Public Policy Initiatives Research Articles

Priorities of Municipal Policy Makers in Relation to Physical Activity and the Built Environment

To examine policy makers' public policy priorities related to physical activity and the built environment, identify classes of policy makers based on priorities using latent class analysis, and assess factors associated with class membership. Cross-sectional survey data from municipal officials in 94 cities and towns across 6 US states were analyzed. Participants (N = 423) were elected or appointed municipal officials spanning public health, planning, transportation/public works, community and economic development, parks and recreation, and city management. Participants rated the importance of 11 policy areas (public health, physical activity, obesity, economic development, livability, climate change, air quality, natural resource conservation, traffic congestion, traffic safety, and needs of vulnerable populations) in their daily job responsibilities. Latent class analysis was used to determine response patterns and identify distinct classes based on officials' priorities. Logistic regression models assessed participant characteristics associated with class membership. Four classes of officials based on policy priorities emerged: (1) economic development and livability; (2) economic development and traffic concerns; (3) public health; and (4) general (all policy areas rated as highly important). Compared with class 4, officials in classes 1 and 3 were more likely to have a graduate degree, officials in class 2 were less likely to be in a public health job/department, and officials in class 3 were more likely to be in a public health job/department. Findings can guide public health professionals in framing discussions with policy makers to maximize physical activity potential of public policy initiatives, particularly economic development.

¿Son posibles las políticas públicas frente a las transnacionales?

La posibilidad de articular políticas públicas que delimiten y disputen el poder de las empresas transnacionales, se ha presentado en el marco de experiencias que buscan salir del neoliberalismo y transitar hacia un nuevo sistema económico, lo cual ha supuesto plantearse la refundación constitucional de los Estados, redefiniendo objetivos estratégicos, instituciones, normas y demás, como es el caso de Ecuador. El artículo hace una breve revisión de iniciativas de políticas públicas que hacen frente al poder de las transnacionales, de manera directa o indirecta, desde agendas específicas de recuperación de soberanías, control del poder de mercado y compras públicas. Desplegando las capacidades de regulación, control y negociación del Estado, y conjugando soberanías nacionales y regionales, se procura delimitar el control transnacional de la producción y el comercio, de la capacidad de demanda local, entre otros, lo que pasa por reestructuraciones de los propios mercados nacionales y de sus lógicas.

Network management and associated firms’ outcomes: multilevel analysis in the southern Brazilian context

This article seeks to provide theoretical and managerial insights with respect to the following questions: What is the effect of network management on the outcomes of associated firms? Do these effects on outcomes vary among small-firm networks (SFNs)? Do these outcomes vary among associated firms within the same SFN? Which management elements are most influential in the variation of these SFN outcomes? To answer these questions, this study adopts a multilevel analytical approach using SFNs in southern Brazil that benefit from the Cooperation Networks Program, a local public policy initiative that supports the formation, development, and consolidation of SFNs. The findings suggest that the outcomes provided by the networks differ between networks but are similar for firms in the same network. They also indicate that strategy and processes at the network level are related to firms’ outcomes. These findings show that the influence of structure on firms’ outcomes varies among networks and that the market segment is the only network-level variable that is significantly related to firms’ outcomes.

Factors affecting agricultural nitrogen removal in riparian strips: Examples from groundwater-dependent ecosystems of the Po Valley (Northern Italy)

