Dataset Information

'Power plays plus push': experts' insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study.

ABSTRACT: OBJECTIVE:To explore experts' views on factors influencing national and global active case-finding (ACF) policy development and implementation, and the use of evidence in these processes. DESIGN:This is an exploratory study based on semistructured expert interviews. Framework analysis was applied. PARTICIPANTS:The study involved a purposive sample of 39 experts from international, non-governmental and non-profit organisations, funders, government institutions, international societies, think tanks, universities and research institutions worldwide. RESULTS:This study highlighted the perceived need among experts for different types of evidence for ACF policy development and implementation, and for stakeholder engagement including researchers and policymakers to foster evidence use. Interviewees stressed the influence of government, donor and non-governmental stakeholders in ACF policy development. Such key stakeholders also influence ACF policy implementation, in addition to available systems and processes in a given health system, and implementers' motivation and incentives. According to the interviewees, the World Health Organization (WHO) guidelines for systematic screening face the innate challenge of providing guidance to countries across the broad area of ACF in terms of target groups, settings and screening algorithms. The guidelines could be improved by focusing on what should be done rather than what can be done in ACF, and by providing howto examples. Leadership, integration into health systems and long-term financing are key for ACF to be sustainable. CONCLUSIONS:We provide new insights into ACF policy processes globally, particularly regarding facilitators for and barriers to ACF policy development, evidence need and use, and donor organisations' influence. According to expert participants, national and global ACF policy development and implementation can be improved by broadening stakeholder engagement. Meanwhile, using diverse evidence to inform ACF policy development and implementation could mitigate the 'power plays plus push' that might otherwise disrupt and mislead these policy processes.

SUBMITTER: Biermann O

PROVIDER: S-EPMC7282330 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

'Power plays plus push': experts' insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study.

Biermann Olivia O Atkins Salla S Lönnroth Knut K Caws Maxine M Viney Kerri K

BMJ open 20200603 6

<h4>Objective</h4>To explore experts' views on factors influencing national and global active case-finding (ACF) policy development and implementation, and the use of evidence in these processes.<h4>Design</h4>This is an exploratory study based on semistructured expert interviews. Framework analysis was applied.<h4>Participants</h4>The study involved a purposive sample of 39 experts from international, non-governmental and non-profit organisations, funders, government institutions, international ...[more]

PMID: 32499270

Similar Datasets

Project description:There is a need to move from binary hazard assessment to more quantitative assessment of genotoxicity to better inform human health risk assessment and understand the relevance of positive in vitro genotoxicity findings. New approach methodologies (NAMs), including transcriptomic biomarkers combined with high-throughput technologies, enable the testing of a broad concentration range, which allows quantitative assessment of in vitro results. Initial work with the transcriptomic GENOMARK and TGx-DDI biomarkers demonstrate their potential use for hazard identification and chemical prioritization; however, no study has evaluated the concordance and complementarity of GENOMARK and TGx-DDI. The overall aim of this study is to examine if a combined approach of integrating both transcriptomic biomarkers for genotoxicity in human relevant HepaRGTM cells increases the certainty in hazard calls and potency rankings of chemicals. A sub-aim is to investigate whether GENOMARK is applicable to the TempO-Seq® high-throughput sequencing technology, to collect concentration-response data to rapidly perform hazard classification and potency ranking. Therefore, HepaRGTM cells were exposed to 10 chemicals (i.e. eight known in vivo genotoxicants and two in vivo non-genotoxicants) in increasing concentrations over 72h. TempO-Seq® was used to obtain concentration-response data for both biomarkers. Benchmark concentration (BMC) modelling of chemicals that were classified positive was conducted to obtain BMCs and transcriptomic points of departure (tPODs) for potency ranking. The results confirm that GENOMARK is applicable to TempO-Seq® since it achieved 100% predictive accuracy. In addition, a high concordance was observed in the hazard classifications and potency rankings between both biomarkers. Overall, our findings show that in vitro transcriptomic data can be used to rapidly and effectively identify genotoxic hazards while simultaneously providing additional insights on potency that is more informative in a modern hazard assessment paradigm. The results of this case study support the high value of integrating these NAMs in a weight of evidence evaluation of genotoxicity using the important human-liver cell line.

Dataset Information

'Power plays plus push': experts' insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study.

Publications

'Power plays plus push': experts' insights into the development and implementation of active tuberculosis case-finding policies globally, a qualitative study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets