Policy Brief Research Articles

Improving the health status of sex workers in Europe: a policy brief with recommendations

Context: Although the United Nations and the European Union are set to improve life on earth through the Sustainable Development Goals (SDG) Framework, sex workers have not been included in this Framework, thereby further increasing various issues, which affect this group, such as discrimination, stigma, and poor mental- and physical health. The COVID-19 pandemic has exacerbated the already existing disadvantages of sex workers, highlighting the need for a systematic change to sustainably improve the empowerment and health status of sex workers throughout the European Union. Policy Options: The aim of this policy brief is to propose recommendations, which can contribute to the sustainable improvement of the health status and empowerment of sex workers throughout the EU. Policy options include a bottom-up approach with use of community-based organizations and public-private partnerships, targeting inclusion of sex workers, the organization of workshops, and the distribution of toolkits. Recommendations: Inclusion of sex workers in the SDG Framework; Organization of community-based workshops by and for sex workers; Distribution of culture-personalized toolkits by and to sex workers.

The road to success: drawing parallels between 'road' and 'research data' infrastructures to foster understanding between service providers, funders and policymakers.

Background: The work of data research infrastructure operators is poorly understood, yet the services they provide are used by millions of scientists across the planet. Policy and implications: As the data services and the underlying infrastructure are typically funded through the public purse, it is essential that policymakers, research funders, experts reviewing funding proposals, and possibly even end-users are equipped with a good understanding of the daily tasks of service providers. Recommendations: We suggest drawing parallels between research data infrastructure and road infrastructure. To trigger the imagination and foster understanding, this policy brief contains a table of corresponding aspects of the two classes of infrastructure. Conclusions: Just as economists and specialist evaluators are typically brought in to inform policies and funding decisions for road infrastructure, we encourage this to also be done for research infrastructures.

Evidence-based Practice among Clinical Nurses in Bahrain: Basis for a Policy Brief

The study aimed to determine clinical nurses' beliefs, knowledge, organizational readiness, and evidence-based practice implementation levels and identify the perceived factors affecting evidence-based practice implementation. A descriptive-correlational in quantitative approach with triangulation was used. Data were gathered through the administration of adapted survey questionnaires along with structured interviews and personal observation to supplement the data. Forty-two voluntarily participated and completed the survey. Frequency, percent, mean, and standard deviation were used to analyze and interpret the participants' demographic profile and evidence-based practice-related variables. Regression analysis was used to identify the predictors from the list of variables. For facilitating and hindering factors in the evidence-based practice implementation of clinical nurses, an open-ended question was asked to triangulate the quantitative data. Most of the nurses are female in their middle adulthood, have completed a bachelor’s degree in nursing, and have worked in the hospital as a senior staff nurse for considerable time. The result shows that nurses somewhat truly believe in evidence-based practice, have acceptable evidence-based practice knowledge, probably consider the culture and organizational readiness, and are interested in implementing specific evidence-based practice tasks. Also, it was found that only knowledge of evidence-based practice is a highly significant predictor of evidence-based practice implementation. Perceived facilitating factors include supportive policies, training opportunities, management, and peer support. At the same time, lack of knowledge and insufficient time were recorded as barriers to implementing evidence-based practice. The salient findings were used in crafting the policy brief.

Improving the primary health care in Iran: a policy brief

Background: Primary healthcare (PHC) is the best method to provide primary healthcare for the people, and is the most efficient and effective way to achieve and improve a high level of health in any society. Failure to pay attention to PHC and low-quality health services can lead to an increase in various diseases, and consequently a higher number of death toll in any society, which would cause economic damages. PHC in Iran received a lot of attention after the revolution in 1979. In PHC, a healthcare network was established throughout the country. With the development of PHC in the Islamic Republic of Iran, the causes of death have decreased, and the death due to infectious diseases, pregnancy, and childbirth problems have also decreased. Despite the vast achievements of PHC in Iran, in recent years, enough attention has not been paid to its reconstruction and consecration. Lack of sufficient financial resources, non-implementation of family doctors in cities and executive problems in family doctors, lack of human resources, lack of attention to the education of students in the health sector, their lack of students’ interest in learning the activities of this field, and structural and administrative problems are some of the existing challenges. Results of the present study suggest that policymakers in Iran need to invest more in PHC in order to improve health indicators, reduce patient admissions to hospitals, and make more appropriate use of limited financial resources. Using the infrastructure that already exists in this sector and strengthening the network of PHC play an important role in reducing household expenses; also, the position of the family doctor and its functions can be properly implemented in the society.

