Health-related Policies Research Articles

National Sporting Organisation policies: A health promotion opportunity?

The objective was to identify whether National Sporting Organisations (NSOs) have policy documentation on healthy behaviours (smokefree, sun-protection, healthy food/beverages and alcohol) and, for organisations with such documentation, whether this was in-line with current scientific evidence of past best practice in cancer prevention. This cross-sectional policy analysis study was performed September to December 2018 in Aotearoa/New Zealand. A content analysis was undertaken using NSO policy documents matched against a framework of key indicators for best practice within health behaviours of interest. Data analysis of the policy process was undertaken through key informant telephone interviews with NSO staff using semi-structured qualitative interviews. Of 96 NSOs, nearly half (49%) mentioned smokefree at least once in one of their policy documents, and 47% had an alcohol policy, although in both instances the policies lacked comprehensiveness. Two NSOs had a reasonably comprehensive sun protection policy. Seventeen had at least one specific nutrition policy/guideline. The contents of the latter were primarily related to short-term athletic performance rather than non-communicable disease prevention, specifically promoting hydration during sports participation, and food and nutrition to support sporting performance. Two NSOs had policies relating to the promotion of healthy food/nutrition more widely. For some NSOs, the lack of health-related policies was not a conscious choice but just not considered previously. Other NSOs reported they lacked resources or had other priorities. Although this study clearly demonstrates that many NSOs lack adequate health-related policies, this is not necessarily a conscious choice, but the result of a lack of resources, other priorities, or just that they had not considered developing policies in these areas. A number expressed support for these types of policies although it was apparent that some, particularly smaller NSOs, would require assistance in policy template development. It seems probable that the development of health-related policies will only occur if partner agencies become involved.

The Liberalization of Cannabis Possession Laws and Birth Outcomes: A State-Level Fixed Effects Analysis, 2003-2019.

As states liberalize their cannabis laws, cannabis use has become more widespread among adults across the United States, including pregnant women. As a result, recent research has investigated the potential effects of prenatal cannabis use on child health, with mixed results. In this study, we investigate the relationship between the liberalization of state-level cannabis possession laws and two birth outcomes indicative of child health: birthweight and gestational age. Drawing on 2003-2019 data from CDC WONDER, the American Community Survey, and multiple legal databases, we use fixed effects models to examine how changes in cannabis policies-moving from a misdemeanor to decriminalized to legalized possession-have influenced state-level averages in birthweight and gestational age and percentages of births classified as low birthweight (<2500g) and preterm (<37 weeks). We account for state-level factors including medical cannabis laws, health-related policies, spending patterns, and demographic characteristics known to influence health. Results indicate that the liberalization of state cannabis possession laws was associated with statistically significant reductions in average birthweight, and to a lesser extent gestational age, with significant effects for subgroups of women by age, race/ethnicity, and risk factors including chronic hypertension and diabetes. However, we did not find increases in the percentage of women with clinically relevant low birthweight or preterm births following cannabis policy liberalization. Although our study does not show substantial changes in adverse birth outcomes, policymakers should be attentive to opportunities to strengthen child health by considering policies that minimize consumption, particularly heavier forms of consumption, by prospective parents.

Death of “Open Data”? - How Open Data has been realising and/or not realising Open Government

Open government is a concept of governance, which holds that citizens have the right to access the documents and proceedings of the government to allow for effective public oversight. Some definitions specify the distinction between Open Data and Open Government: Open Government is defined in terms of service delivery and public accountability; and technology can be used to facilitate disclosure of information, but that the use of open data technologies does not necessarily equate accountability.&#x0D; The paper analyses the relationship between Open Data and Open Government through a case study and tries to understand how the former affected the latter and the role of digital technology. The case is the open data policies and strategies of UK government, especially its application in sports and health related policies in recent years. The preliminary results show positive effect of open data policies on public service delivery, while limited improvement in accountability and mixed result in civic engagement.

Dietary Quality, Sleep Quality and Muscle Mass Predicted Frailty among Chinese Postmenopausal Women in Malaysia.

