-
"WE CAN ALL CONTRIBUTE IN OUR OWN WAY" : KNOWLEDGE MOBILIZATION TOOLS TO PROMOTE BEST PRACTICES IN UNIVERSAL ACCESSIBILITY medRxiv. Health Policy Pub Date : 2024-09-18 Maelle Corcuff, Marie-Eve Lamontagne, Francois Routhier
Background: Cities aim to enhance urban accessibility following the adoption of the United Nations' Convention on the Rights of Persons with Disabilities. However, implementation faces challenges due to complex municipal legislation, lack of awareness, and organizational obstacles. Engaging stakeholders and empowering municipal employees through knowledge mobilization is crucial, as shown in a Quebec
-
Geospatial Analysis of the Association between Medicaid Ex-pansion, Minimum Wage Policies, and Alzheimer's Disease Dementia Prevalence in the United States medRxiv. Health Policy Pub Date : 2024-09-11 Abolfazl Mollalo, Sara Knox, Jessica Meng, Andreana Benitez, Leslie A. Lenert, Alexander V. Alekseyenko
Previous studies indicate that improved healthcare access through Medicaid expansion and alleviation of socioeconomic stressors via higher minimum wages improved health outcomes. This study investigates the spatial relationships between the Medicaid expansion, minimum wage policy, and AD dementia prevalence across the US. We employed the Getis-Ord Gi* statistic to identify hotspots and cold spots of
-
The clinical and cost-effectiveness of interventions for preventing continence issues resulting from birth trauma: a rapid review medRxiv. Health Policy Pub Date : 2024-09-09 Bethany Fern Anthony, Jacob Davies, Kalpa Pisavadia, Sofie Roberts, Llinos Haf Spencer, Elizabeth Gillen, Juliet Hounsome, Jane C Noyes, Dyfrig A Hughes, Deborah Fitzsimmons, Rhiannon Tudor Edwards, Adrian G Edwards, Alison Cooper, Ruth Lewis
Urinary and faecal incontinence, which are often linked to the stresses and strains of childbirth, particularly perineal trauma, are debilitating conditions that can significantly impact womens quality of life. Approximately 85% of vaginal births in the United Kingdom (UK) are affected by childbirth related perineal trauma, either spontaneously or due to episiotomy. Incontinence also places a significant
-
Supporting women, girls and people who menstruate to participate in physical activity - Rapid evidence summary medRxiv. Health Policy Pub Date : 2024-09-09 Judit Csontos, Deborah Edwards, Elizabeth Gillen, Juliet Hounsome, Meg Kiseleva, Mala Mann, Amrita Sidhu, Steven Macey, Ruth Lewis, Adrian Edwards, Alison Cooper
Insufficient physical activity is a leading risk factor for non-communicable diseases and has a negative effect on mental health and quality of life. Women, girls and people who menstruate living in Wales are less likely to engage in regular physical activity than boys and men. The aim of this rapid evidence summary is to identify research focusing on physical activity participation (including exercise
-
Standardizing and Scaffolding Healthcare AI-Chatbot Evaluation medRxiv. Health Policy Pub Date : 2024-09-03 Yining Hua, Winna Xia, David W. Bates, George Luke Hartstein, Hyungjin Tom Kim, Michael Lingzhi Li, Benjamin W. Nelson, Charles Stromeyer, Darlene King, Jina Suh, Li Zhou, John Torous
The rapid rise of healthcare chatbots, valued at $787.1 million in 2022 and projected to grow at 23.9% annually through 2030, underscores the need for robust evaluation frameworks. Despite their potential, the absence of standardized evaluation criteria and rapid AI advancements complicate assessments. This study addresses these challenges by developing the first comprehensive evaluation framework
-
Performance of the Washington Group Questions in Measuring Blindness and Deafness medRxiv. Health Policy Pub Date : 2024-08-31 Scott D. Landes, Bonnielin K. Swenor, Jean P. Hall
The Washington Group Short Set (WGSS) questions are intended to measure the severity of disability and disability status in US federal surveys. We used data from the 2010-2018 National Health Interview Survey to examine the performance of the WGSS visual disability and hearing disability questions in capturing blindness and deafness. We found that the WGSS questions failed to capture 35.7% of blind
-
Questionable practices in data and code sharing policy in high-profile medical journal and research medRxiv. Health Policy Pub Date : 2024-08-30 Wei Li, Xuerong Liu, Qianyu Zhang, Liping Shi, Jing-Xuan Zhang, Xiaolin Zhang, Jia Luan, Yue Li, Ting Xu, Rong Zhang, Xiaodi Han, Jingyu Lei, Xueqian Wang, Yaozhi Wang, Hai Lan, Xiaohan Chen, Yi Wu, Yan Wu, Lei Xia, Haiping Liao, Chang Shen, Yang Yu, Xinyu Xu, Chao Deng, Pei Liu, Zhengzhi Feng, Chun-Ji Huang, Zhiyi Chen
Background The spurious and unavailable data/code sharing actions are crashing open medical sciences. In this study, we aimed to illustrate how high-profile medical journals are practically carried out their sharing policies and what questionable practices regarding data/code sharing are conducted by authors.