Unintended consequences of disseminating behavioral health evidence to policymakers: Results from a survey-based experiment.

Communication research demonstrates that messages often have unintended consequences, but this work has received limited attention in implementation science. This dissemination experiment sought to determine whether state-tailored policy briefs about the behavioral health consequences of adverse childhood experiences (ACEs), compared to national policy briefs on the topic, increased state legislators'/staffers' perceptions of the policy brief relevance and parental blame for the consequences of ACEs, and whether effects differed between Democrats and Republicans. A preregistered, web-based survey experiment with U.S. state legislators/staffers was conducted in 2021 (n = 133). Respondents were randomized to view a policy brief about the behavioral health consequences of ACEs that included state-tailored data (intervention condition) or national data (control condition) and then answered survey questions. Dependent variables were perceived policy brief relevance and parental blame for the consequences of ACEs. The mean policy brief relevance score was 4.1% higher in the intervention than in the control condition (p = .24), but the mean parental blame score was 16.5% higher (p = .02). When outcomes were dichotomized, 61.2% of respondents in the intervention condition rated parents as "very much to blame" for the consequences of ACEs compared to 37.1% in the control condition (p = .01). When the sample was stratified by political affiliation, the effect of the state-tailored policy brief on parental blame was larger in magnitude among Democrats and not significant among Republicans. The intervention policy brief increased the mean parental blame score by 22.8% among Democrats relative to the control policy brief (p = .007) and doubled the proportion rating parents as "very much to blame" (52.2% vs. 26.1%, p = .03). Despite limited statistical power, state-tailored policy briefs significantly increased state legislators'/staffers' perceptions of parental blame for the behavioral health consequences of ACEs, relative to a policy brief with national data. Unintended messaging effects warrant greater attention in dissemination research and practice.

Addressing gaps in AMR awareness in the public: an evidence-based policy brief to guide school curriculum review in Uganda.

The government of Uganda, through its Ministry of Health, previously adopted curriculum review as a mechanism to respond to public health threats such as HIV/AIDS and include content in primary and secondary schools. This approach contributes to raising public awareness, a key strategy recommended by the World Health Organization to support the global response to the threat of antimicrobial resistance (AMR). This policy brief, developed for policymakers related to school curricula, aims to advocate for and support integration of AMR content in Uganda's primary and secondary level school curricula. The policy brief supports efforts by the multisectoral National AMR Subcommittee to create awareness on this issue as part of its role in facilitating the operationalization of Uganda's National Action Plan on AMR.

Future Of Bio-Waste Management in the Context of Developed Countries Legislation

In The next ten years, financing and public interest will be expected to turn to Bio-waste management. Municipalities are frequently the "owners" of the fodder because they are the owners of the garbage produced on their property and are responsible for managing it. A stricter set of guidelines were added to the Waste Framework Directive in 2018 to ensure that waste streams, particularly Bio-waste, be collected separately (from December 31, 2023). In addition, it demanded raising overall recycling goals to 65 percentage points by 2035 and diverting biodegradable trash from landfills and incinerators. In order to increase their Bio-waste collection, avoidance, and recycling rates in line with EU regulations, local and regional governments should refer to the overview provided in the current policy brief on EU efforts. Policies that support a regional circular economy. Additionally, it includes several noteworthy Europe excellent practices and EU-funded projects with a high degree of dependability and adaptation to various municipal contexts. The main article focuses on the future of Bio-waste management and its legislation in developed countries. The qualitative research methodology has been applied in this article.

