Evidence‐based policy versus evidence‐based rural health care reality checks

Kamien, Max

doi:10.1111/j.1440-1584.2008.01040.x

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…The majority of respondents suggested that reduced political power in rural areas makes effective and specific rural health policy a low political priority. Participants perceived that political pressure is lacking from rural Australia and therefore politics is becoming increasingly ‘metro-centric’ in part due to expanding urban populations, which is also echoed in the Australian literature [10,21]. Based on the participants’ views, persistent inequities in the burden of heart disease in rural Australia could be considered through the theoretical lens of the ‘political economy theory’ [30,31].…”

Section: Discussionmentioning

confidence: 99%

Policy makers’ perceptions of the high burden of heart disease in rural Australia: Implications for the implementation of evidence-based rural health policy

2019

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Background Rural Australian populations experience an increased burden of ischaemic heart disease (IHD) compared to their metropolitan counterparts, similar to other developed countries, globally. Policy and other efforts need to address and acknowledge these differences in order to reduce inequalities in health burden. This paper examines rural health policy makers’ perceptions and use of evidence in efforts to reduce the burden of IHD in rural areas. Methods Policy makers and government advisors (n = 21) who worked with, or advised on, rural health policy at local, state and federal government levels, with specific focus on the state of Victoria (n = 9) were identified from publicly available documents and subsequent snowball sample. Semi-structured qualitative interviews were conducted in regards to the use of evidence in policy to prevent IHD and thematic analysis undertaken applying two theoretical perspectives: context-based evidence-based policy making and the conceptual framework for understanding rural and remote health. Results The rural context, particularly low resourcing, was seen as limiting potential for evidence based policy at local government (LG) level. Lower levels of political pressure and education were seen as constraints to evidence-based policy in rural communities. Participants described the potential for policy to have a greater impact on reducing heart disease in rural areas though they felt under-resourced and out of touch with the scientific evidence. Scientific studies were less valued than local anecdote to prioritise specific policy. At all levels (local, state and federal) low self-efficacy in interpreting evidence and perceived lack of relevance inhibited development of evidence informed policy. Conclusion The rural context constrains the use of scientific evidence in policy making for the prevention of heart disease in rural areas in Australia with multiple factors influencing the capacity for evidenced based health policy. This is similar to findings at the international scale and is for consideration across other developed countries that experience inequalities in IHD disease burden between rural and urban populations.

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Section: Discussionmentioning

confidence: 99%

Policy makers’ perceptions of the high burden of heart disease in rural Australia: Implications for the implementation of evidence-based rural health policy

2019

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Rural interprofessional primary health care team development and sustainability: establishing a research agenda

McPherson

McGibbon

2010

Primary Health Care

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Primary health care (PHC) plays a pivotal role in health system reform locally and globally. The use of well functioning interprofessional primary health care (IPHC) teams is recognized as a key strategy in widespread health system reform across global, national, and provincial jurisdictions. IPHC teams contribute to the improvement of the health and well being of the population. These teams engage in issues that are a priority for citizens, such as: providing good evidence-based care; supporting the efforts of individuals, families, and communities in leading healthy lives; actively and deliberatively involving citizens in decisions affecting their health and health care system; and addressing the systemic social, economic, and political causes of health disparities, such as poverty, violence, and rural isolation. Many jurisdictions have begun to experiment with and implement major changes in the delivery of PHC. This has required that health care managers and practitioners reconsider the ways in which they have traditionally worked. However, although many innovative PHC services were developed, the notion of how to best develop and sustain the service delivery team itself and within what contexts could have used more deliberate attention. There are no documented best practices for rural IPHC team development and sustainability in the scholarly literature. This paper presents the results of a literature review, including the empirical and conceptual evidence regarding team development, team sustainability, and the role of rural context in IPHC team development. An argument for advancing PHC research that focuses on rural IPHC team development and sustainability is posited.This development discussion informs a new area for research that has evolved from an identified primary health care (PHC) policy and practice gap in Nova Scotia, Canada. In this paper, we present an argument for advancing PHC research that focuses on rural interprofessional primary health care (IPHC) team development and sustainability. This focus is important because of the known role that PHC plays in health system reform locally and globally, and because there are relatively few documented best practices for IPHC team development and sustainability in the scholarly literature. This paper presents the PHC developmental context in Nova Scotia and the results of our literature review, including the Correspondence to:

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Potential utility of B-type natriuretic peptides in secondary prevention following percutaneous coronary intervention in remote communities of Western Australia

et al. 2023

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Evidence‐based policy versus evidence‐based rural health care reality checks

Cited by 3 publications

References 4 publications

Policy makers’ perceptions of the high burden of heart disease in rural Australia: Implications for the implementation of evidence-based rural health policy

Policy makers’ perceptions of the high burden of heart disease in rural Australia: Implications for the implementation of evidence-based rural health policy

Rural interprofessional primary health care team development and sustainability: establishing a research agenda

Potential utility of B-type natriuretic peptides in secondary prevention following percutaneous coronary intervention in remote communities of Western Australia

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