The role of riparian ecosystems in mitigating the effects of diffuse agricultural sources is recognized in several regulatory measures and public policy initiatives in many parts of the world. This study aimed to evaluate the N buffering capacity of semi-natural riparian zones associated with spring-fed lowland streams, also known as “fontanili”, representing the most important groundwater-dependent ecosystems in Northern Italy. Monitoring parcels were set up in nine riparian sites selected to cover a range of different soil properties and hydrogeological settings, and to sustain the evaluation of the main drivers affecting their N removal efficiency. Subsurface water level, nutrient concentrations and the main hydro-chemical parameters were monitored along transects of piezometers installed from crop fields to the spring channels. On selected samples from two sites stable isotopes of the water molecule were also determined. Median NO3− input concentrations from adjacent cropland to the riparian sites ranged from 0.10 to 21mgNL−1, with maximum values exceeding the drinking water limit recorded during the summer and winter fertilization periods. Highly variable groundwater nitrate patterns were found in the riparian areas, including short nitrate plumes extending from the adjacent cropland into some riparian zones, or in others, small patches where NO3− declined at variable distance from the stream. Some chemical indicators (e.g., NO3−/Cl− ratio, O2, DOC) suggested that NO3− attenuation was mostly due to the denitrifying activity occurring in the subsurface aquifers in specific conditions (hot spots and moments), although, in some cases, physical processes such as dilution also contributed. The overall N removal efficiency was greater than 90% in four sites, 74%, 34% and 30% in three sites, and zero in the remaining two sites. Useful predictors of the nitrate removal capacity were factors linked to the water residence time, such as the hydraulic conductivity, the soil texture and the slope of the riparian profile, together with the water table depth and soil organic carbon. A combination by standardized averaging of these five factors supported a clear discrimination of sites with zero or low N removal effectiveness from those with high efficiency.

A financial and public policy analysis of the meat industry

This study provides an economic and financial performance analysis of prominent companies in the meat industry in the aftermath of public policy initiatives that divert corn to making biofuel and away from making food and animal feed. Results should be of interest to policy makers, investors, and other stakeholders. An important part of personal and societal wellness is the issue of a healthy diet. Meat provides essential nutrients, notably protein, B vitamins, vitamin D, and iron. Eating a proper diet has been a concern from ancient times to the present. For example, the Bible story of Daniel, written about 540 B.C., describes the benefits of eating healthy food (Daniel 1:15). The meat industry is a major agricultural sector that plays an important economic role in many countries of the world. In light of the meat industry's important contributions to the economy and to people's health, great care should be given when developing public policies that affect the industry. Diverting corn crops to make biofuel, perhaps well motivated public policy when initiated, is now questionable.

EParticipation Issues in Contemporary Europe

Today, Information and Communication Technologies have developed to the extent of amplifying political procedures that are central to the contemporary civic society, such as political participation and citizen engagement. eParticipation is a multidisciplinary field of study, which is particularly relevant in several contexts and environments, e.g. digital democracy, public services, open government, popular social media etc. This paper addresses the eParticipation framework in the European context, during the last 10 years.Our research will explore theoretically and empirically how citizen participation is achieved through social media and digital public services. The article explores both the cultural and political environments that favor the development of eParticipation initiatives, with the study of networking interactions based on social and public policy initiatives. We are particularly interested in the public policy formulations that embrace eParticipation and most importantly the recent developments in the field, which include a number of eConsultation, ePolling, eLegislation, eElectioneering, eVoting etc. A review of the good practice examples in eParticipation policy development will help us identify the strengths and weaknesses of the digital framework. Within the context of social value, we want to explore the aspect of eParticipation in the broader political scene, by examining the role of digital participation in political crises. By drawing examples based on case studies of public policy formulation in European countries, the research suggests a correlation between digital innovation and challenging politics. The framework is originally designed to be sustainable for the European societies and it places citizens in the center of its conception. It is, however, argued that the interaction between public policy innovation and citizen engagement needs continuous scholarly attention and study.

EParticipation Issues in Contemporary Europe

Today, Information and Communication Technologies have developed to the extent of amplifying political procedures that are central to the contemporary civic society, such as political participation and citizen engagement. eParticipation is a multidisciplinary field of study, which is particularly relevant in several contexts and environments, e.g. digital democracy, public services, open government, popular social media etc. This paper addresses the eParticipation framework in the European context, during the last 10 years.Our research will explore theoretically and empirically how citizen participation is achieved through social media and digital public services. The article explores both the cultural and political environments that favor the development of eParticipation initiatives, with the study of networking interactions based on social and public policy initiatives. We are particularly interested in the public policy formulations that embrace eParticipation and most importantly the recent developments in the field, which include a number of eConsultation, ePolling, eLegislation, eElectioneering, eVoting etc. A review of the good practice examples in eParticipation policy development will help us identify the strengths and weaknesses of the digital framework. Within the context of social value, we want to explore the aspect of eParticipation in the broader political scene, by examining the role of digital participation in political crises. By drawing examples based on case studies of public policy formulation in European countries, the research suggests a correlation between digital innovation and challenging politics. The framework is originally designed to be sustainable for the European societies and it places citizens in the center of its conception. It is, however, argued that the interaction between public policy innovation and citizen engagement needs continuous scholarly attention and study.

