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Addressing implementation challenges during guideline development - a case study of Swedish national guidelines for methods of preventing disease.

https://arctichealth.org/en/permalink/ahliterature277834
Source
BMC Health Serv Res. 2015 Jan 22;15:19
Publication Type
Article
Date
Jan-22-2015
Author
Linda Richter-Sundberg
Therese Kardakis
Lars Weinehall
Rickard Garvare
Monica E Nyström
Source
BMC Health Serv Res. 2015 Jan 22;15:19
Date
Jan-22-2015
Language
English
Publication Type
Article
Keywords
Adult
Consensus
Evidence-Based Practice - organization & administration - standards
Health promotion - organization & administration - standards
Humans
Practice Guidelines as Topic
Preventive Health Services - organization & administration - standards
Quality of Health Care
Risk Reduction Behavior
Sweden
Abstract
Many of the world's life threatening diseases (e.g. cancer, heart disease, stroke) could be prevented by eliminating life-style habits such as tobacco use, unhealthy diet, physical inactivity and excessive alcohol use. Incorporating evidence-based research on methods to change unhealthy lifestyle habits in clinical practice would be equally valuable. However gaps between guideline development and implementation are well documented, with implications for health care quality, safety and effectiveness. The development phase of guidelines has been shown to be important both for the quality in guideline content and for the success of implementation. There are, however, indications that guidelines related to general disease prevention methods encounter specific barriers compared to guidelines that are diagnosis-specific. In 2011 the Swedish National board for Health and Welfare launched guidelines with a preventive scope. The aim of this study was to investigate how implementation challenges were addressed during the development process of these disease preventive guidelines.
Seven semi-structured interviews were conducted with members of the guideline development management group. Archival data detailing the guideline development process were also collected and used in the analysis. Qualitative data were analysed using content analysis as the analytical framework.
The study identified several strategies and approaches that were used to address implementation challenges during guideline development. Four themes emerged from the analysis: broad agreements and consensus about scope and purpose; a formalized and structured development procedure; systematic and active involvement of stakeholders; and openness and transparency in the specific guideline development procedure. Additional factors concerning the scope of prevention and the work environment of guideline developers were perceived to influence the possibilities to address implementation issues.
This case study provides examples of how guideline developers perceive and approach the issue of implementation during the development and early launch of prevention guidelines. Models for guideline development could benefit from an initial assessment of how the guideline topic, its target context and stakeholders will affect the upcoming implementation.
Notes
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PubMed ID
25608684 View in PubMed
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An integrative framework for community partnering to translate theory into effective health promotion strategy.