-
Application of chaos and systems theories to explore health workforce re-organisation following district splitting in Uganda medRxiv. Health Policy Pub Date : 2024-08-30 Aloysius Mutebi, Moses Mukuru, Suzanne Kiwanuka, Fredrick Makumbi, Elizeus Rutebemberwa
Background District splitting (DS) began in 1962 and intensified in 1997 during implementation of decentralization. This legislative process focuses on geographical demarcation. The health system, organized along local government structures, was re-organized as a result of DS. However, this study explored how the health workforce, as a component of the local government health system, re-organized following
-
The Effects of Social Distancing Policy on the Changes of Floating Population in Korea medRxiv. Health Policy Pub Date : 2024-08-28 Jaehwan Oh, Minsu Choi, Kwang-soo Lee
Objectives In response to the World Health Organization’s declaration of the COVID-19 pandemic in March 2020, nations worldwide, including Korea, implemented social distancing as a critical Non-Pharmaceutical Intervention (NPI) to curb the spread of the disease. Social distancing measures aimed to reduce person-to-person contact through various strategies such as facility restrictions, gathering limitations
-
Overlap between ultra-processed food and food that is high in fat, salt or sugar: analysis of 11 annual waves of the UK National Diet and Nutrition Survey 2008/09-2018/19 medRxiv. Health Policy Pub Date : 2024-08-28 Viktorija Kesaite, Yanaina Chavez-Ugalde, Martin White, Jean Adams
While many countries use guidance and policies based on nutrients and food groups to support citizens to consume healthy diets, fewer have explicitly adopted the concept of ultra-processed foods (UPF). UPF consumption is associated with many adverse health outcomes in cohort studies. In the UK, a nutrient profiling model (NPM) is used to identify foods high in fat, salt or sugar (HFSS) and several
-
A foggy minefield: Experiences of regulation among developers of AI and other medical software in the UK, survey and focus group study medRxiv. Health Policy Pub Date : 2024-08-26 Henry W W Potts, Paulina Bondaronek, Ana Luisa Neves, Alex Bolotov, Lucie Burgess, Jona Shehu, Gabriella Spinellli, Emanuela Volpi, Austen El-Osta
Introduction: Regulation is important for medical software, but advances in software, notably developments in artificial intelligence (AI), are developing quickly. There are concerns that regulatory processes are not keeping up and that there is a need for more pro-innovation approaches. Methods: We conducted a survey (n = 34) and four focus groups to discuss experiences of regulation among UK-based
-
Shouldering our Way into a More Meaningful Research Agenda for Atraumatic Shoulder Pain: A Priority Setting Study medRxiv. Health Policy Pub Date : 2024-08-22 Kristian Damgaard Lyng, Torben Krejberg Boersting, Mikkel Bek Clausen, Annelene Houen Larsen, Behnam Liaghat, Kim Gordon Ingwersen, Marcus Bateman, Amar Rangan, Karen Toftdahl Bjoernholdt, David Hoeyrup Christiansen, Steen Lund Jensen, Janus Laust Thomsen, Kristian Thorborg, Connie Ziegler, Jens Lykkegaard Olesen, Michael Skovdal Rathleff
IMPORTANCE: Atraumatic shoulder pain significantly burdens society and the individual. There is a growing need for involving patients and other stakeholders in setting the research agenda. OBJECTIVE: To use the voices of people with atraumatic shoulder pain, healthcare practitioners, and their relatives to establish research questions. DESIGN, SETTING, AND PARTICIPANTS: This priority-setting study
-
What do the Welsh public understand about NHS dental services, what do they think they could look like, and what are their priorities? A qualitative study medRxiv. Health Policy Pub Date : 2024-08-20 Natalie Joseph-Williams, Abubakar Sha'aban, Francesca Mazzaschi, Anthony Cope
NHS General Dental Services in Wales are undergoing reform. To ensure dental services meet the needs of those who use them, we explored what the public think these services could look like and what their priorities for are. The aim of this study was to consult with the Welsh public to understand their views on NHS dental services to help inform dental reform plans in Wales. Specific objectives were
-
″Implementing a policy is something else″: Governance of complex health information systems in Tanzania medRxiv. Health Policy Pub Date : 2024-08-16 Regine Unkels, Elibariki Mkumbo, Ntuli Kapologwe, Fatuma Manzi, Claudia Hanson, Helle Molsted Alvesson, Andrea B. Pembe
Introduction: Health management information systems are crucial for a country′s health service planning and monitoring. Research indicates that generated data is often of low quality or not used for decision-making in low-resource settings. Digitalization potentially alleviates these problems, but scale-up in these countries is hampered by unreliable availability of resources. We aimed to understand
-
