Public Health Administration Research Articles

Readiness for hospital discharge in primary caregivers for children with acute lymphoblastic leukaemia.

To investigate existing status and factors affecting the readiness for hospital discharge in primary caregivers for children with acute lymphoblastic leukaemia in China. Acute lymphoblastic leukaemia is the most common childhood cancer, but there is not enough research on the readiness for hospital discharge. A cross-sectional study was performed by convenience sampling and questionnaire survey. A self-developed questionnaire of general and clinical characteristics of patients, self-developed questionnaire of general status of family and primary caregivers, questionnaire of readiness of hospital discharge scale and social support rating scale for primary caregivers were delivered to 264 primary caregivers of childhood acute lymphoblastic leukaemia patients. Data collection was carried out 24h before discharge at bedside. In this study, the STROBE checklist was followed. In total, 253 patients aged 0-16years, including their primary caregivers in the hospital, were included from November 2016 to August 2017. Based on the readiness scale, the total mean score of readiness was 157.36. Based on the social support scale, the total mean score was 42.17. According to multivariate analysis, periods of chemotherapy (p<.001), complications (p=.019), family economic situation (p=.023), understanding of leukaemia (p<.001), objective support (p=.004), subjective support (p<.001) and availability of support (p=.045) were the main influencers of readiness. The readiness for hospital discharge in primary caregivers for childhood lymphoblastic leukaemia patients is not satisfactory in China. This study has implications for public health administration, asking for better community services and disease education. In addition, more effort should be made to provide high-quality family and primary caregiver assessments and discharge education by nurses.

Dr. Abolghasem Bahrami (1894–1950): Physician, Pasteurian, and a Pioneer of Microbiology and Public Health Planning in Iran

Dr. Abolghasem Bahrami was among the generation of Iranian scientists in the early twentieth century who gained most of their knowledge through resources available inside the country. Educated at Dar-ul-Funun Medical School, he was a physician with a great talent in learning, especially self-teaching natural sciences and European languages. He joined the Pasteur Institute of Iran (IPI) at the early days of its foundation and became an integral contributor to this institution during the first twenty-five years of its mission. One of his first assignments at IPI was to help initiating an anti-rabies department by bringing back the rabies vaccine and its manufacturing equipment from Institut Pasteur of Paris. During his IPI years, aside from managerial tasks, he actively participated in upgrading the medical treatments and protocols used for controlling many infectious diseases. He functioned twice as the provisional director of IPI (1925-1926 and 1937-1946) and is considered as the first Iranian director of the Institute. Meanwhile, Dr. Bahrami was a significant contributor to the public health system and assumed several responsibilities such as Chief Quarantine Medical Officer, Chief of Public Health, and the Head of Public Health Administration, in order to improve public health planning throughout the country.

Systematic review of methodology and reporting quality of global guidelines on fever in children

Objective:This study aimed to evaluate the global clinical practice guidelines on fever in children. We also aimed to select a guideline with good methodology and reporting quality to provide scientific reference for diagnosis and treatment of fever in children.Methods:The Chinese and English databases Embase, PubMed, Cochrane library, China National Knowledge Infrastructure, Wanfang database, clinical guides, and the website of the Department of Public Health Administration were retrieved up to January 2020. The clinical practice guidelines on fever in children were included. The AGREE II instrument and Reporting Items for Practice Guidelines in Healthcare statement were used to evaluate the methodology and reporting quality of the guidelines.Results:Eight clinical guidelines for fever in children were included. Methodological quality assessment showed that the recommendation level of ISP, South Africa, National Institute for Health and Care Excellence, China, and American College of Emergency Physicians were grade B (recommended with modification), while that of American Academy of Pediatrics, New South Wales, and South Australia was grade C recommendation (not recommended). No grade A recommendation guideline was found. The reporting quality from higher to lower was National Institute for Health and Care Excellence, the Chinese guideline, American College of Emergency Physicians, ISP, South Africa, New South Wales, South Australia, and American Academy of Pediatrics. The guideline recommendations were similar in various countries, but they were slightly different in various aspects, including body temperature measurement and the timing of drug administration.Conclusion:There are limitations in the methodology and reporting quality of all eight global guidelines on fever in children. For future development of these guidelines, attention should be paid to improving applicability of the guidelines in terms of methodology. Additionally, the principles and explanations for formation of recommendations should be described, as well as the limitations of the reporting guideline in detail in terms of the reporting quality. Treatments of fever in children are similar in different countries, but there are still differences that require further research.