The older adult population is growing faster than any age group, which increases their risk of frailty. Studies conducted among older adult are relatively scarce in Malaysia, especially among Chinese postmenopausal women, who have the longest life expectancy. Thus, the present study aimed to determine the prevalence of frailty and its associated factors among Chinese postmenopausal women. A total of 220 eligible respondents were recruited, with information on sociodemographic background, comorbidities, dietary intake and lifestyle behaviour were obtained using a structured questionnaire, while anthropometry indicators were assessed according to standard protocol. Fasting blood was withdrawn for the analysis of serum 25(OH)D. Multinomial logistic regression was used to determine factors that predict pre-frailty and frailty. Prevalence of pre-frailty and prevalence of frailty were 64.5 and 7.3%, respectively, and most of the respondents presented with weak handgrip strength. Pre-frailty was prevalent among the younger population. Dietary quality was unsatisfactory among the respondents, and the majority of them presented with a high percentage of body fat. An increased dietary quality index (DQI), poor sleep and low muscle mass were factors that contributed to frailty. In conclusion, nutritional factors should be considered in developing health-related policies and programs in reducing and delaying the onset of frailty.

Food and agriculture, nutrition and health related policy integration in Iran’s national development agenda and their alignment with the sustainable development goals

Food and agriculture, nutrition and health related policy integration in Iran’s national development agenda and their alignment with the sustainable development goals

What Darwin could teach us today about modern vaccines and related health policies

What Darwin could teach us today about modern vaccines and related health policies

Les dispositifs de coordination, des outils en faveur du décloisonnement ville-hôpital

According to specific medical and social, health related and public policy variations, coordination professionals ensure the return to and/or remain at home of the most vulnerable people. Today, the notion of networks has evolved towards the grouping of professionals into communities, with the objective of sharing and coordinating patient care in order to improve health care pathways through clearer actions and fluider follow-ups.

Exposures to Potentially Psychologically Traumatic Events Among Provincial Correctional Workers in Ontario, Canada.

We know little about potentially psychologically traumatic events (PPTE) exposures among provincial correctional workers in diverse occupational positions and even less regarding how exposure to events are associated with mental health disorders. We designed the current study to unpack and quantify estimates of the frequencies that correctional workers, across occupational roles, experience exposure to diverse incidents. We categorized 1,338 of our 1,487 participants into six occupational categories and our measures included established self-report items measuring PPTE exposure and mental disorder symptoms. Almost all correctional workers reported exposures to most PPTE types. Correctional workers collectively report exposures to physical assault (90.2%) and sudden violent death (81.8%), with many (3.1%-46%) reporting 11+ exposures (M = 10.01, SD = 4.29). We found significant differences in exposure patterns across correctional worker categories; specifically, we found a higher prevalence of exposure to toxic substances, physical assault, assault with a weapon, severe human suffering, sudden accidental or sudden violent death, among those working in institutional correctional services (e.g., governance, correctional officers). PPTE exposure and all assessed mental health disorder symptom profiles were closely related, as correctional workers report high exposure to PPTE. Population attributable fractions indicated that the burden of mental disorders among provincial correction workers might be reduced by between 38%-70% if PPTE exposures were eliminated from the population. We conclude with recommendations for mental health related policies, such as investing in peer and psychologically support, as well as interventions for exposure to PPTE and readiness to inform strategies for employee mental health and well-being.

Understanding medical students' interests in family medicine in Vietnam: A qualitative study.

Family medicine has recently been introduced into undergraduate training programs after more than 10years of only being available for postgraduate doctors in Vietnam. The aim of this study was to explore the perceptions of sixth-year medical students towards family medicine and the factors that influence their career choice for - or against - family medicine. The authors used a qualitative approach with a criterion sampling technique, including 36 participants in eight interviews and four focus group discussions, with thematical analysis. Most students could explain well what they had learned about family medicine but showed little interest in it. Only a few of the interviewees indicated they would choose a career in family medicine. The following factors influenced their career choice: valuing continuing care, the doctor-patient relationship and work-life balance; family medicine clinical rotation and teachers' roles; and related health policies offering a clear practice pathway and patient allocation to capable family doctors. The students' perceptions of family medicine were positive, but their interests in and intention to pursue a career in family medicine were still low after a clinical rotation. The authors concluded that the family medicine rotation should be maintained, family medicine should become more prominent in more components of the medical curriculum, and health policies to support and encourage becoming a family doctor are necessary.

Disease Surveillance Among U.S.-Bound Immigrants and Refugees - Electronic Disease Notification System, United States, 2014-2019.

Disease Surveillance Among U.S.-Bound Immigrants and Refugees - Electronic Disease Notification System, United States, 2014-2019.

Multi-Regional Modeling of Cumulative COVID-19 Cases Integrated with Environmental Forest Knowledge Estimation: A Deep Learning Ensemble Approach.

