The appraisal of public health interventions

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

doi:10.1016/s0140-6736(13)60373-6

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[457][458][459][460] In particular, there are concerns about what the contract encourages in the way of public health activity in general practice. There is an important trade-off here: RCT-based 'certainties' around expensive technical interventions versus 'riskier' but potentially more impactful interventions such as, for example, brief interventions for smoking, which have low impact but are very low cost and, while having a small impact, affect a large number of people.…”

Section: Impact Of Changes In the Health And Social Care Act 2012 Andmentioning

confidence: 99%

“…There is an important trade-off here: RCT-based 'certainties' around expensive technical interventions versus 'riskier' but potentially more impactful interventions such as, for example, brief interventions for smoking, which have low impact but are very low cost and, while having a small impact, affect a large number of people. 460 Similarly, many areas of activity such as community-oriented activities or even welfare advice are not currently rewarded.…”

Section: Impact Of Changes In the Health And Social Care Act 2012 Andmentioning

confidence: 99%

See 1 more Smart Citation

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Peckham

Falconer

Gillam

et al. 2015

Health Serv Deliv Res

View full text Add to dashboard Cite

BackgroundThis project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities.AimsThe aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice.MethodsWe undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff.FindingsMany of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely.Future ResearchFuture research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Section: Impact Of Changes In the Health And Social Care Act 2012 Andmentioning

confidence: 99%

Section: Impact Of Changes In the Health And Social Care Act 2012 Andmentioning

confidence: 99%

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Peckham

Falconer

Gillam

et al. 2015

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

The appraisal of public health interventions

Cited by 1 publication

References 0 publications

The organisation and delivery of health improvement in general practice and primary care: a scoping study

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Contact Info

Product

Resources

About