МАГИСТРЫ ПУБЛИЧНОГО УПРАВЛЕНИЯ И АДМИНИСТРИРОВАНИЯ НМАПО ИМЕНИ П. Л. ШУПИКА - НОВАЯ МОДЕЛЬ СПЕЦИАЛИСТОВ НАЦИОНАЛЬНОЙ СФЕРЫ ЗДРАВООХРАНЕНИЯ

Цель исследования: определение составляющих модели руководителя национальной сферы здравоохранения начала XXI века - слушателя магистерской программы «Публичное управление и администрирование» Национальной медицинской академии последипломного образования имени П. Л. Шупика. Материалы и методы. Проанализированы научные источники по теме (11 ед.) с использованием методов системного подхода и системного анализа. Результаты. Реформирование здравоохранения Украины требует решения очень важной и неотложной задачи - подготовки магистров публичного управления и администрирования в сфере здравоохранения. Этот процесс в НМАПО имени П. Л. Шупика будет осуществляться в условиях созданной в 2020 году магистратуры. Выводы. Основными компонентами профессиональной модели современного руководителя здравоохранения являются: наличие системы профессиональных знаний, умений и навыков; обучение в течение всей жизни; приобретение общечеловеческих качеств через изучение гуманитарных дисциплин; психологическая готовность к выполнению управленческой деятельности. Отдельно выделим такие составляющие профессиональной модели современного руководителя как профессионализм, культура и управленческая ответственность. Главными преимуществами обучения в магистратуре НМАПО имени П. Л. Шупика по специальности «Публичное управление и администрирование в сфере здравоохранения» станут такие: индивидуальный подход к учебе, специальное консультативное сопровождение во время учебы, использование современных форм и методик проведения занятий, практико-ориентированный подход в обучении, практическая работа в лечебно-профилактических учреждениях и органах государственной власти, привлечение к проведению гостевых лекций практиков здравоохранения, возможность поступления в аспирантуру. Магистр публичного управления и администрирования может работать в органах государственной власти, местного самоуправления и общественных организациях.

How Ethics in Public Health Administration Leadership Leverages Connectedness in the Age of COVID-19

Ethics is critical in emergency response to public health and patient care in ways that create a variety of challenging dilemmas and decisions. Understanding ethical codes around medical care, especially during the emergence of COVID 19, has made leadership's role in perpetuating ethical organizational cultures in healthcare vital. Ethical leadership and ethical organizational cultures transform and unite social systems around everyday purposes of ethical decision-making, leveraging organizational connectedness. Leadership value systems mitigate subjectivity constituting ethical themes of moral character and virtues to advance organizational trust. Leadership value systems reduce subjectivity, forming ethical issues of moral character and virtues to promote organizational confidence and moral organizational decision-making. This paper employs the use of content analysis from the literature to take disjointed approaches and combine them into a cohesive understanding of leadership dynamics on organizational ethics in healthcare.

The Economics of Sick Calves: The Use of Calves for Smallpox Vaccine Lymph Production in Britain and its Empire, 1870s–1900s

Summary In this essay, I explore how the production and distribution of animal lymph benefited public and private producers by allowing them to use the calf’s body to profit from compulsory vaccination legislation. Through this process, a market was created in which the state competed with and was beholden to commercial entities for public health administration. By establishing its own vaccine-producing sites, the state participated in this public health market, where it competed with private producers. Building on scholarly work on the history of public health and animal histories, the essay understands how late nineteenth-century British vaccine administration hinged on a view of lymph production that encompassed the calf’s importance to vaccine administration and the commodification of the resulting vaccine lymph. These perspectives shaped how the state and medical practitioners approached and administered vaccination, refashioning lymph from a free tool to a market commodity.

