Considerations of the concept of infant health: a literature review

This study examined a wide range of literature in order to describe factors associated with the concept of infant health. The design of the study is a literature review examining 21 research studies, written in the English language. The study explored which factors were found to exert an influence on the concept of infant health. The result showed that the concept infant health is dependent on many factors but what seems to exert an influence are foremost maternal health and well-being, the family's health care utilization and the parental assessment of their own health. Additional studies are needed to fully understand the concept of infant health. The need for an infant definition that empowers infant health arises because, if a common ground is not clearly established, miscommunication may arise. Furthermore, there is a need to initiate a model for infant health.     

The Joint Action on Health Workforce Planning and Forecasting: Results of a European programme to improve health workforce policies

Health workforce (HWF) planning and forecasting is faced with a number of challenges, most notably a lack of consistent terminology, a lack of data, limited model-, demand-based- and future-based planning, and limited inter-country collaboration. The Joint Action on Health Workforce Planning and Forecasting (JAHWF, 2013–2016) aimed to move forward on the HWF planning process and support countries in tackling the key challenges facing the HWF and HWF planning. This paper synthesizes and discusses the results of the JAHWF. It is shown that the JAHWF has provided important steps towards improved HWF planning and forecasting across Europe, among others through the creation of a minimum data set for HWF planning and the ‘Handbook on Health Workforce Planning Methodologies across EU countries’. At the same time, the context-sensitivity of HWF planning was repeatedly noticeable in the application of the tools through pilot- and feasibility studies. Further investments should be made by all actors involved to support and stimulate countries in their HWF efforts, among others by implementing the tools developed by the JAHWF in diverse national and regional contexts. Simultaneously, investments should be made in evaluation to build a more robust evidence base for HWF planning methods.     

Developing and sustaining adolescent-friendly health services: A multiple case study from Ecuador and Peru

Adolescent-Friendly Health Services (AFHSs) are those that are accessible, acceptable, equitable, appropriate and effective for different youth sub-populations. This study investigated the process through which four clinics in two countries – Peru and Ecuador – introduced, developed and sustained AFHSs. A multiple case study design was chosen, and data from each clinic were collected through document review, observations and informant interviews. National level data were also collected. Data were analysed following thematic analysis. The findings showed that the process of introducing, developing and sustaining AFHSs was long term, and required a creative team effort and collaboration between donors, public institutions and health providers. The motivation and external support was crucial to initiating and sustaining the implementation of AFHSs. Health facilities’ transformation into AFHSs was linked to the broader organisation of country health systems, and the evolution of national adolescent health policies. In Peru, the centralised approach to AFHSs introduction facilitated the dissemination of a comprehensive national model to health facilities, but dependency on national directives made it more difficult to systemise them when ideological and organisational changes occurred. In Ecuador, a less centralised approach to introducing AFHSs made for easier integration of the AFHSs model.     

Sense of place,place attachment,and belonging-in-place in empirical research: A scoping review for rural health workforce research

Rural communities around the world face chronic shortages of medical, nursing, and allied health professionals that contribute to serious inequalities between urban and rural residents. Three concepts have been identified as relevant for health workforce recruitment and retention: sense of place, place attachment, and belonging-in-place. However, there is limited information regarding operationalisation of these concepts within health workforce studies. This paper presents findings from a scoping review investigating empirical application of these concepts across a range of disciplines. Findings identify various strategies for empirical application of two of these three concepts to health workforce research and highlight the value of particular approaches for studies of rural health workforce retention. The paper concludes with several recommendations for future research.     

Variation in the prescription drugs covered by health systems across high-income countries: A review of and recommendations for the academic literature

BackgroundBecause not all medicines are equally safe, effective, and affordable, health systems often use formularies to define explicitly which medicines will be included and excluded from coverage.ObjectiveWe sought to synthesize methods and findings from published studies of formulary variation across health systems in high-income countries.MethodsWe conducted a systematic review of peer-reviewed research papers published from 2000 to 2017, inclusively. Because of the heterogeneous nature of the literature, we used an inductive approach to summarize methods and findings.ResultsNine studies met our study inclusion criteria. Included studies used a variety of methods for selecting medicines for analysis, for measuring coverage levels, and for measuring concordance between formularies. Studies assessing variations in coverage of all licensed medicines and found lower rates of cross-national coverage variation than studies of coverage for selected specialty drugs and indications. The one study that focused on coverage of high-volume medicines found the most complete and consistent levels of formulary listings across countries.ConclusionAlthough published studies contain interesting findings that likely have prompted discussions about their policy implications, the literature can be improved with greater transparency concerning the overarching objective of work in this area and more rigor concerning the selection, analysis, and reporting of data.     