Cross-comparing the Concept of “United in Diversity” as Expressed by European Capitals of Culture

ABSTRACT This paper examines the conceptualization and expression of cultural diversity and unity within the European Capitals of Culture (ECOC) initiative using a case study approach. Previous case studies have examined the impacts of the programmes from a single-city perspective and used quantitative and economic-focused approaches to evaluate impact. However, the ECOC initiative was intended to showcase the diverse cultures in Europe rather than focus on economic outcomes. A cultural discourse analysis was applied to eight winning cities between 2015 and 2019 (proceeding the onset of COVID-19) to answer the question: are ECOC focusing on expressing their national or regional diversity and identities or are they communicating a more generalized European perspective? The results showed that in the past five-year ECOCs have chosen to engage in more diverse and localized forms of cultural expression in their events, but not in their visual communications. Based on the analysis, a series of recommendations for future programme development are made (also published as a separate policy brief) to enhance ECOC’s ability to balance the communication of their diversity with their connection to Europe.

The development of a policy brief on physical activity and health in Africa for children and adolescents with disabilities: COVID-19 and beyond.

No abstract availbale.

Ready (or Not)-Here They Come.

The COVID-19 pandemic impacted all aspects of our lives worldwide, including our medical education system. The impact this disruption had on graduate medical education and graduates’ future practices is still to be determined. The policy brief by Sonoda in this issue of the journal analyzed

Special Issue Introduction: Addressing Healthcare Inequities in Intellectual Disability and Developmental Disabilities.

Special Issue Introduction: Addressing Healthcare Inequities in Intellectual Disability and Developmental Disabilities.

Mitigating the impact of Universal Credit rollout on financial insecurity and crime

Policy brief on how to mitigate the negative impacts of Universal Credit on financial insecurity and crime based on the paper d’Este, R. and Harvey, A. (2022), “The unintended consequences of welfare reforms: Universal Credit, financial insecurity, and crime”, The Journal of Law, Economics, and Organization.

The first nationally and sub-nationally representative non-communicable diseases cohort study in Iran: Iran Cohort Study (ICS) protocol.

Non-communicable diseases (NCDs) have become a global health priority with a great need for prompt evidence-based preventing and managing interventions. Here, we describe the development of a comprehensive cohort study that provides the most accurate results for NCDs' risk factors, named the Iran Cohort Study (ICS) to estimate the effect size of the risk factors associated with major NCDs. This cohort is an observational prospective study, which its baseline data was gathered through the Iran STEPwise Approach to NCD Risk Factor Surveillance (STEPs) survey in 2016. Following the STROBE criteria, the protocols for investigation of several areas were developed. The follow-up phase began through telephone calls to estimate the effect size of socio-demographic, behavioral, and metabolic risk factors on the incidence of or death due to major NCDs during the three years of study period. The main deliverables of ICS are planned to be as following; a comprehensive bank of primary data and follow-up data, national and subnational reports on estimation of the effect size of various risk factors, and a policy brief on the policy options and recommendations for promotion of ongoing programs and designing new interventions. Also, the collected data on the individuals' health status will be sent to the participants as an electronic health record. The present study is the first comprehensive national and sub-national representative cohort study on NCDs' risk factors in Iranian adults. The results could be used for promotion of health planning and also future complementary studies and programs.

The philanthropy's crucial role in alleviating stunting in Indonesia through research funding: A policy brief

Background: Developing countries need funding for researchers to maximize the evidence base, especially in stunting research. This short policy is expected to provide opportunities for Indonesia to receive more research funding to stunt philanthropists. Policy and implications: Multi-sector cooperation is arguably the leading player in acceleration programs to reduce growth delays. The Stunted Reduction Acceleration Program, complemented by higher research and development expenditures (RDEs) and open policies to support philanthropic activities in Indonesia, will help improve the efficiency of stunted stunt reduction through adequate funding and investment. As evidenced by Singapore and Thailand, the increase in government budgets focused on research and development (R&D) and supportive environments, as shown by Global Philanthropy Environment Index (GPEI), prove that evidence-based and practical researches can lead to the reduction of estimated prevalence of stunting rather than innovation-stage research. Recommendations: Attention needs to be directed in proposing major changes in law and policy which regulate the allocation of research-development expenditure, which will initiate the creation of a supportive environment for philanthropy acts regarding stunting. The challenges associated with these issues are: (1) Stunted research and innovation are still left behind, (2) The availability of data and the lack of transparency, (3) Subpar performance in relation to philanthropists, (4) Inconsistent legal definitions and a lack of industry-specific guidelines, (5) Inadequate law enforcement, (6) Local leaders must engage in evidence-based advocacy, (7) Philanthropists have limited opportunities to learn.