Changes in energy content of menu items at out-of-home food outlets in England after calorie labelling policy implementation: a pre-post analysis (2021-2022) medRxiv. Health Policy Pub Date : 2024-08-09 Michael Essman, Thomas Burgoine, Yuru Huang, Andrew Jones, Megan Polden, Eric Robinson, Stephen Sharp, Richard Smith, Martin White, Jean Adams
Importance: Eating from out-of-home food outlets (OHFO) is common and linked to poor dietary quality, weight gain, and obesity. In response, England implemented mandatory calorie labelling regulations in April 2022 to encourage reformulation and reduce calorie consumption. Few studies have examined the impact of a national calorie labelling policy on OHFO menus. Objective: Examine pre-post changes
-
Syncing Strategy and Execution: A Systematic Review of Public Health Preparedness Policy Implementation medRxiv. Health Policy Pub Date : 2024-08-05 Jennifer Swint, Wei Zhang, Amanda Marrison, Sandra Gabriel
Background: The gap between public health preparedness and response policies and their practical implementation remains a critical challenge in global health security. This systematic review synthesizes evidence on barriers to effective policy implementation and identifies strategies for bridging this policy-practice gap. Methods: We systematically searched six electronic databases for peer-reviewed
-
Psilocybin mushrooms and public health in Brazil: a low-risk adverse event profile calls for evidence-based regulatory discussions medRxiv. Health Policy Pub Date : 2024-07-31 Marcel Nogueira, Solimary Garcia-Hernandez, Gleicy Sotero Roberto, Leonardo Marques Zanella
Background: Current drug policy classifies psilocybin, a substance produced by psychoactive mushrooms, as having a high potential for abuse, neglecting its therapeutic properties. We aimed to investigate if psilocybin mushrooms pose a risk to Brazilian public health compared to other toxic agents and whether evidence-based regulatory discussions are needed. Methods: A retrospective cross-sectional
-
Does household income predict health and educational outcomes in childhood better than neighbourhood deprivation? medRxiv. Health Policy Pub Date : 2024-07-26 Ieva Skarda, Richard Cookson, Ruth Gilbert
Background Public health research and prevention policies often use the small area Index of Multiple Deprivation (IMD) at neighbourhood level to proxy individual socio-economic status because it is readily available. We investigated what household income adds to IMD in early childhood for predicting adverse health in adolescence. Methods Using data from the Millennium Cohort Study, we analysed IMD
-
We Are on the Verge of Breakthrough Cures for Type 1 Diabetes, but Who Are the 2 Million Americans Who Have It? medRxiv. Health Policy Pub Date : 2024-07-26 Rebecca A Smith, Samara Eisenberg, Aaron Turner-Pfifer, Jacqueline Le Grand, Sarah Pincus, Yousra Omer, Fei Wang, Bruce Pyenson
Two million Americans have Type 2 Diabetes. Innovative treatments have standardized insulin delivery and improved outcomes for patients, but patients' access to such technologies depends on social determinants of health, including insurance coverage, proper diagnosis, and appropriate patient supports. Prior estimates of US prevalence, incidence, and patient characteristics have relied on data from
-
A rapid review of the effectiveness of smoking cessation interventions for people with anxiety and/or depression living within the community medRxiv. Health Policy Pub Date : 2024-07-23 Jordan Everitt, Toby Ayres, Alesha Wale, Chukwudi Okolie, Amy Fox-McNally, Helen Morgan, Hannah Shaw, Jacob Davies, Rhiannon Tudor Edwards, Alison Cooper, Adrian Edwards, Ruth Lewis
Abstract The Welsh Government aims to reduce smoking prevalence from the current rate of 13% to below 5% of the population by 2030. People with mental health conditions have a higher rate of smoking prevalence and are less likely to access smoking cessation services. Evidence shows that smoking cessation in this population decreases symptoms, improves positive mood and quality of life. This rapid review
-
Rapid review of Allied Health Professionals working in neonatal services medRxiv. Health Policy Pub Date : 2024-07-23 Nathan Bromham, Leona Batten, David Jarrom, Elizabeth Gillen, Juliet Hounsome, Jacob Davies, Rhiannon Tudor Edwards, Alison Cooper, Adrian Edwards, Ruth Lewis
Background This review aimed to quantify the impact of allied health professionals (AHPs) embedded in neonatal services on outcomes by asking the following review questions: Q1. What is the effectiveness of neonatal services with embedded allied health professionals compared to neonatal services without embedded allied health professionals? Q2. What is the effectiveness of early interventions provided
-
Systemic Review of Health Disparities in Access and Delivery of Care for Geriatric Diseases in the United States medRxiv. Health Policy Pub Date : 2024-07-19 Muhammad R. Hussein, Mony Thomas, Sonia Utterman, Jackline Jushua
Background: The U.S. population continues to age, and the identification of disparities in geriatric care -so that they may be understood and solutions addressed - is ever more critical. A systematic review is presented on current disparities found in access to care for geriatric diseases as well as in the delivery of care within the United States. Methods: A comprehensive search for the available
