Health policy theory

OBJECTIVE: To evaluate Food, Health, & Choices, two 10-month interventions. DESIGN: Cluster-randomized, controlled study with 4 groups: curriculum, wellness, curriculum plus wellness, and control. SETTING: Twenty elementary schools (5/group) in New York City. PARTICIPANTS: Fifth-grade students (n = 1,159). At baseline, 44.6% were at the ≥85th body mass index (BMI) percentile for age and 86% qualified for free or reduced-price lunch...

The present study investigated individual-level determinants of community social capital among older adults in urban China, with a particular emphasis on health and family social capital. A quota sampling method was used to select 456 adults aged 60 or older from 16 local communities in the city of Suzhou in 2015. Multiple indicators and multiple courses in structural equation modeling were used to examine the proposed model. Latent constructs of community social capital (i.e., cognitive social capital and structural social capital) were established...

Stigma is a well-documented barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally. In order to halt the stigmatization process and mitigate the harmful consequences of health-related stigma (i.e. stigma associated with health conditions), it is critical to have an explicit theoretical framework to guide intervention development, measurement, research, and policy. Existing stigma frameworks typically focus on one health condition in isolation and often concentrate on the psychological pathways occurring among individuals...

PURPOSE: While emergency department nurses in Indonesia are critical to quality care, the role lacks recognition and standard practices and regulation of scope of practice are absent. This research explored the role of nurses in Indonesian EDs. METHOD: The conceptual lens applied in the research was grounded theory. The main data source was 51 semi- structured interviews with 43 ED nurses, three directors of nursing, three nurse leaders and two nurse educators. Data were also generated through observations and memos...

Through this constructivist grounded theory study, it was our purpose to create a substantive theory to explain how rural-dwelling, working-age adults with disabilities define and pursue well-being. Twelve rural-dwelling participants were interviewed up to 3 times to understand the processes involved in defining and pursuing well-being. From this exploration, we suggest that well-being is not a set state to be achieved and then enjoyed, rather well-being results from establishing and maintaining membership in the rural community...

Worldwide, more than 7 million children have now been born after ART: these delivery rates are steadily rising and now comprise 2-6% of births in the European countries. To achieve higher pregnancy rates, the transfer of two or more embryos was previously the gold standard in ART. However, recently the practise has moved towards a single embryo transfer policy to avoid multiple births. The positive consequences of the declining multiple birth rates after ART are decreasing perinatal risks and overall improved health for the ART progeny...

BACKGROUND: Health behaviours during pregnancy and the early years of life have been proven to affect long term health, resulting in investment in interventions. However, interventions often have low levels of completion and limited effectiveness. Consequently, it is increasingly important for interventions to be based on both behaviour change theories and techniques, and the accounts of pregnant women. This study engaged with pregnant women from deprived communities, to understand their subjective experiences of health in pregnancy...

In her review of Raisa Deber's Treating Health Care: How the Canadian System Works and How It Could Work Better, Jennifer Zwicker characterizes policy analysis as "the bridge where policy theory meets practical application." This observation could serve as a guiding principle for many of the articles we publish in Healthcare Quarterly. Fundamentally, what is at stake for so many of our authors is analyzing the policy theories that spark innovations and then measuring the success of those initiatives in order to revise their theoretical underpinnings...

When the Family Medicine for America's Health (FMAHealth) Workforce Education and Development Tactic Team (WEDTT) began its work in December 2014, one of its charges from the FMAHealth Board was to increase family physician production to achieve the diverse primary care workforce the United States needs. The WEDTT created a multilevel interfunctional team to work on this priority initiative that included a focus on student, resident, and early-career physician involvement and leadership development. One major outcome was the adoption of a shared aim, known as 25 x 2030...

BACKGROUND: We describe the development of sustainability via active garden education (SAGE), an early care and education (ECE) garden-based curriculum developed from a 5-year community partnership to link national health policy guidelines with ECE accreditation standards. METHODS: National health guidelines and ECE accreditation standards were reviewed, and community advisory board members, ECE staff, and parents provided feedback and support throughout the development of the curriculum...