Inequities in the distribution of COVID-19: an adaptation of WHO's conceptual framework

The COVID-19 pandemic currently affects populations worldwide. Although everyone is susceptible to the virus, there are numerous accounts of the pandemic having a greater impact on lower socioeconomic groups and minorities, which is a ubiquitous phenomenon. It is essential for public health administrations and governments to uncover and understanding these inequities to develop proper intersectoral policies to tackle this crisis. Therefore, developing a conceptual framework on this topic, describing the social mechanisms that explain the unjust distribution of the incidence and mortality of COVID-19, is a key task. The aim of this paper is to adapt the framework on social determinants of health from the World Health Organization to the specifics of COVID-19 pandemic. Thus, it identifies and explains the structural and intermediate determinants involved in this pandemic, and adds some new elements (such as the role of the oppression systems and communication) which may help to understand, and ultimately tackle, social inequities in COVID-19 distribution.

Simulation Agent-Based Model to Demonstrate the Transmission of COVID-19 and Effectiveness of Different Public Health Strategies

COVID-19 has changed the world fundamentally since its outbreak in January 2020. Public health experts and administrations around the world suggested and implemented various intervention strategies to slow down the transmission of the virus. To illustrate to the general public how the virus is transmitted and how different intervention strategies can check the transmission, we built an agent-based model (ABM) to simulate the transmission of the virus in the real world and demonstrate how to prevent its spread with public health strategies.

Penyebaran Penyakit Brucellosis di Wilayah Koasistensi Administrasi Dinas dan Kesmavet

Brucellosis is a Brucella bacterial infectious disease that is spread from animals to humans, generally through consumption of milk, especially unpasteurized milk, or other dairy products. Veterinary public health has an important role in preventing transmission of disease to humans through both animals and foodstuffs of animal origin or other animal origin ingredients. Brucellosis is one of the problems often faced by the Animal Husbandry Department, especially at the Animal Health Unit. Handling and controlling about Brucellosis is very vital to maintain animal health and reduce the level of economic losses of farmers due to Brucellosis experienced by livestock owned. This study aims to determine the spread of Brucellosis disease by mapping in the Administrative and Service Coordination areas, to know the handling and control actions carried out by the Animal Husbandry Service throughout the implementation of the Administrative Coordination Office and Veterinary Public Health. The results of the mapping of the spread of Brucellosis in the District of Veterinary Public Health and Public Service Administration Coordination can be divided into 3 groups with the number of cases &lt;10, 10 - 66, and&gt; 66. The number of cases between the range of 10 - 66 there are 3 regions, while the number of cases&gt; 66 there are 2 regions. Keywords : Brucellosis; Mapping; Handling and Control; Descriptive Statistics

Long-term Effects of the COVID-19 Pandemic on Public Sentiments in Mainland China: Sentiment Analysis of Social Media Posts.

BackgroundThe COVID-19 outbreak has induced negative emotions among people. These emotions are expressed by the public on social media and are rapidly spread across the internet, which could cause high levels of panic among the public. Understanding the changes in public sentiment on social media during the pandemic can provide valuable information for developing appropriate policies to reduce the negative impact of the pandemic on the public. Previous studies have consistently shown that the COVID-19 outbreak has had a devastating negative impact on public sentiment. However, it remains unclear whether there has been a variation in the public sentiment during the recovery phase of the pandemic.ObjectiveIn this study, we aim to determine the impact of the COVID-19 pandemic in mainland China by continuously tracking public sentiment on social media throughout 2020.MethodsWe collected 64,723,242 posts from Sina Weibo, China’s largest social media platform, and conducted a sentiment analysis based on natural language processing to analyze the emotions reflected in these posts.ResultsWe found that the COVID-19 pandemic not only affected public sentiment on social media during the initial outbreak but also induced long-term negative effects even in the recovery period. These long-term negative effects were no longer correlated with the number of new confirmed COVID-19 cases both locally and nationwide during the recovery period, and they were not attributed to the postpandemic economic recession.ConclusionsThe COVID-19 pandemic induced long-term negative effects on public sentiment in mainland China even as the country recovered from the pandemic. Our study findings remind public health and government administrators of the need to pay attention to public mental health even once the pandemic has concluded.

