Evidence-based Public Policy Research Articles

Exploring barriers to mental health service access: a preliminary study among the general Paraguayan population

This study aimed to explore the perception of barriers to accessing mental health services within the general population of Paraguay using the Barriers to Access to Care Evaluation (BACE) scale. The barriers were categorized into three types: attitudinal, instrumental, and stigma-related. The sample comprised 321 participants, the majority of whom were women (82.9%). Among the participants, 62.9% reported experiencing mental ill-health, with the most common disorders being anxiety (37.4%), depression (30.5%), and sleep disorders (20.6%). Of the participants, 157 (48.9%) reported significant attitudinal barriers, which include beliefs and perceptions about mental health treatment, among others; 87 (27.1%) reported significant stigma-related barriers, which involve prejudices and stereotypes associated with mental disorders; and 189 (58.9%) experienced significant instrumental barriers, including financial constraints and limited availability of services. Mental ill-health was significantly associated with all types of barriers. In conclusion, significant barriers to accessing mental health services persist among the Paraguayan population. These barriers must be addressed through evidence-based public policies to improve the quality-of-life of both individuals with mental ill-health and the broader general population.

The intervention of local public authorities and the impact of the COVID-19 pandemic in Romania: a subnational analysis.

The COVID-19 pandemic had a strong territorial dimension, with a highly asymmetric impact among Romanian counties, depending on pre-existing vulnerabilities, regions' economic structure, exposure to global value chains, specialization, and overall ability to shift a large share of employees to remote working. The aim of this paper is to assess the role of Romanian local authorities during this unprecedented global medical emergency by capturing the changes of public spending at the local level between 2010 and 2021 and amid the COVID-19 pandemic, and to identify clusters of Romanian counties that shared similar characteristics in this period, using a panel data quantitative model and hierarchical cluster analysis. Our empirical analysis shows that between 2010-2021, the impact of social assistance expenditures was higher than public investment (capital spending and EU funds) on the GDP per capita at county level. Additionally, based on various macroeconomic and structural indicators (health, labour market performance, economic development, entrepreneurship, and both local public revenues and several types of expenditures), we determined seven clusters of counties. The research contributes to the discussion regarding the increase of economic resilience but also to the evidence-based public policies implementation at local level.

To share or not to share – understanding individuals’ willingness to share biomarkers, sensor data, and medical records

ABSTRACT Technological advances in the recent past made it possible for researchers to collect and analyze large amounts of health data at unprecedented scale and speed. For example, fitness trackers and smartwatches produce steady flows of information on individuals’ health. Biomarker data and medical records allow to study individuals at new levels of granularity. The COVID-19 pandemic has highlighted that access to such data for health research and evidence-based public policy decision-making is essential. However, having access to data depends on individuals’ willingness to share their data with others. In this paper, we analyze the factors that may affect the probability of individuals to share their biomarker, health, and sensor data using German survey data and a survey experimental vignette design. We study the impact of data type, recipient, and research purpose on respondents’ willingness to share their data as well as the effects of respondents’ own medical and data sharing history. Overall, participants’ willingness to share biomarker data was higher than the willingness to share other data types. Moreover, those who had shared data before were more willing to do so again. In addition, natural language processing analysis of textual responses capturing respondents’ motives to share their data shows that individuals do understand how valuable their data is for researchers. However, results also underscore that addressing concerns about the protection of data need to be taken seriously. Emphasizing the value of data shared for research and their purpose may help to increase trust and willingness to share data.

