Dissemination Of Policies Research Articles

CDC’s Prevention Research Centers Program: Translating Research into Action with Communities

Chronic diseases account for more than 75% of the nation’s health care costs, and much of that cost is preventable (Remington, Brownson, & Wegner, 2010). Primary prevention of chronic disease requires transdisciplinary skills and collaborations to generate a strong evidence base to guide implementation and dissemination of programs, policies, and systemslevel change. A focus on the most efficient and costeffective approaches is critical for sustainable change. Prevention Research Centers (PRCs) take this approach. The 37 PRCs, funded by the Centers for Disease Control and Prevention (CDC), are a network of academic, community, and public health partners (health care institutions, businesses, public health agencies, and community organizations) committed to conducting research that benefits the research participants and the communities in which they live. This editorial was written on behalf of the PRC Steering Committee.

Promoting Global Cardiovascular Health

Cardiovascular disease (CVD) and related chronic diseases are now recognized as the leading causes of death worldwide, with >80% of all CVD-related deaths now occurring in low- and middle-income countries (LMICs).1 Cardiovascular disease risk factors have also increased globally. In addition to the disease burden, global CVD imposes a substantial economic burden on LMICs at both population and household levels. The accelerating rates of unrecognized and inadequately addressed CVD and related chronic diseases in LMICs are cause for immediate action. Despite several recent calls for action to translate epidemiological data into strategies and policy frameworks, a profound mismatch remains between the compelling evidence documenting the health and economic burden of CVD and the lack of concrete steps to increase investment and implement CVD prevention and disease management efforts in LMICs. To catalyze the action needed to control global CVD, the Institute of Medicine (IOM) has produced a report titled Promoting Cardiovascular Health in the Developing World (http://www.nap.edu/catalog.php?record_id=12815).2 The IOM committee was charged with evaluating the available evidence to offer conclusions and recommendations to reduce the global burden of CVD, with an emphasis on developing guidance for partnerships and collaborations among a range of public- and private-sector entities involved with global health and development. The recommendations of the report include a set of specific actions targeted to specific stakeholders, which are intended to encourage a sufficient shift in the global health and development agenda to facilitate critical next steps that will build toward the eventual goal of widespread dissemination and implementation of evidence-based programs, policies, and other tools to address CVD and related chronic diseases in LMICs. This article presents the recommendations of the IOM report with a condensed version of the committee's commentary describing the rationale and implementation of the recommendations. In this summary, the recommendations are …

The pollution release and transfer register system in the U.S. and Japan: an analysis of productivity

This study analyzes Total Factor Productivity (TFP), which includes all categories of productivity. Our measure investigates productivity in the context of the provision and dissemination of environmental information policies. We investigated data on the emission of toxic chemical substances for the U.S. and Japanese manufacturing firms, including 386 firms for the period 1999–2007 and 466 firms for the period 2001–2008. The results show that productivity improved in all nine industrial sectors and that pollution levels were high in the U.S. and Japan from 2001 to 2007. In particular, the electronics industry improved rapidly after 2002 in both countries, which may be attributed to the enforcement of RoHS and the REACH directive in Europe. As a result of these stringent policies on toxic chemical emissions, the U.S. and Japanese firms, many of which export to the European market, have strong incentives to reduce their toxic chemical emissions.

Aligning the Forces of Magnetism to Achieve Exemplary Professional Practice

This clinical paper presents the evolution of a Point of Care Scholars (POCS) program, which embodies three components of the Magnet model: exemplary professional practice, new knowledge, innovations, and improvements, and empirical outcomes. The drive to achieve Magnet designation and redesignation provides a focused approach on innovation. The innovative POCS program is structured to introduce new knowledge to point-of-care staff with improvements that will lead to quality outcomes. Empirical outcomes of the POCS program include practice and policy changes, improved safety, program cost, dissemination, professional advancement, and program satisfaction.