Beyond the Pandemic: Leveraging Rapid Expansions in U.S. Telemental Health and Digital Platforms to Address Disparities and Resolve the Digital Divide.

The COVID-19 pandemic illuminated persistent health disparities faced by underserved ethnic minorities, immigrants, and refugee communities across the U.S. Simultaneously, expanded telemental health coverage enabled physically-distanced care, lowering the risk of COVID-19 transmission, while potentially yielding a welcomed, secondary outcome: increasing accessibility for harder-to-reach populations (1). Telehealth, or telemental health (TMH) when pertaining to mental health care and treatment, is “the use of electronic information and telecommunication technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration” (2). We discuss how TMH reduces pre-existing barriers to service utilization while possibly worsening others, such as the digital divide excluding those with lower technological literacy from fully benefitting from telemedicine. Yet, we are also at a unique moment in U.S. history to leverage political momentum in response to the pandemic to increase digital connectivity for diverse populations (3).

Health system responses to COVID-19: a multi-level systematic review of primary qualitative studies

COVID-19 had presented challenges to the healthcare systems and healthcare professionals in all countries. After one year of the pandemic, the evidence begins to consolidate, and the literature demands the documentation of the experiences lived by healthcare professionals and other frontline actors. This systematic review of primary qualitative studies depicts the experiences and perceptions of organizations and actors at multiple levels of health systems internationally in responding to COVID-19. Six main databases of biomedical information, public health and health administration research were searched over the period 1 October 2019 to 21 October 2020. Information extracted from included studies was analysed thematically. Twenty-two articles were selected for full assessment. Considering the professional level experiences, the most predominant themes of the studies consisted of the new roles and responsibilities of healthcare workers, burnout and distress, unseen healthcare workers, and positive changes and emergent solutions amid the crisis. Recommendations of the studies discussed mainly about the urge to provide psychological support, and leadership for managers and health authorities. Continuous training, regulation of working conditions, providing supportive resources, coordinating a diversity of actors, and reviewing and updating regulations were recommendations of a wider system support. The experiences of frontline healthcare workers had been the focus of attention of primary qualitative studies as of October 2020. Knowledge gaps and the need for primary research were identified in the organisational and national levels that could answer to the needs of the workforce.

Association between exposure to road traffic noise and hearing impairment: a case-control study.

Noise pollution in urban areas is increasing steadily, and the study of road traffic noises and their effects on the auditory system was rare. This study investigated the potential effects of road traffic noise on auditory systems and hearing. A case-control study recruited outpatients from the Otolaryngology department. The case group (n = 41) had binaural hearing loss (HL) ofstandard pure-tone average(PTA) ≥ 25dB or high frequency PTA≥ 25dB, while the control group (n = 39) had binaural hearing level of any frequency < 25dB. Detailed otologic evaluations were performed. Between-group data were evaluated using logistic regression analysis. Case or control group was identified based on the audiogram. A total of 80 subjects were recruited, including 41 with hearing impairment and 39 as control. The mean exposure level of road traffic noise was significantly higher in the case group than the control group (p = 0.005). A crude OR of 5.78 showed an increased risk of greater than 70dB of road traffic noise on hearing impairment and tinnitus (p < 0.001). The aOR of 9.24 (p = 0.002) from a multiple variate analysis suggested that road traffic noise levels greater than 70dB may have a damaging effect on hearing. Damaging effects on hearing persisted even after adjusting for confounders in the full multivariate model (aOR of 9.24 [95% CI: 2.198-38.869]; p = 0.002). Exposing to road traffic noise greater than 70dB showed an increased risk of damage to the auditory system. These results might help public health administrators and physicians to develop programs that address the health dangers of noise.

