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Development, Adaptation and Evaluation of Public Health Interventions: A Complex Systems Perspective

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 21730

Special Issue Editors

Dr. Lisa Pfadenhauer

E-Mail Website
Guest Editor
1. Pettenkofer School of Public Health, University of Munich (LMU), 81377 Munich, Germany;
2. Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Interests: implementation science; intervention development; multi method process and outcome evaluations; stakeholder engagement; knowledge translation; evidence synthesis
Dr. Ani Movsisyan

E-Mail Website
Assistant Guest Editor
The Institute for Medical Information Processing, Biometry, and Epidemiology, Pettenkofer School of Public Health, University of Munich (LMU), 81377 Munich, Germany
Interests: development, adaptation and evaluation of public health interventions; implementation; evidence-informed practices in public health; systematic reviewing and guideline development in public health

Special Issue Information

Dear Colleagues,

In the last decades, there has been increased recognition of public health interventions being implemented and embedded within complex systems. A complex systems perspective highlights how interventions interact with, influence, and are influenced by the wider system in which they are delivered, regardless of whether they are simple (i.e., monocomponent) or complex (i.e., multicomponent) in design. In this view, public health interventions may impact a range of population health and nonhealth outcomes. Similarly, changes in population health may be brought about by interventions delivered through other sectors, such as education and social welfare. This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the development, adaptation, implementation, and evaluation of public health interventions incorporating a complex systems perspective. We welcome papers related to any aspect of intervention research, including empirical studies, as well as debates and novel methodological approaches on how interventions are developed and coproduced in social systems involving many stakeholders, and how existing evidence-informed interventions are adapted to and implemented in new contexts, their (re) evaluation, as well as scale-up and uptake. We invite papers using a range of methods, including quantitative (e.g., natural experiments), qualitative (e.g., participatory action research), and mixed-method approaches, as well as innovative methods for the study of complex systems in public health.

Dr. Lisa Pfadenhauer
Dr. Ani Movsisyan
Guest Editors

Manuscript Submission Information

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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. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly 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 2500 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

  • complex systems
  • implementation
  • context
  • coproduction
  • intervention development
  • intervention adaptation
  • evaluation
  • population health
  • multimethod research
  • evidence-informed interventions

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Published Papers (5 papers)