Does extending school time reduce the juvenile pregnancy rate? A longitudinal analysis of Ceará State (Brazil)

PurposeAdolescent pregnancy stands as a societal challenge, compelling young individuals to prematurely discontinue their education. Conversely, an expansion of high school education can potentially diminish rates of adolescent pregnancy, given that educational attainment stands as the foremost risk factor influencing sexual initiation, the use of contraceptive methods during initial sexual encounters and fertility. The aim of this paper is to analyze the impact of the implementation of the public educational policy introducing full-time schools (FTS) for high schools in the state of Ceará, Brazil, on early pregnancy rates.Design/methodology/approachUsing the difference-in-differences method with multiple time periods, we measured the average effect of this staggered treatment on the treated municipalities.FindingsThe main result indicates a reduction of 0.849 percentage points in the teenage pregnancy rate. Concerning dynamic effects, the establishment of FTS in treated municipalities results in a 1.183–1.953 percentage point decrease in teenage pregnancy rates, depending on the timing of exposure. We explored heterogeneous effects within socioeconomically vulnerable municipalities, yet discerned no impact on this group. Rigorous tests confirm the robustness of the results.Originality/valueThis paper aims to contribute to: (1) the consolidation of research on the subject, given the absence of such research in Brazil to the best of our knowledge; (2) the advancement and analysis of evidence-based public policy and (3) the utilization of novel longitudinal data and methodology to evaluate adolescent pregnancy rates.

Analyzing the Impact of COVID-19 on Economic Sustainability: A Clustering Approach

This work presents a comprehensive analysis of the economic impact of the COVID-19 pandemic, with a focus on OECD countries and the Chilean case. Utilizing a clustering approach, the research aims to investigate how countries can be categorized based on their pandemic mitigation strategies, economic responses, and infection rates. The methodology incorporates k-means and hierarchical clustering techniques, along with dynamic time warping, to account for the temporal variations in the pandemic’s progression across different nations. The study integrates the GDP into the analysis, thereby offering a perspective on the relationship between this economic indicator and health measures. Special attention is given to the case of Chile, thus providing a detailed examination of its economic and financial indicators during the pandemic. In particular, the work addresses the following main research questions: How can the OECD countries be clustered according to some health and economical indicators? What are the impacts of mitigation measures and the pension fund withdrawals on the Chilean economy? The study identifies significant differences (p-value < 0.05%) in the GDPs and infection rates between the two identified clusters that are influenced by government measures, particularly in the banking sector (55% and 60% in clusters 1 and 2, respectively). In Chile, a rebound in the IMACEC index is noted after increased liquidity, especially following partial pension fund withdrawals, thereby aligning with discrepancies between model forecasts and actual data. This study provides important insights for evidence-based public policies, thus aiding decision makers in mitigating the socioeconomic impact of global health crises and offering strategic advice for a sustainable economy.

Evidence-based sentencing and scientific evidence.

Evidence-based sentencing (EBS) is a new name for an aspiration that has deep roots in criminal law: to apply the sentence most appropriate to each offender's risk of reoffending, in order to reduce that risk as far as possible. This modern version of the traditional sentencing goals of rehabilitation and incapacitation fits into the broader approach of so-called "evidence-based public policy." It takes the view that the best existing evidence for reducing reoffending are modern structured risk assessment tools and claims to be able to achieve several goals at once: reducing reoffending, maintaining high levels of public safety, making more efficient use of public resources, and moving criminal policy away from ideological battles by basing it on the objective knowledge provided by the best available scientific evidence. However, despite the success of this approach in recent years, it is not clear to what extent it succeeds in correctly assessing the risk of individual offenders, nor whether it achieves its intended effect of reducing recidivism. This paper aims to critically examine these two issues: the quality of the scientific evidence on which EBS is based, and the available data on the extent to which it achieves (or does not achieve) its intended goals.

