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This article presents a framework to be used in studying public policy development and implementation in children's mental health. It particularly focuses on policy related to the establishment of community-based systems of care.The framework is based on a review of the literature on policy development and implementation. It focuses on four dimensi...
Context in source publication
Citations
... Literature (Azline et al., 2018;Benoit, 2013;Howlett et al., 2009;Friedman, 2003;Sabatier and Jenkins-Smith, 1993) discusses the ‗staging heuristic' process and narrates how it is helpful to guide reflection and action, leading to better healthcare policymaking. In this process, each of the stages follows each other in sequential progression. ...
... The description of each stage (see Figure 1) is narrated below. Azline et al., 2018;Benoit, 2013;Howlett et al., 2009;Friedman, 2003;Sabatier and Jenkins-Smith, 1993) Stage 1 (Agenda Setting): It relates to the process through which healthcare policy is recognised as being of public interest and the issue it is designed to tackle. The issues are picked up by the media, political parties, or interest groups. ...
Purpose
Despite technological advancements to enhance patient health, the risks of not discovering the correct interactions and trends in digital health are high. Hence, a careful policy is required for health coverage tailored to needs and capacity. Therefore, this study aims to explore the adoption of a cognitive computing decision support system (CCDSS) in the assessment of health-care policymaking and validates it by extending the unified theory of acceptance and use of technology model.
Design/methodology/approach
A survey was conducted to collect data from different stakeholders, referred to as the 4Ps, namely, patients, providers, payors and policymakers. Structural equation modelling and one-way ANOVA were used to analyse the data.
Findings
The result reveals that the behavioural insight of policymakers towards the assessment of health-care policymaking is based on automatic and reflective systems. Investments in CCDSS for policymaking assessment have the potential to produce rational outcomes. CCDSS, built with quality procedures, can validate whether breastfeeding-supporting policies are mother-friendly.
Research limitations/implications
Health-care policies are used by lawmakers to safeguard and improve public health, but it has always been a challenge. With the adoption of CCDSS, the overall goal of health-care policymaking can achieve better quality standards and improve the design of policymaking.
Originality/value
This study drew attention to how CCDSS as a technology enabler can drive health-care policymaking assessment for each stage and how the technology enabler can help the 4Ps of health-care gain insight into the benefits and potential value of CCDSS by demonstrating the breastfeeding supporting policy.
... With respect to mental health, policies administered by government agencies can encourage wanted behaviors (e.g., reimbursing for empirically supported interventions) and discourage unwanted ones (e.g., prohibiting lifetime limits on spending for mental illness). They can also dictate eligibility criteria for public and private insurance coverage and/or reimbursement; establish financing or reimbursement arrangements; set requirements for the delivery of services; and specify outcomes to be monitored, reported, and overseen (Friedman 2003). Broader economic security policies such as the Earned Income Tax Credit have been shown to be independently associated with measures of child development (Dahl and Lochner 2012;Hamad and Rehkopf 2016). ...
... In addition, evidence is still emerging about the ideal channels for translating research into mental health policymaking (Friedman 2003;Williamson et al. 2015). Examination of the processes underpinning likelihood of policy receptivity and action at local, state, and national levels could help advance evidence-based policymaking (Tabak et al. 2012). ...
Policies have potential to help families obtain behavioral healthcare for their children, but little is known about evidence for specific policy approaches. We reviewed evaluations of select policy levers to promote accessibility, affordability, acceptability, availability, or utilization of children’s mental and behavioral health services. Twenty articles met inclusion criteria. Location-based policy levers (school-based services and integrated care models) were associated with higher utilization and acceptability, with mixed evidence on accessibility. Studies of insurance-based levers (mental health parity and public insurance) provided some evidence for affordability outcomes. We found no eligible studies of workforce development or telehealth policy levers, or of availability outcomes.
... Policyprocessen liksom implementeringsprocessen är ofta en sammanhängande kedja av beslut med många beslutsfattare inblandade. Friedman (2003) har beskrivit policy och implementeringsprocessen i fem steg. Första steget är att identifiera vilket problem som man avser att lösa (identifikation). ...