Social Responsibility and Social Change: How to Engage in Public Policy Process Via Social Entrepreneurship

This paper will address a few critical components of social change and social justice including social responsibility, social change, public policy initiatives, and the role of social entrepreneurs in mobilizing communities through building partnership and coalitions for achieving social change. The AEA model will be the main feature of the paper that includes three key elements of Awareness, Empowerment, and Action as its pillars supplemented by addressing the key role of public policy in providing the legal and Implementation base for social change and the pivotal role of social entrepreneurship in facilitating the whole change process. A brief reference to Levin’s Force Field and Change models as well as the role of technology and ethics as they relate to social change process will be addressed too.

Land-use, transport choice and population health: opportunities for highly motorized and rapidly motorizing countries

The presentation will highlight the population health effects arising from land-use changes and public policy initiatives that lead to changes in transport mode share for six international cities namely, Melbourne, Beijing, Delhi, London, Copenhagen and New York. The findings demonstrate that policies encouraging optimal land-use for active transport combined with provision of infrastructure that reduces the risk of injury for vulnerable road users (in association with road safety interventions) can produce considerable population health benefits across both chronic disease and road trauma. Without such infrastructure, however, increases in road trauma are likely, especially within highly motorised cities.

Unproven stem cell-based interventions and achieving a compromise policy among the multiple stakeholders.

BackgroundIn 2004, patient advocate groups were major players in helping pass and implement significant public policy and funding initiatives in stem cells and regenerative medicine. In the following years, advocates were also actively engaged in Washington DC, encouraging policy makers to broaden embryonic stem cell research funding, which was ultimately passed after President Barack Obama came into office. Many advocates did this because they were told stem cell research would lead to cures. After waiting more than 10 years, many of these same patients are now approaching clinics around the world offering experimental stem cell-based interventions instead of waiting for scientists in the US to complete clinical trials. How did the same groups who were once (and often still are) the strongest supporters of stem cell research become stem cell tourists? And how can scientists, clinicians, and regulators work to bring stem cell patients back home to the US and into the clinical trial process?DiscussionIn this paper, we argue that the continued marketing and use of experimental stem cell-based interventions is problematic and unsustainable. Central problems include the lack of patient protection, US liability standards, regulation of clinical sites, and clinician licensing. These interventions have insufficient evidence of safety and efficacy; patients may be wasting money and time, and they may be forgoing other opportunities for an intervention that has not been shown to be safe and effective. Current practices do not contribute to scientific progress because the data from the procedures are unsuitable for follow-up research to measure outcomes. In addition, there is no assurance for patients that they are receiving the interventions promised or of what dosage they are receiving. Furthermore, there is inconsistent or non-existent follow-up care. Public policy should be developed to correct the current situation.ConclusionThe current landscape of stem cell tourism should prompt a re-evaluation of current approaches to study cell-based interventions with respect to the design, initiation, and conduct of US clinical trials. Stakeholders, including scientists, clinicians, regulators and patient advocates, need to work together to find a compromise to keep patients in the US and within the clinical trial process. Using HIV/AIDS and breast cancer advocate cases as examples, we identify key priorities and goals for this policy effort.

AACR Cancer Progress Report 2015.

