Evidence-based Policy Research Articles

Injury mortality in South Africa: a 2009 and 2017 comparison to track progress to meeting sustainable development goal targets

ABSTRACT Background Injuries, often preventable, prompted urgent action within the United Nations’ 2030 Agenda for Sustainable Development Goals (SDGs) to improve global health. South Africa (SA) has high rates of injury mortality, but accurate reporting of official national data is hindered by death misclassification. Objective Two nationally representative surveys for 2009 and 2017 are utilised to assess SA’s progress towards SDG targets for violence and road traffic injuries, alongside changes in suicide and under-5 mortality rates for childhood injuries, and compare these estimates with those of the Global Burden of Disease for SA. Methods The surveys utilised multi-stage, stratified cluster sampling from eight provinces, with mortuaries as primary sampling units. Post-mortem files for non-natural deaths were reviewed, with additional data from the Western Cape. Age-standardised rates, 95% confidence intervals (CIs), and incidence rate ratios (IRRs) were calculated for manner of death rate comparisons and for age groups. Results The all-injury age-standardised mortality rate decreased significantly between 2009 and 2017. Homicide and transport remained the leading causes of injury deaths, with a significant 31% decrease in road traffic mortality (IRR = 0.69), from 36.1 to 25.0 per 100 000 population. Conclusions Despite a reduction in SA’s road traffic mortality rate, challenges to achieve targets related to young and novice drivers and male homicide persist. Achieving SA’s injury mortality SDG targets requires comprehensive evaluations of programmes addressing road safety, violence reduction, and mental well-being. In the absence of reliable routine data, survey data allow to accurately assess the country’s SDG progress through commitment to evidence-based policymaking.

Community-Based Health Information Systems in Africa: A Scoping Review of Data Generation, Utilization, and Community Empowerment.

The community-based health information system (CBHIS) is a vital component of the community health system, as it assesses community-level healthcare service delivery and generates data for community health programme planning, monitoring, and evaluation. CBHIS promotes data-driven decision-making, by identifying priority interventions and programs, guiding resource allocation, and contributing to evidence-based policy development. This scoping review aims to comprehensively examine the use of CBHIS in African countries, focusing on data generation, pathways, utilisation of CBHIS data, community accessibility to the data and use of the data to empower communities. We utilised Arksey and O'Malley's scoping review methodology. We searched eight databases: PubMed, EMBASE, HINARI, Cochrane Library, Web of Science, Scopus, Google Scholar, and grey literature databases (Open Grey and OAIster). We synthesised findings using a thematic approach. Our review included 55 articles from 27 African countries, primarily in Eastern and Southern Africa, followed by West Africa. Most of the studies were either quantitative (42%) or qualitative (33%). Paper-based systems are primarily used for data collection in most countries, but some have adopted electronic/mobile-based systems or both. The data flow for CBHIS varies by country and the tools used for data collection. CBHIS data informs policies, resource allocation, staffing, community health dialogues, and commodity supplies for community health programmes. Community dialogue is the most common approach for community engagement, empowerment, and sharing of CBHIS data with communities. Community empowerment tends towards health promotion activities and health provider-led approaches. CBHIS utilises both paper-based and electronic-based systems to collect and process data. Nevertheless, most countries rely on paper-based systems. Most of the CBHIS investments have focused on digitisation and enhancing data collection, process, and quality. However, there is a need to shift the emphasis towards enabling data utilisation at the community level and community empowerment.

IS THIS (TELE)WORKING? A path model analysis of the relationship between telework, job demands and job resources, and sustainable employability.

Technological advancements and the COVID-19 crisis have accelerated the adoption of telework, impacting employees' work dynamics. Moreover, an aging workforce emphasises the need for sustainable employability. With reference to the Job Demands-Resources (JD-R) Model, this study explores how telework relates to job demands and job resources and, subsequently, to sustainable employability. The present study investigates the repercussions of increased telework on employees' sustainable employability. Hypotheses posit direct and indirect (i.e., mediated) relationships, providing insights for evidence-based telework policies. Data from 552 government employees was collected through an online survey. Data collection occurred during the COVID-19 pandemic when widespread teleworking was prevalent. A path model was employed to analyse associations between telework, job demands (specifically work pressure), job resources (social support, workplace communication, and role clarity), and sustainable employability dimensions, including vitality, work ability, and employability. Our path model reveals that heightened telework was associated with elevated work pressure and diminished role clarity. Surprisingly, a positive association emerges between work pressure and sustainable employability. Notably, no significant relationship is found between telework, social support, and workplace communication. Role clarity is likely to be pivotal, positively influencing vitality and employability. This study provides valuable insights into the effects of telework on job demands, resources, and sustainable employability. The unexpected positive association between work pressure and sustainable employability challenges conventional stressor paradigms. The relationships between telework, job demands, job resources, and sustainable employability uncovered in this study can contribute to evidence-based teleworking policies and strategies that support employee health and employability amidst evolving work structures.