-
The adoption and implementation of local government planning regulations to manage hot food takeaways near schools in England: A qualitative process evaluation. medRxiv. Health Policy Pub Date : 2024-07-18 Suzan Hassan, Claire Thompson, Jean Adams, Michael Chang, Daniel Derbyshire, Matthew Keeble, Bochu Liu, Oliver T Mytton, John Rahilly, Bea Savory, Richard Smith, Martin White, Thomas Burgoine, Steven Cummins
Introduction: Access to hot food takeaways, particularly near schools, is of growing concern for policymakers seeking to reduce childhood obesity globally. In England, United Kingdom (UK), local government jurisdictions are implementing planning policies to reduce access by restricting or denying planning permission for new takeaway outlets near schools. We used a qualitative approach to explore local
-
Disability Inclusion in National Surveys medRxiv. Health Policy Pub Date : 2024-07-17 Caroline Cerilli, Varshini Varadaraj, Jennifer Choi, Fiona Sweeney, Franz Castro, Scott D. Landes, Bonnielin K. Swenor
National surveys are important for understanding the disparities that disabled people experience across social determinants of health; however, limited research has examined the methods used to include disabled people in these surveys. This study reviewed nationally representative surveys administered by the Centers for Disease Control and Prevention (CDC) and the U.S. Census Bureau that collected
-
Beyond the Black Box: Avenues to Transparency in Regulating Radiological AI/ML-enabled SaMD via the FDA 510(k) Pathway medRxiv. Health Policy Pub Date : 2024-07-12 Alaa T Youssef, David Fronk, John Nicholas Grimes, Lina Cheuy, David B. Larson
Background: The majority of AI/M-enabled software as a medical device (SaMD) has been cleared through the FDA 510(k) pathway, but with limited transparency on algorithm development details. Because algorithm quality depends on the quality of the training data and algorithmic input, this study aimed to assess the availability of algorithm development details in the 510(k) summaries of AI/ML-enabled
-
Out-of-pocket prescription medicine expenditure amongst community-dwelling adults: findings from The Irish Longitudinal Study on Ageing (TILDA) in 2016 medRxiv. Health Policy Pub Date : 2024-07-11 James Larkin, Ciaran Prendergast, Logan T. Murry, Michelle Flood, Barbara Clyne, Sara Burke, Conor Keegan, Fiona Boland, Tom Fahey, Nav Persaud, Rose Anne Kenny, Frank Moriarty
Background The number of prescription medicines prescribed to older adults is increasing in Ireland and other countries. This is leading to higher out-of-pocket prescription medicine expenditure for older adults, which has several negative consequences including cost-related non-adherence. This study aimed to characterise out-of-pocket prescription medicine payments, and examine their relationship
-
Vaccinating the Frontlines: A Qualitative Exploration of Hospital Healthcare Worker Perspectives on Influenza and COVID-19 Immunization medRxiv. Health Policy Pub Date : 2024-07-11 Erica N. Rosser, Sabra Klein, Richard Eric Rothman, Andrew Pekosz, Rosemary Morgan
Introduction Although they face higher occupational risk of contracting viral respiratory infections, hospital healthcare worker vaccine hesitancy persists. While most studies have used survey methods to quantify the prevalence of and reasons for healthcare worker vaccine hesitancy, this study employs a qualitative approach to understand their attitudes and beliefs associated with influenza and COVID-19
-
Indian Rare Disease Stakeholder Mapping medRxiv. Health Policy Pub Date : 2024-07-05 Mohua Chakraborty Choudhury, Jerry Philip George, Prashanth N Srinivas
Rare diseases aren't rare collectively, affecting around 300 million people globally and 96 million in India. In low- and middle-income countries like India, policies addressing these diseases have only recently been enacted. In 2021, India launched its first functional rare disease policy. This study comprehensively maps all stakeholders in the rare disease ecosystem in India to understand their power
-
Changes in isolation guidelines for CPE patients results in only a mild reduction in required hospital beds medRxiv. Health Policy Pub Date : 2024-07-05 Michael J Lydeamore, David Wu, Tjibbe Donker, Claire L Gorrie, Charlie Kirk Higgs, Marion Easton, Daneeta Hennessy, Nic Geard, Benjamin P Howden, Ben S Cooper, Andrew Wilson, Anton Y Peleg, Andrew J Stewardson
Carbapenemase-producing Enterobacterales (CPE) are an emerging public health concern globally as they are resistant to a broad spectrum of antibiotics. Colonisation with CPE typically requires patients to be managed under 'contact precautions', which creates additional physical bed demands in healthcare facilities. This study examined the potential impact of revised isolation guidelines introduced
-