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13 pages, 655 KiB  
Article
Effectiveness Evaluation of a Primary School-Based Intervention against Heatwaves in China
by Yonghong Li, Bo Sun, Changlin Yang, Xianghua Zhuang, Liancheng Huang, Qingqing Wang, Peng Bi, Yan Wang, Xiaoyuan Yao and Yibin Cheng
Int. J. Environ. Res. Public Health 2022, 19(5), 2532; https://doi.org/10.3390/ijerph19052532 - 22 Feb 2022
Cited by 8 | Viewed by 4961
Abstract
Background: Evidence of the effectiveness of intervention against extreme heat remains unclear, especially among children, one of the vulnerable populations. This study aimed to evaluate the effectiveness of a primary school-based intervention program against heatwave and climate change in China to provide evidence [...] Read more.
Background: Evidence of the effectiveness of intervention against extreme heat remains unclear, especially among children, one of the vulnerable populations. This study aimed to evaluate the effectiveness of a primary school-based intervention program against heatwave and climate change in China to provide evidence for development of policies for adaptation to climate change. Methods: Two primary schools in Dongtai City, Jiangsu Province, China, were randomly selected as intervention and control schools (CTR registration number: ChiCTR2200056005). Health education was conducted at the intervention school to raise students’ awareness and capability to respond to extreme heat during May to September in 2017. Knowledge, attitude, and practice (KAP) of students and their parents at both schools were investigated by questionnaire surveys before and after intervention. The changes in KAP scores after intervention were evaluated using multivariable difference-in-difference (DID) analysis, controlling for age, sex, etc. Results: The scores of knowledge, attitude, and practice of students and their parents increased by 19.9% (95%CI: 16.3%, 23.6%) and 22.5% (95%CI: 17.8%, 27.1%); 9.60% (95%CI: 5.35%, 13.9%) and 7.22% (95%CI: 0.96%, 13.5%); and 9.94% (95%CI: 8.26%, 18.3%) and 5.22% (95%CI: 0.73%, 9.71%), respectively, after intervention. The KAP score changes of boys were slightly higher than those of girls. Older students had higher score changes than younger students. For parents, the higher the education level, the greater the score change, and change in scores was greater in females than in males. All the health education activities in the program were significantly correlated with the changes in KAP scores of primary school students after intervention, especially those curricula with interesting activities and experiential learning approaches. Conclusions: Heat and health education program in primary school was an effective approach to improve cognition and behavior for both students and their parents to better adapt to heatwaves and climate change. The successful experience can be generalized to respond to the increasing extreme weather/climate events in the context of climate change, such as heatwaves, and other emergent occasions or public health education, such as the control and prevention of COVID-19. Full article
(This article belongs to the Special Issue Development, Adaptation and Evaluation of Public Health Interventions: A Complex Systems Perspective)
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32 pages, 4166 KiB  
Article
Fear, Efficacy, and Environmental Health Risk Reporting: Complex Responses to Water Quality Test Results in Low-Income Communities
by Saskia Nowicki, Salome A. Bukachi, Sonia F. Hoque, Jacob Katuva, Mercy M. Musyoka, Mary M. Sammy, Martin Mwaniki, Dalmas O. Omia, Faith Wambua and Katrina J. Charles
Int. J. Environ. Res. Public Health 2022, 19(1), 597; https://doi.org/10.3390/ijerph19010597 - 5 Jan 2022
Cited by 13 | Viewed by 5070
Abstract
Reducing disease from unsafe drinking-water is a key environmental health objective in rural Sub-Saharan Africa, where water management is largely community-based. The effectiveness of environmental health risk reporting to motivate sustained behaviour change is contested but as efforts to increase rural drinking-water monitoring [...] Read more.
Reducing disease from unsafe drinking-water is a key environmental health objective in rural Sub-Saharan Africa, where water management is largely community-based. The effectiveness of environmental health risk reporting to motivate sustained behaviour change is contested but as efforts to increase rural drinking-water monitoring proceed, it is timely to ask how water quality information feedback can improve water safety management. Using cross-sectional (1457 households) and longitudinal (167 participants) surveys, semi-structured interviews (73 participants), and water quality monitoring (79 sites), we assess water safety perceptions and evaluate an information intervention through which Escherichia coli monitoring results were shared with water managers over a 1.5-year period in rural Kitui County, Kenya. We integrate the extended parallel process model and the precaution adoption process model to frame risk information processing and stages of behaviour change. We highlight that responses to risk communications are determined by the specificity, framing, and repetition of messaging and the self-efficacy of information recipients. Poverty threatscapes and gender norms hinder behaviour change, particularly at the household-level; however, test results can motivate supply-level managers to implement hazard control measures—with effectiveness and sustainability dependent on infrastructure, training, and ongoing resourcing. Our results have implications for rural development efforts and environmental risk reporting in low-income settings. Full article
(This article belongs to the Special Issue Development, Adaptation and Evaluation of Public Health Interventions: A Complex Systems Perspective)
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12 pages, 946 KiB  
Article
Using Intervention Mapping to Develop a Media Literacy-Based Smoking Prevention Program for Female Adolescents
by Sookyung Kim
Int. J. Environ. Res. Public Health 2021, 18(12), 6305; https://doi.org/10.3390/ijerph18126305 - 10 Jun 2021
Cited by 6 | Viewed by 3440
Abstract
Smoking prevalence among female adolescents in South Korea has increased gradually, despite a decreasing trend seen for male adolescents. Smoking scenes or cigarette advertisements in the media have influenced female adolescents’ initiation into smoking. It is therefore crucial to develop a smoking prevention [...] Read more.