Association of bone mineral density and depression in different bone sites and ages: A meta-analysis.

Major depressive disorder (MDD) is considered as a risk factor for osteoporosis. Bone mineral density (BMD), as the main tool for diagnosing osteoporosis, has been reported to have correlation with MDD in different cohorts. However, the information in causative link and etiology determinants of osteoporosis in MDD is still under investigation. The results are unclear. Thus, we perform a meta‐analysis to evaluate the association between altered BMD and MDD. We searched the electronic databases to find studies examining BMD in patients with MDD. Finally, 26 published studies were included in our meta‐analysis up from January 1990 to January 2019. All the data were pooled analysis using RevMan software. The association between altered BMD and MDD was assessed by std. mean difference (STD) and their 95% confidence intervals (CIs) for each study. Twenty‐six studies were included in this meta‐analysis. Pooled results showed a significant lower BMD in spine (STD=0.51, 95% CI=0.30–0.71, p < .00001), total hip (STD=0.41, 95% CI=0.16 to 0.66, p = .001), and femoral neck (STD=0.93, 95% CI=0.32 to 1.55, p = .003) in MDD compared with controls. After stratification by mean age, gender, recruitment, diagnostic criteria, and measuring methods, no significant difference of BMD was found in bone mineral density of male total hip between MDD and controls(p > .05). Moreover, adults appear to have lower BMD than old cohorts. This is an updated meta‐analysis to reveal the association of bone mineral density and depression, suggesting that BMD appears to be more susceptible to occur in spine, total hip, femoral neck in MDD, especially for adults and women. Our meta‐analysis may provide clinicians and public health administrators with an important screening tool for assessing depression and avoiding osteoporosis in adult subjects and female.

Mental health and risk behaviors among secondary school students: A study on ethnic minorities

Mental health disorders are highly correlated with risk behaviors. The objective of the present study is to examine the relationship between risk behaviors and mental health among school-going students with a focus on ethnic minorities. The National Health and Morbidity Survey (NHMS) 2017 (n=8230) was used for analyses. It was a nationwide survey conducted in Malaysia. The dependent variables were measured by three risk behaviors (cigarette smoking, alcohol drinking and use of illicit drugs). Probit regressions were utilized to examine the effect of mental health on the probability of smoking, drinking and using illicit drugs. Demographic and lifestyle factors were used as the control variables. Truancy was identified as a mediating variable. Anxiety, depression and suicidal ideation affected cigarette smoking, alcohol drinking and use of illicit drugs through mediation of truancy. After controlling for demographic and lifestyle factors, students with anxiety, depression and suicidal ideation were more likely to smoke, drink and use illicit drugs compared with their peers without any mental health disorders. Furthermore, the likelihood of consuming cigarettes, alcohol and illicit drugs was found to be higher among students who played truant than those who did not. Mental health plays an important role in determining participation in risk behaviors among ethnic minority students in Malaysia. Public health administrators and schools have to be aware that students who suffer from mental health disorders are likely to indulge in risk behaviors.

Age-Adjusted US Cancer Death Rate Predictions

The likelihood of developing cancer during one's lifetime is approximately one in two for men and one in three for women in the United States. Cancer is the second-leading cause of death and accounts for one in every four deaths. Evidence-based policy planning and decision making by cancer researchers and public health administrators are best accomplished with up-to-date age-adjusted site-specific cancer death rates. Because of the 3-year lag in reporting, forecasting methodology is employed here to estimate the current year rates based on complete observed death data up through three years prior to the current year. The authors expand the State Space Model (SSM) statistical methodology currently in use by the American Cancer Society (ACS) to predict age-adjusted cancer death rates for the current year. These predictions are compared with those from the previous Proc Forecast ACS method and results suggest the expanded SSM performs well.

