Don't Miss...

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

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.

Florence Morestin

Example 2: Producing a Knowledge Synthesis on the Effectiveness of Health Warnings on Sugary Drink Containers
March 2018. Description.
Translation of an example presented by Annie Gauthier
Planning, Programming and Research Officer, Institut national de santé publique du Québec [Québec's public health institute]

Context of use

I used the NCCHPP's analytical framework to organize data extraction within the context of producing a review of the scientific literature evaluating the effectiveness of health warnings on sugary drink containers. Because warnings are an emerging intervention in the food sector, there was not a critical mass of studies having evaluated their effectiveness or potential effectiveness on sugary drink containers. I therefore also examined the results of literature reviews on the effectiveness of this strategy as applied to alcoholic drink containers and tobacco product packaging, so as to draw lessons that could be applicable to warnings on sugary drink containers. 
This knowledge synthesis was produced by the Institut national de santé publique [Québec's public health institute] at the request of the Ministère de la Santé et des Services sociaux du Québec [Québec's ministry of health and social services].

Adaptations made

The NCCHPP's framework was adapted, not only to take into account the type of evidence available in the scientific literature, but also, most importantly, to take into account the perspective adopted for this project, in which health warnings were viewed as an intervention strategy aimed at modifying the socio-cultural environment. Political and economic dimensions were not the central focus of this study; so, even though they were taken into account, they were not subjected to a thorough analysis.

Together with the NCCHPP's analytic framework, the main resources used were: 

Data collection methods

The review focused mainly on articles from scientific journals. These articles were identified by querying various databases in the fields of health, social sciences and psychology. Data collection was supplemented by a documentary search of the grey literature (for example: government reports or reports of research institutes), as well as by an ongoing scan of the field. I prepared a data extraction table in a Word file in which, for each selected scientific article, I recorded the available and relevant data on the effects and applicability of health warnings.

Lessons learned

I read the NCCHPP's document entitled Method for Synthesizing Knowledge About Public Policies (which includes the framework for analyzing six dimensions) and the short summary, which presents the essential content. One difficulty I encountered in seeking to apply this method is a challenge integral to any analysis, which must be structured in accordance with its stated objectives and priorities. My work focuses on effecting change in the socio-cultural environment, so I must leave aside some data on the political, economic, and dietary environments, even if I find this data to be just as relevant and significant. This is the challenge: to clearly delineate one's field of analysis, which entails sorting through many interesting facets, retaining some and setting others aside.

Moreover, if a public health professional is not fully knowledgeable about all the dimensions of the NCCHPP's analytical framework, and if the project is not being carried out by a multidisciplinary team, it may be useful to first identify the analytical dimensions that are relevant to his or her particular expertise and to the project's objectives. The other dimensions can be described as contextual elements, or aspects to be examined in greater depth by other professionals: policy makers can collect information from various resources (lawyers, economists, etc.) in order to gather everything they need to make informed decisions. Sometimes also, a dimension may be examined, but without the intention of conducting a thorough analysis. My advice would be to clarify these points to the extent possible, right from the start, before the data extraction step.

Another issue I encountered is that some publications compel us to distinguish between what constitutes evidence and what reflects the stance taken by the authors of the articles. These authors can interpret the results of research, particularly in the grey literature, in divergent manners, depending on their own perspectives (academic, corporate, industry). To stay on course, it seemed to me best to simply let the facts speak (since they represent a stable footing), leaving aside the commentary "for" or "against" the policy under study. It seems to me that the NCCHPP's framework can be used judiciously in this regard. 

Overall, the added value of this analytical framework was to structure my work, which is reflected in the table of contents of my document. I particularly appreciated this framework because of the fact that it is used by other public health actors. This provides us with a shared conceptual base.

Impact on public policies, programs and/or interventions

It is too early to assess the impact of this knowledge synthesis because it has only just been produced. The Ministère de la Santé et des Services sociaux du Québec, which requested that this work be carried out, will be able to use it to inform reflection related to efforts to implement its action plan for sugary drinks (Plan d'action sur les boissons sucrées).

To learn more:

The knowledge synthesis (available in French only at this moment) has been published, click on the following link to read the document: L'efficacité des mises en garde sur les contenants de boissons sucrées en promotion de la saine alimentation.
The production of the NCCHPP website has been made possible through a financial contribution from the Public Health Agency of Canada.