Human resources for health, service coverage and maternal and perinatal outcomes in Benin, Malawi, Tanzania and Uganda medRxiv. Health Policy Pub Date : 2024-07-05 Ann-Beth Moller, Joanne Welsh, Max Petzold, Amani Siyam
A well-performing and competent health workforce (HWF) is at the core of health systems yet many countries are facing a human resources for health (HRH) crisis. A prerequisite for achieving universal health coverage, including fulfilling the Sustainable Development Goals related to women and newborns, is an adequate supply of health workers able to provide quality of care at all levels of the health
-
Understanding the impact of the COVID-19 pandemic and its control measures on women and children: A Zimbabwe case study medRxiv. Health Policy Pub Date : 2024-07-03 Tinotenda Taruvinga, Rudo S Chingono, Ioana D Olaru, Kenneth Masiye, Claudius Madanhire, Sharon Munhenzva, Sibusisiwe Sibanda, Lyton Mafuva, Natasha O’Sullivan, Abdinasir Yusuf Osman, Kevin Deane, Tsitsi Brandson, Manes Munyanyi, Annamercy Makoni, Solwayo Ngwenya, Karen Webb, Theonevus T Chinyanga, Rashida A Ferrand, Justin Dixon, Katharina Kranzer, David McCoy
ABSTRACT COVID-19 presented countries with unprecedented health policy challenges. For low-income countries in particular, policymakers had to contend with both the direct threats posed by COVID-19 as well as the social, educational, and economic harms associated with lockdown and other infection prevention and control measures. We present a holistic and contextualised case study of the direct and
-
Voting Patterns, Mortality, and Health Inequalities in England medRxiv. Health Policy Pub Date : 2024-07-02 Philip Clarke, Charles Rahal, Josh Knight, Veline L' Esperance, Melinda C Mills
Objectives: To replicate an analysis conducted just prior to the 1997 UK General Election on the relationship between voting patterns at the constituency level, correlations between voting patterns, measured inequality, and premature mortality. Design: Observational study using data from the Office of National Statistics. Setting: England, UK. Participants: The health and mortality co-variates come
-
Treatment recommendations based on Network Meta-Analysis: rules for risk-averse decision-makers medRxiv. Health Policy Pub Date : 2024-07-01 Anthony E Ades, Hugo Pedder, Annabel L Davies, Howard Thom, David M Phillippo, Beatrice Downing, Deborah M Caldwell, Nicky J. Welton
ABSTRACT Background: The treatment recommendation based on a Network Meta-analysis (NMA) is usually the single treatment with the highest Expected Value (EV) on an evaluative function. We explore approaches which recommend multiple treatments and which penalize uncertainty, making them suitable for risk-averse decision makers. Methods: We introduce Loss-adjusted EV (LaEV) and compare it to GRADE and
-
Womens Health And Manifestos (WHAM): UK General Election 2024, a rapid voter information study medRxiv. Health Policy Pub Date : 2024-07-01 Edward Mullins, Kate Womersely, Fardowsa Abdi, Celestine Donovan-Bradley, Christine Ekechi, Leah Hazard, Jane Hirst, Melanie Nana, Alison Perry, Ana-Catarina Pinho-Gomes, Katherine Ripullone, Stephanie Williams
Background The UK 2024 general election manifestos publicly set out the political parties priorities for the eventuality that they are voted into government. We determined to evaluate whether already agreed, evidenced and promoted issues affecting womens health in the UK had been included in the major parties manifestos. Methods We curated a longlist of priorities and recommendations drawn from major
-
Expanding Risks: Medicaid Expansion and Data Security medRxiv. Health Policy Pub Date : 2024-07-01 Jeffrey Clement, Brad N Greenwood, John D'Arcy, Corey Angst
The Patient Protection and Affordable Care Act of 2010 led to the largest expansion of healthcare coverage since the instantiation of Medicare and Medicaid in 1965. Yet, limited attention has been given to the security aftereffects of the statute, specifically the potential for malfeasance in the form of consumer fraud and identity theft resulting from the vast influx of new patient data residing in
-
A descriptive survey of patient experiences and access to specialty medicines with alternative funding programs medRxiv. Health Policy Pub Date : 2024-06-30 William B Wong, Irina Yermilov, Hannah Dalglish, Lori Bienvenu, Jonathan James, Sarah N Gibbs
Background: Alternative funding programs (AFPs) seek to reduce plan sponsor costs by excluding specialty drugs from a beneficiary's plan coverage and requiring patients to obtain medications through alternative sources (typically, the manufacturer's patient assistance programs [PAPs]) via an AFP vendor as a third-party). Objective: To describe patients' experiences and medication access with AFPs,
-
Covid-19 vaccination decisions and impacts of vaccine mandates: A cross sectional survey of healthcare workers in Ontario, Canada medRxiv. Health Policy Pub Date : 2024-06-28 Claudia Chaufan, Natalie Hemsing, Rachael Moncrieffe