The Global Impact of Multisystemic Vulnerabilities on Criminal Variety: A Cross-Continental Study in Young Adults.

Previous research has shown a robust association between different childhood and adolescent vulnerabilities and youth offending. However, these investigations have primarily focused on youths from high-income Western countries. Consequently, the generalizability of these findings to better inform global justice policies remains uncertain. This study aimed to address this gap by examining the relationship between individual, familial, and contextual vulnerabilities and criminal versatility during young adulthood, accounting for sociodemographic factors and cross-national differences. Data were derived from a diverse sample of 4,182 young adults (67% female; mean age = 18.96; SD = 0.81) residing in 10 countries across 5 continents who participated in the International Study of Pro/Antisocial Behavior in Young Adults. The Psychosocial and Family Vulnerability Questionnaire and the Adverse Childhood Experiences questionnaire were used to assess social and family adversity, and past-year criminal diversity was measured with the Criminal Variety Index. Results indicate that child maltreatment, substance abuse, and delinquent peers are global risk factors for criminal variety. Moreover, they are independent across males and females and among youths living in countries that are ranked differently on the Human Development Index (HDI). In addition, some childhood vulnerabilities showed different predictive ability across sexes (e.g., school failure), and across countries ranked differently on the HDI (e.g., family dysfunction). These findings suggest that certain childhood factors contribute to criminal behavior through transcultural mechanisms. Moreover, they highlight the importance of developing evidence-based policies that focus on transcultural risk factors to globally prevent criminal behavior.

Transnational Human Rights Violations: Addressing the Evolution of Globalized Repression through National Human Rights Institutions

Abstract Transnational Human Rights Violations (THRV) are infringements of individual rights that originate outside the jurisdiction in which they take effect. Ranging from violent and criminal forms of transnational repression through to coercion against targets’ family members abroad, digital surveillance, and legal intimidation, THRVs today generate widespread and systemic constraints on the exercise of human rights in jurisdictions around the world. At present, however, targets of THRVs typically find few avenues through which to raise complaints, receive assistance or pursue redress. This article proposes a new domestic institutional mechanism to directly address this situation. It first examines the mutually reinforcing, additive effects of transnational surveillance, coercion and censorship in the digital era. Next, it identifies relevant human rights standards showing state responsibilities to monitor and counter THRVs within their jurisdiction, and the growing recognition of additive, systemic effects of THRVs on broad populations. The third section examines policy responses in the United States, Australia, United Kingdom, and international organizations, noting that none has adequately addressed the contemporary nature and scope of THRVs as international standards require. The final section argues that to meet their obligations, states should establish Transnational Rights Protection Offices (TRPOs) to provide a clear contact point for targets to raise complaints and receive support; monitor and report on the situation of THRVs taking effect within the state’s jurisdiction; advise and inform government departments on THRV issues; and develop evidence-based policy recommendations. We conclude by laying out the rationale for its institutional status within National Human Rights Institutions (NHRIs).

Web application of an integrated simulation for aquatic environment assessment in coastal and estuarine areas

This paper introduces the web application-type Graphical User Interface that has been developed and also presents an application example. The introduced simulator conducts hydrodynamics and ecosystems in coastal and estuarine areas. It consists of (1) a hydrodynamic model that can simulate the current velocity, water temperature, salinity, and water level; (2) an ecosystem model that can simulate dissolved oxygen, phytoplankton, zooplankton, nutrients, fish, and bivalves; and (3) a benthic ecosystem model that can simulate elution. Web GUI is the first web system of aquatic environment simulation system that can both prepare calculation conditions and visualize them. Another significant feature is that it requires no installation and can be easily used by anyone to perform calculations. Thus, the proposed system helps fill the expertise gap experienced by potential users of the model. The use of standard systems, such as those discussed in this study, will facilitate evidence-based policymaking (EBPM).

Understanding the home hospice experience of Puerto Rican caregivers.

