Policy Interventions to Promote Health and Prevent Disease

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Health Policy".

Deadline for manuscript submissions: 7 September 2024 | Viewed by 12195

Special Issue Editor

Center for Public Health and Community Genomics, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
Interests: health policy; ethics; epidemiology; health education; hereditary breast and colorectal cancer; heart arrhythmias

Special Issue Information

Dear Colleagues,

Special Issues in Healthcare often address particular strategies, disciplinary approaches, and developments for patient and health consumer populations. From time to time, it is important to embrace these avenues from a reflective stance. The current Special Issue is devoted to policy pieces on health and disease.

The Community-Based Public Health Task Force defines policy as decisions made by public, private, professional, and community groups or organizations, and by individuals, to affect behavior and to direct resources. The former Institute of Medicine, now the National Academy of Medicine, considers policy development as the means by which problem identification, technical knowledge of possible solutions, and societal values join to set a course of action. As a form of public policy, health policy is an aggregative form of decision-making that depends on individuals coming together and pooling their expertise and perspectives. Demonstrated by the frequent revisions that occur in professional guidelines as new, more refined evidence emerges and novel external and science-driven circumstances arise, health policymaking is a dynamic, evolving process. It is also formal in the sense that groups of professionals engage in evidence collection, consensus building, and policy formation. In order to be significant for care and prevention, the ultimate product needs to lead to action that makes a difference.

The place of policymaking in the health field is most striking in the latest efforts to establish universal healthcare in its various forms—the Patient Protection and Affordable Care Act in the United States, the European Union health strategy “Together for Health,” and the National Health Insurance Bill in South Africa. Such policy efforts are needed to offer the best possible care to diverse populations, and are essential when crises strike, such as the COVID-19 pandemic. COVID-19 has also highlighted the role of institutional policy. Were healthcare institutions not flexible in their distribution of beds and treatment resources, allocation protocols would remain unchanging, and marginalized groups would not have demonstrated the relative improvements in morbidity and mortality that have been reported at various points during the pandemic. Professional organizations have been instrumental in developing HIV/AIDS, diabetes hemoglobin A1C level, and lipid screening and treatment recommendations and guidelines. Sources may differ depending on the preventive or therapeutic emphasis, as has happened between the United States Preventive Services Task Force recommendations and the National Comprehensive Cancer Network guidelines for PSA screening in prostate cancer and genetic testing for hereditary nonpolyposis colorectal cancer. Different sources may also collaborate in formulating health policy. Though declared eliminated in 2000, the United States case count for measles rose to 880 in 2019, the highest level since 1994, a development prompting an update in guidance from the Centers for Disease Control and Prevention and the American Academy of Pediatrics.

Policymaking in the healthcare and public health domains depends on policy development at various levels—governmental, institutional, and professional. Healthcare announces a call for papers dealing with policy interventions aimed at promoting health and ameliorating disease. Submitted papers are expected to address the importance not just of medical and public health actions, which can be offered by single practitioners to single patients and families, but of policy as it pertains to multiple persons, groups, and populations. Articles may address contrasting portions of the healthcare and public health spectrum—from high-tech medical technologies to mental and behavioral health to lifestyle, environmental, and genetically oriented areas of research and practice. A lack of consistent policy has played a role in the current opioid and gun violence epidemics and the torrent of PFAs polluting the environment. The ideal, especially for burgeoning health technologies such as CRISPR/Cas9 gene editing, is for health policy to precede or parallel scientific advancement. The consequences of setting policymaking aside are rogue action on the part of individuals and companies, the marketing of preventive or therapeutic regimens that are at best ineffective and at worst dangerous, and discriminatory or inequitable health practices.

In addition to original research articles and reviews, acceptable submission formats include Perspective pieces and Opinion Editorials that are well referenced.

The pace of medical and public health progress is ongoing. Translation to the clinical domain, population level, and realm of oversight depends on thoughtful policy articulation. Authors are invited to contribute writing that will extend current policy thought and create new insights from within their respective field.

