Improving Policy for the Prevention of Falls Among Community-Dwelling Older People—A Scoping Review and Quality Assessment of International National and State Level Public Policies
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ABSTRACT:
SUBMITTER: Natora A
PROVIDER: S-EPMC9272743 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC5042332 | biostudies-literature
Project description:Objectives(1) To identify national policies for England and local policies for Southampton City that are relevant to maternal and child health. (2) To quantify the extent to which these policies meet the international standards for nutrition and physical activity initiatives set out in the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases (WHO Action Plan).DesignThe policy appraisal process involved three steps: (1) identifying policy documents relevant to maternal and infant health, (2) developing a policy appraisal framework from the WHO Action Plan, and (3) analysing the policies using the framework.SettingEngland and Southampton City.Participants57 national and 10 local policies.ResultsAcross both national and local policies, priority areas supporting public health processes, such as evidence-based practice, were adopted more frequently than the action-oriented areas targeting maternal and child dietary and physical activity behaviours. However, the policy option managing conflicts of interest was rarely considered in the national policies (12%), particularly in white papers or evidence-based guidelines. For the action-oriented priority areas, maternal health policy options were more frequently considered than those related to child health or strengthening health systems. Complementary feeding guidance (9%) and workforce training in empowerment skills (14%) were the least frequent action-oriented policy options adopted among the national policies. The maternal nutrition-focused and workforce development policy options were least frequent among local policies adopted in 10% or fewer. Macroenvironmental policy options tended to have a lower priority than organisational or individual options among national policies (p=0.1) but had higher priority among local policies (p=0.02).ConclusionsFurther action is needed to manage conflicts of interest and adopt policy options that promote a system-wide approach to address non-communicable diseases caused by poor diet and physical inactivity.
| S-EPMC6252630 | biostudies-literature
Project description:BackgroundHospital falls remain a frequent and debilitating problem worldwide. Most hospital falls prevention strategies have targeted clinician education, environmental modifications, assistive devices, hospital systems and medication reviews. The role that patients can play in preventing falls whilst in hospital has received less attention. This critical review scopes patient falls education interventions for hospitals. The quality of the educational designs under-pinning patient falls education programmes was also evaluated. The outcomes of patient-centred falls prevention programs were considered for a range of hospital settings and diagnoses.MethodsThe Arksey and O'Malley (2005) framework for scoping reviews was adapted using Joanna Briggs Institute and PRISMA-ScR guidelines. Eight databases, including grey literature, were searched from January 2008 until February 2020. Two reviewers independently screened the articles and data were extracted and summarised thematically. The quality of falls prevention education programs for patients was also appraised using a modified quality metric tool.ResultsForty-three articles were included in the final analysis. The interventions included: (i) direct face-to-face patient education about falls risks and mitigation; (ii) educational tools; (iii) patient-focussed consumer materials such as pamphlets, brochures and handouts; and (iv) hospital systems, policies and procedures to assist patients to prevent falls. The included studies assessed falls or education related outcomes before and after patient falls prevention education. Few studies reported incorporating education design principles or educational theories. When reported, most educational programs were of low to moderate quality from an educational design perspective.ConclusionsThere is emerging evidence that hospital falls prevention interventions that incorporate patient education can reduce falls and associated injuries such as bruising, lacerations or fractures. The design, mode of delivery and quality of educational design influence outcomes. Well-designed education programs can improve knowledge and self-perception of risk, empowering patients to reduce their risk of falling whilst in hospital.