Nonstandard Programs: The University of Pittsburgh Medical Centerʼs Next Frontier in Graduate Medical Education

The University of Pittsburgh Medical Center has seen continuous growth in the number and types of graduate training programs not accredited by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Medical Specialties, or the American Osteopathic Association. For the purposes of ensuring best educational products and of controlling unrecognized competition with our accredited programs, a sequential process of centralized oversight of these nonstandard programs was undertaken. The first step involved programs whose fellows were hired and tracked like accredited fellows (i.e., not instructors). The basic process began with consensus among leadership, writing of policy with consultation as necessary, establishment of a registry of programs and graduates, and a committee to allow sharing of best practices and dissemination of policy. The second step applied the same process to instructor-level programs. Whereas the previous group of programs was made subject to ACGME regulations, more latitude in duty hours and progressive responsibility were allowed for instructor programs. The final step, in progress, is extending a similar but modified approach to short-duration clinical experiences and observerships. The outcomes of these efforts have been the creation of a centralized organizational structure, policies to guide this structure, an accurate registry of a surprising number of training programs, and a rolling record of all graduates from these programs. Included in the process is a mechanism that ensures that core program directors and department chairs specifically review the impact of new programs on core programs before allowing their creation.

MERCOSUL E A DISSEMINAÇÃO INTERNACIONAL DE POLÍTICAS PÚBLICAS

Este trabalho discute o papel do Mercosul enquanto espaço catalisador de processos de disseminação de políticas públicas entre os países-membros. É adotada uma perspectiva comparada de análise, que leva em conta os trabalhos realizados por teóricos que abordam o fenômeno da disseminação no contexto da União Europeia. São apresentadas tipologias elaboradas por esses autores e que classificam a disseminação de políticas públicas pelo grau de fidelidade à política pública original. Chegou-se à conclusão de que os órgãos temáticos do Mercosul constituem-se como espaços que propiciam a troca de experiências e de ideias, possibilitando processos de disseminação, ainda que nas modalidades mais "fracas". PALAVRAS-CHAVE Mercosul, disseminação, difusão, transferência, políticas públicas. ABSTRACT This paper discusses the role of Mercosur as a catalysing agent for policy dissemination among member-states. A comparative perspective was adopted, taking into account the works of scholars who have studied policy dissemination in the European context. A categorization typology, created by such scholars, separates and classifies policy dissemination processes by their fidelity to the original source. It was possible to conclude that Mercosur’s many thematic departments can be considered as chambers that allow for the exchange of experiences and ideas, resulting indeed in policy dissemination processes, even if they fall in the “weak” categories. KEYWORDS Mercosur, dissemination, policy transfer, policy diffusion, public policy.

Culture Industry and the Marketing of Human Rights

How were the tactics of the burgeoning human rights movement shaped by the pressures of the market in the age of mass consumption? In the 1980s, following the institutionalization of human rights and the rise to popularity of human rights discourse, the global movement sought to grow its base of support and began to market itself to a broader audience utilizing tactics driven by economic forces of globalization. Consumer culture that had originated in the affluent societies of the post-war world deepened in the waning years of the Cold War due to the opening of markets in the developing world and the dissemination of neoliberal economic policies suited to benefit the West. This society of mass consumption dictated the strategies utilized by human rights organizations, specifically the connection of activism to popular consumption. In order to bring its message to the masses, human rights was commercialized to the extent that the movement communicated its message through patterns of consumption: donation, sponsorship, t-shirts, bumper stickers, concert tickets, and cause songs. While these tactics were successful in raising political consciousness around human rights issues and producing positive effects for human rights struggles, the relationship between the individual and the movement is forged in an alienated and reified manner. A constitutive component of human rights activism during this period was the focus on subsistence rights, namely famine and malnutrition, due to their marketability and the suggestion that an influx of economic resources would be sufficient to feed the hungry; therefore the more you give and buy, the more help you are providing. The decoupling of violations of subsistence rights from their political contexts obscured the causes of conflict and complicated humanitarian remedy. Deploying the critical theory approach of the Frankfurt School, this paper takes seriously the impact of benefit concerts, celebrity endorsement, and popular culture in general when it is placed in the service of human rights campaigns. This trend was initiated in the late 1970s with UK Amnesty International’s “Secret Policemen’s Ball” starring Monty Python’s Flying Circus, continuing through USA for Africa’s “We Are the World,” and is alive today in the activism of the SaveDarfur Coalition and the One.org global poverty project. While these approaches reach a broader audience than more targeted strategies, the politics of human rights is transmitted as entertainment; fact is blurred with fiction, reality is alienated as make believe. As Herbert Marcuse, Theodor Adorno, and others instruct, advanced industrial capitalism operates through sophisticated methods of social control in order to hijack subversive politics and mitigate critical perspectives. Mainstream culture is simply the product of the machine that generates false needs and repressive desublimation in its audience of consumers. To the extent that human rights is understood as a set of mechanisms through which individual human dignity is protected and arbitrary power checked, human rights indeed confronts the world as a threat to entrenched power. Therefore, hegemonic forces in the market and in geopolitics will seek to commodify and co-opt human rights, so as to undercut its efficacy. In essence, the commercialization of human rights made human rights susceptible to the pressures of the market and vulnerable to the dictates of the superficiality and short attention span of mass society.