Hospice use among Hispanic Medicare beneficiaries has declined in the last few years, and Hispanic caregivers have reported insufficient support around the emotional and spiritual aspects of care. Understanding the home hospice experience of Puerto Rican (PR) caregivers can yield insight into ways to improve hospice participation and quality of care for the Hispanic population. This exploratory study utilizes qualitative methods to identify PR caregivers' experience in the setting of home hospice care. Data from interviews with eight (n=8) bereaved PR caregivers of patients who received home hospice care were qualitatively analyzed. Participants were mostly well-educated (n=6/8) female caregivers caring for their parent (n=7/8) with mean age of 57 [standard deviation (SD) =13] years. Emerging domains from the study included (I) symptom management; (II) cultural and religious values; and (III) interaction with hospice providers. Caregivers found managing patients' loss of appetite, pain, anxiety, and confusion to be challenging. They identified family-centered values and religious support as culturally important, which manifested as the need for frequent communication from hospice providers and increased support and education at the end-of-life. Culturally tailored interventions that focus on managing symptoms, tailoring care to support family-centered values, integrating religious officials representative of the patient's beliefs into the hospice team, and communicating effectively with providers may reduce the burden experienced by PR caregivers in home hospice and improve outcomes for patients and caregivers. Additional research will aid in the development of evidence-based intervention and policies urging healthcare providers to offer culturally appropriate hospice care and resources to this population.

Evaluating factors affecting sexual abuse prevention education for primary school students according to the life skills approach

This comprehensive study delves into the intricate factors influencing sexual abuse prevention education for elementary school students, capturing insights from diverse stakeholders, including 423 students, 115 teachers, and 423 parents. Employing a Likert scale, the research evaluates various dimensions, shedding light on the nuanced dynamics that shape prevention programs. The results reveal that student-related factors, encompassing positive behavior, cognitive capacity, personality traits, and knowledge levels, received moderately positive mean scores. This underscores the significant contribution of inherent qualities and cognitive abilities of primary school students to the effectiveness of sexual abuse prevention education. Moving to family-related factors, parents’ extensive knowledge and understanding garnered a positive mean score of 2.91, signifying a favorable impact, while financial considerations received a slightly lower mean score of 2.92. Notably, parental educational methods and the inclination to delegate educational responsibilities to schools scored higher at 2.99 each, underscoring the influential role parents play in shaping their children's perspectives on sexual abuse prevention. Within the school environment, positive interactions between teachers and students stood out with a mean score of 2.97, emphasizing the pivotal role of supportive teacher-student relationships in facilitating effective sexual abuse prevention education. Societal factors exhibited varying influences, with local customs, culture, and social psychology receiving a mean score of 2.91, indicating a moderately positive impact. However, the development of the internet and information channels scored lower at 2.60, revealing potential challenges in adapting prevention education to the evolving landscape of online information dissemination. These nuanced findings contribute to a deeper understanding of the multifaceted factors shaping sexual abuse prevention education for elementary school students, providing a foundation for evidence-based interventions and policy decisions.

Managing barriers to resource allocation for the rehabilitation services in Pakistan: a review article

The rehabilitation services including physical therapy, occupational therapy, speech and language therapy is an essential part of the healthcare system, which is required to enhance patients' quality of life. These services need a streamlined support system, which is required from the funding sources that significantly impact the efficacy. The accessibility, affordability, and quality of healthcare services are significantly influenced by healthcare finance and its utilization, which involves revenue generation and reimbursement processes to budgetary supervision and allocation of resources. Effective resource allocation is made possible by sound financial management, which minimizes undue usage and maximizes the use of existing resources in underfunded healthcare systems like Pakistan, where there is a greater need for funds for rehabilitation. Despite their value in the budget, rehabilitation services frequently receive a smaller portion of the healthcare budget. There is a need to focus on several funding sources, such as commercial insurance plans, public sector grants, out-of-pocket costs for patients and families, and the functions of foreign aid and charitable donations. The possible ways can be increasing insurance coverage for rehabilitation services, increasing public sector investment and encouraging increased cooperation between public and private sector parties. Ultimately, the healthcare system and the rehabilitative services can be improved for future prevention of disability and evidence-based health policies that maximize available resources and high-quality healthcare. This review offers a thorough analysis of and describes the current state of rehabilitation financing in Pakistan. In addition, it also provides considerable evaluation of barriers and suggested solutions in managing the finances required for running a viable rehabilitation system. Keywords: Budgets; Funds; Funding Resources; Finance; Healthcare System; Hospitals; Patients; Rehabilitation Citation: Waheed A, Shah S, Mahmood T. Managing barriers to resource allocation for the rehabilitation services in Pakistan: a review article. Anaesth. pain intensive care 2024;28(4):776−782; DOI: 10.35975/apic.v28i4.2528 Received: July 08, 2024; Reviewed: July 12, 2024; Accepted: July 26, 2024