Methodological and ethical issues in Internet-mediated research in the field of health: an integrated review of the literature

The advantages and disadvantages of using the Internet in both qualitative and quantitative researches in the field of health are readily available in the literature, but little examination has been made of the factors to be considered in developing and running Internet-mediated research. A bibliographic search of English language publications indexed in eight computerized databases (EBSCO, EMBASE, MedLine, PsycInfo, CINAHL, PubMed, Cochrane, and TRIP) was undertaken with no limit set for the data of publication. The keywords Internet, research, quality, credibility, reliability, and validity were used in all possible combinations, and mappings to headings made wherever possible. The search revealed three key areas in setting up and undertaking Internet-mediated research: addressing sampling biases, ensuring ethical practice, and exploring the validity of data collected using an online interface. This paper contributes to the ongoing development of quality standards in the conduct and write-up of Internet-mediated research in the field of health.     

Recruitment and retention of youth for research using social media: Experiences from the Just/Us study

Youth, particularly youth of color, continue to face disparities with regard to sexually transmitted infections (STIs), including HIV. Yet, comprehensive education about sex and sexual risk for STIs is not universal for youth in the United States. While Internet research on HIV prevention has demonstrated that the medium can be as effective as face-to-face education and prevention approaches, Internet-based research has faced challenges in recruitment of diverse samples, has not consistently been able to retain adequate samples, and do so for long-term follow-up. Additionally, we have few examples of research on social networking sites, which are particularly popular with youth and represent locations where they spend the majority of their time online. In this work, we describe efforts to recruit and retain youth on My Space and Facebook for a randomized controlled trial testing the efficacy of using social media for HIV prevention. Findings demonstrate no success in using My Space to recruit for our STI prevention intervention, but success in recruitment of a diverse sample and short-term retention of this sample using Facebook. We recruited 1578 diverse youth aged 16–24 years for the study and retained 69% of them for a two-month follow-up; follow-up dropped to 50% at six months, demonstrating challenges with longer-term retention. This work represents innovation in recruitment and retention of individuals and networks using social media.     

The ethics of researching intimate partner violence in global health: A case study from global health research

There has been an increase in attention to intimate partner violence (IPV) as a health issue that contributes to the spread of HIV, physical and emotional stress, depression, substance use, serious injuries, and higher rates of mortality in low-income settings. This paper explores the ethical implications raised by research on IPV by global health scholars. Drawing on Hedgecoe’s work on critical bioethics to analyse a qualitative study of IPV in Rwanda, this paper discusses the risks and benefits of conducting research on IPV as part of the global health agenda. We discuss ethical issues that have become evident through our work in this area, including: raising IPV as an issue of concern in women’s lives in settings where economic support for women experiencing IPV may not exist; recording interviews and focus group discussions in contexts with significant government surveillance; ethical tensions in appropriating local voices in ways that position women as ‘victims’ of violence; and the risks associated with framing IPV as a global health issue separate from feminist advocacy. We recommend more tailored approaches to ethics in IPV research, which considers the specificity of the social, cultural and economic context.     

The impacts of crime on health and health services: A literature review

Crime poses substantial risks to the health of victims and, consequently, generates additional demand for health services. This literature review examines the current state of knowledge and understanding of the impacts of crime on physical and psychological health; responses to the needs of victims by health workers and other professionals; and resulting costs to health services. The review concludes by identifying issues for research, policy and practice.     

Assessing the risk of endogeneity bias in health and mortality inequalities research using composite measures of multiple deprivation which include health-related indicators: A case study using the Scottish Index of Multiple Deprivation and population health and mortality data

The inclusion of health-related indicators in composite measures of multiple deprivation introduces a risk of endogeneity bias when using the latter in health inequalities research. This bias may ultimately result in the inappropriate allocation of healthcare resources and maintenance of preventable health inequalities. Mitigation strategies to avoid this bias include removing the health-related indicators or using single constituent domains (such as income or employment class) in isolation. These strategies have not been widely validated. This study used population-level health and mortality data with a contemporary composite measure of multiple deprivation (Scottish Index of Multiple Deprivation; SIMD) to assess these mitigation strategies. The differences between deprivation methods (original, health excluded, and income domain) were negligible. The results of quantitative research on health inequalities are unlikely to be affected by endogeneity bias.     

