Engagement In Health Policy Research Articles

Recruiting for Engagement in Health Policy.

Who participates in public and patient engagement processes, and in what capacity they participate, matters. The strategies employed to recruit participants shape the outcomes and legitimacy of engagement processes. We explore these issues through a case study of workshop recruitment. We conducted a mixed-methods study drawing on literature about existing theories of engagement, and integrated findings from the research team's own public engagement workshop in September 2022. We sought to align theoretical frameworks with practical approaches to recruiting for engagement. There are inherent trade-offs in recruitment methods. While the theory of recruitment is valuable, practical implementation is complex and highly context-dependent. Engaging existing partners and fostering relationships beyond specific events is crucial. Hybrid workshops and low-barrier honoraria promote participation; however, decisions about location and time create barriers. Finally, balancing trusting relationships with critical perspectives can create tension. Recruitment is foundational for the engagement process, and requires flexibility, responsiveness and a realistic understanding of barriers. Our study suggests that there is no universal formula for ideal participant makeup or event format. Meaningful engagement requires ongoing dialogue and constant adjustment based on practice. Policy makers can use these insights to align recruitment and engagement strategies with their goals in order to move beyond quick, technocratic fixes.

Trends in Government-Initiated Public Engagement in Canadian Health Policy From 2000 to 2021.

Canada has a rich history of public engagement in health policy; however, shifts in engagement practices over time have not been critically examined. We searched for cases of government-initiated public engagement in Canadian health policy from 2000 to 2021 at the federal, provincial (Ontario, British Columbia, Nova Scotia) and pan-Canadian levels. Government databases, portals and platforms for engagement were searched, followed by academic and grey literature using relevant search terms. A coding scheme was iteratively developed to categorize cases by target population, recruitment method and type of engagement. We identified 132 cases of government-initiated public engagement. We found a predominance of feedback and consultation engagement types and self-selection recruitment, especially at the federal level from 2016 onward. Engagements that targeted multiple populations (patients, public and other stakeholders) were favoured overall and over time. Just over 10% of cases in our survey mentioned efforts to engage with equity-deserving groups. Overall, our results identify a heavy reliance over time on more passive, indirect engagement approaches, which limit opportunities for collaborative problem solving and fail to include equity-deserving populations. Those overseeing the design and implementation of government-initiated public engagement will draw valuable lessons from this review to inform the design of engagement initatives.

Black Community Health Advocates in Ontario: A Look at Health Policy Engagement From the Ground Up.

Disproportionately negative pandemic outcomes, lack of race-based data collection and poor engagement of Black communities in policy decision making have been widely documented for Black Canadians. We examine this to understand how formal public engagement processes might be more inclusive of Black peoples to inform more responsive policies. The study employed an asset-based lens to examine how Black communities have engaged in health policy and advocacy in Ontario. In-depth interviews were conducted with eight participants who self-identify as Black, recruited using purposive and intensity sampling to (1) identify information-rich cases, including people who have been at the forefront of high-impact work in this space and (2) participants whose mission and mandates represented diverse approaches and sub-populations. Our findings suggest that while Black community advocates face systemic and contextual barriers, they also embody deep and multifaceted knowledge, training and experience, which inform the rich ways that they approach advocacy. Despite its Ontario focus, this study adds breadth and depth to the existing literature on health policy and historically marginalized populations, offering broader lessons for policy makers across jurisdictions. Our findings encourage policy makers to better recognize, make space for and cultivate fertile advocacy foundations, cultural knowledge and community-driven systems already present in Black communities.

Sugar-sweetened beverage taxes in Europe: learning for the future

BackgroundSugar-sweetened beverage (SSB) taxes are recommended globally as part of measures to prevent diet-related NCDs. However, their uptake in the World Health Organization (WHO) European Region has been limited. The aim of this study was to inform strategic, cross-sectoral, public health policy engagement to support the uptake and effective implementation of SSB taxation.MethodsWe conducted a policy analysis of SSB taxes in the WHO European Region, drawing on theories of policy making and diffusion of innovation. Data were collected from policy documents and media, secondary contextual sources and qualitative interview data (n = 20) to analyze factors influencing the adoption of taxes in 10 countries.ResultsBelgium, Finland, France, Hungary, Ireland, Latvia, Monaco, Norway, Portugal and the UK had current SSB taxes, but Monaco was excluded from the findings due to its unique taxation context. All countries were characterized by policy priority for NCD prevention, and in many there was a fiscal imperative to raise revenue. The taxes took the form of excises or levies, and the tax base and rate varied between countries. SSB taxation was fostered by constructive engagement between health and fiscal policy makers, but also influenced by external industry and public health stakeholders. Policy learning from national and international experience was evident in all countries.ConclusionsThis study points to the value of ongoing policy learning for improving tax design, and the importance of constructive collaboration between finance and health policy makers. It also suggests regional bodies could play a greater role in supporting SSB taxation.

