this article was to highlight the latest key peer-reviewed research findings on Medicare Part D and major public policy initiatives for Part D for 2012.
Methods
PubMed was searched for studies on Medicare Part D published in 2011 in biomedical/scientific, peer-reviewed, English-language journals. For the policy update, sources included the Federal Register, the Medicare Prescription Drug Benefit Manual, the 2012 Final Call Letter, and guidance from the Centers for Medicare and Medicaid Services.
Results
Medicare Part D has been associated with increased medication utilization, reduced out-of-pocket expenditures, and an overall decrease in cost-related non-adherence and nonpersistence. Its impact on reduction in non-drug utilization of health services has been more apparent after the transition year in 2006 and among subsets of Medicare beneficiaries. Recent policy changes promise to make Part D more user-friendly, simplify choice, and offer greater protection to beneficiaries. The coverage gap will phase out by 2020. Both the quality rating system for prescription drug plans and medication therapy management programs were enhanced.
Conclusions
Although Part D was designed to improve drug benefits, improvements may be needed in plan selection and simplification, quality assessment (especially with regard to long-term impact and health outcomes), evidence-based improvements in medication therapy management, and disparities among priority subpopulations. Medicare Parts A, B, and D could be coordinated to offset costs by increasing medication expenses and decreasing expenses for nonprescription medical services, thereby improving the overall cost-effectiveness of the Medicare program.
doi:10.1016/j.clinthera.2012.02.012
PMCID: PMC3392198  PMID: 22417714
beneficiaries; drug benefits; drug costs; Medicare Part D
21.  Media and politics: Empirical data on their cross-influence in health policy 
European journal of public health  2011;21(Supplement 1):258.
Objectives
Despite the central influence of public policies on health and welfare, relatively little is known about actual health care policy-making processes. This presentation will offer preliminary results from a federally funded project aimed at gaining insights into the interrelations among interest-group strategies, media discourses and political debates in health care. The policy debate on health care privatization in Quebec is used as a case study.
Approach
Two sources of data were used: media sources and political debates. Media sources were the six main provincial newspapers in Quebec, two national newspapers and The Canadian Press, as well as transcripts from specific news-related programs of three national television stations and two national radio stations. Political debates were obtained through transcripts of all question periods in the Parliament and debates in the standing committee on health. Sources were systematically searched to identify all relevant data. Multiple search syntaxes were developed and tested to maximize sensitivity and specificity. All data was entered and coded into qualitative analysis software.
Results
Data was analyzed longitudinally from June 2005 to January 1, 2010. Four levels of results will be presented: 1) Descriptive analysis of the interest groups involved, their policy preferences and the rhetoric they employed to support their views. 2) Descriptive analysis of the main policy proposals that structured the debate as well as of the coalition of groups behind those proposals. 3) Graphic longitudinal analysis of the intensity of the debate and of the relative importance and evolution of various policy proposals. 4) Preliminary results on the nature, direction and level of inter-influence between the policy and media agendas.
Conclusion
This presentation provides empirical evidence on current policy-making processes in health care. It shows, unsurprisingly, that policy-making is a circumvoluted process of inter-influence among interest groups, politicians and the media. It also highlights the fact that scientific evidence actually plays a minor (if any) role in policy processes.
PMCID: PMC3496778  PMID: 23155352 CAMSID: cams2440
22.  Harnessing the Power of Advocacy–Research Collaborations 
Feminist criminology  2008;3(4):247-275.