*These authors contributed to the devlopment and review of this manuscript but are unable to endorse the request for NIH funding. On Sept. 20, 2011, the American Association for Cancer Research (AACR) released its inaugural AACR Cancer Progress Report to commemorate the

Abstract IA14: Translating science into policy for public benefit

Abstract The effective prevention of cancer is based upon cancer control, which, historically, has been defined somewhat differently across institutions. UT-MD Anderson defines cancer control as implementation and dissemination of evidence-based products in three domains: 1) public policy, 2) education (both public and professional), and 3) community-based clinical service delivery and delivery enhancement. Comprehensive cancer control programs combining all three of these elements are typically most impactful. Although behavioral/clinical interventions and educational initiatives will always be necessary, public policy interventions applied at any organizational level (e.g., institutional, regional, statewide, national, international) represent a critical component of cancer control, given their broad reach, sustained impact across time, and potential to promote and reinforce cultural transformation. The mission of UT-MD Anderson's Cancer Prevention & Control Platform (CP & CP) is to develop and implement clinic and community-oriented, evidence-based projects in cancer prevention, screening, early detection, and survivorship to achieve a measureable and lasting reduction in the cancer burden, particularly among the poor and underserved of our catchment area, and extending to the global community. This translational goal is entirely consistent with our institutional mission “…to eliminate cancer in Texas, the nation, and the world.” Although the CP & CP has a broad mandate and numerous actions involving the full range of control activities, it currently supports a number of policy-driven initiatives through partnerships with various organizations, including the American Cancer Society, the Centers for Disease Control & Prevention and various other local, state and national public health agencies and coalitions. The recent passage of legislation restricting minors' access to tanning beds in Texas represents just one policy-related, educational component of a comprehensive strategy undertaken by the CP & CP to promote skin cancer awareness and preventive actions. As part of a comprehensive approach to tobacco control, the Platform is also educating the public regarding Smoke-Free Texas legislation. Additionally, the Platform recently convened a large public forum involving leading tobacco control representatives to discuss, deliberate, and prioritize potential policy, public education, and clinical service initiatives that could be considered to reduce tobacco use in our population. Recently, our faculty and staff developed a comprehensive set of evidence-based, strategic and tactical recommendations entitled, “EndTobacco” to guide UT-MD Anderson's and partners' efforts to collaboratively reduce the tobacco burden in our population. As one component of the EndTobacco program, UT-MD Anderson has implemented a new tobacco-free hiring policy. We aspire to develop public education, clinical service, and policy initiatives that will promote the effective delivery and dissemination of cancer preventive vaccines (such as HPV vaccines) in our population, as well. Continued partnering to inform and support policy change is critical to our success in translating compelling scientific discoveries into tangible actions to improve the public's health and reduce cancer's burden in our population. Submitted on behalf of the UT-MD Anderson Cancer Center's Cancer Prevention & Control Platform Leadership Team - Mark Moreno (co-lead), Jenny Tektiridis, Lewis Foxhall, David Wetter, Martha Salas, Kendra Woods, Stephanie Kim, Rosalind Bello, Shibu Varghese Citation Format: Ernest Hawk. Translating science into policy for public benefit. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr IA14.

Understanding AmeriCorps Service: Perspectives from Psychological Theory and Research on Volunteerism

Although national service programs such as AmeriCorps share many characteristics with volunteerism (such as sustained, prosocial action aimed at community improvement), little research has examined how theory and research relevant to volunteer behavior might help understand such service programs. We used psychological theory from the volunteerism literature to test hypotheses about how the constructs of altruistic personality, role identity, and service motivations relate to AmeriCorps satisfaction, intentions, and behavior. In a longitudinal study of 188 AmeriCorps members, personality, identity, and motivation were all associated with important service experiences and outcomes. Specifically, whereas overall motivation was related to both satisfaction and intentions, altruistic personality and AmeriCorps identity were only related to intentions. Additionally, distinct service motivations were related to specific service experiences and outcomes. Finally, AmeriCorps members who felt that their motivations were satisfied during service tended to more frequently engage in additional voluntary service‐related behaviors. We discuss implications of these findings for understanding AmeriCorps service, and for potentially improving public policy initiatives concerning AmeriCorps.

The Epidemiology of Upper Extremity Fractures in the United States, 2009.