To better health and health guidance.

Dr. Stephen M. Modell
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health policy
  • policy making
  • health promotion
  • prevention
  • guideline
  • legislation
  • delivery of health care
  • health services research
  • public health

Published Papers (6 papers)

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Research

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16 pages, 1551 KiB  
Article
Impact of State Stroke Systems of Care Laws on Stroke Outcomes
by Erika B. Fulmer, Dana Keener Mast, Lucas Godoy Garraza, Siobhan Gilchrist, Aysha Rasool, Ye Xu, Amanda Brown, Nina Omeaku, Zhiqiu Ye, Bruce Donald, Sharada Shantharam, Sallyann Coleman King, Adebola Popoola and Kristen Cincotta
Healthcare 2023, 11(21), 2842; https://doi.org/10.3390/healthcare11212842 - 28 Oct 2023
Viewed by 886
Abstract
Since 2003, 38 US states and Washington, DC have adopted legislation and/or regulations to strengthen stroke systems of care (SSOCs). This study estimated the impact of SSOC laws on stroke outcomes. We used a coded legal dataset of 50 states and DC SSOC [...] Read more.
Since 2003, 38 US states and Washington, DC have adopted legislation and/or regulations to strengthen stroke systems of care (SSOCs). This study estimated the impact of SSOC laws on stroke outcomes. We used a coded legal dataset of 50 states and DC SSOC laws (years 2003–2018), national stroke accreditation information (years 1997–2018), data from the Healthcare Cost and Utilization Project (years 2012–2018), and National Vital Statistics System (years 1979–2019). We applied a natural experimental design paired with longitudinal modeling to estimate the impact of having one or more SSOC policies in effect on outcomes. On average, states with one or more SSOC policies in effect achieved better access to primary stroke centers (PSCs) than expected without SSOC policies (ranging from 2.7 to 8.0 percentage points (PP) higher), lower inpatient hospital costs (USD 610–1724 less per hospital stay), lower age-adjusted stroke mortality (1.0–1.6 fewer annual deaths per 100,000), a higher proportion of stroke patients with brain imaging results within 45 min of emergency department arrival (3.6–5.0 PP higher), and, in some states, lower in-hospital stroke mortality (5 fewer deaths per 1000). Findings were mixed for some outcomes and there was limited evidence of model fit for others. No effect was observed in racial and/or rural disparities in stroke mortality. Full article
(This article belongs to the Special Issue Policy Interventions to Promote Health and Prevent Disease)
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11 pages, 338 KiB  
Article
The Vulnerability of International Floating Populations to Sexually Transmitted Infections: A Qualitative Study
by Jiahan Jiang, Yuyin Zhou, Junfang Xu and Zhaochen Wang
Healthcare 2023, 11(12), 1744; https://doi.org/10.3390/healthcare11121744 - 14 Jun 2023
Viewed by 783
Abstract
With the rapid development of the global economy, along with globalisation, the health of international floating populations (especially their sexual health) has become a problem that cannot be ignored. This study explored the potential vulnerability of international floating populations to sexually transmitted infections [...] Read more.
With the rapid development of the global economy, along with globalisation, the health of international floating populations (especially their sexual health) has become a problem that cannot be ignored. This study explored the potential vulnerability of international floating populations to sexually transmitted infections (STIs) from the points of view of society, religion, culture, migration, community environment, and personal behaviours. In-depth exploratory interviews with 51 members of the international floating population living in China were conducted in June and July 2022. A qualitative thematic analysis methodology was used to analyse the content of these interviews. We found that a conservative culture orientated around religion leads to a lack of sex education, resulting in insufficient personal knowledge as well as a lack of the motivation and awareness required to encourage condom use during sexual contact. Additionally, both geographical isolation and reduced social supervision have expanded personal space, which has led to social isolation and marginalisation, in addition to challenges for coping with STI risk. These factors have increased the possibility of individuals engaging in risky behaviours. Full article
(This article belongs to the Special Issue Policy Interventions to Promote Health and Prevent Disease)
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26 pages, 946 KiB  
Article
A History of Heat Health Management Policies in the Singapore Military
by Joshua Dao Wei Sim and Jason Kai Wei Lee