A model of faulty and faultless disagreement for post-hoc assessments of knowledge utilization in evidence-based policymaking

When evidence-based policymaking is so often mired in disagreement and controversy, how can we know if the process is meeting its stated goals? We develop a novel mathematical model to study disagreements about adequate knowledge utilization, like those regarding wild horse culling, shark drumlines and facemask policies during pandemics. We find that, when stakeholders disagree, it is frequently impossible to tell whether any party is at fault. We demonstrate the need for a distinctive kind of transparency in evidence-based policymaking, which we call transparency of reasoning. Such transparency is critical to the success of the evidence-based policy movement, as without it, we will be unable to tell whether in any instance a policy was in fact based on evidence.

Setting the Priorities for LGBT+ Research and Intervention Effort in Malaysia Through Community Voices: A Brief Report.

Internationally, there is a growing acceptance of gender and sexuality diversity and acknowledgment of LGBT + identities as health determinants. However, caution is warranted when applying research and intervention priorities from Global North countries to regions where LGBT + identities remain criminalized. In 2024, Malaysia maintains legal stances persecuting LGBT + individuals and shows no intent to address this human rights issue. This study offers an overview of pivotal issues identified by LGBT + communities in Malaysia that urgently require attention and resolution. Data were employed from a large-scale community-based survey: the KAMI Survey that recruited LGBT + participants in Malaysia in late 2023 and descriptive analyses were conducted on the responses of 637 participants (mean age = 27.75). Results revealed key issues deemed 'very important' to address by participants comprised HIV/AIDS, training for healthcare providers, police mistreatment, and discrimination, with more than 80% reporting each of these. When prompted to select a single issue for urgent resolution, three-fifths (61.0%) prioritized 'criminalizing laws affecting LGBT + individuals'. Echoing prolonged advocacy by local LGBT + community organizations, the author emphasizes the need for collective allyship across stakeholders to develop evidence-based practices and policies to address the concerns articulated in this paper.

The differential impact of evidence types in policy decisions: comparing evidence priorities in employment and education ministries

ABSTRACT Evidence-based policy-making has received increasing attention among governments in recent decades. However, comparative research examining patterns of evidence impact and administrative priorities for different forms of evidence remains scarce. In response, this article investigates the impact of different evidence types in two Danish ministries – the Ministry of Employment and the Ministry of Children and Education – characterized by similar analytical capacities but different strategies and criteria for prioritizing and using evidence. Applying a novel document matching method to analyze 1159 research publications and policy decisions from 2015–2021 about Danish active labor market policies and public school policies, the article shows how causal effect evidence has to a greater extent influenced policy decisions in the Ministry of Employment than in the Ministry of Children and Education. The article proposes that the observed variation between the policy domains can be attributed to ministerial evidence strategies, shaping administrative perceptions of the relevance and usefulness of different types of evidence. Based on the results, the article discusses the implications of prioritizing particular evidence types in ministries, considering variations between study designs and their appropriateness for different policy needs and purposes.

Trends in fetal alcohol spectrum disorder research: Abibliometric review of original articles published between2000 and 2023.

Fetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disability globally. International organizations have highlighted an urgent need for improved prevention, diagnosis, and support. However, the evidence base needed to inform this is thought to be limited. We conducted two complementary reviews to (i) describe trends in the volume and characteristics of original FASD research articles (Review 1) and (ii) compare the volume of published research on FASD to that of other neurodevelopmental disorders (Review 2). In Review 1, we systematically searched MEDLINE, Embase, CINAHL and PsycInfo for original studies with FASD terms in the title, published between 2000 and 2023. We summarised study characteristics including the article topic(s), sample population, country of origin, and publication year using quantitative content analysis and time-series plots. A total of 854 studies were eligible. Studies showed a relative focus on diagnosis and screening, compared to prevention and intervention. FASD research originated from 31 countries, however most countries (68%) had fewer than 10 articles published over the 23-year review period. In Review 2, we searched PubMed for records published between 2000 and 2023 with FASD, autism, or attention-deficit-hyperactivity disorder (ADHD) terms in the title. We compared the volume of records for these conditions using descriptive statistics and time-series plots. Of the 64,069 records retrieved, 2% were for FASD, compared to 60% for autism and 38% for ADHD. FASD remains considerably under-researched. While there has been an increase in the number of original FASD research articles published annually over time, this is much lower than expected compared to publication trends for other neurodevelopmental conditions, and the wider scientific literature. Further research is needed to understand the impact of FASD across the lifespan, to inform evidence-based policy and support, and to advance progress in strength-based, stigma-reducing approaches to FASD research and practice.