Mental health policy process: a comparative study of Ghana, South Africa, Uganda and Zambia

BackgroundMental illnesses are increasingly recognised as a leading cause of disability worldwide, yet many countries lack a mental health policy or have an outdated, inappropriate policy. This paper explores the development of appropriate mental health policies and their effective implementation. It reports comparative findings on the processes for developing and implementing mental health policies in Ghana, South Africa, Uganda and Zambia as part of the Mental Health and Poverty Project.MethodsThe study countries and respondents were purposively selected to represent different levels of mental health policy and system development to allow comparative analysis of the factors underlying the different forms of mental health policy development and implementation. Data were collected using semi-structured interviews and document analysis. Data analysis was guided by conceptual framework that was developed for this purpose. A framework approach to analysis was used, incorporating themes that emerged from the data and from the conceptual framework.ResultsMental health policies in Ghana, South Africa, Uganda and Zambia are weak, in draft form or non-existent. Mental health remained low on the policy agenda due to stigma and a lack of information, as well as low prioritisation by donors, low political priority and grassroots demand. Progress with mental health policy development varied and respondents noted a lack of consultation and insufficient evidence to inform policy development. Furthermore, policies were poorly implemented, due to factors including insufficient dissemination and operationalisation of policies and a lack of resources.ConclusionsMental health policy processes in all four countries were inadequate, leading to either weak or non-existent policies, with an impact on mental health services. Recommendations are provided to strengthen mental health policy processes in these and other African countries.

Collaboration between For-Profit and Nonprofit Organizations: Some Insights into the Encyclical Caritas in Veritate

In current economic systems, the nonprofit and voluntary world plays an important role; several studies analyse the reason for the emergence and development of these organizations and suggest reasons related to the dissemination (in particular after the Great Depression of the Thirties) of policies that, with a view to safeguarding the weaker social groups, first consider public intervention and then the third way of the economy, ways to increase wealth and support economic development. The characteristic of modern nonprofit concerns is their organization in the form of enterprises; this encourages the development of capabilities to satisfy human needs in terms of production of goods and utilities. For the survival and development of nonprofit organizations, systematic cooperation with the local context, especially with enterprises, is becoming increasingly more important. Of course, excellent opportunities for economic and social growth and for mutual development can develop from this type of cooperation. Starting from these considerations, the purpose of our research is to offer a series of reflections on the cooperation between for-profit and nonprofit enterprises (as proposed in the Encyclical Caritas in Veritate) considering a number of collaboration experiences between the two types of organization developed in our local territory. From a methodological point of view, after a theoretical analysis of the nonprofit concept, this work analyses the Encyclical Letter Caritas in Veritate focusing particular attention on the topic of nonprofit organizations and their relations with the world of enterprise. In this sense, a description of the initiative promoted by Forum Solidarieta and an analysis of the empirical results are of interest; the paper proposes some final considerations and further discussions.

From mental health policy development in Ghana to implementation: what are the barriers?