RATIONALE: Although obesity represents a potential public health crisis, our understanding of public perceptions of obesity, emotional responses to the obese, and related policy preferences is limited. OBJECTIVE: We employed Weiner's attribution theory of controllability (Weiner, 1988, 2011) to examine perceived causes of obesity, emotional responses, and related policy implications. If the perceived cause is controllable (eating and lifestyle habits), we expected less sympathy and greater anger toward obese people and support for prejudicial hiring policies based on weight...

OBJECTIVES: The present study aimed to investigate the mediating role of cognitive social capital in the association between community-based structural social capital and depressive symptoms among older adults living in urban China. METHODS: Data were derived from a community survey conducted in Suzhou City, China, in late 2015 with 456 respondents aged 60 or older. Structural equation modeling was used to test the proposed hypothesis. RESULTS: The latent variables of cognitive and structural social capital were established...

Singing in groups is a global phenomenon and there is a growing body of evidence that singing can affect health and wellbeing. This is the first gender-based study to explore how women's perceptions of their own health and wellbeing can be affected by singing in a choir; and also how choral singing may have an impact on social inclusion. Qualitative data was collected from nine choirs in two regions of Norway. The sample consisted of 19 (n = 19) women aged 21-75 (mean age, 51.3.) who had sung in choirs from 6 months to 20 years (mean, 6...

The minimally invasive autopsy (MIA), an innovative approach for obtaining post-mortem samples of key organs, is increasingly being recognized as a robust methodology for cause of death (CoD) investigation, albeit so far limited to pilot studies and research projects. A better understanding of the real causes of death in middle- and low-income countries, where underlying causes of death are seldom determined, would allow improved health planning, more targeted prioritization of available resources and the implementation of coherent public health policies...

Important insights have been gained from studying how corporate social actors -- such as Big Tobacco or Big Food -- influence how global health issues are framed, debated, and addressed, and in so doing contribute to reproducing health inequities. Less attention has been paid to the role of nonprofit organizations (NPOs), even when all too often NPOs actively contribute to these inequities through normalizing discourses and practices that legitimize establishment views, poor public policies and existing relations of power...

BACKGROUND: In the context of serious concerns over the affordability of healthcare, various authors and international policy bodies advise that strategic purchasing is a key means of improving health system performance. Such advice is typically informed by theories from the economics of organization (EOO). This paper proposes that these theories are insufficient for a full understanding of strategic purchasing in healthcare, because they focus on safeguarding against poor performance and ignore the coordination and adaptation needed to improve performance...

This commentary discusses the interesting and surprising findings by Hagen and colleagues, focusing on the role of the public health coordinator as a Health in All Policies (HiAP) tool. The original article finds a negative association between the employment of public health coordinators in Norwegian municipalities and consideration of a fair distribution of social and economic resources between social groups in local policymaking and planning. The commentary contemplates whether this surprising negative association should be interpreted as a failure of implementation, as suggested by the authors, or whether it might be the theory of change that has failed...

BACKGROUND: Nowadays, health systems are generally acknowledged to be complex social systems. Consequently, scholars, academics, practitioners, and policy-makers are exploring how to adopt a complexity perspective in health policy and system research. While leadership and complexity has been studied extensively outside health, the implications of complexity theories for the study of leadership in healthcare have received limited attention. We carried out a scoping review of complex leadership (CL) in healthcare to investigate how CL in healthcare has been defined, theorised and conceptualised and to explore how 'CL' has been applied in healthcare settings...

BACKGROUND: This study aims to examine the adaptive process of children and mothers from multistressed low-income families in Singapore. It aims to bridge the knowledge gap left by existing poverty studies, which are predominately risk focused. Through a sequential longitudinal mixed-methods design, we will differentiate children and mothers who demonstrate varied social, developmental, and mental health trajectories of outcomes. Through utilizing the Latent Growth Curve Model (LGCM), we aim to detect the development and changes of the positive Family Agency and adaptive capacities of these families over time...

BACKGROUND: Cancer survivors face a myriad of biopsychosocial consequences due to cancer and treatment that may be potentially mitigated through enabling their self-management skills and behaviors for managing illness. Unfortunately, the cancer system lags in its systematic provision of self-management support (SMS) in routine care, and it is unclear what implementation approaches or strategies work to embed SMS in the cancer context to inform health policy and administrator decision-making...