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European Journal of Public Health, Vol. 23, Supplement 1, 2013
A joint initiative of WHO, the International Association of Impact Assessment (IAIA), and EUPHA analyses healthinclusive IAs and looks into options for improvement. The set of specific IAs consists of: Environmental Impact Assessment, Strategic Environmental Assessment, Social Impact Assessment, Sustainability Assessment, and HIA. Key questions of discussion include the following: How can the various assessments contribute to promoting and protecting human health? How can the further integration of health support other forms of IAs? What forms and levels of integration seem advisable? How do IAs fit into the policy cycle? What should be seen as priorities for further development? Health Technology Assessment (HTA) and Health impact Assessment (HIA) – Opportunities for mutual benefit Walter Ricciardi W Ricciardi1, R Fehr2 1 Catholic University of the Sacred Heart, Rome, Italy 2 Universita¨t Bielefeld, Bielefeld, Germany Contact:
[email protected]
The term ‘‘health (care) technology’’ includes drugs and devices, medical / surgical procedures, prevention and rehabilitation, and the systems within which health is protected and maintained. The rapid development of these technologies, the high stakes often involved, and the economic implications call for systematic evaluations. In this situation, many countries embrace HTA as an essential approach. Similar to HIA, it is a multidisciplinary approach aiming to support decision-making. It studies the medical, social, ethical, and economic implications of development,
diffusion, and use of health technology. There are national as well as international bodies, e.g. International Network of Agencies for HTA. Experiences on which the presentation builds include a recent HTA of genetic testing for susceptibility to venous thromboembolism, covering analytic and clinical validity, predictivity / utility, ethical considerations, and the patients’ perspective. In this HTA, also the role of guidelines of scientific societies was considered. HTA and HIA share essential features and may profit from a detailed comparison. They both have evolved into ‘‘cultures’’, including their specific raison d’eˆtre, agendas, actors, and methodologies. Based on a SWOT analysis, we identify commonalities as well as differences. Shared strengths include the systematic, transparent orientation. Shared opportunities result, e.g., from EC and WHO fostering both. A shared weakness is the difficulty to incorporate a systems perspective adequately. Among shared threats are perceptions as ‘‘red tape’’. Concerning differences, for HTA the starting point is more concrete; and the relationship with health obvious. For HIA, the starting point can look vague, and the relationship with health not so obvious. Strengths of HTA include an explicit legal basis (in many countries), ‘‘horizon scanning’’ features, and well-developed networks. Strengths of HIA include the focus on prevention and health promotion, the prospective approach, adjustable set of Methods, and explicit role for participation. HTA and HIA fulfill complementary functions. Both have reached remarkable levels of development. Up to now, there is little mutual exchange although this should be useful for the further development of both.
D.1. Workshop: Context matters: social and cultural factors in health behaviour research Organised by: EUPHA Section on Health Promotion Contact:
[email protected] Chairperson: Thomas Abel, Switzerland and Christiane Stock, Denmark
Context specific social and cultural factors are likely to affect people’s health relevant behaviours. What do we know about those factors and how they relate to health behaviours? And how should those context factors influence the way we do health promotion research and the planning of culturally sensitive interventions? The four papers selected for this workshop address those questions from different angles and on different intervention levels. We start off with a paper by Kate Frohlich offering a structure- agency theory perspective with a focus on neighborhoods as contexts for smoking behaiours. Kate’s presentation will be followed by a paper by Bart de Clercq who provides empirical findings on the associations between smoking and social capital in the context of families, schools and neighborhoods; and those finding will add but might also challenge some of the findings from the proceeding presentation. Then we move on to Annika Frasha whose presentation shows how a theoretical framework which gives context a key role, can be successfully used in comparative policy studies on physical activity promotion. Her paper is followed by a paper in which Giovanni Capelli presents the findings from a large EC project collecting and analyzing data from physical activity promotion projects among groups in socio-economically disadvantaged contexts: lessons are presented and discussed on the determinants of intervention success and transferability of results.
With a guiding perspective on contextual social and cultural factors in health behaviours this workshop invites participants to engage in conceptual thinking as well discussing latest empirical findings. It is focused on two key health behaviours, namely smoking and physical activity. The presentations show why and how context matters for health behaviours and health promotion interventions and address central issues on different levels namely schools, neighborhoods, communities, national and international platforms. After a short introduction by the chairs of the EUPHA HP section, each presentation will be allowed 15 min. After the first two papers (both on smoking) we will have some time for short questions. The same pattern is repeated for presentations 3 and 4 (both on physical activity). More issues addressed in the presentations and the general pros and cons of a context perspective on health behaviours will be the starting point for an open discussion with the workshop participants. The chairs will briefly summarize the discussions to round up and close this workshop. Key message Social and cultural context matters for health promotion research and practise
The ISIS study: Studying Context through the Spatiality of Injustice Kathrine Frohlich KL Frohlich De´partement de medicine sociale et preventive, E´cole de Sante´ Publique, Universite´ de Montreal et IRSPUM, Montreal, Canada Contact:
[email protected]
