Background: While many guidelines explain how to conduct Health Impact Assessments (HIAs), less i... more Background: While many guidelines explain how to conduct Health Impact Assessments (HIAs), less is known about the factors that determine the extent to which HIAs affect health considerations in the decision making process. We investigated which factors are associated with increased or reduced effectiveness of HIAs in changing decisions and in the implementation of policies, programs or projects. This study builds on and tests the Harris and Harris-Roxas ’ conceptual framework for evaluating HIA effectiveness, which emphasises context, process and output as key domains. Methods: We reviewed 55 HIA reports in Australia and New Zealand from 2005 to 2009 and conducted surveys and interviews for 48 of these HIAs. Eleven detailed case studies were undertaken using document review and stakeholder interviews. Case study participants were selected through purposeful and snowball sampling. The data were analysed by thematic content analysis. Findings were synthesised and mapped against the c...
Po l i c y Disclaimer: While every effort has been made to ensure the accuracy of the information... more Po l i c y Disclaimer: While every effort has been made to ensure the accuracy of the information contained in this report, the conclusions and recommendations represent the views of the authors and should not be taken to represent the views of any of the authors ’ institutions. ACKNOWLEDGEMENTS i
Background The practices of transnational corporations (TNCs) affect population health through un... more Background The practices of transnational corporations (TNCs) affect population health through unhealthy products, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. The aim of this paper was to adapt existing Health Impact Assessment methods that were previously used for both a fast food and an extractives industry corporation in order to assess Carlton and United Breweries (CUB) operations within Australia. CUB is an Australian alcohol company owned by a large transnational corporation Asahi Group Holdings. Data identifying potential impacts were sourced through document analysis, including corporate literature; media analysis, and 12 semi-structured interviews. The data were mapped against a corporate health impact assessment framework which included CUB’s political and business practices; products and marketing; workforce, social, environ...
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
International Journal of Environmental Research and Public Health
The objectives of this review were to map and summarize the existing evidence from a global persp... more The objectives of this review were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities. We searched MEDLINE, EMBASE, and CINAHL using both medical subject headings (MeSH) and free-text keywords for empirical studies exploring inequity in ambulatory services offered virtually. Forty-one studies were included, most of them cross-sectional in design. Included studies were extracted using a customized extraction tool, and descriptive analysis was performed. The review identified widespread differences in accessing and using virtual care interventions among cultural and ethnic minorities, older people, socioeconomically disadvantaged groups, people with limited digital and/or health literacy, and those with limited access to digital devices and good connectivity. Potential solutions addressing these barrie...
Integrating healthcare services for people experiencing homelessness in Australia: key issues and... more Integrating healthcare services for people experiencing homelessness in Australia: key issues and research principles.
The recent Lancet Commissions report on The Global Syndemic of Obesity, Undernutrition, and Clima... more The recent Lancet Commissions report on The Global Syndemic of Obesity, Undernutrition, and Climate Change highlights the need for comprehensive actions to address the global epidemic of obesity. The Campbelltown - Changing our Future project utilised a community led participatory systems mapping approach to develop interventions to address childhood obesity in an urban environment. While there is evidence demonstrating the impact of systems approaches on outcomes, there is limited examples internationally demonstrating what works in which circumstances, for whom and most importantly how. A realist evaluation framework was used by project staff to identify key mechanisms that enabled project outcomes. This framework uses four key interrelated concepts: “mechanism”, “context”, “outcome pattern” and “context-mechanism-outcome (CMO) pattern configuration”. Five key underlying properties that influenced the project were analysed using the CMO pattern configuration. The five key properti...
Health Justice Partnerships (HJPs) in NSW are local collaborations between legal assistance agenc... more Health Justice Partnerships (HJPs) in NSW are local collaborations between legal assistance agencies (e.g. Legal Aid NSW, community legal centres), health agencies (e.g. Local Health Districts, health NGOs) and human service agencies (e.g. the Department of Family and Community Services, welfare agencies).
The effectiveness of health impact assessment in influencing decision-making in Australia and New... more The effectiveness of health impact assessment in influencing decision-making in Australia and New role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a Haigh et al. BMC Public Health 2013, 13:1188
Influencing land use planning: making the most of opportunities to work upstream. Editorial paper... more Influencing land use planning: making the most of opportunities to work upstream. Editorial paper in the Australian and New Zealand Journal of Public Health by Patrick Harris, Fiona Haigh, Peter Sainsbury & Marilyn Wise, 2012. The newly elected government of New South Wales recently embarked on the first review of the State’s land use planning legislation since 1979. The existing legislation had become confusing, unresponsive to modern planning issues and community concerns and a political millstone of (alleged) inefficiency and corruption. The review is a chance to improve public health by influencing the legislation, rules and processes that govern land use planning and development throughout the state, rather than being restricted to trying to influence the content of specific plans and development applications one by one.
Background: Health Impact Assessment (HIA) involves assessing how proposals may alter the determi... more Background: Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs. Methods: We used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics. Results: We found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement. Conclusions: This study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders put on indirect impacts such as learning and relationship building suggest HIA has a role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a mechanism for developing relationships with and influencing other sectors. Accordingly when evaluating the effectiveness of HIAs we need to look beyond the direct impacts on decisions.