| S-EPMC7161005 | biostudies-literature
Project description:BackgroundBreast cancer has positioned itself worldwide as one of the main public health problems, especially in Latin America. In some countries, several programs for the prevention and control of breast cancer in women have been developed and implemented on a permanent basis, but there are no public reports on the policies that originated such programs.ObjectiveA scoping review of scientific publications that identify the type, extent, and scope of policies and programs for the prevention and control of breast cancer in Latin American women was performed, and the main results were presented in this paper.MethodsThis scoping review was carried out according to the method by Arksey and O'Malley based on 3 fundamental questions about breast cancer prevention and control policies in Latin America: their type, extent and scope, and reference framework. The search period was from 2000 to 2019, and the search was carried out in the following databases: MEDLINE (PubMed), MEDLINE (EbscoHost), CINAHL (EbscoHost), Academic Search Complete (EbscoHost), ISI Web of Science (Science Citation Index), and Scopus in English, Spanish, and Portuguese, and Scielo, Cochrane, and MEDES-MEDicina in Spanish and Portuguese. Of the 743 studies found, 20 (2.7%) were selected, which were analyzed using descriptive statistics and qualitative content analysis.ResultsThe selected studies identified several Latin American countries that have generated policies and programs to prevent and control breast cancer in women, focusing mainly on risk communication, prevention and timely detection, effective access to health services, improvement of the screening process, and evaluation of screening programs. Evaluation criteria and greater participation of civil society in policy design and program execution are still lacking. This could undoubtedly help eliminate existing barriers to effective action.ConclusionsAlthough several Latin American countries have generated public policies and action programs for the prevention and control of breast cancer, a pending issue is the evaluation of the results to analyze the effectiveness and impact of their implementation given the magnitude of the public health problem it represents and because women and civil society play an important role in its prevention and control.International registered report identifier (irrid)RR2-10.2196/12624.
| S-EPMC9301550 | biostudies-literature
Project description:BackgroundPoor diet is a significant contributor to the burden of global disease. There are numerous policies available to address poor diets; however, these policies often require public support to encourage policy action. The current study aimed to understand the level of public support for a range of food policies and the factors associated with policy support.MethodsAn online survey measuring support for 13 food policies was completed by 19,857 adults in Australia, Canada, Mexico, the United Kingdom (UK) and the United States (US). The proportion of respondents that supported each policy was compared between countries, and the association between demographic characteristics and policy support was analysed using multivariate logistic regression.ResultsThe level of support varied between policies, with the highest support for policies that provided incentives (e.g., price subsidies) or information (e.g., calorie labelling on menus), and the lowest support for those that imposed restrictions (e.g., restrictions on sponsorship of sport events). This pattern of support was similar in all countries, but the level differed, with Mexico generally recording the highest support across policies, and the US the lowest. Several demographic characteristics were associated with policy support; however, these relationships varied between countries.ConclusionThe results suggest that support for food policies is influenced by several factors related to the policy design, country, and individual demographic characteristics. Policymakers and advocates should consider these factors when developing and promoting policy options.
| S-EPMC6721115 | biostudies-literature
Project description:With ageing comes increased vulnerability such that older adults' ability to recover from acute illnesses, fall-related injuries and other stresses related to the physical ageing processes declines. This increased vulnerability, also known as frailty, is common in older adults and associated with increased healthcare service use and adverse health outcomes. Currently, there is no overview of available interventions to prevent or reduce the level of frailty (as defined by study's authors) which will help healthcare providers in community settings caring for older adults. We will address this gap by reviewing interventions and international policies that are designed to prevent or reduce the level of frailty in community-dwelling older adults.We will conduct a scoping review using the updated guidelines of Arksey and O'Malley to systematically search the peer-reviewed journal articles to identify interventions that aimed to prevent or reduce the level of frailty. We will search grey literature for international policies. The 6-stage scoping review model involves: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting the data; (5) collating, summarising and reporting the results and (6) consulting with key stakeholders.Our scoping review will use robust methodology to search for available interventions focused on preventing or reducing the level of frailty in community-dwelling older adults. We will consult with stakeholders to find out whether they find the frailty interventions/policies useful and to identify the barriers and facilitators to their implementation in Canada. We will disseminate our findings to relevant stakeholders at local, national and international levels by presenting at relevant meetings and publishing the findings. Our review will identify gaps in research and provide healthcare providers and policymakers with an overview of interventions that can be implemented to prevent or postpone frailty.
| S-EPMC4785293 | biostudies-other
Project description:The aim of this article is to provide recommendations on behalf of the International MS Falls Prevention Research Network (IMSFPRN) for the primary outcome measure for multiple sclerosis (MS) falls-prevention interventions. The article will consider the definition of a fall, methods of measuring falls, and the elements of falls that should be recorded, as well as how these elements should be presented and analyzed. While this information can be used to inform the content of falls-prevention programs, the primary aim of the article is to make recommendations on how the outcome of these programs should be captured.