No single epidemiological study of upper extremity fractures exists in the United States using data from all payers. Current epidemiological estimates are based on case series, foreign databases, or Medicare data, which are not representative of the entire US population. The objective of this project was to accurately describe the incidence of fractures of the upper extremity in a representative sample of the US population. Using International Classification of Disease, Ninth Edition codes for patient visits reported in the 2009 State Emergency Department Database and the State Inpatient Database, available from the Healthcare Cost and Utilization Project, and 2010 US Census data, we calculated the annual incidence rates per 10,000 persons of upper extremity fractures of all patients, regardless of age or payer type. This was done using a representative national sample from 8 states: Arizona, California, Iowa, Maryland, Massachusetts, New Jersey, and Vermont. Overall, in this population of over 87 million Americans, there were 590,193 fractures of the upper extremity, yielding an annual incidence of 67.6 fractures per 10,000 persons. Distal radius and ulna fractures were the most common upper extremity fractures (16.2 fractures per 10,000 persons), followed by hand fractures (phalangeal and metacarpal fractures; 12.5 and 8.4 per 10,000, respectively), proximal humerus fractures (6.0 per 10,000), and clavicle fractures (5.8 per 10,000). The most common type of fracture for all age groups was distal radius fractures, except in the 18- to 34-year-old group, in which metacarpal and phalangeal fractures were more common (16.1 and 12.5 per 10,000, respectively) and the 35- to 49-year-old group, in which phalangeal fractures were most common (11.5 per 10,000). The incidence of distal radius fractures was bimodal, with the highest rates in the under 18 and over 65 age groups (30.18 and 25.42 per 10,000, respectively) with lower rates in the middle age groups. The most common type of fracture for males was phalangeal fractures (11.5 per 10,000), and distal radius and ulna fractures were the most common type for females (11.8 per 10,000). Interestingly, phalangeal and metacarpal fractures varied by socioeconomic status (SES), which decreased with increasing SES. No other fracture type varied by SES. Epidemiological studies are necessary for research, clinical applications, and public health and health policy initiatives. This study reports national estimates of upper extremity fractures with subgroup analysis.

Street-level planning; the shifty nature of “local knowledge and practice”

Purpose– The purpose of this paper is to explore and problematizes one of the oft-cited reasons why the implementation of public policy and other development initiatives goes wrong – namely that there is a mismatch or antagonistic relationship between street-level worker’s decisions and priorities on the one hand and on the other hand the policy-makers’ or administrators’ directives and priorities.Design/methodology/approach– The paper builds on seven months of ethnographic fieldwork set in a Danish municipal unit which administered the sickness benefit legislation.Findings– Through the reading of an ethnographic example of implementation of labour market policy this paper suggests that when policy invariably is distorted at the administrative level it is not necessarily due to lack of will among street-level workers to comply with legislation or centrally devised directives but rather because: in practice, planning and implementation are concurrent processes that continuously feed into each other; and that the concerns and the “local knowledge and practice” that guide planning-implementation do not belong to individual people but are dynamic perspectives that individual people might take up in certain situations.Originality/value– This challenges conventional descriptions of street-level workers as a distinct group of people with distinctive concerns and attitudes to their work. The paper suggests instead the metaphor “vector of concern” to capture the way street-level workers’ changes of perspectives might cause interventions to disintegrate and evolve in potentially conflicting directions.

Cooperation for a competitive position: The impact of hospital cooperation behavior on organizational performance.

Several public policy initiatives, particularly those involving managed care, aim to enhance cooperation between partners in the health care sector because it is expected that such cooperation will reduce costs and generate additional revenue. However, empirical evidence regarding the effects of cooperation on hospital performance is scarce, particularly with respect to creating a comprehensive measure of cooperation behavior. The aim of this study is to investigate the impact of hospital cooperation behavior on organizational performance. We differentiate between horizontal and vertical cooperation using two alternative measures-cooperation depth and cooperation breadth-and include the interaction effects between both cooperation directions. Data are derived from a survey of German hospitals and combined with objective performance information from annual financial statements. Generalized linear regression models are used. The study findings provide insight into the nature of hospitals' cooperation behavior. In particular, we show that there are negative synergies between horizontal administrative cooperation behavior and vertical cooperation behavior. Whereas the depth and breadth of horizontal administrative cooperation positively affect financial performance (when there is no vertical cooperation), vertical cooperation positively affects financial performance (when there is no horizontal administrative cooperation) only when cooperation is broad (rather than deep). Horizontal cooperation is generally more effective than vertical cooperation at improving financial performance. Hospital managers should consider the negative interaction effect when making decisions about whether to recommend a cooperative relationship in a horizontal or vertical direction. In addition, managers should be aware of the limited financial benefit of cooperation behavior.