https://arctichealth.org/en/permalink/ahliterature182801
Source
Am J Health Promot. 2003 Nov-Dec;18(2):168-76
Publication Type
Article
Author
Allan Best
Daniel Stokols
Lawrence W Green
Scott Leischow
Bev Holmes
Kaye Buchholz
Author Affiliation
Centre for Clinical Epidemiology and Evaluation, Vancouver Hospital and Health Sciences Centre, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada.
Source
Am J Health Promot. 2003 Nov-Dec;18(2):168-76
Language
English
Publication Type
Article
Keywords
Canada
Community-Institutional Relations
Comprehensive Health Care - organization & administration
Cooperative Behavior
Health Policy
Health promotion - organization & administration - standards
Health Services Research
Humans
Models, organizational
Practice Guidelines as Topic
Systems Theory
Abstract
Although there is general agreement about the complex interplay among individual-, family-, organizational-, and community-level factors as they influence health outcomes, there is still a gap between health promotion research and practice. The authors suggest that a disjuncture exists between the multiple theories and models of health promotion and the practitioner's need for a more unified set of guidelines for comprehensive planning of programs. Therefore, we put forward in this paper an idea toward closing the gap between research and practice, a case for developing an overarching framework--with several health promotion models that could integrate existing theories--and applying it to comprehensive health promotion strategy.
We outline a theoretical foundation for future health promotion research and practice that integrates four models: the social ecology; the Life Course Health Development; the Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation-Policy, Regulatory and Organizational Constructs in Educational and Environmental Development; and the community partnering models. The first three models are well developed and complementary. There is little consensus on the latter model, community partnering. However, we suggest that such a model is a vital part of an overall framework, and we present an approach to reconciling theoretical tensions among researchers and practitioners involved in community health promotion.
THE NEED FOR SYSTEMS THEORY AND THINKING: Systems theory has been relatively ignored both by the health promotion field and, more generally, by the health services. We make a case for greater use of systems theory in the development of an overall framework, both to improve integration and to incorporate key concepts from the diverse systems literatures of other disciplines.
(1) Researchers and practitioners understand the complex interplay among individual-, family-, organizational-, and community-level factors as they influence population health; (2) health promotion researchers and practitioners collaborate effectively with others in the community to create integrated strategies that work as a system to address a wide array of health-related factors; (3) The Healthy People Objectives for the Nation includes balanced indicators to reflect health promotion realities and research-measures effects on all levels; (4) the gap between community health promotion "best practices" guidelines and the way things work in the everyday world of health promotion practice has been substantially closed.
We suggest critical next steps toward closing the gap between health promotion research and practice: investing in networks that promote, support, and sustain ongoing dialogue and sharing of experience; finding common ground in an approach to community partnering; and gaining consensus on the proposed integrating framework.
PubMed ID
14621414 View in PubMed
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Source
Pages 300-304 in P. Bjerregaard et al., eds. Part I, Proceedings of the 11th International Congress on Circumpolar Health, Harstad, Norway, June 5-9, 2000. International Journal of Circumpolar Health. 2001;60(2)
Publication Type
Article
Date
Apr-2001
  1 document  
Author
Alexeeva, N.V
Alexeev, O.L
Author Affiliation
Institute of Internal Medicine, Novosibirsk, Russia. zima_iim@issa.nsc.ru
Source
Pages 300-304 in P. Bjerregaard et al., eds. Part I, Proceedings of the 11th International Congress on Circumpolar Health, Harstad, Norway, June 5-9, 2000. International Journal of Circumpolar Health. 2001;60(2)
Date
Apr-2001
Language
English
Geographic Location
Russia
Publication Type
Article
Digital File Format
Text - PDF
Keywords
Adolescent
Adult
Female
Health promotion - organization & administration - standards
Humans
Male
Middle Aged
Prevalence
Program Evaluation
Siberia - epidemiology
Smoking - epidemiology - prevention & control
Smoking Cessation
Tobacco
Abstract
The prevalence of smoking is very high and growing in Siberia. Three population surveys carried out by the Institute of Internal medicine within the framework of the MONICA project (WHO) during 1988-1995 revealed that 59% of the men and 11% of the women aged 25-64 are smokers (2). The number of smokers among children is also growing: 21% of girls and 40% of boys aged 14-17 are smokers (1). Tobacco product advertising is widespread in the city. Cheap cigarettes of bad quality are easily available for the population. The economic situation in the region makes it difficult for people to pay for specialised treatment. That is why new methods of smoking prevention should be found. The main components of our work are: involving local decision-makers in the activity, educating the population, work with mass media, epidemiological studies, international Quit & Win campaigns.
PubMed ID
11507986 View in PubMed
Documents
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Applying TQM to community health improvement: nine works in progress.

https://arctichealth.org/en/permalink/ahliterature214945
Source
Qual Lett Healthc Lead. 1995 Jul-Aug;7(6):23-9
Publication Type
Article
Author
M. Knapp
D. Hotopp
Author Affiliation
Institute for Healthcare Improvement, USA.
Source
Qual Lett Healthc Lead. 1995 Jul-Aug;7(6):23-9
Language
English
Publication Type
Article
Keywords
Academies and Institutes
Canada
Community Health Planning - organization & administration - standards
Health promotion - organization & administration - standards
Humans
Interinstitutional Relations
Mentors
Organizational Objectives
Pilot Projects
Total Quality Management - standards
United States
Urban health
Abstract
Traditionally, quality improvement principles have been used in business and healthcare settings. Nine North American cities, however, have demonstrated how these same QI principles can be applied to improving community health. Guided by a conceptual framework based on a three-question model and employing a Plan-Do-Check-Act cycle, the communities were able to develop interventions that are bringing about change in targeted populations, ranging from reducing the number of suspensions from school due to violence among youths to improving post-neonatal mortality rates.
Notes
Erratum In: Qual Lett Healthc Lead 1995 Sep;7(7):15
PubMed ID
10144756 View in PubMed
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Benchmarking for investment for health.