Artikeln redovisar resultatet från en nationell enkät om implementeringen av Addiction Severity Index (ASI) till 555 anställda i socialtjänsten, kriminalvården och i missbrukarvården som deltagit i en ASI-utbildning mellan år 1996 -2000. Resultatet visar att det är arbetsledare och chefer som alltmer tar initiativet till ASI-utbildningar och att implementeringens villkor skiljer sig åt beroende på var man arbetar. ASI har främst använts i det direkta klientarbetet och i liten utsträckning för uppföljning och utvärdering.
... Use of research to help identify which issues or problems are priorities and should be addressed by policy/program development (Friedman, 2003;Hanney et al., 2003;HM Treasury, 2011) * ...
The recent proliferation of strategies designed to increase the use of research in health policy (knowledge exchange) demands better application of contemporary conceptual understandings of how research shapes policy. Predictive models, or action frameworks, are needed to organise existing knowledge and enable a more systematic approach to the selection and testing of intervention strategies. Useful action frameworks need to meet four criteria: have a clearly articulated purpose; be informed by existing knowledge; provide an organising structure to build new knowledge; and be capable of guiding the development and testing of interventions. This paper describes the development of the SPIRIT Action Framework. A literature search and interviews with policy makers identified modifiable factors likely to influence the use of research in policy. An iterative process was used to combine these factors into a pragmatic tool which meets the four criteria. The SPIRIT Action Framework can guide conceptually-informed practical decisions in the selection and testing of interventions to increase the use of research in policy. The SPIRIT Action Framework hypothesises that a catalyst is required for the use of research, the response to which is determined by the capacity of the organisation to engage with research. Where there is sufficient capacity, a series of research engagement actions might occur that facilitate research use. These hypotheses are being tested in ongoing empirical work.
Copyright © 2015. Published by Elsevier Ltd.
... Following the changes, GPs have continued their involvement in the 6–8 week review but provision of other standard reviews has essentially ceased. This finding is broadly in line with what would have been expected from the policy recommendations, although it is worth noting that policy is by no means always implemented as intended [16,17]. Our findings also show that, since 2005, GPs have had minimal involvement in provision of the selective 24 month review. ...
GPs contribute to preventive child health care in various ways, including provision of child health surveillance (CHS) reviews, opportunistic preventive care, and more intensive support to vulnerable children. The number of CHS reviews offered in Scotland was reduced from 2005. This study aimed to quantify GPs' provision of different types of preventive care to pre-school children before and after the changes to the CHS system.
GP consultation rates with children aged 0-4 years were examined for the 2½ years before and after the changes to the CHS system using routinely available data from 30 practices in Scotland. Consultations for CHS reviews; other aspects of preventive care; and all reasons were considered.
Prior to the changes to the CHS system, GPs often contributed to CHS reviews at 6-8 weeks and 8-9 and 39-42 months. Following the changes, GP provision of the 6-8 week review continued but other reviews essentially ceased. Few additional consultations with pre-school children are recorded as involving other aspects of preventive care, and the changes to CHS have had no impact on this. In the 2½ years before and after the changes, consultations recorded as involving any form of preventive care accounted for 11% and 7.5% respectively of all consultations with children aged 0-4 years, with the decline due to reductions in CHS reviews.
Effective preventive care through the early years can help children secure good health and developmental outcomes. GPs are well placed to contribute to the provision of such care. Consultations focused on preventive care form a small minority of GPs' contacts with pre-school children, however, particularly since the reduction in the number of CHS reviews.
... The information gathered during this research led the investigators to propose a series of "necessary conditions" that must be in place at the organization and system levels in order for wraparound implementation to be successful and sustainable (Walker and Koroloff 2007;Walker et al. 2003Walker et al. , 2010. The research was conducted using an approach called "backward mapping" (Dunst et al. 1993;Elmore 1979Elmore /1980Friedman 2003). Backward mapping is a strategy for policy and implementation analysis that begins with a description of desired behavior at the "lowest" level of intervention, where "public servants touch the public. ...