Australia and New Zealand's responsibilities in improving oncology services in the Asia-Pacific: A call to action.

To review the expected increasing demand for cancer services among low and middle-income countries (LMICs) in the Asia-Pacific (APAC), and to describe ways in which Australia and New Zealand (ANZ) can provide support to improve cancer outcomes in our region. We first review the current and projected incidence of cancer within the APAC between 2018 and 2040, and the estimated demand for chemotherapy, radiotherapy and surgery. We then explore potential ways in which ANZ can increase regional collaborations to improve cancer outcomes. We identify 6 ways that ANZ can collaborate with LMICs to improve cancer care in the APAC through the ANZ Regional Oncology Collaboration Strategy: Increasing education and institutional collaborations in the APAC region through in-country training, twinning partnerships, observerships and formalised training programs in order to increase cancer care quality and capacity. Promoting and assisting in the establishment and maintenance of population-based cancer registries in LMICs. Increasing research capacity in LMICs through collaboration and promoting high quality global oncology research within ANZ. Engaging and training Australian and New Zealand clinicians in global oncology, increasing awareness of this important career path, and increasing health policy engagement. Increasing web-based endeavours through virtual tumour boards, web-based advocacy platforms and web-based teaching programs. Continuing to leverage for funding through professional bodies, government, industry, not-for-profit organisations and local hospital funds. We propose the creation of an Australian and New Zealand Interest Group to provide formalised and sustained collaboration between researchers, clinicians and stakeholders.

Integrating Health Policy Education Into an Undergraduate Adult Development and Aging Psychology Course

Active engagement in health policy by psychologists is vital to the well-being of the aging population; however, few feel prepared to engage in policy making or know how to get involved. A novel policy curriculum was developed and integrated into an undergraduate psychology course. N = 34 students completed assessments of policy knowledge and assignments designed to increase their skills, knowledge, and critical thinking about health policy. Students reported strong beliefs that psychological research can impact health policies and a desire to understand how to use research to inform policy; however, they reported less understanding of how policy is made. Preliminary evidence suggests students are interested in applying psychological research to policy processes; however, they do not know how to get involved. Policy education was easily integrated into the course, and further study is needed to determine students’ future engagement in health policy and change health policy skills.

Roma child participation in public health policy and practice across Europe

Roma teenagers are often excluded from participation opportunities, when they could be informing a wide range of law, policy and practice. CoE and EU recommendations make it clear that improvements in living conditions can only be achieved through active participation of Roma people. The 2018 Roma Civil Society Monitoring report reinforces that 'it is essential for Roma to be involved not only in narrowly defined 'Roma issues', but also in a wider range of topics and policies'. We address the question of what methods enable Roma children to become involved in influencing health policy and service design, focusing on the case of Bulgaria. A qualitative European survey (Feb - June 2020) in English, French, Spanish and Bulgarian identified professional perspectives on the impact of COVID-19 on children, with a focus on Roma families. Case studies of Roma children's experiences, and examples of their participation, were analysed of these case studies was conducted by the authors (combining sociological, public health and community perspectives). Accuracy of emergent findings were assessed through dialogue with survey participants. Preliminary results indicate that participatory practices that enable Roma children's participation in designing public health policy, services and responses are limited and pre-existing inequalities are deepening. However relevant isolated examples of inclusive participation were identified: information design, peer-administered questionnaires, arts-based activities, dialogue events, and campaigning in Bulgaria and beyond. Inclusive methods that enable Roma teenagers' engagement in health policy and service design are closely tied to methods used with other communities facing discrimination. However, significant structural barriers, related to economic inequalities and anti-gypsyism are additional barriers faced by some Roma children. International exchange of examples of such practices could inform future health promotion practice.

Health Policy Engagement Strategy for the Health Information Technology Policy Project of the Transdisciplinary Collaborative Center for Health Disparities Research.

Rulemaking is one of the most important ways the federal government makes public policy. It frequently has significant impact on individuals, communities, and organizations. Yet, few of those directly affected are familiar with the rulemaking process, and even fewer understand how it works. This article describes a case study of the Transdisciplinary Collaborative Center for Health Disparities Research Health Information Technology (TCC HIT) Policy Project's approach to health-policy engagement using: 1) social media; and 2) a webinar to educate stakeholders on the rulemaking process and increase their level of meaningful engagement with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) proposed rule public comment submission. The webinar "Paying for Quality: What Is the Impact on Health Equity" was promoted through Twitter and held in June 2016. In total, we posted 19 tweets using two distinct hashtags (#MACRA4Equity, #MACRA2Equity) to raise awareness of the upcoming MACRA proposed rule and its possible effects on health equity. Overall, 252 individuals registered for the webinar, and more than half participated (n=133). Most (67%) registrants reported that health policy was not the primary focus of their current position. Based on information provided in the webinar, 95% agreed that their understanding of the topic improved. By the end of the webinar, 44% of participants indicated that they planned to submit public comments for MACRA, a 12% increase compared with those who planned to submit at the time of registration. The TCC health-policy engagement strategy demonstrates the feasibility of engaging a diverse audience around health policy issues, particularly those who are not typically engaged in policy work.