Background: While many guidelines explain how to conduct Health Impact Assessments (HIAs), less i... more Background: While many guidelines explain how to conduct Health Impact Assessments (HIAs), less is known about the factors that determine the extent to which HIAs affect health considerations in the decision making process. We investigated which factors are associated with increased or reduced effectiveness of HIAs in changing decisions and in the implementation of policies, programs or projects. This study builds on and tests the Harris and Harris-Roxas ’ conceptual framework for evaluating HIA effectiveness, which emphasises context, process and output as key domains. Methods: We reviewed 55 HIA reports in Australia and New Zealand from 2005 to 2009 and conducted surveys and interviews for 48 of these HIAs. Eleven detailed case studies were undertaken using document review and stakeholder interviews. Case study participants were selected through purposeful and snowball sampling. The data were analysed by thematic content analysis. Findings were synthesised and mapped against the c...
Po l i c y Disclaimer: While every effort has been made to ensure the accuracy of the information... more Po l i c y Disclaimer: While every effort has been made to ensure the accuracy of the information contained in this report, the conclusions and recommendations represent the views of the authors and should not be taken to represent the views of any of the authors ’ institutions. ACKNOWLEDGEMENTS i
Background The practices of transnational corporations (TNCs) affect population health through un... more Background The practices of transnational corporations (TNCs) affect population health through unhealthy products, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. The aim of this paper was to adapt existing Health Impact Assessment methods that were previously used for both a fast food and an extractives industry corporation in order to assess Carlton and United Breweries (CUB) operations within Australia. CUB is an Australian alcohol company owned by a large transnational corporation Asahi Group Holdings. Data identifying potential impacts were sourced through document analysis, including corporate literature; media analysis, and 12 semi-structured interviews. The data were mapped against a corporate health impact assessment framework which included CUB’s political and business practices; products and marketing; workforce, social, environ...
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
International Journal of Environmental Research and Public Health
The objectives of this review were to map and summarize the existing evidence from a global persp... more The objectives of this review were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities. We searched MEDLINE, EMBASE, and CINAHL using both medical subject headings (MeSH) and free-text keywords for empirical studies exploring inequity in ambulatory services offered virtually. Forty-one studies were included, most of them cross-sectional in design. Included studies were extracted using a customized extraction tool, and descriptive analysis was performed. The review identified widespread differences in accessing and using virtual care interventions among cultural and ethnic minorities, older people, socioeconomically disadvantaged groups, people with limited digital and/or health literacy, and those with limited access to digital devices and good connectivity. Potential solutions addressing these barrie...
Integrating healthcare services for people experiencing homelessness in Australia: key issues and... more Integrating healthcare services for people experiencing homelessness in Australia: key issues and research principles.
The recent Lancet Commissions report on The Global Syndemic of Obesity, Undernutrition, and Clima... more The recent Lancet Commissions report on The Global Syndemic of Obesity, Undernutrition, and Climate Change highlights the need for comprehensive actions to address the global epidemic of obesity. The Campbelltown - Changing our Future project utilised a community led participatory systems mapping approach to develop interventions to address childhood obesity in an urban environment. While there is evidence demonstrating the impact of systems approaches on outcomes, there is limited examples internationally demonstrating what works in which circumstances, for whom and most importantly how. A realist evaluation framework was used by project staff to identify key mechanisms that enabled project outcomes. This framework uses four key interrelated concepts: “mechanism”, “context”, “outcome pattern” and “context-mechanism-outcome (CMO) pattern configuration”. Five key underlying properties that influenced the project were analysed using the CMO pattern configuration. The five key properti...
Health Justice Partnerships (HJPs) in NSW are local collaborations between legal assistance agenc... more Health Justice Partnerships (HJPs) in NSW are local collaborations between legal assistance agencies (e.g. Legal Aid NSW, community legal centres), health agencies (e.g. Local Health Districts, health NGOs) and human service agencies (e.g. the Department of Family and Community Services, welfare agencies).
The effectiveness of health impact assessment in influencing decision-making in Australia and New... more The effectiveness of health impact assessment in influencing decision-making in Australia and New role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a Haigh et al. BMC Public Health 2013, 13:1188
Influencing land use planning: making the most of opportunities to work upstream. Editorial paper... more Influencing land use planning: making the most of opportunities to work upstream. Editorial paper in the Australian and New Zealand Journal of Public Health by Patrick Harris, Fiona Haigh, Peter Sainsbury & Marilyn Wise, 2012. The newly elected government of New South Wales recently embarked on the first review of the State’s land use planning legislation since 1979. The existing legislation had become confusing, unresponsive to modern planning issues and community concerns and a political millstone of (alleged) inefficiency and corruption. The review is a chance to improve public health by influencing the legislation, rules and processes that govern land use planning and development throughout the state, rather than being restricted to trying to influence the content of specific plans and development applications one by one.
Background: Health Impact Assessment (HIA) involves assessing how proposals may alter the determi... more Background: Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs. Methods: We used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics. Results: We found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement. Conclusions: This study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders put on indirect impacts such as learning and relationship building suggest HIA has a role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a mechanism for developing relationships with and influencing other sectors. Accordingly when evaluating the effectiveness of HIAs we need to look beyond the direct impacts on decisions.
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