Abstract 72: Slow Progress in Low-Resource Environments: Is Lack of Education and Training in Cancer Prevention Key?

Abstract Purpose: Explore attitudes about education and training in cancer prevention research and practice on dissemination and implementation of cancer prevention practices in India. Methods: Conduct focus groups to understand how cancer prevention education and training – or their absence – influence dissemination and implementation of cancer prevention and control strategies from stakeholder groups: o Professionals with leadership responsibilities in cancer and public health, managing people and resources, and with experience working with patients and communities, clinicians and public health professionals, health administrators, government agencies, and non-profits; and o Patients with cancers for which prevention and early detection strategies exist. Results: In focus group discussion guides, we consider how to appropriately probe aspects of individual and professional responsibility, leadership style, public and system capacity, cultural and educational influence, and surface other aspects important to the influence of education and training of professionals, leaders, and the public in cancer prevention and control. We expect to gain rich insight from leaders and professionals with knowledge of cancer prevention and control success achieved in developed countries and lived experience managing cancer resources for patients and systems in India. We also anticipate rich insight from survivors about their expectations of and experiences with oncology care for contrast and alignment of themes from leaders and professionals. Conclusio:n Slow progress in dissemination and adoption of proven cancer prevention and control initiatives in LMICs creates critical opportunities missed. Through focus groups, we hope to unearth foundational barriers to cancer prevention in low-resource settings related to cancer prevention education and training for fuller NCI R01 dissemination science investigations in India and other low-resource settings that share the experience of preventable cancers diagnosed at advanced stage but are culturally different for comparison. Insight from such studies may reveal new directions for achieving high impact, long-term implementation of cancer prevention strategies. Citation Format: Melissa Varon, Chang Shine, Sharmila Pimple, Surendranath Shastri. Slow Progress in Low-Resource Environments: Is Lack of Education and Training in Cancer Prevention Key? [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 72.

The Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19: Antigen Testing.

Immunoassays designed to detect SARS-CoV-2 protein antigens are now commercially available. The most widely used tests are rapid lateral flow assays that generate results in approximately 15 minutes for diagnosis at the point-of-care. Higher throughput, laboratory-based SARS-CoV-2 antigen (Ag) assays have also been developed. The overall accuracy of SARS-CoV-2 Ag tests, however, is not well defined. The Infectious Diseases Society of America (IDSA) convened an expert panel to perform a systematic review of the literature and develop best practice guidance related to SARS-CoV-2 Ag testing. This guideline is the third in a series of rapid, frequently updated COVID-19 diagnostic guidelines developed by IDSA. IDSA's goal was to develop evidence-based recommendations or suggestions that assist clinicians, clinical laboratories, patients, public health authorities, administrators and policymakers in decisions related to the optimal use of SARS-CoV-2 Ag tests in both medical and non-medical settings. A multidisciplinary panel of infectious diseases clinicians, clinical microbiologists and experts in systematic literature review identified and prioritized clinical questions related to the use of SARS-CoV-2 Ag tests. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make testing recommendations. The panel agreed on five diagnostic recommendations. These recommendations address antigen testing in symptomatic and asymptomatic individuals as well as assess single versus repeat testing strategies. Data on the clinical performance of U.S. Food and Drug Administration SARS-CoV-2 Ag tests with Emergency Use Authorization is mostly limited to single, one-time testing versus standard nucleic acid amplification testing (NAAT) as the reference standard. Rapid Ag tests have high specificity and low to modest sensitivity compared to reference NAAT methods. Antigen test sensitivity is heavily dependent on viral load, with differences observed between symptomatic compared to asymptomatic individuals and the time of testing post onset of symptoms. Based on these observations, rapid RT-PCR or laboratory-based NAAT remain the diagnostic methods of choice for diagnosing SARS-CoV-2 infection. However, when molecular testing is not readily available or is logistically infeasible, Ag testing can help identify some individuals with SARS-CoV-2 infection. The overall quality of available evidence supporting use of Ag testing was graded as very low to moderate.