| S-EPMC4321456 | biostudies-other
Project description:BackgroundOpioid addiction and overdose rates are reaching unprecedented levels in the U.S., with around 47,736 overdose deaths in 2017. Many stakeholders affect the opioid epidemic, including government entities, healthcare providers and policymakers, and opioid users. Simulation and conceptual modeling can help us understand the dynamics of the opioid epidemic by simplifying the real world and informing policymakers about different health interventions that could reduce the deaths caused by opioid overdose in the United States every year.ObjectivesTo conduct a scoping review of simulation and conceptual models that propose policies capable of controlling the opioid epidemic. We demonstrate the strengths and limitations of these models and provide a framework for further improvement of future decision support tools.MethodsUsing the methodology of a scoping review, we identified articles published after 2000 from eight electronic databases to map the literature that uses simulation and conceptual modeling in developing public health policies to address the opioid epidemic.ResultsWe reviewed 472 papers of which 14 were appropriate for inclusion. Each used either system dynamics simulation modeling, mathematical modeling, conceptual modeling, or agent-based modeling. All included studies tested and proposed strategies to improve health outcomes related to the opioid epidemic. Factors considered in the models included physicians prescribing opioids, trafficking, users recruiting new users, and doctor shopping; no model investigated the impact of age and spatial factors on the dynamics of the epidemic. Key findings from these studies were (1) prevention of opioid initiation is better than treatment of opioid addiction, (2) the analysis of an intervention's impact should include both benefits and harms, and (3) interventions with short-term benefits might have a counterproductive impact on the epidemic in long run.ConclusionsWhile most studies examined the role of prescription opioids and trafficking on this epidemic, the transition of patients from prescription opioid use to nonprescription use including heroin and synthetic opioids such as fentanyl impacts the system significantly and results in an epidemic with quite different characteristics than what it had a decade ago. We recommend including the impact of age and geographic location on the opioid epidemic using modeling methods.
| S-EPMC6689912 | biostudies-literature
Project description:Backgroundfrailty impacts older adults' ability to recover from an acute illness, injuries and other stresses. Currently, a systematic synthesis of available interventions to prevent or reduce frailty does not exist. Therefore, we conducted a scoping review of interventions and international policies designed to prevent or reduce the level of frailty in community-dwelling older adults.Methods and analysiswe conducted a scoping review using the framework of Arksey and O'Malley. We systematically searched articles and grey literature to identify interventions and policies that aimed to prevent or reduce the level of frailty.Resultsfourteen studies were included: 12 randomised controlled trials and 2 cohort studies (mean number of participants 260 (range 51-610)), with most research conducted in USA and Japan. The study quality was moderate to good. The interventions included physical activity; physical activity combined with nutrition; physical activity plus nutrition plus memory training; home modifications; prehabilitation (physical therapy plus exercise plus home modifications) and comprehensive geriatric assessment (CGA). Our review showed that the interventions that significantly reduced the number of frailty markers present or the prevalence of frailty included the physical activity interventions (all types and combinations), and prehabilitation. The CGA studies had mixed findings.Conclusionnine of the 14 studies reported that the intervention reduced the level of frailty. The results need to be interpreted with caution, as only 14 studies using 6 different definitions of frailty were retained. Future research could combine interventions targeting more frailty markers including cognitive or psychosocial well-being.
| S-EPMC5405756 | biostudies-literature
Project description:BackgroundEngaged scholarship includes the coproduction and use of research by partnerships that blend research, policy and/or practice perspectives. This way of doing research attempts to bridge-the-gap between knowledge and its application. Recent reviews have described practices that support engagement and involve the community in research and patients in healthcare but there is less known about how to engage individuals working to inform public policy.Aims and objectivesThe purpose of this research was to articulate the actions and context that support the coproduction and use of research to inform public policy decisions. The study focuses on partnerships between researchers and stakeholders working in public policy across different levels and sectors of government.MethodsA scoping review methodology was used. Relevant articles were identified from six electronic bibliographic databases of peer-reviewed literature.FindingsA total of 9904 articles were screened and 375 full-text articles were assessed for eligibility. The included 11 studies were from research partnerships internationally and described actions and contextual factors contributing to the coproduction and use of research to inform public policy. Key actions included facilitating frequent interactions with public policy stakeholders, joint planning for research, and collaboration to execute data collection and analysis. Contextual factors included clarity in responsibilities, prior relationships, and mutual respect for partner priorities and perspectives.ConclusionsKey actions and contextual factors were identified in this review and warrant further study to strengthen research-policy partnerships and their outcomes.
| S-EPMC7449077 | biostudies-literature