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National strategies for knowledge translation in health policy-making: A scoping review of grey literature.
Background and objectives: Without strategic actions in its support, the translation of scientific research evidence into health policy is often absent or delayed. This review systematically maps and assesses national-level strategic documents in the field of knowledge translation (KT) for health policy, and develops a practical template that can support Evidence-informed Policy Network (EVIPNet) Europe countries in producing national strategies for evidence-informed policy-making. Methods: Websites of organizations with strategic responsibilities in KT were electronically searched, on the basis of pre-defined criteria, in July-August 2017, and an updated search was carried out in April-June 2021. We included national strategies or elements of national strategies that dealt with KT activities, as well as similar strategies of individual institutions with a national policy focus. Two reviewers screened the strategies for inclusion. Data were analysed using qualitative content analysis. Results: A total of 65 unique documents were identified, of which 17 were eligible and analysed for their structure and content. Of the 17, 1 document was a national health KT action plan and 6 documents were institution-level KT strategies. The remaining 10 strategies, which were also included were 2 national health strategies, 5 national health research strategies and 3 national KT strategies (not specific to the field of health alone). In all, 13 structural elements and 7 major themes of health policy KT strategies were identified from the included documents. Conclusion: KT in health policy, as emerged from the national strategies that our mapping identified, is based on the production and accessibility of policy-relevant research, its packaging for policy-making and the activities related to knowledge exchange. KT strategies may play different roles in the complex and context-specific process of policy-making. Our findings show that the main ideas of health-specific evidence-informed policy literature appear in these strategies, but their effectiveness depends on the way stakeholders use them. Specific knowledge-brokering institutions and organizational capacity, advocacy about the use of evidence, and close collaboration and co-decision-making with key stakeholders are essential in furthering the policy uptake of research results.
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Developing and strengthening services to achieve an integrated continuum of long-term car in Türkiye: EVIPNet evidence brief for policy, number 12
The proportion of the elderly population and the number of individuals who experience limitations in performing basic daily activities independently have increased in Türkiye. The need for long-term care (‎LTC)‎ services has dramatically increased based on these driving forces. In addition, the need for LTC services, which were traditionally associated with housewives and non-working women in Türkiye, has also increased because women have become more involved in work outside the home. Many individuals who need assistance to maintain their functional ability cannot receive critical quality care without a significant burden on their families or finances in Türkiye. This requires multi-stakeholder health policy interventions for a solution to the need for LTC services. The Türkiye Institute for Health Policies, the Ministry of Health of Türkiye and the WHO Country Office in Türkiye came together to develop this evidence brief for policy, to be published under the aegis of the WHO European Evidence-informed Policy Network and provide evidence-informed options for policy-makers to tackle LTC-related problems in Türkiye. The work was carried out within the framework of the collaboration between the Türkiye Institute for Health Policies and WHO; it involved the Ministry of Health of Türkiye, high-level national policy institutions and national experts, and was supported by technical experts from the WHO Regional Office for Europe. The Türkiye Institute for Health Policies convened a working group comprising representatives from the Ministry of Health. The group identified, selected, appraised, and synthesized relevant research evidence on the problem; devised three options for tackling it; and weighed considerations in implementing each option.
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Issues and challenges in access to medicines faced by small countries in the WHO European Region: policy brief.
Essential medicines save lives and improve health when they are available, affordable, of assured quality and properly used. Lack of access to essential medicines is one of the most serious global public health problems and many new medicines are becoming expensive even for the health systems of high- and middle-income countries. This policy brief focuses on the issues and challenges in access to medicines faced by the 11 countries of the WHO Regional Office for Europe Small Countries Initiative. Many of these countries’ challenges arise from or are aggravated because of the size of their pharmaceutical markets. Small countries have low negotiating power and country-specific requirements such as producing tailored health technology assessment (‎HTA)‎ and pricing and reimbursement dossiers, packaging and leaflets in local languages also decreases the appeal for marketing products in small countries. Furthermore, development of HTA, managed entry agreements and horizon scanning processes requires resources and specialized knowledge and skills often less available in small countries, leading to less favourable procurement terms for public payers. The strategy to address these issues and challenges is through voluntary cooperation, on joint horizon scanning, pooled demand and procurement, and HTA integration, which the Access to Novel Medicines Platform can support.