APCs in a diamond wonderland

The economy of open access (OA) publishing has been a topic of intensive research over the last two decades. Dichotomies between the so-called 'green' and 'gold' models, or between fee-based and non-fee-based gold models, the latter known as the diamond model, have been addressed from diverse perspectives. However, some critical insights that would enable a thorough understanding of publishers’ and editors’ decision-making and provide a foundation for developing future evidence-based public policies are still missing.In recent years, more importance has been given to the diamond OA model, and the European research area has recognized its potential to bring change and possibly transform the scholarly publishing landscape. The 2021 EC-funded OA Diamond Journals Study (Bosman et al., 2021) reveals that while Europe is rich in OA Diamond journals, they are far from all being included in the DOAJ, nor are they equally distributed across scholarly disciplines and European regions. The study indicates the dominance of large commercial and APC-based publishers in Western Europe contrasted to the prevalence of smaller, diamond OA publishers in Central and Eastern Europe. Yet, subsequent research by Laakso and Multas (2023) shows that such a distribution across European regions could oversimplify a more diverse landscape. Their bibliometric-based analysis indicates that within regions, countries can vary significantly in their publishing ecosystems, based on several factors: the type (and size) of dominant publishers, the availability of country-level public funding mechanisms for scholarly journals, and the availability of common publishing infrastructures. There are examples of countries from different European regions that appear to be successful in building a thriving and sustainable national diamond publishing ecosystem. However, some publishers adopt an APC-based business model even in such predominantly diamond ecosystems. Our study will be twofold: a comparative investigation will establish the share of APC journals in several dominantly diamond countries: Croatia, Finland, France, Norway, Serbia, and Spain. Although limited in geographical scope, the intended sample will strive for complete coverage of OA journals: authors from each country will provide comprehensive national addenda to DOAJ lists. The publicly available information on the websites of all identified OA journals issued by the publishers located in the countries mentioned above will be inspected for evidence of APC schemes (any fees or charges required of authors or their institutions for submitting or publishing a paper in a journal). The study will address the following research questions: 1. What is the share of journals charging APCs at the time of research (among all OA journals in the country, and especially among journals receiving public subsidies, if there are such subsidies available)?; 2. What is the range, median and mode of APC costs?; 3. Is the existence of APCs and their cost related to the type of a journal publisher or owner, the scholarly discipline, or the fact that the journal is indexed inestablished international indices and databases?The insight into the incidence of APC-based journals and the context in which they are introduced will be complemented with a qualitative analysis of APC descriptions. This is expected to reveal some of the reasons for their introduction and possibly show that smaller publishers could resort to some local and nonstandard mechanisms. It will answer additional research questions: 4. Are there any specificities of the APC mechanisms among the analysed journals (waivers, discounts, membership fees, etc.)?, and 5. How transparent are journals about their APCs? (What are the terms used for APCs in different languages? Are they listed in their DOAJ records? Is it explained what they are charged for and how the funds are used?).The results are expected to deepen the existing knowledge about the diversity and sustainability of OA ecosystems.

Missing persons patterns from Mexico: evidence of a forensic emergency crisis.

The relatives of missing persons in Mexico have denounced the slowness with which a court prosecution file is created by the justice administration system. Theoretically, the search is immediate, but many cases must wait 72h to build an investigation folder as a legal criterion. This standard has been copied from the UK and Australian police reports without adapting to the Mexican context. The analysis of disappearance reports between 2006 and 2018 shows that this timing criterion in Mexico is not supported. The analyzed database (the National Center for Planning, Analysis, and Information to Combat Crime, CENAPI) showed that in the 72-h range, only 34.53% of the people had been found alive or dead; figure far from 50% to 80% of Europe or Australia. This fact shows that those searching officers or the judicial bureaucracy can act as a factor that limits the search for missing persons. Additionally, there is a random pattern in the geospatial distribution of disappearance, with non-homogeneous frequencies per year. Results highlight the participation of families, the adoption of an evidence-based model, and the generation of geospatial forensic intelligence analysis to generate evidence-based public policies. The social demand of families to the government for not considering them takes relevance in forensic practice in Mexico, and the disappearance data support this assertion.