https://arctichealth.org/en/permalink/ahliterature190795
Source
Promot Educ. 2000;7(2):24-32, 59, 68
Publication Type
Article
Date
2000
Author
M B Mittelmark
Author Affiliation
Research Centre, University of Bergen, Chrisitesgt 13, 5015 Bergen, Norway. maurice.mittelmark@uib.no
Source
Promot Educ. 2000;7(2):24-32, 59, 68
Date
2000
Language
English
Publication Type
Article
Keywords
Benchmarking
Estonia
Guidelines as Topic
Health promotion - organization & administration - standards
Health status
Humans
Norway
Quality of Health Care
Slovenia
PubMed ID
11924345 View in PubMed
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A case of standardization? Implementing health promotion guidelines in Denmark.

https://arctichealth.org/en/permalink/ahliterature282713
Source
Health Promot Int. 2016 Sep;31(3):692-703
Publication Type
Article
Date
Sep-2016
Author
Morten Hulvej Rod
Mette Terp Høybye
Source
Health Promot Int. 2016 Sep;31(3):692-703
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - prevention & control
Denmark
Exercise
Health promotion - organization & administration - standards
Humans
Interviews as Topic
Mental health
Practice Guidelines as Topic - standards
Reproductive Health - standards
Smoking - prevention & control
Abstract
Guidelines are increasingly used in an effort to standardize and systematize health practices at the local level and to promote evidence-based practice. The implementation of guidelines frequently faces problems, however, and standardization processes may in general have other outcomes than the ones envisioned by the makers of standards. In 2012, the Danish National Health Authorities introduced a set of health promotion guidelines that were meant to guide the decision making and priority setting of Denmark's 98 local governments. The guidelines provided recommendations for health promotion policies and interventions and were structured according to risk factors such as alcohol, smoking and physical activity. This article examines the process of implementation of the new Danish health promotion guidelines. The article is based on qualitative interviews and participant observation, focusing on the professional practices of health promotion officers in four local governments as well as the field of Danish health promotion more generally. The analysis highlights practices and episodes related to the implementation of the guidelines and takes inspiration from Timmermans and Epstein's sociology of standards and standardization. It remains an open question whether or not the guidelines lead to more standardized policies and interventions, but we suggest that the guidelines promote a risk factor-oriented approach as the dominant frame for knowledge, reasoning, decision making and priority setting in health promotion. We describe this process as a case of epistemic standardization.
PubMed ID
25912256 View in PubMed
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Case study: the Canadian Heart Health Initiative.

https://arctichealth.org/en/permalink/ahliterature192357
Source
WHO Reg Publ Eur Ser. 2001;(92):463-73
Publication Type
Article
Date
2001

[Characteristics of health status of children-orphans and the effectiveness of health promotion in a preventive sanatorium].

https://arctichealth.org/en/permalink/ahliterature227479
Source
Sov Zdravookhr. 1991;(1):20-2
Publication Type
Article
Date
1991
Author
M N Rakhmanova
V G Saitova
T N Pavlenko
T I Sudareva
P V Kuznetsova
O A Kharchenko
V V Utenina
Source
Sov Zdravookhr. 1991;(1):20-2
Date
1991
Language
Russian
Publication Type
Article
Keywords
Adolescent
Child
Child Care - organization & administration - standards
Child, Institutionalized
Foster Home Care - organization & administration - standards
Health promotion - organization & administration - standards
Health Resorts
Health status
Humans
Russia
Abstract
The data are provided on the health status of 850 children-orphans and effectiveness of their health promotion under conditions of sanatorium dispensary. The following results were obtained: the abnormalities in physical development were identified in 22 percent of children, high incidence of ENT diseases (18.8%), visual disturbance (18.8%), deviations in the somatic status (18.7%) and in neuropsychic development (12%). The children of the I group health constituted 7 percent. The experience is summarized of health promoting activities among children from 4 boarding schools. It is indicated that health promotion has a favourable effect on child neuropsychic status, with the rate of acute diseases per year being declined by 2.2 times and the incidence of chronic diseases aggravations--by 1.5. The high efficiency of health promotion under conditions of sanatorium-dispensary permits to recommend this method for wide introduction into the practical performance of curative and preventive institutions.
PubMed ID
1827532 View in PubMed
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Evaluating the Fabreville Heart Health Program in Laval, Canada: a dialogue between two paradigms, positivism and constructivism.

