Involvement Of External Stakeholders Research Articles

Factors Associated with Improved MCH Epidemiology Functioning in State Health Agencies

This paper discusses characteristics that are associated with enhanced maternal and child health (MCH) epidemiology functioning in state health agencies. The concept of the "MCH Epidemiology Effort" is introduced as "the epidemiologic work carried out by multiple units and agencies aimed at informing program planning and policy development on behalf of women, children and families." This concept focuses attention on MCH epidemiology functioning at the organizational level rather than on individual MCH epidemiologists. The analysis used data from all 50 states and the District of Columbia. Each state participated in a telephone interview and submitted material that demonstrated the breadth, depth, and capacity of its MCH Epidemiology Effort. Several organizations, including the Council for State and Territorial Epidemiologists, the Health Resources and Services Administration/Maternal and Child Health Bureau, and the Centers for Disease Control and Prevention provided additional secondary data. The outcome for analysis was a three-category measure of MCH epidemiology functioning. The findings are consistent with, and add specificity to, those from prior assessments. In a multivariable model, agenda-setting by consensus, involvement of external stakeholders, the total of doctorally trained staff, and accessing CDC assignees or other staff were all significantly related to higher level MCH epidemiology functioning (ORs of 6.1, 6.6, 2.5, and 6.4, respectively; P<0.05). Organizational visibility of the MCH Epidemiology Effort and a data environment marked by routine data-sharing and data integration were marginally related. We provide recommendations for action at the state and federal level for advancing evidence-based decision-making in maternal and child health.

Adapting systems of care for child welfare practice with immigrant Latino children and families

Recent reform efforts in the child welfare system have called for child welfare agencies to provide community-based services and to increase the involvement of external stakeholders in identifying and developing services within the community. At the same time, child welfare agencies are faced with the challenge of providing services to an increasingly diverse population of children and families. As a result, there is a need for evidence-based practice models that respond to these challenges and promote positive outcomes for children and families. This paper describes the development of a program designed to train child welfare staff on the application of an existing evidence-based framework, systems of care, to practice with immigrant Latino children and families as a means of responding to these multiple calls for systems change and practice improvement. Immigrant Latino children and families represent the largest and fastest-growing population in the United States, and thus require the attention of child welfare systems and the development of evidence-based practices designed to respond to the unique needs of this population. Recommendations for program planners and evaluators on the application of systems of care to child welfare practice with immigrant Latino children and families are provided.

What Constitutes Success in Pacific Island Community Conserved Areas?

In recent years, few if any community conserved areas (CCAs) in the Pacific island region have been regarded as being successful. However, as success is rarely defined, what constitutes “success” is not clear. This paper reports an investigation into the way “outsiders” perceive success in Pacific island CCAs. An exploratory survey revealed six umbrella themes of success: the locus of control; local benefits; resource aspects; management; external stakeholder involvement; and sustainability. Multivariate analysis distinguished two groups, a Big picture group and a Locally focused group. These differ in how they define success, as well as their organizational alignment. The Big picture group, largely from funder agencies and international NGOs, were focused on the broad issues of success, especially the sustainability of CCAs. The Locally focused group was concerned with the practical workings and needs of successful CCAs in the Pacific; many in this group were based with Pacific island governments and NGOs or CCAs. The study concludes that success in CCAs should not be defined solely on project objectives, especially when these have been developed by an external entity or under their guidance. If they are, high rates of failure are to be expected.

The Lamfalussy process four years on

The Lamfalussy process was implemented from early 2001, following the report of the Committee of Wise Men on the Regulation of European Securities Markets, chaired by Alexandre Lamfalussy. Four years on, this paper concludes that, while it is too early to assess progress in areas such as implementation and enforcement (Levels 3 and 4 of the Lamfalussy process), significant progress has been made in implementing the proposals contained in the original Lamfalussy Report. Preparation of EU legislation affecting securities markets is now more transparent, with better involvement of external stakeholders and enhanced political cooperation between all the institutions (Commission, Council and European Parliament). This has resulted in an improvement in the quality of legislation and an acceleration of the legislative process. The use of implementing measures will make it easier and faster to adapt Community legislation in the future. The process is also encouraging regulatory and supervisory convergence. Nevertheless, this paper suggests further improvements that could be made in areas such as consultation, including better involvement of consumers; timetables for transposing measures into national law; focusing more on general rules and principles in framework legislation (Level 1) and avoiding over‐prescription in implementing measures (Level 2); achieving more consistent implementation across member states (Level 3); further strengthening political accountability; and strengthening efforts to foster greater understanding of the Lamfalussy process.