Reliable modeling of novel commutative cases of COVID-19 (CCC) is essential for determining hospitalization needs and providing the benchmark for health-related policies. The current study proposes multi-regional modeling of CCC cases for the first scenario using autoregressive integrated moving average (ARIMA) based on automatic routines (AUTOARIMA), ARIMA with maximum likelihood (ARIMAML), and ARIMA with generalized least squares method (ARIMAGLS) and ensembled (ARIMAML-ARIMAGLS). Subsequently, different deep learning (DL) models viz: long short-term memory (LSTM), random forest (RF), and ensemble learning (EML) were applied to the second scenario to predict the effect of forest knowledge (FK) during the COVID-19 pandemic. For this purpose, augmented Dickey–Fuller (ADF) and Phillips–Perron (PP) unit root tests, autocorrelation function (ACF), partial autocorrelation function (PACF), Schwarz information criterion (SIC), and residual diagnostics were considered in determining the best ARIMA model for cumulative COVID-19 cases (CCC) across multi-region countries. Seven different performance criteria were used to evaluate the accuracy of the models. The obtained results justified both types of ARIMA model, with ARIMAGLS and ensemble ARIMA demonstrating superiority to the other models. Among the DL models analyzed, LSTM-M1 emerged as the best and most reliable estimation model, with both RF and LSTM attaining more than 80% prediction accuracy. While the EML of the DL proved merit with 96% accuracy. The outcomes of the two scenarios indicate the superiority of ARIMA time series and DL models in further decision making for FK.

ASSESSMENT OF READINESS OF GONDOKUSUMAN SUB-DISTRICT IN FILLING INTEGRATED PALLIATIVE CARE FOR OLDER PEOPLE

Background : Every year the number of elderly people in Indonesia continues to increase. In 2018 the highest number of elderly people was in the DI Yogyakarta Province, amounting to 12.37%. Data from Riskesdas showed that 51.28% of the elderly experienced health complaints and 25.99% of the elderly experienced illness. This can reduce the patient's quality of life. Therefore, integrated palliative care is needed for the elderly to improve the quality of life for patients and their families in dealing with health problems. Palliative care already exists in 5 hospitals in 5 regions in Indonesia, namely DKI Jakarta, DI Yogyakarta, Surabaya, Denpasar, and Makassar. Objective : The general objective of this study was to explore the readiness of Gondokusuman District in fulfilling integrated palliative care for the elderly. Method : This study used a thematic analysis research design. The research sample was 46 respondents. The data is taken from previous research entitled "Mapping Community Assets Related to Health and Social Services for the Elderly in Yogyakarta City in 2019". Result : An overview of health-related policies was found, such as the Chronic Disease Management Program (Prolanis), the Health Social Security Administration (BPJS), and Supplementary Food Provision (PMT). However, no policy description regarding palliative care has been found. A description of the availability of drugs was found which included prescribing, distribution and financing. Educational programs and content found in the form of education through counseling and counseling. Resources found are in the form of health infrastructure, community infrastructure, and human resources. However, there is no culture related to integration either vertically or horizontally. Conclusion : There is a description of health-related policies, availability of medicines, educational programs and content, and resources that support palliative care in Gondokusuman District. However, no specific policies have been found regarding palliative care and integration.

Mental Health Status and Health-Promoting Lifestyle Behaviors among Call Center Employees

Background: Call center employees experience high levels of occupational stress and other mental health issues. This study aimed to examine the relationship between mental health status and health-promoting lifestyles among call center employees.Methods: A secondary data analysis from a descriptive cross-sectional study of 302 call center employees was conducted. Call center employees were asked to complete the Depression Anxiety Stress Scale (DASS) and the Health Promoting Lifestyle Profile-II (HPLP-II).Results: Participants’ overall DASS score was 23.87±13.98 out of 63. Among the six subscales of the HPLP-II, participants’ highest scores were for interpersonal relations, spiritual growth, and stress management, whereas physical activity had the lowest score. Participants with a severe level of mental health issues (i.e., depression, anxiety, and stress) reported lower levels of health-promoting lifestyle behaviors, especially in the areas of physical activity, spiritual growth, interpersonal relationships, and stress management.Conclusions: As call center service sectors increase in modern industries, so does the need to address the physical and mental health needs of its employees. Healthcare providers and organizations should closely and routinely monitor employee’s levels of depression, anxiety, and stress and develop organizational and health-related policies for the call center sector. Additionally, the development and implementation of health-related interventions to promote healthy lifestyle behaviors is critical for call center employees.

Electoral campaign contributions: an obstacle to sugary drink industry regulation in Brazil?