Key issues for implementation of Genomics in Healthcare: a Policy Brief

Abstract Issue/problem Healthcare (HC) can significantly benefit from genomic information for earlier, accurate diagnosis, effective personalized treatment with less adverse events, and accurate profiling of individuals for disease prevention. However, European countries are currently at variable maturity stages regarding the implementation of genomic medicine (GM) in healthcare, hindering the equitable delivery of personalized medicine to citizens across borders. Description of the problem The European 1+Million Genomes Initiative (1+MG) aims to provide cross-border access to quality genomic information and related clinical data, to advance data-driven research and HC solutions to benefit citizens. This initiative is encouraging countries to develop national GM strategies, but guidance for successful implementation is needed. In this context, the Beyond 1 Million Genomes, a supporting action to the 1+MG initiative, organized three Country Exchange Visits (CEV) to discuss critical issues, share experiences and best practices, for the implementation of sustainable GM strategies in healthcare. Results The United Kingdom, Estonia and Finland, which have advanced GM programs, hosted CEV describing progress and lessons learnt. Representatives of 1+MG signatory countries participated in these events and were able to present country level progress. The resulting Policy Brief (PB) captures key issues discussed at the CEVs, with real-life examples, and proposes policy recommendations for the successful implementation of GM in European healthcare systems. Lessons Sustainable GM implementation in HC systems requires: 1) Patient and citizens trust and engagement; 2) Sustainable infrastructure and data regulation, with solid ethical and legal frameworks; 3) Capacity building of healthcare professionals; 4) A strong ecosystem involving all stakeholders, and encouraging synergies between healthcare, research and industry to promote continuous innovation. Key messages • The implementation of GM in healthcare will take countries further towards making personalized medicine a reality, with remarkable health and socioeconomic benefits for patients and healthcare systems. • Promoting cooperation, capacity building and sharing of best practices is crucial to reduce asymmetries between countries, which constrains effective and equitable cross-border personalized medicine.

Vengeful Equity: Gendering the School-to-Prison Pipeline

The ‘school-to prison pipeline’ problem has typically been framed as predominantly affecting boys since punitive school discipline practices become firmly entrenched in U.S. public schools beginning in the 1990’s. Since then, the experiences of girls and gender non-conforming students has largely been overlooked. Girls and gender non-conforming students represent an increasing number of students suspended from schools annually and the number of juvenile justice involved girls has increased. This policy brief presents context to the problem and suggests a gendered analysis of aggression and violence is warranted to identify differences in the ways girls’ and gender non-conforming students’ behaviors are perceived and punished in schools utilizing intersectionality as an analytic tool of critical praxis to provide researchers, policy-makers, and practitioners recommendations for future empirical study and practical approaches to correct policy and practice that perpetuate gender bias and social inequality. Improved policy and practice that address inequitable application of school discipline decision-making and juvenile justice decisions can have a direct effect on girls’ and gender non-conforming students’ academic success and decrease the number of women incarcerated across the United States.

The World Health Organization's work and recommendations for improving the health of trans and gender diverse people.