Investigate-Design-Practice-Reflect: An Iterative Community-Engaged Action Process to Improve Population Health

BackgroundCommunity-based coalitions are a common strategy for community engagement efforts targeting the improvement of a variety of population health outcomes. The typical processes that coalitions follow to organize efforts include steps that are sequential, slow, and time intensive. These processes also limit local decision-making to the selection of evidence-based policies or programs.MethodsWe present a process control theory-based Community Action Process, Investigate-Design-Practice-Reflect (IDPR), where community hubs (i.e., coalitions) organize agile efforts in a non-sequential, rapid, and efficient manner to harness local assets and data to make decisions regarding the provision and production of population health services. Using qualitative methods, we illustrate and analyze the use of IDPR in a one community case study as part of Wellscapes, a Type 3-hybrid implementation-effectiveness community randomized controlled trial to improve children’s population health physical activity.ResultsWe found community members followed the IDPR Community Action Process to rapidly design, organize, deliver, and receive feedback on a community-based, children’s population physical activity prototype, an afterschool Play-in-the-Park opportunity for all children.DiscussionFollowing IDPR afforded the community coalition timely learning through feedback within a process that coordinated decisions regarding what community services met community needs (provision decisions) and how to organize the production of the population health services (production decisions).

Transition toward Sustainability in the Moroccan Food System: Drivers, Outcomes, and Challenges

Nowadays, food systems are undergoing major transformations to achieve the 2030 Sustainable Development Goals (SDGs). However, there are a lack of comprehensive reviews on this topic in developing countries. This work highlights food systems’ transition towards sustainability, focusing on Morocco. It was carried out through searching, selecting, evaluating, and synthesizing existing relevant scholarly and gray literature. In Morocco, a meaningful transition towards sustainability is being guided and carried out on several levels, despite numerous challenges, e.g., inability to cope with the detrimental effects of climate change and escalating water scarcity constitute fundamental problems. However, there are conflicting views on the outcomes of food system transformation. Some studies showed that Morocco has increased its agri-food export and reduced poverty to less than 5% of the population over the past decade; the proportion of wasted and malnourished children has declined from 25 to 15% and 4 to 3%, respectively, and the 2023 Global Hunger Index (GHI) showed a score of 9.0. Other studies showed that North Africa has entered a food security crisis; specifically, food inflation has reached unprecedented levels in Morocco. This paper provides valuable insights for policymakers and planners to design evidence-based policies and strategies to boost sustainable development in Morocco.

Development of sport policy and practice recommendations for pregnant, postpartum and parenting Canadian high-performance athletes

Our objective is to describe the development of evidence-based policy and practice recommendations for pregnant, postpartum and parenting Canadian high-performance athletes. A community-based participatory research approach was employed as the...

Assessment on the Impact of Mining and Industrial Activities in Groundwater Quality in Chandrapur, Maharashtra Through Remote Sensing and GIS Applications

This study evaluated the quality of groundwater in Chandrapur Taluka, Maharashtra, using geospatial techniques and data from 2014 and 2018. The study assessed various water quality parameters such as chloride, fluoride, pH, residual sodium carbonate (RSC), and sodium adsorption ratio (SAR). The findings showed that chloride concentrations were mostly within acceptable limits, but there was a slight increase in areas near mining and industrial sites, which was statistically significant (p < 0.05). Fluoride levels were generally within permissible bounds, but there was a noticeable increase near industrial areas in 2018 compared to 2014, which was statistically significant (p < 0.05) and raised environmental concerns. Variations in pH values were also observed, which could impact aquatic ecosystems, with a decrease noted from 2014 to 2018. RSC levels were higher near mining and industrial zones in 2018, exceeding recommended limits, indicating a potential threat to water quality. SAR levels in 2018 were higher, potentially impacting agriculture, but still within acceptable limits. Sulphate levels showed a reduction from 2014 to 2018. These comprehensive findings highlight the specific impacts of mining and industrial activities on groundwater quality and raise broader scientific questions. They can be used to develop evidence-based policies for effective mitigation measures and engage a wider readership.