Leveraging Technology to Enhance Doctor of Nursing Practice Student Health Policy Engagement.

Doctor of nursing practice (DNP) students need to develop health policy competencies. The American Association of Colleges of Nursing formed the Faculty Policy Think Tank (FPTT) in 2015, which developed recommendations about health policy curriculum at all levels of nursing education including the DNP. Prior to the FPTT recommendations, there were no standardized examples of health policy competencies and their evaluation. A DNP health policy course was redesigned based on the FPTT recommendations. Technological capabilities were leveraged to provide an active and experiential learning environment integrating the concepts of cultural competence, health equity, and social awareness. At the conclusion of the course, DNP students are actively engaged in health policy and have increased confidence in their advocacy abilities. Providing DNP students with an experiential, technologically driven learning platform gives students practical tools and applications they can use beyond the classroom to influence health policy.

Nurse Advocacy: Adopting a Health in All Policies Approach

Policy advocacy and committed resources are essential to address social factors that shape population health. In this article, we discuss nurse advocacy to advance public health and health equity through targeted social determinants, particularly on behalf of poor and disadvantaged persons. We discuss components of the right social policies and consider evidence-based policies that have linked improvements in social and economic conditions with increased physical, emotional, and mental health outcomes among poor and disadvantaged social groups. With a partnership perspective, select social determinants of health (SDOH) and mitigating policies focus nurses' social policy advocacy to improve the health of disadvantaged populations and reduce health inequities. We suggest nurses engage in multisectoral partnerships and adopt a Health in All Policies (HiAP) approach to address social and health needs of concern. The conclusion offers resources and strategies to promote nurse engagement in health policy.

Health policy engagement among graduate nursing students in the United States.

The aim was to understand how health policy education is currently being delivered in the United States' graduate nursing programs. This exploratory cross-sectional design used an anonymous online survey to target graduate nursing students attending American Association of College of Nursing (AACN) member institutions. Over 75% of the sample (n = 140) reported taking a dedicated health policy course and 71.5% ( n = 131) of the sample responded that a health policy course was required and an equal distribution among master's and doctoral students. There was no significant difference between type of graduate degree sought and the requirement to take a health policy course ( P = 0.37). For students involved in health policy, there was a greater proportion of master's students involved at the state level, than doctorate of nursing practice (DNP) or PhD students ( P = 0.04). Health policy and advocacy education are important aspects of graduate nursing curriculum and have been integrated into curricula. Graduate nursing students at all levels reported that health policy AACN Essential competencies are being included in their program, either as stand-alone health policy courses or integrated health policy learning activities during matriculation.

Reconciling profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research

Reconciling profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research

What's Involved with Wanting to Be Involved? Comparing Expectations for Public Engagement in Health Policy across Research and Care Contexts.

Objectives:We explored public preferences for involvement in health policy decisions, across the contexts of medical research and healthcare.Approach:We e-surveyed a sample of Canadians, categorizing respondents by preferences for decision control: (1) more authority; (2) more input; (3) status quo. Two generalized ordered logistic regressions assessed influences on preferences.Results:The participation rate was 94%; 1,102 completed responses met quality criteria. The dominant preference was for more input (average = 52.0%), followed by status quo (average = 24.9%) and more authority (average = 21.1%), though preferences for more control were higher in healthcare (57.2%) than medical research (46.8%). Preferences for greater control were associated with constructs related to reduced trust in healthcare systems.Conclusion:The public expects health policy to account for public views, but not base decisions primarily on these views. More involvement was expected in healthcare than medical research policy. As opportunities for public involvement in health research grow, we anticipate increased desired involvement.

Can public health reconcile profits and pandemics? An analysis of attitudes to commercial sector engagement in health policy and research.