To assess corporate electoral campaign contributions from industries related to sugary drinks production and the characteristics of the elected officials financed by the sector. Cross-sectional analysis of electoral campaign contributions from corporations related to sugary drinks production (sugary drink industries and sugary drink input industries) to candidates to the Chamber of Deputies, Brazil. Elections to the 55th Congress (2015-2019), held in October 2014. Candidates to the Chamber of Deputies, Brazil. Forty-nine companies or corporate groups that produce sugary drinks and fifty-two corporations that produce inputs for sugary drinks manufacturing contributed to electoral campaigns of candidates in the 2014 Election. Contributions from this industry sector represented 7·3 % of all corporate contributions and helped finance 11·7 % of the candidates and 46·2 % of the elected officials. The transnationals Ambev and Coca-Cola were the first and second biggest donors, respectively. Revenues mediated by political parties, from sugary drink industries and from corporate members of some industry associations (Abir, Unica and CitrusBR), were more prevalent. Among elected officials, a significant association was found between being financed by the sector and representing the south-east region, having higher education level and referring themselves as being professional politicians. In the multivariate model, financed candidates were 27 % more likely to be elected. Corporations related to sugary drinks production have contributed to the electoral campaigns of almost half of the Federal Deputies in Brazil in 2014. This possibly facilitates access to decision-makers and could help buy influence on legislative proposals, including health-related food policies.

Who Started, Stopped, and Continued Participating in Outdoor Recreation during the COVID-19 Pandemic in the United States? Results from a National Panel Study

The COVID-19 pandemic has been proposed as a catalyst for many U.S. residents to re-engage in outdoor recreation or engage in outdoor recreation for the first time. This manuscript describes the results of a representative U.S. national panel study aimed at better understanding the socio-demographic profile (gender, ethnicity, community type, income, and age) of those participants new to outdoor recreation since the start of the COVID-19 pandemic. In doing so, we address how these new outdoor recreationists differ from (1) those who frequently participated in outdoor recreation prior to the pandemic and continue to participate in outdoor recreation, (2) those who did not frequently participate in outdoor recreation prior to the pandemic and remain un-engaged, and (3) those who frequently participated in outdoor recreation prior to the pandemic but stopped their frequent participation following the onset of the pandemic. Results from this U.S. national study suggest that 35.8% of respondents indicated that they did not participate regularly in outdoor recreation prior to the pandemic or during the pandemic, 30.4% indicated that they did participate regularly in outdoor recreation prior to the pandemic and continued to do so regularly during the pandemic, and 13.5% indicated that they did participate regularly in outdoor recreation prior to the pandemic, but did not continue to do so during the pandemic. More than 20% of the sample indicated that they were new outdoor recreationists. The majority of respondents in all categories, including those that were new to outdoor recreation amidst the pandemic, identified as being white, however these new outdoor recreationists were also the least ethnically diverse. The previously but no longer outdoor recreationist respondents were significantly more ethnically diverse than the other three groups, and they tended to live in more urbanized settings. Discussion of these results includes implications for outdoor recreation managers, and researchers who seek to better understand who the COVID-19 pandemic has influenced with regard to outdoor recreation participation. Implications regarding social justice, access and equity to public places that facilitate outdoor recreation, and health-related policies are discussed.

A Typology of Health Services Regulated in U.S. Assisted Living Communities

State agencies regulate assisted living (AL) with varying approaches across and within states. The implications of this variation for resident case mix, health service use, and policy, are not well described. We collected health services-relevant AL regulatory requirements for all 50 states and DC and used a mixed-methods approach (thematic analysis; k-means cluster analysis) to identify six types: Housing, Affordable, Hybrid, Hospitality, Healthcare, and Hybrid-Healthcare. We stratified Medicare claims data by regulatory type, identifying variation in resident case mix and health service use. Housing and Affordable clusters have larger proportions of dual-eligible beneficiaries, Black residents, and residents of Affordable had more long-term nursing home use compared to other clusters. Dual-eligible beneficiaries account for 26.6% of Housing cluster residents compared to 8.1% of Hybrid Healthcare cluster residents. We provide other examples and explain the implications in terms of sampling AL for single and multi-state studies, racial disparities, and health-related policies.