This paper identifies the key barriers to mental health policy implementation in Ghana and suggests ways of overcoming them. The study used both quantitative and qualitative methods. Quantitatively, the WHO Mental Health Policy and Plan Checklist and the WHO Mental Health Legislation Checklist were employed to analyse the content of mental health policy, plans and legislation in Ghana. Qualitative data was gathered using in-depth interviews and focus group discussions with key stakeholders in mental health at the macro, meso and micro levels. These were used to identify barriers to the implementation of mental health policy, and steps to overcoming these. Barriers to mental health policy implementation identified by participants include: low priority and lack of political commitment to mental health; limited human and financial resources: lack of intersectoral collaboration and consultation; inadequate policy dissemination; and an absence of research-based evidence to inform mental health policy. Suggested steps to overcoming the barriers include: revision of mental health policy and legislation; training and capacity development and wider consultation. These results call for well-articulated plans to address the barriers to the implementation of mental health policy in Ghana to reduce the burden associated with mental disorders.

Cultura e desenvolvimento humano

A cultura pode ser entendida como fenômeno da criação humana que mantém fortes relações com o imaginário, com as idéias e com as diferentes formas de expressão de sentimentos e emoções, entre as quais se destacam a arte e a literatura. Este artigo aborda em especial este último aspecto. Nesse se argumenta que o acesso aos bens culturais é uma das principais ferramentas de transformação humana e de aproximação entre as pessoas, possibilitando o reconhecimento da diferença como algo positivo, componente fundamental para a construção da igualdade na diversidade. A cultura digital, que se apóia em novas tecnologias da comunicação, potencializa a transmissão do conhecimento, incidindo principalmente na velocidade com que circulam novas informações, e pode ser uma das ferramentas de aproximação cultural e mudança. Contudo, essa maior difusão de bens culturais demanda novas políticas culturais que incidam sobre a infraestrutura – espaços e equipamentos – que permitam aos agentes sociais operacionalizarem suas idéias. Salienta-se que mais que criar novos espaços é preciso atentar para aqueles já existentes, cabendo ao poder público o fomento, mas não a gestão direta das ações culturais.

Translating Epidemiology Into Policy to Prevent Childhood Obesity: The Case for Promoting Physical Activity in School Settings

Childhood obesity is a serious public health problem resulting from energy imbalance (when the intake of energy is greater than the amount of energy expended through physical activity). Numerous health authorities have identified policy interventions as promising strategies for creating population-wide improvements in physical activity. This case study focuses on energy expenditure through physical activity (with a particular emphasis on school-based physical education [PE]). Policy-relevant evidence for promoting physical activity in youth may take numerous forms, including epidemiologic data and other supporting evidence (e.g., qualitative data). The implementation and evaluation of school PE interventions leads to a set of lessons related to epidemiology and evidence-based policy. These include the need to: (i) enhance the focus on external validity, (ii) develop more policy-relevant evidence on the basis of "natural experiments," (iii) understand that policy making is political, (iv) better articulate the factors that influence policy dissemination, (v) understand the real-world constraints when implementing policy in school environments, and (vi) build transdisciplinary teams for policy progress. The issues described in this case study provide leverage points for practitioners, policy makers, and researchers as they seek to translate epidemiology to policy.

Robert Wood Johnson Survey Results Show Opinion Leaders Believe Nurses Should Have More Influence on Health Systems and Services

Craven & Ober Policy Strategists, LLC, is a full-service Massachusetts-based government relations firm dedicated to credible, assertive advocacy and to the dissemination of reliable public policy information.Figure: Stacey Ober, BSN, JD; Gloria Craven, BSN, MSN

Governance of Education Related ECCE Policies in Malaysia

Abstract Early Childhood Care and Education (ECCE) in Malaysia is catching much more limelight now than in the past. In a country where governance is very centralized, such attention has given rise to more quality preschool classes and initiatives. Comprehensive policies have been developed and implemented, however studies have shown that there are gaps between the aspired and the implemented. Good governance ensures successful implementation of policies. Good governance requires the authority and other stakeholders to focus on the vulnerable population including the indigenous people, children with special needs and refugee. Providing effective dissemination of policies, maintaining a sustainable mechanism of monitoring, attention to coordination and integration are tasks at hand to ensure successful implementation of policies. The ECCE Policy Implementation Review initiated by UNESCO and UNICEF has provided much evidence-based input to tackle these issues. This paper provides a situation analysis of the status of ECCE in Malaysia based on the findings of ECCE Policy Implementation Review.

