A cross-country study of mis-implementation in public health practice
Abstract Background Mis-implementation (i.e., the premature termination or inappropriate continuation of public health programs) contributes to the misallocation of limited public health resources and the sub-optimal response to the growing global burden of chronic disease. This study seeks to descr...
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-019-6591-x |
| _version_ | 1811202426483507200 |
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| author | Karishma S. Furtado Elizabeth L. Budd Rebecca Armstrong Tahna Pettman Rodrigo Reis Pauline Sung-Chan Zhaoxin Wang Ross C. Brownson |
| author_facet | Karishma S. Furtado Elizabeth L. Budd Rebecca Armstrong Tahna Pettman Rodrigo Reis Pauline Sung-Chan Zhaoxin Wang Ross C. Brownson |
| author_sort | Karishma S. Furtado |
| collection | DOAJ |
| description | Abstract Background Mis-implementation (i.e., the premature termination or inappropriate continuation of public health programs) contributes to the misallocation of limited public health resources and the sub-optimal response to the growing global burden of chronic disease. This study seeks to describe the occurrence of mis-implementation in four countries of differing sizes, wealth, and experience with evidence-based chronic disease prevention (EBCDP). Methods A cross-sectional study of 400 local public health practitioners in Australia, Brazil, China, and the United States was conducted from November 2015 to April 2016. Online survey questions focused on how often mis-termination and mis-continuation occur and the most common reasons programs end and continue. Results We found significant differences in knowledge of EBCDP across countries with upwards of 75% of participants from Australia (n = 91/121) and the United States (n = 83/101) reporting being moderately to extremely knowledgeable compared with roughly 60% (n = 47/76) from Brazil and 20% (n = 21/102) from China (p < 0.05). Far greater proportions of participants from China thought effective programs were never mis-terminated (12.2% (n = 12/102) vs. 1% (n = 2/121) in Australia, 2.6% (n = 2/76) in Brazil, and 1.0% (n = 1/101) in the United States; p < 0.05) or were unable to estimate how frequently this happened (45.9% (n = 47/102) vs. 7.1% (n = 7/101) in the United States, 10.5% (n = 8/76) in Brazil, and 1.7% (n = 2/121) in Australia; p < 0.05). The plurality of participants from Australia (58.0%, n = 70/121) and the United States (36.8%, n = 37/101) reported that programs often mis-continued whereas most participants from Brazil (60.5%, n = 46/76) and one third (n = 37/102) of participants from China believed this happened only sometimes (p < 0.05). The availability of funding and support from political authorities, agency leadership, and the general public were common reasons programs continued and ended across all countries. A program’s effectiveness or evidence-base—or lack thereof—were rarely reasons for program continuation and termination. Conclusions Decisions about continuing or ending a program were often seen as a function of program popularity and funding availability as opposed to effectiveness. Policies and practices pertaining to programmatic decision-making should be improved in light of these findings. Future studies are needed to understand and minimize the individual, organizational, and political-level drivers of mis-implementation. |
| first_indexed | 2024-04-12T02:39:30Z |
| format | Article |
| id | doaj.art-2e96920308e9459da43ed37e3c41e351 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-12T02:39:30Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-2e96920308e9459da43ed37e3c41e3512022-12-22T03:51:21ZengBMCBMC Public Health1471-24582019-03-0119111010.1186/s12889-019-6591-xA cross-country study of mis-implementation in public health practiceKarishma S. Furtado0Elizabeth L. Budd1Rebecca Armstrong2Tahna Pettman3Rodrigo Reis4Pauline Sung-Chan5Zhaoxin Wang6Ross C. Brownson7Prevention Research Center, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196College of Education, University of OregonMelbourne School of Population and Global Health, The University of MelbourneMelbourne School of Population and Global Health, The University of MelbournePrevention Research Center, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196Hong Kong University of Science & TechnologyTongji UniversityPrevention Research Center, Brown School, Washington University in St. Louis, One Brookings Dr., Campus Box 1196Abstract Background Mis-implementation (i.e., the premature termination or inappropriate continuation of public health programs) contributes to the misallocation of limited public health resources and the sub-optimal response to the growing global burden of chronic disease. This study seeks to describe the occurrence of mis-implementation in four countries of differing sizes, wealth, and experience with evidence-based chronic disease prevention (EBCDP). Methods A cross-sectional study of 400 local public health practitioners in Australia, Brazil, China, and the United States was conducted from November 2015 to April 2016. Online survey questions focused on how often mis-termination and mis-continuation occur and the most common reasons programs end and continue. Results We found significant differences in knowledge of EBCDP across countries with upwards of 75% of participants from Australia (n = 91/121) and the United States (n = 83/101) reporting being moderately to extremely knowledgeable compared with roughly 60% (n = 47/76) from Brazil and 20% (n = 21/102) from China (p < 0.05). Far greater proportions of participants from China thought effective programs were never mis-terminated (12.2% (n = 12/102) vs. 1% (n = 2/121) in Australia, 2.6% (n = 2/76) in Brazil, and 1.0% (n = 1/101) in the United States; p < 0.05) or were unable to estimate how frequently this happened (45.9% (n = 47/102) vs. 7.1% (n = 7/101) in the United States, 10.5% (n = 8/76) in Brazil, and 1.7% (n = 2/121) in Australia; p < 0.05). The plurality of participants from Australia (58.0%, n = 70/121) and the United States (36.8%, n = 37/101) reported that programs often mis-continued whereas most participants from Brazil (60.5%, n = 46/76) and one third (n = 37/102) of participants from China believed this happened only sometimes (p < 0.05). The availability of funding and support from political authorities, agency leadership, and the general public were common reasons programs continued and ended across all countries. A program’s effectiveness or evidence-base—or lack thereof—were rarely reasons for program continuation and termination. Conclusions Decisions about continuing or ending a program were often seen as a function of program popularity and funding availability as opposed to effectiveness. Policies and practices pertaining to programmatic decision-making should be improved in light of these findings. Future studies are needed to understand and minimize the individual, organizational, and political-level drivers of mis-implementation.http://link.springer.com/article/10.1186/s12889-019-6591-xDissemination and implementationEvidence-based public healthChronic diseaseMis-implementationEvidence-based chronic disease prevention |
| spellingShingle | Karishma S. Furtado Elizabeth L. Budd Rebecca Armstrong Tahna Pettman Rodrigo Reis Pauline Sung-Chan Zhaoxin Wang Ross C. Brownson A cross-country study of mis-implementation in public health practice BMC Public Health Dissemination and implementation Evidence-based public health Chronic disease Mis-implementation Evidence-based chronic disease prevention |
| title | A cross-country study of mis-implementation in public health practice |
| title_full | A cross-country study of mis-implementation in public health practice |
| title_fullStr | A cross-country study of mis-implementation in public health practice |
| title_full_unstemmed | A cross-country study of mis-implementation in public health practice |
| title_short | A cross-country study of mis-implementation in public health practice |
| title_sort | cross country study of mis implementation in public health practice |
| topic | Dissemination and implementation Evidence-based public health Chronic disease Mis-implementation Evidence-based chronic disease prevention |
| url | http://link.springer.com/article/10.1186/s12889-019-6591-x |
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