Upscaling the recruitment and retention of human resources for health at primary healthcare centres in Lebanon: a qualitative study

The sustainability of primary healthcare (PHC) worldwide has been challenged by a global shortage in human resources for health (HRH). This study is a unique attempt at systematically soliciting and synthesising the voice of PHC and community stakeholders on the HRH recruitment and retention strategies at the PHC sector in Lebanon, the obstacles and challenges hindering their optimisation and the recommendations to overcome such obstacles. A qualitative design was utilised, involving 22 semi‐structured interviews with PHC experts in Lebanon conducted in 2013. Nvivo qualitative data analysis software was employed for the thematic analysis of data collected from interviews. Five comprehensive themes emerged: understanding PHC scope, HRH recruitment issues, HRH retention challenges, rural areas' specific challenges and stakeholders' recommendations. Analysis of stakeholders' responses revealed a lack of a unified understanding of the PHC scope impacting the capacity for appropriate HRH planning. Identified impediments to recruitment included the suboptimal supply of HRH, financial constraints and poor management. Retention difficulties were attributed to poor working environments, financial constraints and lack of professional development. There was consensus that HRH challenges faced were aggravated in rural areas, jeopardising the equitable access to PHC services of quality. Equitable access was also jeopardised by the reported shortage of female HRH in a sociocultural context where many females prefer providers of the same gender. The study sets the path towards upscaling recruitment and retention policies and practices through the endorsement of a nationally acknowledged PHC definition and scope, the sustainable development of the PHC workforce and through the implementation of targeted recruitment and retention strategies addressing rural settings and gender equity. Decision‐makers and planners are urged to identify HRH as the most important input for the success of PHC programmes and interventions, especially in the growing fields of mental health and geriatric care.     

Key concepts relevant to quality of complex and shared decision-making in health care: a literature review

High-quality provider-patient decision-making is key to quality care for complex conditions. We performed an analysis of key elements relevant to quality and complex, shared medical decision-making. Based on a search of electronic databases, including Medline and the Cochrane Library, as well as relevant articles' reference lists, reviews of tools, and annotated bibliographies, we developed a list of key concepts and applied them to a decision-making example. Key concepts identified included provider competence, trustworthiness, and cultural competence; communication with patients and families; information quality; patient/surrogate competence; and roles and involvement. We applied this concept list to a case example, shared decision-making for live donor kidney transplantation, and identified the likely most important concepts as provider and cultural competence, information quality, and communication with patients and families. This concept list may be useful for conceptualizing the quality of complex shared decision-making and in guiding research in this area.     

Studies regarding supported housing and the built environment for people with mental health problems: A mixed-methods literature review

Places where people live are important for their personal and social lives. This is also the case for people with mental health problems living in supported housing. To summarise the existing knowledge, we conducted a systematic review of 13 studies with different methodologies regarding the built environment in supported housing and examined their findings in a thematic analysis.The built environment of supported housing involves three important and interrelated themes: well-being, social identity and privacy. If overregulated by professionals or located in problematic neighbourhoods or buildings, the settings could be an obstacle to recovery. If understood as meaningful places with scope for control by the tenants or with amenities nearby, the settings could aid recovery.     

Priorities of patients,caregivers and health‐care professionals for health research – A systematic review

BackgroundBased on subjective experience, patients can identify research priorities important for health services research. A systematic method for priority setting has been developed by the James Lind Alliance.ObjectiveThis article reviews the literature on the research priorities of patients, caregivers and health‐care professionals and presents the prioritized research themes and prioritization methods used.Search strategyThree electronic databases were searched on 22 May 2018. The search was not limited to any time period or language.Inclusion criteriaThe included studies reported the identification and prioritization of research priorities involving patients, relatives and caregivers. Each included paper addressed a specific ICD‐coded health problem, and at least one‐third of the sample involved in the prioritization process was affected by the health problem.Data extraction and synthesisThe 10 top‐ranked research priorities were included in the thematic analysis. With an inductive approach, a system of identified themes and subthemes was developed from the research priorities. Each research priority was assigned to one research theme.Main resultsThe priority lists of 34 publications involving 331 research priorities were included. Nine main themes represent the content of the research priorities. The most frequently represented main themes are ‘Treatment’, ‘Patients’ and ‘Health condition’. The distribution of the research priorities varied depending on the health conditions and prioritization methods.Discussion and conclusionsThis review provides a comprehensive overview of the overarching research themes in research priorities of affected individuals. The results can guide future patient‐oriented research.     