Brief report: Multilevel analysis of school smoking policy and pupil smoking behaviour in Wales

A multilevel analysis of cross-sectional data from a survey involving 1941 pupils (in grades 10 and 11) and policy indicators developed from interviews with staff from 45 secondary schools in Wales examined the hypotheses that pupil smoking prevalence would be associated with: restrictive staff and pupil smoking policies; dissemination of school smoking policies; and implementation of smoking policies in the context of a health promoting whole school environment. The only statistically significant association found was that pupils attending schools that did not disseminate pupil smoking policy in a written document had a greater tendency (OR = 2.16, 95% CI 1.13–4.10) to smoke daily on school premises than those who attended schools that disseminated policy through a written document. This association was not significant ( p < 0.05) when pupil level covariates were included. Further research is required to identify the effectiveness and optimal content, enforcement and support of school smoking policies.

Boosting Population Quits Through Evidence-Based Cessation Treatment and Policy

Only large increases in adult cessation will rapidly reduce population smoking prevalence. Evidence-based smoking-cessation treatments and treatment policies exist but are underutilized. More needs to be done to coordinate the widespread, efficient dissemination and implementation of effective treatments and policies. This paper is the first in a series of three to demonstrate the impact of an integrated, comprehensive systems approach to cessation treatment and policy. This paper provides an analytic framework and selected literature review that guide the two subsequent computer simulation modeling papers to show how critical leverage points may have an impact on reductions in smoking prevalence. Evidence is reviewed from the U.S. Public Health Service 2008 clinical practice guideline and other sources regarding the impact of five cessation treatment policies on quit attempts, use of evidence-based treatment, and quit rates. Cessation treatment policies would: (1) expand cessation treatment coverage and provider reimbursement; (2) mandate adequate funding for the use and promotion of evidence-based state-sponsored telephone quitlines; (3) support healthcare systems changes to prompt, guide, and incentivize tobacco treatment; (4) support and promote evidence-based treatment via the Internet; and (5) improve individually tailored, stepped-care approaches and the long-term effectiveness of evidence-based treatments. This series of papers provides an analytic framework to inform heuristic simulation models in order to take a new look at ways to markedly increase population smoking cessation by implementing a defined set of treatments and treatment-related policies with the potential to improve motivation to quit, evidence-based treatment use, and long-term effectiveness.

Implementation of the Communities That Care prevention system by coalitions in the Community Youth Development Study

While advances in prevention science over the past 2 decades have produced a growing list of tested and effective programs and policies for preventing adolescent delinquency and drug use, widespread dissemination and high-quality implementation of effective programs and policies in communities has not been achieved. The Community Youth Development Study (CYDS) is a randomized, community-level trial of the Communities That Care (CTC) system for promoting science-based prevention in communities. This paper compares 12 community prevention coalitions implementing the CTC system in 12 intervention communities as part of the CYDS to prevention coalitions located in the 12 control communities. As hypothesized, the CYDS coalitions implemented significantly more of the CTC core intervention elements, and also implemented significantly greater numbers of tested, effective prevention programs than the prevention coalitions in the control communities. Implications of the findings for efforts to achieve widespread dissemination of effective prevention programs, policies, and practices are discussed.

Survey of Jail Visitors About Visitation Policies

Little has been written about policies affecting the public who visit jails. As the number of jail inmates increases, many offenders’ families are affected. For the majority, their first contact with the criminal justice system might be by visiting an inmate in jail. This study measured the levels of visitors’ understanding and satisfaction with visitation policies at two county jails in a northeastern state. A total of 281 visitors from two county jails completed the surveys. Data from this study revealed that—to meet the needs of the visitors—attention should be given to methods of visiting, jail staff training, dissemination of visitation policies, and conditions of inmate incarceration. By addressing these issues, problems that visitors encounter while visiting inmates may be lessened, and their concerns about inmates may be decreased. These changes may lead to more amenable interactions between visitors and jail staff during visitation.