Background: Since vaccination policies were introduced in the healthcare sector in the province of Ontario, Canada, most establishments implemented vaccination or termination requirements, with most enforcing them to this day. Researchers have shown a strong interest in the perceived problem of vaccine hesitancy among healthcare workers, yet not in their lived experience of the policy or in their views
-
Estimating the lives that could be saved by expanded access to weight-loss drugs medRxiv. Health Policy Pub Date : 2024-06-28 Abhishek Pandey, Yang Ye, Chad R Wells, Burton H Singer, Alison P Galvani
Obesity is a major public health crisis in the United States (US) affecting 42% of the population, exacerbating a spectrum of other diseases and contributing significantly to morbidity and mortality overall. Recent advances in pharmaceutical interventions, particularly glucagon-like peptide-1 (GLP-1) receptor agonists (e.g., semaglutide, liraglutide) and dual gastric inhibitory polypeptide and glucagon-like
-
Could the Inflation Reduction Act Maximum Fair Price Hurt Patients? medRxiv. Health Policy Pub Date : 2024-06-27 Esteban Rivera, Anne M Sydor, Robert Popovian
Background The Inflation Reduction Act′s Medicare Drug Price Negotiation Program allows the federal government to negotiate caps for select medications. These price caps may reduce revenue for the pharmacy benefit managers (PBMs) that negotiate the actual price paid for medicines in the US. To offset the resulting pressure on their profit margins, it is possible that PBMs would, in turn, increase patient′s
-
Reshaping trade for vaccine equity: gaps in policy discourse medRxiv. Health Policy Pub Date : 2024-06-26 Toby Pepperrell, Meri Koivusalo, Liz Grant, Alison McCallum
Introduction The recent Pandemic Agreement negotiations illustrate significant gaps in action required to respond effectively to the lessons of the COVID-19 pandemic and make progress towards public health goals, including SDGs. The pandemic revealed vaccine equity as a unifying health need, and international trade as a Commercial Determinant of Health. We explored where policy action could reshape
-
Evaluating the Effectiveness of a Population-Level Health Intervention to Increment HCV Treatment Coverage in Tuscany Region, Italy: An Interrupted Time Series Analysis medRxiv. Health Policy Pub Date : 2024-06-25 Chiara Seghieri, Luca Ceccarelli, Costanza Tortù, Lara Tavoschi
Worldwide, an estimated 71.1 million people are chronically infected with the Hepatitis C virus (HCV). The advent of direct-acting antivirals (DAAs) has made possible the definition of elimination targets by 2030. This study aimed to evaluate the effectiveness of a population-level health intervention to expand access to HCV treatment in the Tuscany Region, Italy.
-
Cross-sectional study assessing the feasibility of measuring residents′ Quality of Life in English care homes and assessing the construct validity and internal consistency of measures completed by staff-proxy. medRxiv. Health Policy Pub Date : 2024-06-24 Ann-Marie Towers, Stacey Rand, Stephen Allan, Sinead Palmer, Rachael Carroll, Gizdem Akdur, Nick Smith, Jennifer Kirsty Burton, Anne Killett, Barbara Hanratty, Julienne Meyer, Karen Spilsbury, Claire Goodman
Objectives: To assess the feasibility of capturing older care home residents′ quality of life (QoL) in digital social care records (DSCRs) and the construct validity (hypothesis testing) and internal consistency (Cronbach′s Alpha) of four QoL measures. Design: Cross-sectional data collected in wave one of the DACHA (Developing resources And minimum dataset for Care Homes′ Adoption) Study, a mixed-methods
-
Policies on Artificial Intelligence Chatbots Among Academic Publishers: A Cross-Sectional Audit medRxiv. Health Policy Pub Date : 2024-06-20 Daivat Bhavsar, Laura Duffy, Hamin Jo, Cynthia Lokker, R. Brian Haynes, Alfonso Iorio, Ana Marusic, Jeremy Y. Ng
Background: Artificial intelligence (AI) chatbots are novel computer programs that can generate text or content in a natural language format. Academic publishers are adapting to the transformative role of AI chatbots in producing or facilitating scientific research. This study aimed to examine the policies established by scientific, technical, and medical academic publishers for defining and regulating
-
Intrapartum antibiotic prophylaxis to prevent Group B streptococcal infections in newborn infants: a systematic review and meta-analysis comparing various strategies medRxiv. Health Policy Pub Date : 2024-06-17 Timothy J. R. Panneflek, Gea F. Hasperhoven, Yamikani Chimwaza, Connor Allen, Tina Lavin, Arjan B. te Pas, Vincent Bekker, Thomas van den Akker
Background Early-onset Group B Streptococcus (EOGBS) leads to substantial morbidity and mortality in newborn infants. Intrapartum antibiotic prophylaxis (IAP) prevents EOGBS infection, but IAP strategies vary. The approach to the provision of IAP can be risk-based, universal or a combination of the two strategies. Previous systematic reviews reported that universal strategies might be most optimal
-
Socioeconomic Inequalities in Non-Adherence to Antihypertensive Medication in Peru medRxiv. Health Policy Pub Date : 2024-06-16 Claudio Intimayta-Escalante, Lynn A. Quintana-Garcia