Telehealth: a new opportunity to discuss smoking cessation with indigenous cancer patients and their families.

[Extract] Public health initiatives aimed at promoting the negative health impacts of smoking have led to decreases in smoking among non-indigenous populations; however, higher rates of smoking continue to be the leading cause of disease burden among indigenous populations throughout the developed world. For Aboriginal and Torres Strait Islander peoples (hereafter referred to as Indigenous Australians), the situation is dire with Indigenous Australians 1.9 times more likely to die of lung cancer Rates of smoking vary within and between Indigenous communities with significantly higher rates reported for Indigenous populations (41%) compared with non-Indigenous Australians (16%). Remoteness and younger age appear to be critical risk factors for higher rates of smoking among Indigenous Australians with rates as high as 62% reported for women aged 15 to 34 years in a remote community in North Queensland and 76% among men in a community in the Northern Territory.

A Financial and Public Policy Analysis of the Meat Industry

This study provides an economic and financial performance analysis of prominent companies in the meat industry in the aftermath of public policy initiatives that divert corn to making biofuel and away from making food and animal feed. Results should be of interest to policy makers, investors, and other stakeholders. An important part of personal and societal wellness is the issue of a healthy diet. Meat provides essential nutrients, notably protein, B vitamins, vitamin D, and iron. Eating a proper diet has been a concern from ancient times to the present. For example, the Bible story of Daniel, written about 540 B.C., describes the benefits of eating healthy food (Daniel 1:15). The meat industry is a major agricultural sector that plays an important economic role in many countries of the world. In light of the meat industry’s important contributions to the economy and to people’s health, great care should be given when developing public policies that affect the industry. Diverting corn crops to make biofuel, perhaps well motivated public policy when initiated, is now questionable.

Agent interactions and the response of supply chains to pricing and incentives

The paper analyzes how the interactions among the freight agents influence the supply chain’s response to public policy initiatives based on pricing and incentives. The fundamental tenet of this paper is that, because of the role played by agent interactions in supply chains, carrier centered approaches are likely to be less effective than comprehensive approaches that exploit the power relations between supply chain agents to achieve policy goals. The paper characterizes the typical roles and interactions between the agents involved in supply chains; provides an economic interpretation of these interactions; and conducts a comparative analysis of the (limited) real-life evidence pertaining to the behavioral impacts of pricing and incentives.

Between a rock and a hard place: Smoking trends in a Manitoba First Nation.

The purpose of this study is to estimate and compare smoking prevalence over two time periods in a Manitoba First Nation community. Data fromtwo independent Diabetes Screening Studies in Sandy Bay First Nation, collected in 2002/2003 (n = 482) and 2011/2012 (n = 596),were used. Crude prevalence of current and ever smoking as well as current smoke exposure was estimated. Change over time was tested using a χ² statistic. The crude prevalence of current smoking was 74.0% (95% confidence interval [CI]: 70.1, 78.0) in 2002/2003 and 80.0% (95% CI: 76.8, 83.2) in 2011/2012. The crude prevalence of ever smoking was 83.0% in 2002/2003 and 91.4% in 2011/2012. The prevalence of both current smoking status and ever smoking were significantly higher in 2011/2012 compared to 2002/2003 (p = 0.020 and p < 0.001 respectively). Among participants who were not current smokers, 58.5% (95% CI: 49.6, 67.4) and 76.5% (95% CI: 68.9, 84.1) reported at least one person who smoked in the home in 2002/2003 and 2011/2012 respectively (p = 0.003). In 2011/2012, 96.5% (95% CI: 94.8, 98.2) of those who reported having any children under the age of 18 living in the home were either a current smoker and/or reported that someone else smoked in the home. Public health and policy initiatives are needed to address the increase in smoking prevalence in the study community.