Profiling COVID-19 Genetic Research: A Data-Driven Study Utilizing Intelligent Bibliometrics.

The COVID-19 pandemic constitutes an ongoing worldwide threat to human society and has caused massive impacts on global public health, the economy and the political landscape. The key to gaining control of the disease lies in understanding the genetics of SARS-CoV-2 and the disease spectrum that follows infection. This study leverages traditional and intelligent bibliometric methods to conduct a multi-dimensional analysis on 5,632 COVID-19 genetic research papers, revealing that 1) the key players include research institutions from the United States, China, Britain and Canada; 2) research topics predominantly focus on virus infection mechanisms, virus testing, gene expression related to the immune reactions and patient clinical manifestation; 3) studies originated from the comparison of SARS-CoV-2 to previous human coronaviruses, following which research directions diverge into the analysis of virus molecular structure and genetics, the human immune response, vaccine development and gene expression related to immune responses; and 4) genes that are frequently highlighted include ACE2, IL6, TMPRSS2, and TNF. Emerging genes to the COVID-19 consist of FURIN, CXCL10, OAS1, OAS2, OAS3, and ISG15. This study demonstrates that our suite of novel bibliometric tools could help biomedical researchers follow this rapidly growing field and provide substantial evidence for policymakers’ decision-making on science policy and public health administration.

Validation of 4D Components for Measuring Quality of the Public Health Data Collection Process: Elicitation Study.

BackgroundIdentification of the essential components of the quality of the data collection process is the starting point for designing effective data quality management strategies for public health information systems. An inductive analysis of the global literature on the quality of the public health data collection process has led to the formation of a preliminary 4D component framework, that is, data collection management, data collection personnel, data collection system, and data collection environment. It is necessary to empirically validate the framework for its use in future research and practice.ObjectiveThis study aims to obtain empirical evidence to confirm the components of the framework and, if needed, to further develop this framework.MethodsExpert elicitation was used to evaluate the preliminary framework in the context of the Chinese National HIV/AIDS Comprehensive Response Information Management System. The research processes included the development of an interview guide and data collection form, data collection, and analysis. A total of 3 public health administrators, 15 public health workers, and 10 health care practitioners participated in the elicitation session. A framework qualitative data analysis approach and a quantitative comparative analysis were followed to elicit themes from the interview transcripts and to map them to the elements of the preliminary 4D framework.ResultsA total of 302 codes were extracted from interview transcripts. After iterative and recursive comparison, classification, and mapping, 46 new indicators emerged; 24.8% (37/149) of the original indicators were deleted because of a lack of evidence support and another 28.2% (42/149) were merged. The validated 4D component framework consists of 116 indicators (82 facilitators and 34 barriers). The first component, data collection management, includes data collection protocols and quality assurance. It was measured by 41 indicators, decreased from the original 49% (73/149) to 35.3% (41/116). The second component, data collection environment, was measured by 37 indicators, increased from the original 13.4% (20/149) to 31.9% (37/116). It comprised leadership, training, funding, organizational policy, high-level management support, and collaboration among parallel organizations. The third component, data collection personnel, includes the perception of data collection, skills and competence, communication, and staffing patterns. There was no change in the proportion for data collection personnel (19.5% vs 19.0%), although the number of its indicators was reduced from 29 to 22. The fourth component, the data collection system, was measured using 16 indicators, with a slight decrease in percentage points from 18.1% (27/149) to 13.8% (16/116). It comprised functions, system integration, technical support, and data collection devices.ConclusionsThis expert elicitation study validated and improved the 4D framework. The framework can be useful in developing a questionnaire survey instrument for measuring the quality of the public health data collection process after validation of psychometric properties and item reduction.