BackgroundPublic health’s terms of engagement with unhealthy commodity industries (alcohol, tobacco and ultra-processed food and drinks) have become increasingly contested in policy and research. We sought to identify approaches that could attract consensus support within and across policy domains.MethodsUsing snowball sampling, we undertook an online survey of 335 health researchers, advocates and policymakers, in 40 countries, assessing responses to stated principles, claims and recommendations for engaging with unhealthy commodity industries in relation to key policy and research initiatives.ResultsMost respondents identified a fundamental conflict between industry interests and public health objectives for all three industries, with agreement greatest in relation to tobacco and weakest for food. This pattern was replicated across diverse questions regarding potential forms of engagement, including in rejecting voluntarism and partnership approaches to health policy. While awareness of tobacco industry tactics to influence policy and research was higher than for alcohol and food, most respondents rejected the view that the influence of the latter was less significant for public health. Proposals that health and research organisations should divest their funds attracted less support with respect to food, while restricting publication of industry-funded research in academic journals was the issue that most divided opinion. Respondents reported most difficulty in answering questions about the food industry.ConclusionsThe strong consensus around restricting interactions with the tobacco industry supports increased implementation of the WHO Framework Convention on Tobacco Control’s conflict of interest provisions. There is strong support for the extension of such practices to the alcohol industry, challenging current norms. More mixed responses indicate a need for greater clarity in defining the food industry, and for research analyzing links, similarities and differences across different types of unhealthy commodity producers. Partnership approaches to addressing non-communicable diseases seem incapable of attracting widespread support across public health, challenging practice in many contexts.

Community Psychology as a Process of Citizen Participation in Health Policy Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

This brief commentary discusses a recent paper by Speed and Mannion that explores "The Rise of post truth populism in liberal democracies: challenges for health policy." It considers their assertion that through meaningful democratic engagement in health policy, some of the risks brought about by an exclusionary populist politics can be mediated. With an overview of what participation means in modern healthcare policy and implementation, the field of community psychology is presented as one way to engage marginalized groups at risk of exploitation or exclusion by nativist populist policy.

Enhancing Nurse Leadership Capacity in Resource-Limited Countries

Background: Nurse leaders are essential contributors to global health and health care delivery systems. Developing and strengthening nurse leader capacity enhances quality care and improves patient outcomes so no one is left behind. Low workforce capacity leads to poor health outcomes for patients. Collaborations between institutions have been shown to strengthen nurse capacity in resource-limited countries and supplement the brain drain phenomenon. This discursive paper aims to share lessons learned from implementing a graduate nursing program to develop leadership capacity in a resourcelimited country and to discuss strategies to enhance partnerships, influence health policies, and improve global health care. Materials and Method: Develop nurse leadership capacity through a graduate nursing program. Results: To date, 51 students have been enrolled and 16 have successfully completed the master’s program with thesis. Most of the graduates now hold top management positions ranging from middle to senior management. These nurse leaders are in charge of operations and management, programming and policy implementation. Contributions of the program is demonstrated in changes in leadership capacity exemplified in marked infrastructural and process changes in the National Association of Gambian Nurses through increased nurse involvement at the Ministry of Health level, and enthusiasm and commitment to quality care for patients. Conclusions: Efforts to strengthen nurse leadership capacity through collaborations between developed and developing countries are essential to improve nurse leadership capacity, increase health policy engagement, and workforce retention. Workforce improvement and quality nursing services through these collaborations will strengthen nurse leadership and propagate positive health outcomes for patients as well as contribute to solving the brain drain in resource-limited countries.

Strengthening the Role the Workforce Plays in Health Policy Engagement in Underserved Communities: Lessons from a Multi-site Federally Qualified Health Center

Studies on the engagement of the CHC workforce in health policy are limited. Most uninsured Americans do not understand how the ACA affects them. We assessed knowledge and interest of our workforce in health policy, and applied the Socio-Ecological model to a plan for engagement, sharing strategies for similar settings.

Better health, better care, better value: National Expert Commission, part 1.

Since about the midway point of the First Ministers' 10-year plan to strengthen healthcare, its impending expiry in 2014 has prompted the leading health professions to consider "what comes next," how to influence that decision and then, how best to position their messages in the politics of whatever might emerge. The Canadian Nurses Association (CNA), which has a century-long history of engagement in health policy, was no exception.

보건의료 정책 의사결정과 시민참여 : 『건강보험 보장성 시민위원회』의 사례

【Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.】

Public Engagement in Health Technology Assessment and Coverage Decisions: A Study of Experiences in France, Germany, and the United Kingdom

In the United States and internationally, the trend for public engagement in health policy and practice is increasing, particularly regarding health technology assessment (HTA), which informs often controversial coverage decisions. However, there is no consensus about which members of the public should be involved in which processes or what the respective rationales and benefits of public engagement are. This article explores operational processes and underlying rationales of public engagement at HTA agencies in France, Germany, and the United Kingdom. The analysis is based on website information, legal framework documents, published and gray literature, and semistructured, in-depth interviews with top officials at these agencies. Engagement processes differ across agencies, particularly regarding the areas in which the public is involved, which groups of the public are involved, what weight they have in influencing decisions, how they are recruited and supported, and how potential conflicts of interests are addressed. Different emphases on rationales and drivers behind public engagement partly reflect the respective political environments. Interviewees indicated a range of benefits of engagement and factors influencing success or failure. The results highlight the need to be clear about the purpose and conduct of engagement in order to maximize the benefits of this increasingly widespread policy tool.