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Patient involvement interventions in patients with kidney failure making end-of-life care decisions: A scoping review
OBJECTIVE: The objective of this review was to investigate and map empirical evidence of patient involvement interventions supporting patients with kidney failure making end-of-life care decisions in kidney services. INTRODUCTION: Clinical guidance integrating end-of-life care within kidney failure management pathways varies. Advance care planning interventions aimed at involving patients with kidney failure in their end-of-life care planning are established in some countries. However, there is limited evidence of the other types of patient involvement interventions integrated within services to support patients with kidney failure making decisions about their end-of-life care. INCLUSION CRITERIA: This scoping review includes studies exploring patient involvement interventions evaluated for patients with kidney failure considering end-of-life care, and/or their relatives, and/or health professionals in kidney services. Studies of children under the age of 18 were excluded. METHODS: The review was informed by JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Review (PRISMA-ScR) guidelines. MEDLINE, Scopus, Embase, and CINAHL were searched for full-text studies in English, Danish, German, Norwegian, and Swedish. Two independent reviewers assessed the literature against the inclusion criteria. Data retrieved from included studies used a relational analysis framework to synthesize the data and investigate and map different patient involvement interventions. RESULTS: The search identified 1628 articles, 33 articles met the inclusion criteria, describing 23 different interventions. Interventions targeted patients (n=3); health professionals (n=8); patients and health professionals (n=5); and patients, relatives, and health professionals (n=7). Intervention components included patient resources (eg, information, patient decision aids), consultation resources (eg, advance care planning, shared decision-making), and practitioner resources (eg, communication training). Patient involvement interventions were delivered within hospital-based kidney services. CONCLUSIONS: The review identified several ways to support patients with kidney failure to be involved in end-of-life care decisions. Future interventions may benefit from adopting a complex intervention framework to engage multiple stakeholders in the research and design of an intervention for shared decision-making between patients with kidney failure, their relatives, and health professionals in kidney services about integrating end-of-life care options into their kidney disease management pathway.
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Promoting environment and health policies at local level: a policy brief for decision-makers and practitioners
Experiences from countries in the WHO European Region show that planning for healthy, sustainable cities can be achieved locally but that this requires political will and leadership, a coherent vision, targeted financing, sustainable commitments at all levels of government and citizen engagement. An integrated approach, including collaboration between urban developers and environmental and health professionals, is necessary to address the current and future challenges to urban health and sustainability posed by environmental trends. “Boundary spanners” to connect different groups and expertise are key. This brief summarizes messages and lessons learnt on how local authorities across Europe can establish effective policies and interventions to provide healthy, sustainable environments for their citizens. It addresses the design and implementation of health-promoting urban policies that have been effective at local level, including both the challenges to be overcome and the enablers that should be maximized. The target readers of this brief are national, regional and local decision-makers and practitioners working in urban planning, environmental management and health promotion.
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Policy brief on integrating rehabilitation into palliative care services
World Health Organization (‎WHO)‎ policy on universal health coverage states that both rehabilitation and palliative care are essential components of quality health services and should be integrated within health systems using a multiprofessional workforce. Rehabilitation in palliative care can deliver many benefits for people and health systems but access to interventions is limited by a range of barriers including limited resource, siloed organization of services and attitudes of professionals and funders. While integrated rehabilitation has been achieved in high income countries in health services for people with chronic long-term conditions or trauma, it remains underresourced and highly variable within palliative care services. This policy brief aims to understand how integrating rehabilitation in palliative care services may improve the quality, accessibility, effectiveness and cost-effectiveness of health services for people approaching end of life. It provides practical and actionable information and recommendations to support health ministers and leaders in health systems planning to integrate rehabilitation in palliative care services.
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Self-management support needs of patients with inflammatory arthritis and the content of self-management interventions: A scoping review
BACKGROUND: Self-management skills can empower a person to manage the physical, psychological, and social impact of a health condition. However, the components of self-management interventions differ widely between studies and interventions. By performing a scoping review, we aimed to describe patients' self-management needs and how health professionals (HPs) can provide effective self-management support to patients with inflammatory arthritis (IA). OBJECTIVES: 1) to identify the evidence for self-management support needs of patients with IA, and 2) to identify the content (theory/theoretical approach, mode of delivery, duration and frequency) of self-management interventions that target patients with IA. METHODS: In May 2021, we performed a systematic literature search (from 2000 onward) in five databases (CINAHL (Ebsco), Cochrane Library, Embase (Ovid), Medline (Ovid) and PsycINFO (Ovid)) regarding self-management in patients with IA. RESULTS: Out of 11,748 records identified, we included 31 articles describing patients' support needs and 33 articles describing the content of self-management interventions. Patients' support needs were sorted into six topics: 1) disease impact and the pharmacological treatment, 2) care continuity and relations with HPs, 3) the importance of non-pharmacological treatment, 4) the need for support from family and friends, 5) support needs related to work issues, and 6) contextual preferences for self-management support. The theory/theoretical approach, mode of delivery, duration and frequency varied widely and were often unclearly or insufficiently described. In addition, the self-management concept was scarcely - or not - defined in the included articles. The identified topics for support needs were compared with the described content in the included articles. Only a few self-management interventions focused on patients' need for support in relation to work, and to family and friends. CONCLUSION: HPs provided self-management support to patients with IA in various ways, but there were gaps between the patients' support needs and the identified interventions. In developing self-management interventions, the self-management concept needs to be defined and a clear theory is required to support the development of the intervention. Future studies should seek to investigate various modes of delivery, frequency and duration, to develop effective interventions that meet patients' support needs.