Smoking prevalence among female adolescents in South Korea has increased gradually, despite a decreasing trend seen for male adolescents. Smoking scenes or cigarette advertisements in the media have influenced female adolescents’ initiation into smoking. It is therefore crucial to develop a smoking prevention program to enhance female adolescents’ smoking media literacy by implementing gender-specific approach. The purpose of this study is to describe how intervention mapping protocol (IMP) was used to develop a media literacy-based smoking prevention program (MLSP) for female adolescents. The IMP was used in six steps: needs assessment (literature review and focus groups comprising 24 female adolescents and 12 teachers), program goal setting, selection of intervention methods, production of program components and materials, program implementation planning, and program evaluation by ten experts and three adolescents. Six performance objectives and 14 change objectives were generated. Each module consisted of theory-based methods such as raising consciousness. Half of the modules covered topics regarding smoking media literacy, while half covered topics related to gender-specific intervention. The major advantages of utilizing IMP are that MLSP has been developed to reflect multiple perspectives, including of adolescents, teachers, and professors through a systematic process, and identified to be acceptable and valid. Full article
(This article belongs to the Special Issue Development, Adaptation and Evaluation of Public Health Interventions: A Complex Systems Perspective)
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14 pages, 1482 KiB  
Article
Redesigning a Healthcare Demand Questionnaire for National Population Survey: Experience of a Developing Country
by Diane Woei Quan Chong, Suhana Jawahir, Ee Hong Tan and Sondi Sararaks
Int. J. Environ. Res. Public Health 2021, 18(9), 4435; https://doi.org/10.3390/ijerph18094435 - 22 Apr 2021
Cited by 9 | Viewed by 4079
Abstract
Since its inception in 1986, the contents of the National Health and Morbidity Survey (NHMS) have been periodically updated to support emerging health data needs for evidence-based policy and program development. In 2018, the healthcare demand questionnaire was redesigned to capture diverse and [...] Read more.
Since its inception in 1986, the contents of the National Health and Morbidity Survey (NHMS) have been periodically updated to support emerging health data needs for evidence-based policy and program development. In 2018, the healthcare demand questionnaire was redesigned to capture diverse and changing population demand for healthcare services and their utilization pattern. This paper describes the methods and processes undertaken in redesigning the questionnaire. We aim to highlight the systematic and inclusive approach, enabling all potential evidence users to be involved, indirectly encouraging research evidence uptake for policy and program planning. We applied a systematic approach of comprehensive literature search for national-level population survey instruments implemented globally and translated non-English tools to English. The development phases were iterative, conducted in parallel with active stakeholder engagements. Here, we detailed the processes in the planning and exploratory phase as well as a qualitative assessment of the questionnaire. We included instruments from 45 countries. The majority were from the Organisation for Economic Co-operation and Development (OECD) countries and focused on perceived health, health-related behavior, and healthcare use. Thirty-four stakeholders from 14 areas of expertise were involved. Stakeholders identified additional content areas required, such as chronic pain, alternative use of healthcare services (community pharmacy, home-visit, and private medical laboratory), family doctor, and informal caregiving. The questionnaire, redesigned based on existing literature with concordant involvement and iterative feedback from stakeholders, improved the choice of health topics through the identification of new topics and modification of existing questions to better meet future evidence needs on health problems, strategy, and program planning towards strengthening the nation’s health systems. Full article
(This article belongs to the Special Issue Development, Adaptation and Evaluation of Public Health Interventions: A Complex Systems Perspective)
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8 pages, 592 KiB  
Protocol
A Telephone-Based Tobacco Cessation Program in the State of Qatar: Protocol of a Feasibility Study
by Mohammed Al Thani, Vasiliki Leventakou, Angeliki Sofroniou, Safa M. Eltayeb, Eman Sadoun, Iman A. Hakim, Cynthia Thomson and Uma Nair
Int. J. Environ. Res. Public Health 2021, 18(9), 4750; https://doi.org/10.3390/ijerph18094750 - 29 Apr 2021
Cited by 3 | Viewed by 2965
Abstract
In Qatar, tobacco is the leading preventable cause of death and disease. Telephone-based interventions for smoking are cost-effective and scalable interventions that are effective in promoting smoking behavior change. While many countries have implemented these services within their tobacco control programs, there is [...] Read more.
In Qatar, tobacco is the leading preventable cause of death and disease. Telephone-based interventions for smoking are cost-effective and scalable interventions that are effective in promoting smoking behavior change. While many countries have implemented these services within their tobacco control programs, there is a distinct dearth of a telephone-based smoking cessation intervention that is adapted and tailored to meet the needs of people who smoke in Qatar. This study presents the protocol of a primary health care center integrated smoking quitline program in Qatar. Participants will be recruited from seven smoking clinics (recruitment sites). Trained clinic staff will provide brief advice on quitting followed by a referral to the quitline. Eligible participants (male smokers over 18 years of age) will complete baseline questionnaires and receive five weekly proactive counseling calls, an end-of-treatment assessment (approx. 1 week after Session 5), and 1- and 3-month follow-up assessments. The main aim of this study is to assess the feasibility and acceptability, which include the recruitment and retention rate, compliance to pharmacotherapy, and participant satisfaction. This is the first study to integrate an evidence-based smoking cessation intervention delivered via telephone within the healthcare system in Qatar. If effective, results can inform the development of a large-scale telephone-based program that widely reaches users of tobacco in Qatar as well as in the Middle East. Full article
(This article belongs to the Special Issue Development, Adaptation and Evaluation of Public Health Interventions: A Complex Systems Perspective)
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