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FREE online training course – A framework for analyzing public policies

Constructing a Logic Model for a Healthy Public Policy: Why and How?
669 K

A Framework for Analyzing Public Policies – Practical Guide
643 K

Method for Synthesizing Knowledge About Public Policies
  323 K



Links 
What Works for Health: Policies and Programs that can Improve Health  - A directory of short descriptions of different public policies. Each summarizes the data about the policy's effectiveness and provides a few indications about its implementation and its impact on inequalities. On the County Health Rankings & Roadmaps site (USA).

Prevention Policy Directory. A regularly updated, searchable inventory of Canadian policies as well as legal instruments (legislation, regulations, codes). The Directory is on Cancerview Canada.

How can the health equity impact of universal policies be evaluated? Insights into approaches and next steps
6.26 MB. Milton, B., et al. (Eds.) (2011). On the site of the World Health Organization. 

Practitioner opinions on health promotion interventions that work: Opening the “black box” of a linear evidence-based approach. Kok, M., et al. (2012). Social Science and Medicine, 74, 715-723. doi:10.1016/j. socscimed.2011.11.021   Abstract on the site PubMed.

Assessing equity in systematic reviews: realising the recommendations of the Commission on Social Determinants of Health. Tugwell, P., et al. (2010). BMJ 2010; 341: bmj.c4739. On the site of the BMJ.

Real world reviews: A beginner's guide to undertaking systematic reviews of public health policy interventions. Bambra, C. (2009). Abstract available on the site the Journal of Epidemiology and Community Health. doi:10.1136/jech.2009.088740 

Conceptualizing and Combining Evidence for Health System Guidance.  By Lomas, J., et al. (2005). Canadian Health Services Research Foundation (CHSRF). On the site of the CHSRF

Systematic reviews in social policy: To go foward, do we first need to look back? By Pearson, M. 2007. In Evidence & Policy : A Journal of Research, Debate and Practice, 3 (4) pp. 505-526. Abstract on the site of ingentaConnect.


Contact
Florence Morestin

Example 3: Reviewing and Assessing Nutrition-Related Chronic Disease Prevention Interventions
March 2018. Description.
An example presented by: 
Kally Cheung, Public Health Nutrition Provincial Lead, Alberta Health Services
Sheila Tyminski, Population Public Health Strategy Director, Alberta Health Services


Context of use 

Our provincial nutrition department at Alberta Health Services undertook an evidence review of nutrition-related chronic disease prevention (CDP) interventions for adults. Interventions included policies, approaches, and programs. The intent of this review was to provide health care providers and other CDP stakeholders in Alberta with guidance on the effectiveness of the different population health-level interventions, to help inform planning.  
 
We expect many of our stakeholders will want some overall direction or information on whether an intervention is recommended. We used the dimensions outlined in the NCCHPP's analytical framework to inform our recommendations.


Adaptations made


The recommendations we provided for each intervention were largely based on the analytical dimensions of effectiveness, equity, and unintended effects. As the dimensions of cost, feasibility and acceptability of an intervention will depend on implementation strategies and the local context, we advised readers of our report to undertake a situational analysis to include these dimensions prior to making decisions about whether to implement an intervention to ensure it fits their local context and target audience. These dimensions were not weighted as part of our analysis.

We also compared the NCCHPP's framework to the GRADE approach for reviewing evidence and found alignment, as they looked at similar dimensions. 


Data collection methods 

We collected data from systematic reviews. We primarily looked for evidence on effectiveness, but we pulled out themes about equity, unintended effects and other considerations where relevant. The data extracted and conclusion statements were shared with content experts to help validate our findings.


Lessons learned 

We used the information presented in the practical guide and online course to understand what each dimension of the NCCHPP's analytical framework entails. The framework is easy to understand, and leads to a more thoughtful and comprehensive approach to intervention selection.
 
By examining multiple dimensions that may affect the success of an intervention's effectiveness, equity, acceptability, cost, etc., the framework enabled us to assess an intervention more holistically. We feel our recommendations would not have been as comprehensive were we to have focused only on effectiveness. Dimensions such as equity and unintended consequences are important considerations when choosing an intervention. In the end, we feel we were able to provide robust recommendations for our stakeholders. A few reviewers of our report commended us for using the NCCHPP's framework in our work. The framework was highly regarded by those reviewers.

Our advice for public health colleagues who are considering using this framework: when planning interventions, it will help if the framework's dimensions are considered at the beginning of the project.


Impact on public policies, programs and/or interventions 

Our evidence review will help inform chronic disease prevention (CDP) stakeholders in Alberta, primarily policy and program planners and decision makers, of the current evidence on nutrition-related CDP interventions. The information can help support them with priority setting and planning. 


Next steps 

The report is available at https://www.albertahealthservices.ca/info/Page15343.aspx.

Please email publichealthnutrition@ahs.ca if you have any questions about this work.

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The production of the NCCHPP website has been made possible through a financial contribution from the Public Health Agency of Canada.