The World Health Organization (WHO) is guided by its global programme of work and the goal that a billion more people have universal health coverage (UHC). To achieve UHC, access for those most vulnerable must be guaranteed and prioritized. WHO is committed to developing evidence-based guidance to work towards UHC for trans and gender diverse (TGD) people. This commentary describes WHO's work related to TGD people over the last decade. In 2011, WHO developed guidelines for the prevention and treatment of HIV and sexually transmitted infections (STIs) in men who have sex with men and TGD people. In 2013, the "HIV civil society reference group" called on WHO to provide specific guidance for TGD people. Values and preferences of TGD people were considered by WHO for the first time, which informed the development of the 2014 WHO Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations. The 2014 Guidelines included a comprehensive package of HIV-related health and enabling interventions with specific considerations for TGD people, as well as a specific policy brief in 2015. Regional WHO offices developed and/or supported the development of blueprints on transgender health and HIV in 2014 and 2016. A 2015 WHO report on sexual health, human rights and the law elucidated the harmful impacts of discriminatory laws on the basis of sexual orientation and gender identity. In 2019, the 11th edition of the international classification of diseases saw the removal of "transsexualism" as a mental and behavioural disorder. WHO's first guideline on self-care interventions, updated in 2021, included key considerations concerning TGD people. In 2022, WHO's updated key populations guidelines include a prioritized package of not just HIV, but also viral hepatitis and STI health interventions for TGD people. Still, a broader and more specific health approach and a greater focus on social issues are needed to better serve the health needs of TGD people. WHO's understanding and commitment to TGD people's health has evolved and improved over the past decade. Together with professional and community trans health organizations, WHO should now start developing evidence-informed global guidance on TGD health as part of its remit to support UHC to all.

Regulations on nutrition in Indonesia and its relation to early childhood caries.

There is a close relationship between food and nutrition policies and oral health. The relationship between nutrition and dental problems has been widely discussed, including the major dental problem in children: early childhood caries (ECC). Health-oriented national policies are the main principles of public health welfare. This article is a policy brief that provide a review of the food and nutrition policies in Indonesia that may have a relationship with ECC. It is concluded that some policies support the efforts to prevent ECC however, other technical explanations are still needed for health workers and especially parents regarding its simple implementation in everyday life. Multisectoral approaches that includes health, nutrition and education are needed to address ECC.

Africa’s Ed-Tech Platforms: Protecting Children’s Right to Privacy

Ed-tech platforms are used to create a more engaging, inclusive, and individualized learning experience. A number of these platforms utilize Artificial Intelligence (AI). AI-enabled learning tools and approaches have revolutionized the global education sector (Pedro et al., 2019). They have been recognized for their contributions to enhancing the quality of learning and teaching. AI aids teachers and students in their lessons (Pedro et al., 2019). Additionally, AI has been lauded for its potential to boost students' knowledge and learning habits, while also creating a more personalized approach to learning (Pedro et al., 2019). Children are less likely to read or understand privacy policies, and they may have a limited understanding of their right to privacy and data protection. In addition, they are more susceptible to marketing techniques that adults can identify. The existence of their personal information online poses potential safety and security risks. Therefore, privacy policies on Ed-tech platforms must incorporate children's rights and an understanding of their right to privacy. This includes online protection and security measures established to protect children's data. The primary audience for this policy brief is corporations. Although, children’s rights to privacy are a collective responsibility of the parents, legal guardians, and other individuals legally responsible for the child. In the Ed-tech space, this responsibility extends to AI platform owners, who manage the platforms, and policymakers and regulators concerned with data protection and children’s rights.

La explotación de los acuíferos en México: la situación empeora

In Mexico, the serious problem of groundwater overexploitation is not slowing down, nor are there signs that the situation is going to improve. Of the existing 653 aquifers in the country, 157 were registered as overexploited as of 2020. This number has increased for years, demonstrating the resounding failure of water governance from all federal governments. This trend is characterised by poor political will on the matter, invisibilisation of the problem, corruption in management, an absence of comprehensive long-term projects, and weak governance - among other causes which are discussed in the policy brief. Factors such as unsustainable economic and urban growth, severe surface water pollution, and a lack of budgetary and regulatory reforms complicate the country’s outlook further. It is necessary to continue analysing the problem and to generate momentum to boost public policies and promote sustainable development for greater water security in Mexico.