Healthcare 2023, 11(2), 211; https://doi.org/10.3390/healthcare11020211 - 10 Jan 2023
Cited by 2 | Viewed by 3381
Abstract
Our paper, which is the first historical study about heat injuries in Singapore, seeks to situate the Singapore Armed Forces’ (SAF) history of heat stress management policies within the national context. Firstly, we observe that since the late 1970s, a research-driven approach has [...] Read more.
Our paper, which is the first historical study about heat injuries in Singapore, seeks to situate the Singapore Armed Forces’ (SAF) history of heat stress management policies within the national context. Firstly, we observe that since the late 1970s, a research-driven approach has been adopted by the SAF’s military medical leaders to formulate a range of policies to address the Forces’ high incidence of heat injuries. This has resulted in the introduction of SAF-wide training measures, and the assembling of local scientific research expertise, which has led to a sharp reduction in heat injury incidence from the 1980s to 2000s. Through this, the SAF sought to demonstrate that its heat stress mitigation measures made the Singapore military ‘heat proof’. Secondly, the state shaped a soldier safety agenda in the late 2000s on the back of an increasing emphasis on safety and the transformation of the SAF into a highly-educated and technologically-sophisticated force. This meant a shift towards concern about the welfare of every soldier, particularly through the state’s drive to eradicate all training-related deaths. Accordingly, the SAF medical military leaders responded to the state’s safety agenda by introducing heat stress management research and policies that were oriented towards the target of eradicating deaths due to heat stress. This policy and research direction, as such, has been strongly guided by the state’s safety agenda and utilised to demonstrate to the public that all efforts have been taken to comprehensively mitigate the risks of heat. Full article
(This article belongs to the Special Issue Policy Interventions to Promote Health and Prevent Disease)
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18 pages, 846 KiB  
Article
Priority Criteria for Community-Based Care Resource Allocation for Health Equity: Socioeconomic Status and Demographic Characteristics in the Multicriteria Decision-Making Method
by Hui-Ching Wu
Healthcare 2022, 10(7), 1358; https://doi.org/10.3390/healthcare10071358 - 21 Jul 2022
Cited by 2 | Viewed by 1780
Abstract
SDG 10 stipulates that inequality within and between countries can be reduced by governmental policies that focus on the allocation of fiscal resources and social protection strategies to improve equity. The sustainability of community-based care stations is a crucial support network for achieving [...] Read more.
SDG 10 stipulates that inequality within and between countries can be reduced by governmental policies that focus on the allocation of fiscal resources and social protection strategies to improve equity. The sustainability of community-based care stations is a crucial support network for achieving the goal of active aging. Unequal allocation would occur only if the populations of administrative districts are considered. Comprehensive policies, in accordance with data and sustainable goals, must consider multiple factors. Hence, this study used multicriteria decision making (MCDM) to investigate how nine criteria-related socioeconomic statuses (SES) and demographic characteristics are prioritized in community resource and funding allocation. Thirty-four community care and aging experts were invited to complete a questionnaire based on the modified Delphi method and the analytical hierarchy process (AHP) method. The assessment criteria for the allocation of community resources are prioritized in the following order: disability level, age, household composition, identity of social welfare, family income, ethnicity, marital status, educational attainment, and gender. Quantitative indices can be used to determine the importance of resource allocation policymaking. The benefit of this study lies in decision makers’ application of ranking and weighting values in public funding allocation ratios for community-based care resources for health equity in Taiwan. Full article
(This article belongs to the Special Issue Policy Interventions to Promote Health and Prevent Disease)
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12 pages, 964 KiB  
Project Report
Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam
by Duong Hoang Vu, Binh T. T. Ta, Ina Landau Aasen, Dai Q. T. Le, Roger Mathisen, Genevieve E. Becker, Hang Thi Phan, Cuong Minh Bui, Trinh Thi Kieu Nguyen, Suong Thi Thu Hoang and Jennifer Cashin
Healthcare 2023, 11(18), 2520; https://doi.org/10.3390/healthcare11182520 - 12 Sep 2023