COVID-19 Outbreaks and Control Measures Are Associated With Depression Risk Among Older Adults

Local COVID-19 outbreaks and infection control measures may affect mental health in older persons. This study aims to investigate the effects of COVID-19 outbreaks and control measures on depression risk in community-dwelling older adults in Hong Kong. With rolling cross-sectional design, telephone screenings for depressive risk were conducted among 8163 older people using Patient Health Questionnaire-2 (PHQ-2) from February to September 2020. COVID-19 outbreaks across thirty weeks were measured using real-time effective reproductive number (Rt), infected new cases, and change of infected new cases by week. Infection control measures were assessed using four policy indices, including government response, government stringency, containment and health, and economic support. Linear regressions were used to test the associations of depression risk with COVID-19 outbreaks and control measures. We found that being female and higher Rt were associated with higher depression risk in the overall sample. In older adults without pre-existing mental health issues, higher depression risk were related to older age (t=-1.974, 95%CI[-0.006, 0.000], p<0.05), a higher level of government stringency (t=2.954, 95%CI[0.007, 0.033], p<0.01), and less stringent containment and health-related policy (t=-2.599, 95%CI[-0.041, -0.006], p<0.01). In older adults with pre-existing mental health issues, greater changes in newly infected cases were related to higher depression risk (t=2.813, 95%CI[0.002, 0.010], p<0.01). In conclusion, the effects of COVID-19 infection risk and control measures on depression risk differ among older Chinese by pre-existing mental health issues. Future public health communication could build on resilience to balance awareness of infection risks and mental health risks in older persons.

Evidence-based Training to Improve Communication between Health Advocates and State Policymakers

ABSTRACT Persuading state policymakers to adopt effective child health policies requires effective communication from health advocates. This study examined the effectiveness of evidence-based communication training among child obesity advocates and their state legislators. A health advocacy group conducted training using evidence-based strategies and health-related policy updates in one Midwestern State Capitol building in January 2020. Twenty-three health professionals participated in the training prior to meetings with their legislators to discuss child obesity policies. An 18-item, pre- and post-questionnaire assessed training effects on knowledge, confidence, competence, importance of communicating, and future intentions to communicate with state policymakers. Satisfaction with the training was also assessed. Knowledge, confidence, importance, and future intentions to deliver child health messages to Missouri legislators all improved as a result of the training. Participants significantly increased their competence to speak with legislators on child health issues (Mann–Whitney U = 99.5; p = .039). Participants were very satisfied with the training and enjoyed receiving health-related policy updates and learning policymakers’ preferred message frames related to child health. Evidence-based training and in-person practice can significantly improve the competence of health advocates for communicating with their policymakers. This in-person training is one feasible strategy for developing impactful child health policies and informing health education efforts.

The Food and Health Environment in Junior Secondary Schools in Urban Burkina Faso: A Cross-Sectional Study of Administrators, Food Vendors and Early Adolescents.

School enrolment rates have increased globally, making the school environment a unique setting to promote healthy nutrition and eating outcomes among early adolescents. In this cross-sectional study, we describe the food and health environment of junior secondary schools in Ouagadougou (Burkina Faso, West Africa). We evaluated the food and health environment using three components: (1) the implementation of health-related policies or guidelines in the schools, (2) the provision of health, nutrition and water, sanitation & hygiene (WASH) services in the schools, and (3) the quality of the school food environment, including foods sold by vendors. We used stratified random sampling to recruit 22 junior secondary schools from the five Ouagadougou districts in 2020. Trained fieldworkers collected standardized questionnaire data from 19 school administrators, 18 food vendors, and 1059 in-school adolescents. We report that only 7 out of 19 school administrators were aware of existing health-related policies and guidelines at their school and only 3 schools had a school health and nutrition curriculum in place. The overall provision of health, nutrition and WASH services was low or inadequate. Likely because of the lack of school canteens, 69% of the students bought snacks and unhealthy foods from food vendors. There is a critical need to improve the food and health environment of junior secondary schools in urban Burkina Faso.

Embracing policy implementation science to ensure translation of evidence to cancer control policy.

Although health-related policies are abundant, efforts to understand how to ensure that these policies serve as an effective vehicle for translating scientific evidence are relatively sparse. This paper explores how policy-focused implementation science (IS) may contribute to understanding the translation of scientific evidence to health-related policy in governmental and nongovernmental sectors. Expanding the focus of implementation science in cancer control could systematically address policy to both increase the use of scientific evidence in general and to address health equity. In this Commentary, we look to relevant work outside of IS that could be informative, most notably from the field of political science. We propose several ideas for future research that could help move the field of policy implementation science in cancer control in the USA forward. Although most efforts to increase uptake of the scientific evidence base reference translation to "practice and policy," there has been relatively little emphasis in the USA on implementation at the policy level, especially related to cancer control. If we are to achieve the full benefits of scientific discovery on population and public health, we will need to consider policy as a critical mechanism by which evidence can be translated to practice. We have a robust set of methods within implementation science that are increasing the pace of adoption and maintenance of evidence-based programs in a variety of settings. Building on these efforts, the time is right to expand our focus to include policy implementation.