Veterinary Services'use of the Global Burden of Animal Diseases to prioritise interventions, monitor impact and develop critical competencies.

Attracting and sustaining investment in Veterinary Services and animal health programmes from national government budgets, development aid and grants, and philanthropic donors requires economic rationale using relevant, reliable and validated analytical approaches. The complex interwoven relationships between animal health, livestock husbandry systems, national food security, global health security and environmental sustainability emphasise the importance of improving data governance and stewardship and applying economic analysis to understand animal disease burdens. These efforts should enable prioritised investment of limited resources and effective monitoring of the impact of programmes over time. Data governance and stewardship capacities are fundamental to development, implementation and performance monitoring of evidence-based policies in animal health. There are challenges in data availability for national and subnational livestock populations in different sectors, for disease incidence and prevalence, and for animal health expenditure in support of optimised allocation of scarce resources, be they finance, land, labour, or management attention and policy focus. Animal health data systems governance and stewardship and economic analysis are core skills for Veterinary Services in developing and applying evidence-based policy, but capability probably varies among World Organisation for Animal Health (WOAH) Members. The WOAH Performance of Veterinary Services programme has several critical competencies that are relevant to economics of animal health and to data governance and stewardship, but these have not yet been targeted for coordinated capacity development. Implementation of publicâ€"private partnership approaches for animal health programmes creates increasing expectations of robust data and methods for prioritisation, options analysis, and assessing impacts and costs. Experience and examples from national systems in New Zealand, Australia, Ethiopia and Indonesia illustrate current challenges associated with prioritisation of animal health programmes using economic analysis. The Global Burden of Animal Diseases programme intends to support WOAH Members and partners to develop capacities for and standardise approaches to economic analysis and prioritisation in animal health programmes.

The Use of Pictorial Recall Aids Modifies Dietary Assessment Results: Experiences from Quantitative 24-hour Dietary Recalls of Young Children in Nepal and Senegal

BackgroundRecall bias or memory error is a known limitation of recall-based dietary assessment methods and can lead to substantial misrepresentation of diets. Pictorial recall aids have been used by various studies to mitigate recall bias, but their effect on quantitative, 4-pass 24-h dietary recall (24HR) results has not yet been measured. ObjectivesThis article examines uptake of pictorial recall aids among caregivers of young children in Kathmandu Valley, Nepal, and Guédiawaye Department, Senegal; describes what foods/beverages are subject to recall bias in these contexts; and assesses the effect of these recall aids on estimated dietary outcomes. MethodsWe used cross-sectional data from 24HR surveys that provided a recall aid to reduce caregiver recall bias. Young children’s dietary outcomes were calculated from the 24HR data. Logistic regressions were used to compare characteristics and estimated dietary outcomes of children by recall aid uptake. McNemar’s test and paired t-tests were used to compare estimated dietary outcomes in initial 24HR data with revised 24HR data that incorporated omitted items identified by the recall aid. ResultsPictorial recall aids had relatively high uptake by caregivers in both contexts. Beverages, unhealthy snacks, and fruit were most subject to recall bias. Adding omitted items identified by recall aids resulted in statistically significant changes in most dietary outcomes assessed. Children of caregivers who chose to use the recall aid had significantly different estimated dietary outcomes than children of caregivers who did not use the recall aid. ConclusionsThe use of pictorial recall aids modifies 24HR results in these 2 contexts. Rigorous research is needed to fully understand the impact of recall aids on 24HR methodology and results, with an aim to improve the accuracy of dietary assessment and ultimately inform evidence-based nutrition programming, policy, and recommendations.

Eliminating Health Care Access and Quality Inequities in Sickle Cell Disease: Policy Lessons from the End Sepsis Initiative

Abstract: Sickle cell disease is a prime example of the devastating impact of healthcare inequities. The End Sepsis Initiative developed after a tragic death due to sepsis, provides a powerful model for the sickle cell community. This model recognizes the importance of evidence-based protocols and policy recommendations/mandates to drive transformative systems change. We propose that the sickle cell community mirror this approach. We propose that hospital systems, healthcare organizations, and insurers implement evidence-based protocols, including personalized pain plans, stigma reduction through staff training, vaccinations, preventative screening, disease-modifying therapies, pediatric to adult transition, and connecting unaffiliated SCD patients to a medical home. We recommend state-level interventions, such as using SCD navigator in electronic health records for quality reporting, supporting community health workers' use, and ensuring rural hospitals have access to SCD specialists.