Health among hospital employees in Europe: a cross-national study of the impact of work stress and work control

This article analyses the effect of working conditions on the health of hospital employees across Europe. Hospital employees often have demanding jobs that increase their stress levels and, consequently, their risk of health problems. Work control - typified by employee autonomy and working time flexibility - helps them cope with high levels of work stress. Researchers have traditionally studied the relationship between working conditions, coping strategies and occupational health from an individual perspective. We argue that the individual work-health relationship is closely connected with the social and institutional context. This study explores how work stress and work control influence the health of hospital employees and aims to understand cross-country differences in this respect. Using data on over 1500 hospital employees who participated in the study 'Quality of work and life in a changing Europe' (2007) in eight European countries, we used ordinal regression analyses to test a range of hypotheses. The results show that work stress has a negative effect on the health of hospital employees, while work control is not found to have any effect on their health. Comparative analyses reveal that the effects of working conditions on health vary across European countries. While working overtime is more closely related to poorer health in Eastern European countries, we found evidence of a positive relationship between job autonomy and health in Western Europe only, indicating that circumstances in the working environment have differing effects on employee health in Eastern and Western Europe.     

Recruitment and retention of older adults in Assisted Living Facilities to a clinical trial using technology for falls prevention: A qualitative case study of barriers and facilitators

Older adults often have health complexities and higher levels of attrition. Even though they are the main users of healthcare, they are often not included in health research because the health research may not be well designed to accommodate their evolving health needs. One research area in which participation of older adults is essential focuses on improving physical function. In this field, there are many innovations and new technologies developed. Barriers and facilitators to recruit older adults to research that improves physical function by using technology are not well explored yet. This study aims to explore barriers and facilitators regarding recruitment and retention of older adults living in Assisted Living Facilities to a randomised controlled trial study that aimed to improve physical function by using technology. Nine semi-structured interviews were conducted with four Scheme Managers, three therapists and two researchers. The interviews were transcribed. After open, axial and selective coding, the codes were thematic analysed in ATLAS.ti. Scheme Managers, therapists, researchers and older adults’ peers appear to play an important role in the recruitment and retention of older adults living in Assisted Living Facilities. Additionally, the technology itself and the presentation of the research appear to influence recruitment. Creating a social setting, inviting people face-to-face, demonstrating the technology, showing the benefits by presenting results from a pilot study and alleviating people's fears were experienced as important factors for recruitment. The results from this study can help other researcher to improve recruitment and retention strategies so evidence-based practice in care for older adults can be improved to enhance quality of life of older adults.     

At the intersection of chronic disease,disability and health services research: A scoping literature review

Background

There is a concerted effort underway to evaluate and reform our nation's approach to the health of people with ongoing or elevated needs for care, particularly persons with chronic conditions and/or disabilities.

Twelve months of implementation of health care performance‐based financing in Burkina Faso: A qualitative multiple case study

To improve health services' quantity and quality, African countries are increasingly engaging in performance‐based financing (PBF) interventions. Studies to understand their implementation in francophone West Africa are rare. This study analysed PBF implementation in Burkina Faso 12 months post‐launch in late 2014. The design was a multiple and contrasted case study involving 18 cases (health centres). Empirical data were collected from observations, informal (n = 224) and formal (n = 459) interviews, and documents. Outside the circle of persons trained in PBF, few in the community had knowledge of it. In some health centres, the fact that staff were receiving bonuses was intentionally not announced to populations and community leaders. Most local actors thought PBF was just another project, but the majority appreciated it. There were significant delays in setting up agencies for performance monitoring, auditing, and contracting, as well as in the payment. The first audits led rapidly to coping strategies among health workers and occasionally to some staging beforehand. No community‐based audits had yet been done. Distribution of bonuses varied from one centre to another. This study shows the importance of understanding the implementation of public health interventions in Africa and of uncovering coping strategies.