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Concept: Policy

482

Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites.

Concepts: Policy, Public policy, Firearm, Gun politics, Open carry, Gun politics in the United States

455

 To quantify the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide.

Concepts: Policy, Government, Nation, Sovereign state

222

Evidence-based policy ensures that the best interventions are effectively implemented. Integrating rigorous, relevant science into policy is therefore essential. Barriers include the evidence not being there; lack of demand by policymakers; academics not producing rigorous, relevant papers within the timeframe of the policy cycle. This piece addresses the last problem. Academics underestimate the speed of the policy process, and publish excellent papers after a policy decision rather than good ones before it. To be useful in policy, papers must be at least as rigorous about reporting their methods as for other academic uses. Papers which are as simple as possible (but no simpler) are most likely to be taken up in policy. Most policy questions have many scientific questions, from different disciplines, within them. The accurate synthesis of existing information is the most important single offering by academics to the policy process. Since policymakers are making economic decisions, economic analysis is central, as are the qualitative social sciences. Models should, wherever possible, allow policymakers to vary assumptions. Objective, rigorous, original studies from multiple disciplines relevant to a policy question need to be synthesized before being incorporated into policy.

Concepts: Economics, Science, Decision theory, Policy, Implementation, Social sciences, Political science, Scholarly method

179

BACKGROUND: Numerous policies have been proposed to address the public health problem of obesity, resulting in a policy cacophony. The noise of so many policy options renders it difficult for policymakers to determine which policies warrant implementation. This has resulted in calls for more and better evidence to support obesity policy. However, it is not clear that evidence is the solution. This paper argues that to address the policy cacophony it is necessary to rethink the problem of obesity, and more specifically, how the problem of obesity is framed. This paper argues that the frame “obesity” be replaced by the frame “caloric overconsumption”, concluding that the frame caloric overconsumption can overcome the obesity policy cacophony. DISCUSSION: Frames are important because they influence public policy. Understood as packages that define issues, frames influence how best to approach a problem. Consequently, debates over public policy are considered battles over framing, with small shifts in how an issue is framed resulting in significant changes to the policy environment. This paper presents a rationale for reframing the problem of obesity as caloric overconsumption. The frame “obesity” contributes to the policy cacophony by including policies aimed at both energy output and energy input. However, research increasingly demonstrates that energy input is the primary cause of obesity, and that increases in energy input are largely attributable to the food environment. By focusing on policies that aim to prevent increases in energy input, the frame caloric overconsumption will reduce the noise of the obesity policy cacophony. While the proposed frame will face some challenges, particularly industry opposition, policies aimed at preventing caloric overconsumption have a clearer focus, and can be more politically palatable if caloric overconsumption is seen as an involuntary risk resulting from the food environment.

Concepts: Thermodynamics, Policy, Implementation, Government, Political science, Frame, Public policy, Policy analysis

171

Policy makers and funding agencies require relevant information on current practices of the use of telemedicine infrastructure and services. Several metrics have been used to describe average use of telemedicine services. None are adequate.

Concepts: Policy, Metric, Metrics

171

BACKGROUND: Although significant advances have been made in implementation science, comparatively less attention has been paid to broader scale-up and spread of effective health programs at the regional, national, or international level. To address this gap in research, practice and policy attention, representatives from key stakeholder groups launched an initiative to identify gaps and stimulate additional interest and activity in scale-up and spread of effective health programs. We describe the background and motivation for this initiative and the content, process, and outcomes of two main phases comprising the core of the initiative: a state-of-the-art conference to develop recommendations for advancing scale-up and spread and a follow-up activity to operationalize and prioritize the recommendations. The conference was held in Washington, D.C. during July 2010 and attended by 100 representatives from research, practice, policy, public health, healthcare, and international health communities; the follow-up activity was conducted remotely the following year. DISCUSSION: Conference attendees identified and prioritized five recommendations (and corresponding sub-recommendations) for advancing scale-up and spread in health: increase awareness, facilitate information exchange, develop new methods, apply new approaches for evaluation, and expand capacity. In the follow-up activity, ‘develop new methods’ was rated as most important recommendation; expanding capacity was rated as least important, although differences were relatively minor. SUMMARY: Based on the results of these efforts, we discuss priority activities that are needed to advance research, practice and policy to accelerate the scale-up and spread of effective health programs.