Introduction: In Peru, adherence to antihypertensive treatment ranges from 55.5% to 46.6%. Adherence decreases under adverse socioeconomic conditions. Therefore, the aim of this study was to evaluate the socioeconomic inequalities in non-adherence to antihypertensive medication in Peru. Methods: A cross-sectional study was conducted through the analysis of data from the Demographic and Family Health
-
What is the effectiveness of antiracist interventions for ethnic minority healthcare staff? A systematic review. medRxiv. Health Policy Pub Date : 2024-06-14 Kismet Lalli, Oluwatomisin Adewole, Holly Peters, Christopher Price, Blanche Lumb, Micaela Gal, Alison Cooper
Background: The National Health Service (NHS) has the most diverse workforce in the United Kingdom (UK), 25% (n= 309,532 out of ,200,000) of staff belong to ethnic minority groups. However, there is evidence of longstanding issues of racism within the NHS and discrimination towards ethnic minority healthcare staff has been rising since 2016. In the first wave of the COVID-19 pandemic, 95% of COVID-19
-
Optimizing costs and sustainability for Gamma Knife Radiosurgery: A cost and breakeven analysis at India's largest Neurosurgery Centre medRxiv. Health Policy Pub Date : 2024-06-14 Nitin Agrawal, Nishant Sharma, Tilotma Jamwal, Kshitija Singh, Vijaydeep Siddharth, Sidhartha Satpathy
Background Establishing and maintaining gamma knife facility incurs significant costs, mandating healthcare institutions to meticulously assess financial implications for sustainability. Methods This study explores the financial implications of setting up and operating a Gamma Knife facility, with an aim to ascertain user charges for achieving breakeven. The study was conducted from January to June
-
What works to support better access to mental health services (from primary care to inpatients) for minority groups to reduce inequalities? A rapid evidence summary. medRxiv. Health Policy Pub Date : 2024-06-14 Judit Katalin Csontos, Deborah Edwards, Elizabeth Gillen, Juliet Hounsome, Meg Kiseleva, Mala K Mann, Abubakar Sha'aban, Ruth Lewis, Alison Cooper, Adrian Edwards
Abstract: It is estimated that one in four people will experience poor mental health throughout their lifetimes. However, ethnic minority groups, refugees and asylum seekers experience more barriers accessing mental health services and have poorer mental health outcomes than those from non-ethnic minority groups. Evidence suggests that interventions that improve access and engagement with mental health
-
Did institutional racism contribute to adverse COVID-19 clinical outcomes in ethnic minority healthcare staff? Systematic review medRxiv. Health Policy Pub Date : 2024-06-13 Tomi Adewole, Kismet Lalli, Holly Peters, Christoper Price, Blanche Lumb, Micaela Gal, Alison Cooper
Abstract Introduction: Of the United Kingdom National Health Service (NHS) healthcare workers who died during the first wave of the pandemic, 63% belonged to an ethnic minority background, despite making up 21% of the NHS workforce. Previous research has considered biological and social causes such as obesity or overcrowded housing. This review aims to explore whether elements of institutional racism
-
State-level disparities in cervical cancer prevention and impact on outcomes in the U.S.: A modeling study medRxiv. Health Policy Pub Date : 2024-06-12 Fernando Alarid-Escudero, Valeria Gracia, Marina Wolf, Ran Zhao, Caleb W. Easterly, Jane J. Kim, Karen Canfell, Inge M.C.M. de Kok, Ruanne V. Barnabas, Shalini Kulasingam
Background. Despite the availability of HPV vaccines for over a decade, coverage across the United States (US) is varied. While some states have made concerted efforts to increase HPV vaccination coverage, most model-based analyses have estimated vaccine impact on the US. We estimated the impact of hypothetical changes in HPV vaccination coverage at the state level for three states with varying levels
-
GroceryDB: Prevalence of Processed Food in Grocery Stores medRxiv. Health Policy Pub Date : 2024-06-09 Babak Ravandi, Peter Mehler, Gordana Ispirova, Albert-Ĺaszló Barabási, Giulia Menichetti
The offering of grocery stores is a strong driver of consumer decisions, shaping their diet and long-term health. While highly processed food like packaged products, processed meat, and sweetened soft drinks have been increasingly associated with unhealthy diet, information on the degree of processing characterizing an item in a store is not straightforward to obtain, limiting the ability of individuals
-
Socioeconomic Inequalities in the Visual Assessment of Older Adults with Cataracts in Peru medRxiv. Health Policy Pub Date : 2024-06-07 Claudio Intimayta-Escalante, Gino Vitteri-Soto
Introduction In Peru, one in six adults over 50 years old has cataracts. This proportion increases due to the lack of routine visual assessments among older adults. Therefore, the objective of this research was to evaluate the socioeconomic inequalities in visual assessments among older adults with cataracts in Peru.