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Implementation and efficacy of knowledge translation frameworks in family focused nursing care: A scoping review.
Aim: To provide an overview of the characteristics, variety and outcomes of knowledge translation (KT) strategies used in nursing care involving adult patients and their family members. Background: The gap in providing family nursing practice could be due to a lack of explicit KT frameworks and understanding of ways to translate evidence-based knowledge into clinical practice. Design: A scoping review conducted according to the Joanna Briggs Institute. Methods: The review is reported according to PRISMA-ScR. Relevant studies were searched in MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL Complete, ProQuest Nursing & Allied Health Premium, PsycINFO, Social Work Abstracts, Social Services Abstracts and Scopus. Grey literature was searched in ProQuest Dissertations & Theses Global. Search results were imported into the web-based programme Covidence. Studies describing concepts of KT, strategies of implementation, involvement of families and nurses/family caregivers in adult health care and conducted within the last 15 years were included. Results: Eight studies met the inclusion criteria. Three studies used the KTA Framework to guide the implementation process. The remaining five studies used different frameworks/guidelines to translate a variety of family focused interventions into their clinical practice. Translation strategies were often targeted towards nurse education. Reported outcomes included nurses' attitudes towards and acceptance of involving families in health care. The outcomes were conceptualized and measured differently, showing inconclusive results on effectiveness on family focused care and family health. Conclusion and implications for clinical practice: The application of KT frameworks to implement evidence-based family nursing into clinical practice is limited. The process of KT mainly targets at nurses' adoption of family focused interventions with limited information about short-, intermediate- and long-term efficacy on family health. Clinical leaders should consider time and resources needed to implement family focused care KT strategies before putting it into practice. Patient or public contribution: No Patient or Public Contribution. Data were obtained from other's literature.
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Behavioural and cultural insights for mpox control and elimination: policy brief No. 3, 30 November 2022
The WHO Regional Office for Europe mpox policy brief series summarizes policy recommendations, knowledge and interim technical guidance on key policy areas related to the mpox public health emergency of international concern in the WHO European Region. The first two briefs in the series provide an overarching set of considerations for the mpox response and for planning related to vaccination against mpox. Following a series of consultations with global experts, WHO has begun using a new preferred term “mpox” as a synonym for monkeypox and has changed the policy brief series name accordingly. Both names will be used simultaneously for one year while “monkeypox” is phased out. This third policy brief in the series describes how behavioural and cultural insights may be used to support broader mpox control and elimination strategies in countries. Such an approach requires carefully tailored policies, interventions and communication, based on an understanding of the behaviours, perceptions and context of priority populations, including health workers.
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Health 2020: transport and health: sector brief on transport
The Health 2020 policy framework has been adopted by all Member States of the WHO European Region in order to address Europe’s great social and health challenges, calling upon the health sector to reach out to, and work with, all the various sectors and parties in the continuous work of improving people’s health and well-being. Investing in transport plays an important role in determining health throughout the life-course. The transport sector is crucial to opportunities for participation in society, sustainable development, preventing injuries and disease and promoting health as well as the quality and liveability of the environment. By working together, health and transport can contribute significantly to individuals, communities and societies, reduce inequalities and support human development and high-quality, liveable environments, not only improving good health and well-being but also enhancing sustainable transport and fostering healthy and resilient communities and economies.