Prevalence and Factors Associated With Vaping Cannabidiol Among US Adolescents

e-Cigarette use and vaping marijuana (cannabis) are popular among US adolescents. Cannabidiol (CBD) is a compound found in the cannabis plant that has recently increased in use. To examine the prevalence of and factors associated with youths vaping CBD. This cross-sectional study included a nationally representative sample of students from middle and high schools (typical age, 11-18 years) in the US from the 2022 National Youth Tobacco Survey, conducted from January to May 2022. Demographic characteristics, harm perception of tobacco use, and vaping behaviors. The main outcomes were weighted prevalence and population estimates of ever and current (past 30-day) vaping of CBD overall and by e-cigarette use status. Multivariable logistic regression analyses were conducted to estimate the association of currently vaping CBD with demographic factors and e-cigarette and tobacco use behaviors stratified by current e-cigarette use status. The study included 28 291 participants (51.1% male; mean [SD] age, 14.5 [2.0] years). Among 2448 current e-cigarette users, 21.3% (95% CI, 18.4%-24.1%) reported any past-month vaping of CBD and 6.3% (95% CI, 4.7%-7.8%) reported that they did not know whether they had vaped CBD. Hispanic e-cigarette users were more likely than their non-Hispanic White peers to report currently vaping CBD (adjusted odds ratio [AOR], 1.9; 95% CI, 1.3-2.8). Current e-cigarette users with higher frequency (≥20 days vs ≤5 days) and longer duration (2-3 years or >3 years vs <1 year) of use were more likely to report currently vaping CBD (frequency: AOR, 1.5 [95% CI, 1.1-1.9]; 2-3 years: AOR, 2.2 [95% CI, 1.2-3.9]; 3 years: AOR, 3.2 [95% CI, 1.7-6.1]). Among 25 091 noncurrent e-cigarette users, 1.2% (95% CI, 1.0%-1.5%) reported currently vaping CBD and 2.3% (95% CI, 2.1%-2.6%) reported that they did not know. High school students (vs middle school students; AOR, 4.2; 95% CI, 2.8-6.1) and gay or lesbian (AOR, 2.9; 95% CI, 1.6-5.4) or bisexual (AOR, 2.7; 95% CI, 1.8-4.0) (vs heterosexual) youths were more likely to report vaping CBD, while those who perceived tobacco as dangerous (vs not dangerous; AOR, 0.4; 95% CI, 0.3-0.6) had lower odds of reporting vaping CBD. In this cross-sectional study of US middle and high school students, the prevalence of youths vaping CBD was high, particularly among e-cigarette users and Hispanic and sexual minority populations. The findings suggest that evidence-based educational campaigns, interventions, and public policy changes are needed to reduce the harmful health outcomes possible with vaping CBD among developing youths.

Advancing the science of policy implementation: a call to action for the implementation science field.

Public policies have been essential in addressing many of the most pressing public health problems in the USA and around the world. A large and convincing body of multidisciplinary research has established the impacts or effectiveness of public policies, such as smoke-free air laws and nutrition standards, on improving health outcomes and behaviors. Most of this research assumes that because an evidence-based policy is adopted or takes effect, it is implemented as intended. This assumption, however, is often incorrect. Like with clinical guidelines and other interventions, implementation science has an important role to play in promoting the uptake and implementation of evidence-based public policies that promote public health. To realize this potential, there remains a critical need to first establish a common understanding of what public policy is, the role of specific policies in the context of implementation (i.e., is it the evidence-based intervention or the implementation strategy?), and to establish an appropriate methodological foundation for the field of policy implementation science. We recommend that the field must evolve to (i) include policy experts and actors on policy implementation science study teams; (ii) identify theories, models, and frameworks that are suitable for policy implementation science; (iii) identify policy implementation strategies; (iv) adapt and/or identify study designs best suited for policy implementation science research; and (v) identify appropriate policy implementation outcome measures.