The wraparound process has emerged as perhaps the most frequently implemented comprehensive approach for planning and providing
individualized, community-based care for children and adolescents with serious mental health conditions. Providing comprehensive
care through the wraparound process necessarily requires a high level of collaboration across organization and agency boundaries.
This need for significant inter-agency or “system-level” collaboration creates a complex implementation environment for wraparound.
It is therefore not surprising that creating and sustaining a hospitable implementation environment has proven to be extremely
challenging. For the people who are responsible for managing the inter-organizational collaboration, it is not easy to evaluate
the adequacy of local system-level support for wraparound and to see exactly what kinds of supports are lacking or where system-development
efforts should focus. Furthermore, as system-development strategies are put into practice, it can be difficult to assess whether
or not meaningful progress is occurring. The Community Supports for Wraparound Inventory (CSWI) was developed to respond to
the need for an assessment of the extent to which a community has developed system-level capacity to implement wraparound.
This article reports on a study that evaluated the reliability and validity of the CSWI for use in communities implementing
wraparound. Findings indicate that the CSWI shows promise as a reliable, valid and useful tool.
KeywordsWraparound–Implementation–System integration–Community-based care–Inter-agency collaboration–Implementation assessment–System of care
... These challenges are further complicated by (a) the need to work in collaboration with additional service sectors, (b) the multiple ''systems of care'' necessary, and (c) the complex problems of an at-risk youth population. Although issues related to coordinating sectors of care in a dynamic policy environment are not new, surprisingly little has been written to guide practitioners and policymakers in addressing them (Friedman 2003). The authors (a social worker, community psychologist, and nurse), therefore, worked together to identify models from a variety of social science disciplines that address issues across service systems in order to address statewide policy reform for at-risk youth. ...
Policy reform for at-risk youth is complicated by involvement of various service sectors. Issues related to coordinating systems
of care in a dynamic policy environment are not new, but surprisingly little has been written to guide practitioners and policymakers
in addressing them (Friedman in Journal of Emotional and Behavioral Disorders 11:11–18, 2003). To that end, a social worker, community psychologist, and nurse, working as part of a multidisciplinary team reviewed the
practice literature on models to guide policy reform in justice and behavioral health systems. Five models are presented to
assist community practitioners assessing similar policy reform.
KeywordsAt-risk youth-Juvenile justice-Behavioral health-Policy reform
... In reality, nevertheless, it is often skeptical how and how much the claimed policy has actually been implemented. As Friedman (2003) points out, written policies typically contain broad declared intentions of policymakers yet often fail to give lucid procedures for implementation. If the espoused policy and the assumptions of responsible agencies are divergent, ambiguity and discrepancy in carrying out the intended policy to actual implementation may likely evolve. ...
Private higher education (PHE) worldwide has been a rapid development in the last several decades. The private sector will continue to grow, diversify and undoubtedly play a significant role in the political economy of higher education. Nevertheless, systematically empirical studies on the trio relationships among PHE, institutional diversity and political economy are still miniscule, especially outside the U.S. In Thailand, studies on even public higher education utilizing international literature are rare, as is research with a macro-level empirical analysis of private-public comparison. Thus, this study focuses on the fundamental differences among Thai private higher education institutions (PHEIs) and between private and public ones and the extent to which political economy influences their shapes and differences. The study attempts to determine and demonstrate whether, how and how much the Thai case fits Levy’s
(1986b) PHE pioneering concepts on types of PHE: religious-oriented, semi-elite, demand-absorbing.
The study employs combined methods of analysis: content analysis of 24 interviews of private university presidents and national policymakers and institutional data and legislative documentation, descriptive statistical analysis and Ragin’s (2000, 2008, 2009) Fuzzy-Set Qualitative Comparative Analysis (fsQCA). The findings show
clusters of characteristics on governance and finance in relation to different institutional types. Intra-sectorally, Thai PHEIs are different among themselves based on types of ownership and characteristics previously identified in the literature. Levy’s theory is vigorously applicable to the Thai context. Nonetheless, several deviations appear. The findings introduce a new category, serious-demand-absorbing, which incorporates elements from other types. The findings also suggest that institutional isomorphism happens due to all PHE types tending to share comparable characteristics in both governance and finance and that institutional diversity becomes a matter of degrees.