https://arctichealth.org/en/permalink/ahliterature185380
Source
Health Promot Int. 2003 Jun;18(2):127-34
Publication Type
Article
Date
Jun-2003
Author
Minh Nguyet Nguyen
Joanne Otis
Author Affiliation
Public Health Department of Laval, Quebec, Canada. nguyet_nguyen@ssss.gouv.qc.ca
Source
Health Promot Int. 2003 Jun;18(2):127-34
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - prevention & control
Community Health Services - organization & administration - standards
Consumer Participation
Focus Groups
Health Behavior
Health Care Coalitions
Health Education - organization & administration - standards
Health promotion - organization & administration - standards
Humans
Primary prevention - methods
Program Evaluation - methods
Quebec
Abstract
As part of the Canadian Federal-Provincial Initiative in Heart Health, the goal of the Fabreville Heart Health Program was to sensitize a district of Laval, Quebec's second most populous city, to heart-healthy behaviours. The program was planned and implemented by a committee composed of Fabreville community leaders and professionals from the Public Health Department. Between 1992 and 1994, intervention objectives were defined by the department in terms of changing individual behaviours associated with cardiovascular risk factors, namely diet, sedentariness and smoking, as well as adapting physical and social environments to facilitate these changes. However, from 1994 to its conclusion in 1997, the program was re-oriented to engage the population in mobilizing their own community and taking charge of interventions themselves. Actions then became dependent on the interests and motivation of Fabreville residents to transform their lifestyles and aspects of their physical environment. The initial evaluation process, based on the positivist paradigm, was designed to measure changes in individual behaviours and certain physical environments, such as an increase in designated non-smoking areas. However, following the re-orientation towards community mobilization, it was decided that evaluation should go beyond the professional production of data to include a process of the collective construction of knowledge. Evaluation methodology then became based on the constructivist paradigm. Yet field constraints such as lack of community involvement in both leadership and process evaluation, and the need to ensure evaluation standards and fulfil sponsor obligations, compelled the Public Health Department to return to using a certain number of positivist methods. The ensuing inter-paradigm dialogue helped broaden the scope of evaluation and contributed to gaining a more in-depth understanding of the processes and outcomes of community mobilization.
PubMed ID
12746384 View in PubMed
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Everyday life and health concepts among blue-collar female workers in Denmark: implications for health promotion aiming at reducing health inequalities.

https://arctichealth.org/en/permalink/ahliterature112797
Source
Glob Health Promot. 2013 Jun;20(2):13-21
Publication Type
Article
Date
Jun-2013
Author
Jeanette Magne Jensen
Author Affiliation
Research Programme in Learning for Care, Sustainability and Health, University of Aarhus, Tuborgvej 164, 2400 Copenhagen NV, Denmark. jema@dpu.dk
Source
Glob Health Promot. 2013 Jun;20(2):13-21
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adult
Attitude to Health
Denmark
Educational Status
Female
Health Behavior
Health promotion - organization & administration - standards
Health Status Disparities
Humans
Interviews as Topic
Life Style
Middle Aged
Occupations - classification - economics
Qualitative Research
Smoking - psychology
Women, Working - psychology - statistics & numerical data
Abstract
This article introduces a perspective on the health of women with low levels of education in terms of organisation of their everyday life. The aim is to demonstrate the ways in which the women's concept of health is contingent on the conditions encountered in everyday life. A qualitative study based on interviews with the women forms the basis for the discussion. The analysis shows that the women find it difficult to adopt the official discourse on health and its foundation in a biomedical tradition. The article argues that it is necessary to move away from the educational approach focusing on risk and lifestyle with the goal of regulating individual behaviour. Instead, an approach is suggested which can provide the women with the opportunity to gain control of the everyday health determinants which are normally beyond their immediate reach. This is based on the argument that it is necessary to work with a health promotion and education strategy capable of operating within the various interactive patterns between 'environment' and 'individual' which form the foundation for health.
PubMed ID
23797936 View in PubMed
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24 records – page 1 of 3.