The appraisal of public health interventions: an overview

Fischer, Asja; Threlfall, Anthony; Meah, Soraya; Cookson, Richard; Rutter, Harry; Kelly, Michael P.

doi:10.1093/pubmed/fdt076

Cited by 32 publications

(24 citation statements)

References 11 publications

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“…Further, while evidence drawn from large controlled intervention trials meets higher standards of rigour, this evidence is not necessarily the most applicable to 'real world' practice [38] and may hinder the implementation of costeffective interventions. Fischer et al have argued that in the case of many public health interventions it is impractical to demonstrate individual effects through RCTs, but such interventions may be cost-effective even without evidence demonstrating efficacy [39].…”

Section: Considerations For Public Health Policy and Practicementioning

confidence: 99%

Mechanisms and pathways to impact in public health research: a preliminary analysis of research funded by the National Institute for Health Research (NIHR)

Boulding

Kamenetzky

Ghiga

et al. 2020

BMC Med Res Methodol

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Background: The mechanisms and pathways to impacts from public health research in the UK have not been widely studied. Through the lens of one funder (NIHR), our aims are to map the diversity of public health research, in terms of funding mechanisms, disciplinary contributions, and public health impacts, identify examples of impacts, and pathways to impact that existing reporting mechanisms may not otherwise have captured, and provide illustrations of how public health researchers perceive the generation of non-academic impact from their work. Methods: A total of 1386 projects were identified as 'public health research' by the NIHR and listed in the NIHR Public Health Overview database (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016). From these, a subset of 857 projects were matched as potentially having begun reporting impacts via an external data-gathering platform (Researchfish). Data on the 857 projects were analyzed quantitatively, and nine projects were selected to investigate further through semi-structured interviews with principal investigators. Two workshops took place to validate emerging and final findings and facilitate analysis.Results: In addition to the NIHR School for Public Health Research and the NIHR Public Health Research Programme, 89% of projects contained in the NIHR Public Health Overview portfolio as 'public health research' are funded via other NIHR research programmes, suggesting significant diversity in disciplines contributing to public health research and outcomes. The pathways to impact observed in our in-depth case studies include contributing to debates on what constitutes appropriate evidence for national policy change, acknowledging local 'unintended' impacts, building trusted relationships with stakeholders across health and non-health sectors and actors, collaborating with local authorities, and using non-academic dissemination channels. Conclusions: Public health as a discipline contributes substantially to impact beyond academia. To support the diversity of these impacts, we need to recognise localized smaller-scale impacts, and the difference in types of evidence required for community and local authority-based impacts. This will also require building capacity and resources to enable impact to take place from public health research. Finally, support is required for engagement with local authorities and working with non-health sectors that contribute to health outcomes.

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Section: Considerations For Public Health Policy and Practicementioning

confidence: 99%

Mechanisms and pathways to impact in public health research: a preliminary analysis of research funded by the National Institute for Health Research (NIHR)

Boulding

Kamenetzky

Ghiga

et al. 2020

BMC Med Res Methodol

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show abstract

“…This suggests that a decision-theoretic approach will be required (and may be sufficient by itself) in some circumstances, such as where the intervention could not conceivably cause harm, and where the likely effect size would produce an estimate of cost effectiveness that is well below currently acceptable thresholds. 19,20 For example, in a hand washing intervention designed for use in an influenza pandemic, 21 international dissemination of a fully automated digital intervention to reduce spread of respiratory infection would likely result in healthcare savings and wider health and socioeconomic benefits so great that the cost of the intervention becomes negligible.…”

Section: Medical Research Council Framework For Complex Interventionsmentioning

confidence: 99%

Designing and Undertaking a Health Economics Study of Digital Health Interventions

McNamee

Murray

Kelly

et al. 2016

American Journal of Preventive Medicine

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“…As such, the guidelines are now being developed at international, national and local levels [6] . The Cochrane Collaboration and the National Institute for Health and Care Excellence (NICE) are few examples of organizations that have a long experience in developing guidelines to support decisions regarding safe and effective medical and public health interventions [7] . There are signs of an increased emphasis on better pace and better quality on the development of guidelines in the past decade, which is exemplified by the emergence of guideline clearing houses and many international programs and societies [8] .…”

Section: Research Papermentioning

confidence: 99%

A Study of Barriers and Facilitators of Clinical Practice Guidelines Implementation among Physicians

Alnaim¹,

Almazrou²

2017

pharmaceutical-sciences

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Alnaim and Almazrou.: Barriers and Facilitators of Clinical Practice GuidelinesThere is a gap in understanding the barriers and facilitators related to guideline implementation in Saudi Arabia. A descriptive cross sectional study was conducted to identify the factors that may act as barriers or facilitators of clinical practice guidelines used by physicians working in Riyadh, Saudi Arabia. A survey was distributed to 215 physicians working at universities and government hospitals in Riyadh city. The survey was pilot-tested on a small group of physicians to improve the clarity and limit response bias. A total of 157 physicians completed the questionnaire. About 88.5% of the physicians indicated that they did implement clinical practice guidelines in their practice while 9.6% declared that they did not implement any guidelines. Clinical practice guideline implementation was not affected by the physician role, years of experience or nationality. There were less female physicians that opted for clinical practice guidelines (P<0.5). Eighty four percent of the physicians chose them because they are evidence-based while only 40.1% incorporated them because it was part of their institutions' regulation. There was a weak positive relation between the total scores of barriers and facilitators assessment tool and the nationality of the physician. The reasons for choosing specific guidelines were not determined by the physician role, years of experience, nationality or gender. Most agreed that clinical practice guidelines served as a good foundation for self-study and still provide space for them to come to their own conclusions, but at the same time, they would like to know more about them before they decide to apply it. The implementation of guidelines was obstructed by three barriers, which were lack of support by the leadership, lack of awareness and lack of knowledge. On the other hand, the ease of access and autonomy has driven the implementation of clinical practice guidelines. Nonetheless, the barriers and facilitators experienced by the physicians may differ depending on their ethnicity and gender.

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The appraisal of public health interventions: an overview

Abstract: This analysis provides a rigorous theoretical framework for decision-makers in public health. The implied paradigm shift also applies to some clinically based areas.

Cited by 32 publications

References 11 publications

Mechanisms and pathways to impact in public health research: a preliminary analysis of research funded by the National Institute for Health Research (NIHR)

Mechanisms and pathways to impact in public health research: a preliminary analysis of research funded by the National Institute for Health Research (NIHR)

Designing and Undertaking a Health Economics Study of Digital Health Interventions

A Study of Barriers and Facilitators of Clinical Practice Guidelines Implementation among Physicians

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