Perceived Effects of the COVID-19 Pandemic on Loneliness: The Most Vulnerable Population Groups

COVID-19 pandemic lockdown measures reasonably limited the social contacts of people in many countries. It is crucial to understand the effect of such policies on people’s social ties and the possible need for evidence-based public policy amendments. Therefore, this study examines 1) the prevalence of loneliness in the population aged 15+ in Lithuania in late 2021 and 2) the self-rated effect of the COVID crisis on loneliness in population groups with different levels of loneliness. It also focuses on the socio-demographic characteristics of these population groups. Data from a representative cross-sectional quantitative survey (N = 1067), carried out in November–December 2021, was used. Based on the 6-item De Jong Gierveld Loneliness Scale, descriptive statistics analysis revealed the high prevalence (51% of a medium level of loneliness) in the Lithuanian population. One in three people (36%) declared low-level loneliness, and each seventh or eighth (13%) reported high-level loneliness. The feelings of respondents who reported a high level of loneliness were also less stable; they more often stated that their feelings of loneliness increased during the pandemic. These research findings make contributions to studies of loneliness within the context of sudden crises. They emphasise the importance of policymakers focusing on additional measures when preparing for future emergencies and providing special attention to residents who experience the highest levels of loneliness. Doi: 10.28991/ESJ-2023-SPER-020 Full Text: PDF

INTERNATIONAL AND RUSSIAN EXPERIENCE IN APPLYING EVIDENTIAL POLICY INSTRUMENTS IN THE SPHERE OF PUBLIC ADMINISTRATION: ISSUES OF CONTINUITY IN SECTORAL BALANCE

The article provides an analytical review of modern international practices in the development and practical implementation of an evidence-based approach in public administration. A brief description of the evidence-based approach, prerequisites, as well as the first (pioneer) practices of applying its elements to achieve sustainable development goals and leveling barriers in socially significant areas is given. The cases formed to date on the implementation of evidence-based public policy in a number of developed countries are considered. It is suggested that, given the accumulated international experience, there is a possibility of using evidence-based public policy tools for the purposes of sectoral balancing. Confirmation of this hypothesis is carried out through the prism of the industry. The Russian Federation is cited as a recipient country, as one of the largest world powers, the industrial sector of which, like in many other countries of the world, is in conditions of uncertainty and episodic imbalance. It is indicated that in view of the constantly changing conditions for the functioning of industrial enterprises, it is important to constantly evaluate the effectiveness and, as a result, adjust the measures of state support for industrial enterprises in order to maintain the "health" of the entire sector. It is postulated that for a long period of time in many countries of the world, in particular in Russia, there was a “rational-intuitive” approach to public administration, which is inappropriate in the new reality. The possibility of replacing this approach with an evidence-based approach is considered, examples of successful practices in the application of evidence-based policy tools in the field of public administration are presented, in particular, in the context of evaluation (audit) measures of the results obtained; special attention is paid to the approach adopted in the UK. The alternatives of their use for further improvement of state support for industrial enterprises that are forced to conduct their activities in conditions of uncertainty are specified.

The Global Leprosy Assessment Index (GLAI): A new approach for measuring the severity of disease in Brazil

BackgroundIn Brazil, the Ministry of Health (MH) monitors leprosy using 15 indicators, with the aim of implementing and evaluating evidence-based public policies. However, an excessive number of variables can complicate the definition of objectives and verification of epidemiological goals. MethodsIn this paper, we develop the Global Leprosy Assessment Index (GLAI), a composite measure that integrates two key dimensions for the control the disease: epidemiological and operational. Using a confirmatory factor analysis model to examine 2020 state-level data, we have standardized GLAI to a range of 0 to 1. ResultsHigher values within this range indicate a greater severity of the disease. The mean value of the GLAI was 0.67, with a standard deviation of 0.22. Roraima has the highest value, followed by Paraíba with 0.88 while Tocantins records the lowest value of the indicator, followed by Mato Grosso with 0.14. The epidemiological and operational indicators have a positive but statistically insignificant correlation (r = 0.25; p-value = 0.20). ConclusionsThe development of evidence-based public policies depends on the availability of valid and reliable indicators. The GLAI presented in this paper is easily reproducible and can be used to monitor the disease with disaggregated information. Furthermore, the GLAI has the potential to serve as a more robust parameter for evaluating the impact of actions designed to eradicate leprosy in Brazil.