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Tobacco use and mental health conditions: a policy brief
This policy briefing focuses on the interplay between mental health conditions and tobacco use. It reviews the evidence behind tobacco control interventions targeting people with mental health conditions and explains why they should be implemented. The suggested key policy recommendations to reduce smoking prevalence in people with mental health conditions include ensuring completely smoke-free health services, targeting mental health professionals through awareness campaigns and investing in tobacco cessation tailored to individuals with mental health conditions.
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Digital solutions to health risks raised by the COVID-19 infodemic: policy brief
This policy brief highlights the need for specific improvements and developments that call upon stakeholders in the European Region to cooperate in infodemic management. To this end, the Regional Office highlights the following six policy considerations: 1. Reinforcing multistakeholder networks for infodemic management. 2. Strengthening overall risk communication and community engagement. 3. Implementing continuous monitoring of online harmful and false content. 4. Improving digital literacy approaches and organizing infodemic management trainings. 5. Advocating for infodemic management through communication campaigns. 6. Ensuring safe online platforms, which protect people from harmful content. The implementation of the digital solutions and policy considerations above calls for a whole-of-society approach with the collaboration of all stakeholders involved in infodemic management, ranging from users themselves to social media platforms, the information technology sector, health policy-makers, and fact-checking and civil society organizations, among others – with a shared objective of improving the Region’s public health response to the COVID-19 infodemic and enhancing preparedness for future health emergencies.
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Human resources for health in small countries: developing and sustaining postgraduate training: policy brief
This policy brief focuses on the challenges that small countries in the WHO European Region face and the opportunities they avail themselves of to develop and maintain postgraduate specialist training in the health sector. The brief reviews recent evidence on specialist and postgraduate training of the health workforce in small countries and illustrates examples of good practice to emulate and build on, as well as tools available to measure and ensure high standards of specialist training. It also highlights the need for small countries to participate in international collaboration and networking to be able to overcome challenges related to postgraduate specialist training over the longer term.
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Palliative care utilization among Non-Western migrants in Europe: A systematic review
The paper aims to identify and describe the European evidence on opportunities and barriers to access and utilization of palliative care among non- western migrants. A systematic review in accordance with PRISMA guidelines was conducted in June 2020, searching Medline, CINAHL, PsychINFO and EMBASE databases. PROSPERO# CRD42020193651. Studies included empirical research published between 2011 and 2020. Search words were, for example, ethnic groups and palliative care. Thematic analysis was used to analyze data. Twenty nine qualitative and six quantitative studies were included. Four main themes were identified: communication and language; knowledge and awareness; patient preferences, cultural and religious issues; and lack of resources at different levels of palliative care service provision. Migrants' access to palliative care is impeded at system, community and individual levels, yet, recommendations are mostly at the individual level. Closer attention is required to these different levels when designing future palliative interventions for migrants.
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The effects of obstetric emergency team training on patient outcome: A systematic review and meta-analysis
INTRODUCTION: Little is known about the optimal simulation-based team training in obstetric emergencies. We aimed to review how simulation-based team training affects patient outcomes in obstetric emergencies. MATERIAL AND METHODS: Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were searched up to and including May 15, 2021. SELECTION CRITERIA: randomized controlled trials (RCTs) and cohort studies on obstetric teams in high-resource settings comparing the effect of simulation-based obstetric emergency team training with no training on the risk of Apgar scores less than 7 at 5 min, neonatal hypoxic ischemic encephalopathy, severe postpartum hemorrhage, blood transfusion of four or more units, and delay of emergency cesarean by more than 30 min. DATA COLLECTION AND ANALYSIS: The included studies were assessed using PRISMA, EPCO, and GRADE. RESULTS: We found 21 studies, four RCTs and 17 cohort studies, evaluating patient outcomes after obstetric team training compared with no training. Annual obstetric emergency team training may reduce brachial plexus injury (six cohort studies: odds ratio [OR] 0.47, 95% CI 0.33-0.68; one RCT: OR 1.30, 95 CI% 0.39-4.33, low certainty evidence) and suggest a positive effect; but it was not significant on Apgar score below 7 at 5 min (three cohort studies: OR 0.77, 95% CI 0.51-1.19; two RCT: OR 0.87, 95% CI 0.72-1.05, moderate certainty evidence). The effect was unclear for hypoxic ischemic encephalopathy, umbilical prolapse, decision to birth interval in emergency cesarean section, and for severe postpartum hemorrhage. Studies with in situ multi-professional simulation-based training demonstrated the best effect. CONCLUSIONS: Emerging evidence suggests an effect of obstetric team training on obstetric outcomes, but conflicting results call for controlled trials targeted to identify the optimal methodology for effective team training.
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