Institutional functions, e.g., size, age, mission, fields of study are catalysts in differentiation or isomorphism of different PHE types. Inter-sectorally, private and public higher education institutions are most different from one another in the law governing them, internal administration style, and government funding. Finally, political
economic policies, e.g., quality assurance, the PHE Act, and student loans result in coercive isomorphism while aggressive market competition bolsters institutional diversity.
... Given that school psychologists increasingly deliver services within a community health perspective (Friedman, 2003;Strein, Hoagwood, & Cohn, 2003) and intervene when communities are exposed to traumatic events (Allen et al., 2002;Motta, 1995;Stein, 1997) they should be familiar with the effects of trauma on children for screening, diagnosis, and intervention planning; be members of the response team; use their knowledge of the local system; provide continued services following rapid response interventions (Cook-Cottone, 2004); and consider differential diagnosis and comorbidity of posttraumatic stress disorder (PTSD) when children are referred for other symptoms (Ford et al., 2000). However, to date, despite the frequent exposure of children to beatings, shootings, arrests, bombings from the air, ground shelling, and house demolitions (B'Tselem, 2002), the majority of training programs include merely brief coverage of PTSD and only few cover in-depth the effects of violent war-like events on children. ...
Children exposed to violent war-like and repeated political violence often experience a continued threat to life and their sense of safety, as well as a disruption of daily functioning. The purpose of the study was to examine the psychological impact of exposure to Israeli occupation on Palestinian school children in the West Bank and Gaza, Palestine. We assessed the association between exposure to occupation and the severity of posttraumatic symptoms and the inter-relationship between posttraumatic symptoms, functional impairment, somatic complaints, and coping strategies in school children. Palestinian students (n = 2100) from grades 9—11 were screened from both the West Bank (n = 1235) and Gaza (n = 724) and responded to self-report questionnaires. Results showed that extensive exposure to violence was associated with higher levels of posttraumatic distress and more somatic complaints in both the West Bank and Gaza regions. More Gaza than West bank students reported symptoms meeting the criteria for PTSD, and more girls than boys in both groups reported somatic complaints. Thus, school-based screening can be an effective method for case identification of students showing PTSD symptoms as a result of exposure to political violence.
... Traditional policy development begins at the federal, provincial, or state level, and specific policy initiatives are identified for implementation at local levels. In contrast, Dunst 42 and Friedman 43 have recommended the use of backward mapping to address the barriers associated with persons with special needs. Backward mapping involves the use of locally identified knowledge and information to discover or ascertain an individual's needs and perceived barriers. ...
... Backward mapping involves the use of locally identified knowledge and information to discover or ascertain an individual's needs and perceived barriers. 43 The use of a backward-mapping approach situates policy development closer to the actual problem. Local knowledge is then used to build policies that improve local capacity to address problems such as environmental barriers to participation. ...
To comprehensively describe parent perceptions of environmental barriers to recreational, community, and school participation for children with physical disabilities.
Secondary analysis of cross-sectional data gathered in the first wave of a longitudinal study of the child, family, and environmental factors affecting the recreational and leisure participation of school-age children with physical disabilities.
General community.
Parent-child pairs (N=427). Child participants included 229 boys and 198 girls with physical disabilities in 3 age cohorts (6-8, 9-11, 12-14 y).
Not applicable.
Craig Hospital Inventory of Environmental Factors.
Barriers to participation were encountered in school and work environments (1.54+/-1.88), physical and built environments (1.36+/-1.35), within institutional and government policies (1.24+/-1.71), services and assistance (1.02+/-1.2), and attitudes and social support (.87+/-1.17). Age, socioeconomic status, level of physical functioning, and behavioral difficulties were related to the impact of barriers reported in certain areas. No significant differences by the sex of the children or rural versus urban community were found.
Parents report environmental barriers in several areas, providing valuable information about the environmental factors that support or hinder participation while showing the complexity of these issues. Future research is required to further identify potential avenues for intervention.