Concepts: Health care, Health economics, Public health, Health, Policy, Stakeholder, Initiative, Avengers: The Initiative

169

BACKGROUND: The emigration of skilled nurses from the Philippines is an ongoing phenomenon that has impacted the quality and quantity of the nursing workforce, while strengthening the domestic economy through remittances. This study examines how the development of brain drain-responsive policies is driven by the effects of nurse migration and how such efforts aim to achieve mind-shifts among nurses, governing and regulatory bodies, and public and private institutions in the Philippines and worldwide. METHODS: Interviews and focus group discussions were conducted to elicit exploratory perspectives on the policy response to nurse brain drain. Interviews with key informants from the nursing, labour and immigration sectors explored key themes behind the development of policies and programmes that respond to nurse migration. Focus group discussions were held with practising nurses to understand policy recipients' perspectives on nurse migration and policy. RESULTS: Using the qualitative data, a thematic framework was created to conceptualize participants' perceptions of how nurse migration has driven the policy development process. The framework demonstrates that policymakers have recognised the complexity of the brain drain phenomenon and are crafting dynamic policies and programmes that work to shift domestic and global mindsets on nurse training, employment and recruitment. CONCLUSIONS: Development of responsive policy to Filipino nurse brain drain offers a glimpse into a domestic response to an increasingly prominent global issue. As a major source of professionals migrating abroad for employment, the Philippines has formalised efforts to manage nurse migration. Accordingly, the Philippine paradigm, summarised by the thematic framework presented in this paper, may act as an example for other countries that are experiencing similar shifts in healthcare worker employment due to migration.

Concepts: Psychology, Focus group, Qualitative research, Immigration, Human migration, Philippines, Policy, Nurse

146

There is wide agreement that there is a lack of attention to health in municipal environmental policy-making, such as urban planning and regeneration. Explanations for this include differing professional norms between health and urban environment professionals, system complexity and limited evidence for causality between attributes of the built environment and health outcomes. Data from urban health indicator (UHI) tools are potentially a valuable form of evidence for local government policy and decision-makers. Although many UHI tools have been specifically developed to inform policy, there is poor understanding of how they are used. This study aims to identify the nature and characteristics of UHI tools and their use by municipal built environment policy and decision-makers.

Concepts: Natural environment, City, Policy, Government, Urban decay, Urban planning, Town, Urban design

137

Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information.

Concepts: Health care, Scientific method, Epidemiology, The Canon of Medicine, Avicenna, Policy, Malnutrition, Religion

109

The integration of immigrants presents a major challenge for policymakers in the United States. In an effort to improve integration, several US states recently have implemented laws that provide driver’s licenses to unauthorized immigrants. These new laws have sparked widespread debate, but we lack evidence on the traffic safety impact of these policies. We examine the short-term effects of the largest-scale policy shift, California’s Assembly Bill 60 (AB60), under which more than 600,000 licenses were issued in the first year of implementation in 2015 alone. We find that, contrary to concerns voiced by opponents of the law, AB60 has had no discernible short-term effect on the number of accidents. The law primarily allowed existing unlicensed drivers to legalize their driving. We also find that, although AB60 had no effect on the rate of fatal accidents, it did decrease the rate of hit and run accidents, suggesting that the policy reduced fears of deportation and vehicle impoundment. Hit and run behaviors often delay emergency assistance, increase insurance premiums, and leave victims with significant out of pocket expenses. Overall, the results suggest that AB60 provides an example of how states can facilitate the integration of immigrants while creating positive externalities for the communities in which they live.

Concepts: United States, United States Congress, U.S. state, Law, California, Policy, Implementation, Legislature