Searching for Vitality in Teacher Education

The hopes and dreams for our shared JTE editorship began 6 years ago over three bowls of tortilla soup. During that lunchtime meeting, through deliberation and debate, we formed our editorial vision statement. Scanning the professional horizon in fall 2003, we characterized the teacher education landscape for our American Association for Colleges of Teacher Education (AACTE) editorship proposal in the following terms: Those committed to education share a historically unprecedented goal: To ensure all children will develop the knowledge, understandings, and competencies needed to reach their full potential and to contribute to our democratic society. Furthermore, most accept that quality teachers play a crucial role in realizing this aim. Yet, in the face of this common goal, different visions for how best to realize this aim compete in the marketplace of ideas. On the one hand, some reforms promote standards-based accountability systems, market-based approaches to public education, advocacy of direct instruction and prescribed curricula, and deregulation of teacher preparation and licensure. On the other hand, other reformers encourage a broader conception of the aims and purposes of education, a view of public schools as institutions uniquely charged with shaping and creating a fairer, equitable, and just society, a preference for pedagogies and assessments that focus on conceptual understanding, and the promotion of teaching as a profession. One thing is certain in all of this mix, a consensus about teaching, public schooling, and the role of teacher education does not exist. Add to these debates an increasing number of alternative and state-sanctioned routes to teacher certification, the changing cultural and class demographics of our public schools, the relatively stable white, middle-class pool of prospective and practicing teachers, and the decreasing state appropriations for higher education, and we end up with a terrain ripe for structural transformation. While we don't believe these changes will be designed or guided solely by rational deliberations, we do maintain that the Journal of Teacher Education has and should provide a scholarly forum for the dissemination and examination of teacher education research, policy, and practice. If we were chosen to guide the Journal in upcoming years we would provide a ... setting where distinct and varied scholarly approaches could explore, interrogate, and illuminate the contours of teacher education. (1) The guiding metaphor for our editorial vision was then and has continued to be a conversation of many voices. We believe that rich conversational lines with many distinct participants allow us to crisscross the ill-structured landscape of teaching and learning to teach, to explore and thereby affirm its complexity (Lampert, 2001; Spiro, Coulson, Feltovich, & Anderson, 1988/2004). Although understanding complexity is a scholar's primary aim (and delight), such multi-vocal conversations offer those involved in the endeavor opportunities to see the terrain from different vantage points and to cross well trodden paths in new places. Out of these encounters, it was our hope that fresh ideas and practices would emerge. As we approached this, the final issue published under our editorship, we revisited our proposal statement. To some extent, we were discouraged. The statement written in 2003 could easily be written in 2009. The field continues to be in flux, and university-based teacher preparation is arguably more besieged today than when we began. We wondered about the vitality of our field: Is there any evidence or reason to believe that creative, vital, and powerful ideas and practices are being taken up in the field of teacher education? We asked individuals who hold diverse views to respond to the following question: Is there vitality in the field of teacher education? …

Promoting Social Welfare Through Oral Health: New Jersey's Fluoridation Experience

This study examines the contentious public health policy of treating community water with fluoride in the United States. The question for scholarly investigation is why water fluoridation has been unsuccessful in several parts of the United States relative to the rest. It addresses this question by looking into the processes of scientific discovery and information dissemination, benefits and risks of science-based health policy, related issues of provision and production, and spatial dimensions of policy development. The case method based on New Jersey's experience in public water fluoridation, was opted for this study. We find that policy debates, which are confined to single key issues, tend to breed binary choices and bipolar debates and result in policy stalemates. Consumer accessibility and desirability of merit goods thus become sharply conflicting social welfare values. They undermine the intent of science-based policies and often make alternative and second-best policies more practical to adopt.