When good evidence is not enough: the role of context in bowel cancer screening policy in New Zealand

Flitcroft, Kathy; Gillespie, James; Carter, Stacy M; Trevena, Lyndal; Salkeld, Glenn

doi:10.1332/174426411x591735

Cited by 6 publications

(7 citation statements)

References 29 publications

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“…Two further cases illustrated how institutional ‘silos’ could limit evidence consideration for complex health issues that require multi-disciplinary evidence and horizontal thinking across sectoral boundaries, such as in a bowel cancer programme in New Zealand [51] and HIV/AIDS policy in Cambodia [52].…”

Section: Resultsmentioning

confidence: 99%

Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

2013

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BackgroundThere is increasing recognition that the development of evidence-informed health policy is not only a technical problem of knowledge exchange or translation, but also a political challenge. Yet, while political scientists have long considered the nature of political systems, the role of institutional structures, and the political contestation of policy issues as central to understanding policy decisions, these issues remain largely unexplored by scholars of evidence-informed policy making.MethodsWe conducted a systematic review of empirical studies that examined the influence of key features of political systems and institutional mechanisms on evidence use, and contextual factors that may contribute to the politicisation of health evidence. Eligible studies were identified through searches of seven health and social sciences databases, websites of relevant organisations, the British Library database, and manual searches of academic journals. Relevant findings were extracted using a uniform data extraction tool and synthesised by narrative review.Findings56 studies were selected for inclusion. Relevant political and institutional aspects affecting the use of health evidence included the level of state centralisation and democratisation, the influence of external donors and organisations, the organisation and function of bureaucracies, and the framing of evidence in relation to social norms and values. However, our understanding of such influences remains piecemeal given the limited number of empirical analyses on this subject, the paucity of comparative works, and the limited consideration of political and institutional theory in these studies.ConclusionsThis review highlights the need for a more explicit engagement with the political and institutional factors affecting the use of health evidence in decision-making. A more nuanced understanding of evidence use in health policy making requires both additional empirical studies of evidence use, and an engagement with theories and approaches beyond the current remit of public health or knowledge utilisation studies.

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Section: Resultsmentioning

confidence: 99%

Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

2013

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“…As these questions have to be answered in context, this review only provides input for the contextual decision-making process. In the same manner as evidence does not dictate implementation, [154][155][156] neither does a review of the ethical issues, ie, there is no ethical "imperative of evidence." Nonetheless, the review can prepare and facilitate this process.…”

Section: Discussionmentioning

confidence: 99%

“…Despite evidence and recommendations, several countries have not implemented screening. [154][155][156] On the other hand, some types of screening have been implemented without high-quality evidence, eg, with iFOBT and colonoscopy. Although such decisions may be based on accuracy data and modeling studies, making it "unethical not to screen," it can become difficult to obtain evidence on these screening strategies in the future.…”

Section: The Ethics Of Evidence and Actionmentioning

confidence: 99%

Ethical issues with colorectal cancer screening—a systematic review

Hofmann

2016

Evaluation Clinical Practice

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“…Details of the three individual cases and their specific methods is available elsewhere: Australia (Flitcroft et al, 2010); New Zealand (Flitcroft et al, 2011b); and the UK (Flitcroft et al, 2011c). Ethics approval for this project was granted by the Human Research Ethics Committee of the University of Sydney (Approval no.…”

Section: Methodology Methodsmentioning

confidence: 99%

“…A closer look at the New Zealand situation reveals other important barriers to the initiation of a bowel cancer screening programme (Flitcroft et al, 2011b). These included the symbolic part played by the 1840 Treaty of Waitangi in contemporary New Zealand public policy.…”

Section: New Zealand: Cultural and Ethical Interpretations Of Evidencementioning

confidence: 99%

Incorporating evidence and politics in health policy: can institutionalising evidence review make a difference?

Flitcroft¹,

Gillespie²,

Carter³

et al. 2014

Evidence &Amp; Policy

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Much of the evidence translation literature focuses narrowly on the use of evidence in the initial policy formulation stages, and downplays the crucial role of institutions and the inherently political nature of policy making. More recent approaches acknowledge the importance of institutional and political factors, but make no attempt to incorporate their influence into new models of evidence translation. To address this issue, this article uses data from a comparative case study of bowel cancer screening policy in Australia, the United Kingdom and New Zealand, to propose alternative models of evidence incorporation which apply to all stages of the policy process.

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When good evidence is not enough: the role of context in bowel cancer screening policy in New Zealand

Cited by 6 publications

References 29 publications

Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review

Ethical issues with colorectal cancer screening—a systematic review

Incorporating evidence and politics in health policy: can institutionalising evidence review make a difference?

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