The advocacy–research partnership has been identified as a key method of conducting the feminist and activist research that is important to domestic violence. However, these partnerships are often fraught with challenges that may jeopardize their development, sustainability, and potential impact on policy. Previous commentators have identified key challenges to engaging in advocate–researcher collaborations. This article takes particular care to set forth an advocate perspective through the authors’ experience of planning and executing a collaborative study on the effects of mandatory arrest. The authors use a study that was specifically designed to affect policy to offer insight into the challenges faced and to make recommendations for successfully incorporating social action in advocacy–researcher collaborations.
doi:10.1177/1557085108323365
PMCID: PMC2771936  PMID: 19890488
domestic violence; advocate research collaborations
23.  Towards an International Classification for Patient Safety: the conceptual framework 
Global advances in patient safety have been hampered by the lack of a uniform classification of patient safety concepts. This is a significant barrier to developing strategies to reduce risk, performing evidence-based research and evaluating existing healthcare policies relevant to patient safety. Since 2005, the World Health Organization's World Alliance for Patient Safety has undertaken the Project to Develop an International Classification for Patient Safety (ICPS) to devise a classification which transforms patient safety information collected from disparate systems into a common format to facilitate aggregation, analysis and learning across disciplines, borders and time. A drafting group, comprised of experts from the fields of patient safety, classification theory, health informatics, consumer/patient advocacy, law and medicine, identified and defined key patient safety concepts and developed an internationally agreed conceptual framework for the ICPS based upon existing patient safety classifications. The conceptual framework was iteratively improved through technical expert meetings and a two-stage web-based modified Delphi survey of over 250 international experts. This work culminated in a conceptual framework consisting of ten high level classes: incident type, patient outcomes, patient characteristics, incident characteristics, contributing factors/hazards, organizational outcomes, detection, mitigating factors, ameliorating actions and actions taken to reduce risk. While the framework for the ICPS is in place, several challenges remain. Concepts need to be defined, guidance for using the classification needs to be provided, and further real-world testing needs to occur to progressively refine the ICPS to ensure it is fit for purpose.
doi:10.1093/intqhc/mzn054
PMCID: PMC2638753  PMID: 19147595
classification; patient safety; incident; conceptual framework
24.  Domestic violence surveillance system:a model 
Salud publica de Mexico  2008;50(Suppl 1):S12-S18.
Objective
To develop a domestic violence surveillance system.
Material and Methods
The strategies included implementation of a standard digitalized reporting and analysis system along with advocacy with community decision makers, strengthening inter-institutional attention networks, consultation for constructing internal flow charts, sensitizing and training network teams in charge of providing health care in cases of domestic violence and supporting improved public policy prevention initiatives.
Results
A total of 6 893 cases were observed using 2004 and 2005 surveillance system data. The system reports that 80% of the affected were women, followed by 36% children under 14 years. The identified aggressors were mainly females' partners. The system was useful for improving victim services.
Conclusions
Findings indicate that significant gains were made in facilitating the attention and treatment of victims of domestic violence, improving the procedural response process and enhancing the quality of information provided to policy-making bodies.
PMCID: PMC3413269  PMID: 18373003
domestic violence; health surveillance; inter-sectorial action; prevention and control; public policies
25.  Community-based Participatory Research in the California Health Interview Survey 
Preventing Chronic Disease  2005;2(4):A03.
Introduction
The California Health Interview Survey, the largest state health survey in the United States, uses community-based participatory research principles to develop each cycle. Other large-scale health surveys rarely include participatory research approaches. Every 2 years, the California Health Interview Survey generates state and local population-based data on health insurance coverage, access to health care, chronic disease prevalence and management, health behaviors and disease prevention, and other health issues in California. The survey is used for policy and program development, advocacy, and research.
Methods
The development of the California Health Interview Survey involves more than 145 people from more than 60 state and local policymaking bodies, public health agencies, advocacy groups, research organizations, and health care organizations. They participate as volunteers in an advisory board, on technical advisory committees, and in work groups that interact with California Health Interview Survey research staff in an accountable advisory process that shapes survey topics, measures, and sample design and determines languages selected for translation. Survey results and data are provided to the communities involved in the survey.
Results
California Health Interview Survey data have been widely used by local, state, and national public health leaders, policymakers, advocates, and researchers to improve access to health insurance and health care services and to develop and target prevention programs for obesity and chronic illnesses.
Conclusion
The California Health Interview Survey participatory research model has been an effective approach to planning and implementing a health survey and should be considered by developers of other large health surveys.
PMCID: PMC1435701  PMID: 16164807

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