Evidence-based Standards in the Design of Family Support Programmes in Spain

The positive parenting approach has highlighted the importance of supporting families to perform the functions associated with their parental role and to improve children’s well-being. The aims of this study were to identify and describe the characteristics of family support programmes in Spain, and to examine the extent to which they meet evidence-based standards for programme formulation. The sample includes 57 programmes identified by the Spanish Family Support Network, which belongs to the pan-European Family Support Network(EurofamNet) . Frequency analyses and contingency tables were carried out. The results show that the Spanish programmes meet several evidence-based standards for programme formulation (i.e., manualization). However, further efforts are required in some areas, such as universality and interdisciplinarity of family support programmes. The findings provide a platform from which to design new initiatives in accordance with standards for prevention programmes, and inform stakeholders and politicians in drawing up evidence-based public policies.

The Suicide Prevention and Intervention Study (SURVIVE): Study protocol for a multisite cohort study with nested randomized-controlled trials

IntroductionSuicide is one of the leading causes of avoidable death. Gathering national data on suicidal behaviour incidence is crucial to develop evidence-based public policies. The study has two primary objectives: (1) to determine the incidence of suicide attempts in Spain and related risk factors, and (2) to analyze the efficacy of secondary prevention programmes to prevent suicide re-attempting in comparison to treatment as usual (TAU). Materials and methodsMultisite, coordinated, cohort study with three nested randomized controlled trials. A cohort of 2000 individuals (age >=12) with suicidal behaviour will be recruited at ten sites distributed across Spain. Assessments will be conducted within 10 days of the suicide attempt (V0-baseline visit) and after 12 months (V4-last visit) and will include clinician reported and participant reported outcomes (PROs). Between V0 and V4, PROs will be collected remotely every three months (V1, V2 and V3). Optatively, cohort participants will participate in three nested randomized-controlled-trials (RCTs) evaluating different secondary prevention interventions: Participants aged 18 years and older will be randomly allocated to: Telephone-based Management+TAU vs. TAU or iFightDepression-Survive+TAU vs. TAU. Participants aged between 12 and 18 years will be allocated to a specific intervention for youths: Self Awareness of Mental Health+TAU vs. TAU. ResultsThis study will provide interesting data to estimate suicide attempt incidence in Spain. and will provide evidence on three. ConclusionsEvidence on three potentially efficacious interventions for individuals at high risk of suicide will be obtained, and this could improve the treatment given to these individuals. Trial registrationNCT04343703

UTILIZING A HEALTH BEHAVIOR APPROACH TO ENCOURAGE ORGAN DONATION IN LATIN AMERICA: INSIGHTS FROM A CASE STUDY IN CHILE

Organ transplantation presents a promising opportunity to enhance quality of life and extend life expectancy in patients with end-stage chronic organ failure. Although the societal benefits of transplantation are clear, the shortage of organs donated in Latin America poses a significant barrier to accessing this life-saving treatment, resulting in high waitlist mortality rates and prolonged time on the waitlist. To address the problem of organ donation hesitancy, we thoroughly analyzed the behavioral factors by applying concepts from the Socioecological Model, the PRECEDE/PROCEDE framework, and Health Behavior Theories. We identified various personal, interpersonal, and community factors that may explain low donation rates and hinder the effectiveness of current strategies, highlighting the lack of information, the spread of myths about donation, the emotional burden for families, and the lack of sufficient human and technical resources. We propose a 10-step evidence-based intervention recommendation that involves focusing on increasing donation rates in the population, improving knowledge about donation and its process, preparing health professionals, developing strategies to promote donation with a focus on the young adult population, implementing specialized teams in transplants and the massification of preservation technologies. In summary, developing countries or countries with low organ donation rates must design evidence-based public policies. This article provides readily accessible information for the public, decision makers and relevant stakeholders.