-
Screening for breast cancer with mammography medRxiv. Health Policy Pub Date : 2024-06-06 Peter C Gøtzsche, Karsten Juhl Jørgensen, Cochrane Breast Cancer Group
Background A variety of estimates of the benefits and harms of mammographic screening for breast cancer have been published and national policies vary. This is an update of a review previously updated 2013 and originally published 2001.
-
Factors associated with care home resident quality of life: Demonstrating the value of a pilot Minimum Data Set using cross-sectional analysis from the DACHA study medRxiv. Health Policy Pub Date : 2024-05-31 Stephen Allan, Stacey Rand, Ann-Marie Towers, Kaat De Corte, Freya Tracey, Elizabeth Crellin, Therese Lloyd, Rachael E Carroll, Sinead Palmer, Lucy Webster, Adam Gordon, Nick Smith, Gizdem Akdur, Anne Killett, Karen Spilsbury, Claire Goodman
Background To maintain good standards of care, evaluations of policy interventions or potential improvements to care are required. A number of quality of life (QoL) measures could be used but there is little evidence for England as to which measures would be appropriate. Using data from a pilot Minimum Data Set (MDS) for care home residents from the Developing resources And minimum dataset for Care
-
Publication status and disclosure gaps in a cohort of 71 clinical trials assessing the safety and efficacy of 3 COVID-19 vaccines developed by Chinese biopharmaceutical companies: An observational cohort study medRxiv. Health Policy Pub Date : 2024-05-30 Till Bruckner, Yixuan Chen, Carolina Cruz, Christie Ebube Dike, Belen Chavarria, Shiyu Chen, Ernest Dela Dzidzornu, Martin Ringsten
Transparency shortcomings can undermine confidence in the safety and efficacy of vaccines. This study assesses the publication status and disclosure gaps in a cohort of 71 clinical trials assessing the safety and efficacy of 3 COVID-19 vaccines developed by Chinese biopharmaceutical companies that received a World Health Organization Emergency Use Listing (EUL) and have been marketed globally. We searched
-
The Longevity Landscape: Value Creation for Healthy Aging medRxiv. Health Policy Pub Date : 2024-05-28 Wasu Mekniran, Odile-Florence Giger, Elgar Fleisch, Tobias Kowatsch, Mia Jovanova
Background The global aging population underscores a critical need to tackle accompanying health and economic challenges, at all levels of society. This All-of-Society approach emphasizes the involvement of various stakeholders—governments, NGOs, researcher centers, private companies, local communities, and opinion leaders—to collectively promote healthy aging. However, how stakeholders enable healthy
-
Prevalence and determinants of tobacco use among school-going adolescents in 53 African countries: evidence from Global Youth Tobacco Surveys medRxiv. Health Policy Pub Date : 2024-05-25 Retselisitsoe Pokothoane, Terefe Gelibo Agerfa, Christus Cito Miderho, Noreen Dadirai Mdege
Introduction Tobacco use typically begins during adolescence. There is a lack of comprehensive evidence on the use of different tobacco products among adolescents in Africa.
-
Tackling the primary healthcare workforce crisis: time to talk about health systems and governance. A comparative assessment of the European region medRxiv. Health Policy Pub Date : 2024-05-24 E Kuhlmann, M Falkenbach, MG Brinzac, T Correia, M Panagioti, B Rechel, A Sagan, M Santric-Milicevic, M-I Ungureanu, I Wallenburg, V Burau
Background Primary healthcare has emerged as a powerful global concept, but little attention has been directed towards the pivotal role of the healthcare workforce and the diverse institutional setting in which they work. This study aims to bridge the gap between the primary healthcare policy and the ongoing healthcare workforce crisis debate by introducing a health system and governance approach to
-
The role of Construction of Healthcare Consortium on the allocation of human resources for primary care resources and its equity in China medRxiv. Health Policy Pub Date : 2024-05-23 Shijie Li, Changze Liao, Shengli Zhang
Objectives This study aims to measure the effect of Construction of Healthcare Consortium (CHC) on the allocation and equity of human resources (HR) for primary health care (PHC) in China, at the same time, it provides some data to support the government’s policies improvement in the next stage.
-
The prevalence and factors associated with alcohol, cigarette, and marijuana use among adolescents in 25 African countries: evidence from Global School-Based Health Surveys medRxiv. Health Policy Pub Date : 2024-05-23 Retselisitsoe Pokothoane, Terefe Gelibo Agerfa, Josiane Djiofack Tsague, Noreen Dadirai Mdege
Objectives To provide first comprehensive estimates of the prevalence of psychoactive substances: alcohol, cigarettes and marijuana and their associated factors among school-going adolescents in 25 African countries, and thereby contribute to the evidence base of substance use in Africa.