Viewed by 1179
Abstract
(1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims [...] Read more.
(1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims to deliver high-quality breastfeeding and early essential newborn care services within a supportive policy environment. The aim of this project report is to outline the steps undertaken to reduce episiotomies, the experience in pilot hospitals, and the process towards changing policy. (3) Results: During the 14 months following the change in episiotomy policy, pilot hospital records showed no infant death or injury. Monthly monitoring data from four pilot hospitals showed that the prevalence of episiotomy was substantially lower than the average in national hospitals in Vietnam. Facilitators to reducing the episiotomy rate include the incentive of Centers of Excellence for Breastfeeding designation and supportive hospital leadership. Challenges include the ambiguity of Vietnam’s national guideline on episiotomy and lack of routine monitoring on the episiotomy rate and indications. (4) Discussion: Our experience suggests that through training and routine monitoring hospitals can apply a policy of selective episiotomy and reduce the practice, particularly among multiparous women, and improve breastfeeding rates.(5) Conclusions: Sharing our experience of implementing this process and offering four areas for action will hopefully contribute to expanded use of mother-friendly, evidence-based care as policy and routine practice in Vietnam and similar settings. Full article
(This article belongs to the Special Issue Policy Interventions to Promote Health and Prevent Disease)
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10 pages, 2527 KiB  
Brief Report
Program Report: Improving Patient Experience at an Outpatient Clinic Using Continuous Improvement Tools
by Muhammad Usman Hassan Siddiqui, Abdullah Ahmed Khafagy and Faisal Majeed
Healthcare 2023, 11(16), 2301; https://doi.org/10.3390/healthcare11162301 - 15 Aug 2023
Cited by 2 | Viewed by 2355
Abstract
Patient satisfaction with prompt and high-quality healthcare services plays a pivotal role in healthcare settings. The delivery of high-quality services within the healthcare sector is closely associated with continuous quality improvement (CQI), which is an incremental and progressive process that prioritizes the safety [...] Read more.
Patient satisfaction with prompt and high-quality healthcare services plays a pivotal role in healthcare settings. The delivery of high-quality services within the healthcare sector is closely associated with continuous quality improvement (CQI), which is an incremental and progressive process that prioritizes the safety of all participants, favorable outcomes, systematic processes, and a regulated and improved working environment, particularly in later stages. Surprisingly, these aspects are less frequently explored in Middle Eastern countries. Thus, this research paper aims to assess the impact of quality services on patient satisfaction in tertiary care clinics located in the Middle East. To improve the quality of services in our clinic, we employed patient feedback as a valuable resource. We proactively reached out to all patients who had visited our hospital via mobile phone messages and requested their feedback on the services they received. Approximately 5% of all visitors responded and completed a comprehensive questionnaire. The majority of respondents expressed satisfaction with the services provided across various departments. However, they also offered valuable suggestions that helped us identify further areas for improvement and enhance the overall patient experience within our clinic. Drawing upon the feedback received, we meticulously considered the identified issues, redesigned our policies, and implemented strategic changes. Following the implementation of these new approaches, we once again sought patients’ feedback on the quality of our services. Patient feedback highlighted the significant impact of optimized service delivery methods, resulting in a substantial increase in patient satisfaction. Overall, this study sheds light on the vital factors that can enhance patients’ experience in outpatient clinics, emphasizing the importance of integrating patient feedback into continuous quality improvement initiatives. By utilizing this approach, healthcare providers, administrators, and researchers can effectively improve service quality and patient satisfaction. Consequently, this research paper serves as a valuable reference for public health stakeholders, administrators, and researchers in their pursuit of delivering exceptional healthcare experiences. Full article
(This article belongs to the Special Issue Policy Interventions to Promote Health and Prevent Disease)
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