Exploring food security/insecurity determinants within Venezuela's complex humanitarian emergency.

The complex humanitarian emergency that Venezuela has been going through for several years has deteriorated the quality of life of its citizens, deepened food insecurity in households and has promoted migratory movements of almost six million people to neighboring countries. To analyze food security in Venezuelan households to identify the determinant factors that might contribute to the design of evidence-based public policies. A non-probabilistic survey of national scope was used in 2,041 urban and non-urban households. A descriptive statistical test was performed to analyze demographic variables and the three component indicators of the food security index (FSI): food consumption, economic vulnerability and coping strategies. The FSI was built according to the World Food Program (WFP) methodology, and a segmentation analysis was applied using the Chi-squared Automatic Interaction Detection (CHAID) algorithm to specify the influence of some variables as the best predictor at each level. Only 9% of the households presented food security, 69% classified as marginally secure, and 22% presented moderate or severe food insecurity. The food consumption score (FCS) was the variable that best discriminated the level of food security, followed by coping strategies and the percentage of spending on food. Conclusion: Most of the households studied sacrifice their livelihoods to feed themselves and cover the minimum of their nutritional requirements. This needs attention to stop and reverse the deterioration within a framework of respect for the human rights to health and food.

Measuring the Value of Patents Where it Matters Most

The ability to measure patent quality is essential to evidence-based innovation strategy and public policy, to contrast costs with benefits. Traditionally, a patent’s quality has been proxied by the number of its forward citations. More recently, Kogan et al. (2017) proposed a more direct (and immediately available) measure of patent quality based on stock-market reactions. In this paper, we show that forward citations and Kogan et al. (2017) measure, while being largely correlated around the median as assumed by prior literature, are only marginally overlapping around the tails of the distribution, i.e. for breakthroughs and for failures. Arguably, these are the most interesting outcomes for organizational scholars. We then theorize regarding the potential origin of this lack of overlap at the extremes of the two distributions, and find evidence consistent with the idea that this divergence is not driven by a misvaluation from the financial market, but rather from the fact that forward citations and market-based measures of patent value proxy for different and complementary dimensions of patent value. Our results present important implications for the literature. Specifically, we show that a firm could rarely develop an innovation that is highly impactful from both an economic and a technological perspective. Managers and public policy makers need to recognize and acknowledge an inherent trade-off between the private and the public benefits of innovation. What improves the chances of reaching an innovation breakthrough in terms of economic value can also hamper the likelihood of reaching highly relevant technological and scientific advancements.

Gender-Affirming Hormone Therapy Linked to Better MH in Trans Youth

Gender-Affirming Hormone Therapy Linked to Better MH in Trans Youth

Ayahuasca and Public Health II: Health Status in a Large Sample of Ayahuasca-Ceremony Participants in the Netherlands

ABSTRACT Ayahuasca is a plant decoction in traditional Amazonian medicine. Its ritual use has been internationalized, leading to policy challenges that countries should address. This study evaluates the impact of regular ayahuasca ceremony participation on health by assessing the health status of 377 participants in ayahuasca ceremonies in the Netherlands using validated health indicators. A questionnaire was developed and administered to study participants. The questionnaire included several health indicators with public health relevance (e.g., BMI, diet, physical activity) and psychometrically validated questionnaires (ELS and COPE-easy). The data retrieved through health indicators was compared to normative Dutch data. Participants (50.1% women) were mostly Dutch (84.6%) with a mean age of 48.8 years (SD = 11.6). Compared to normative Dutch data, regular participants in ayahuasca ceremonies showed better general well-being, fewer chronic or lifestyle-related diseases, more physical activity, and a more balanced diet. Participants also used less alcohol during the COVID-19 pandemic, and although they used more illegal drugs than the general population, they did not report associated harms. Our findings suggest that regular participation in ayahuasca ceremonies is not linked to relevant health harms. This data could help drug policymakers to develop and implement evidence-based public policies.