Public health practitioners’ views of the ‘Making Every Contact Count’ initiative and standards for its evaluation

Chisholm, A. et al. Journal of Public Health, 2018: doi.org/10.1093/pubmed/fdy094

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Background
National Health Service England encourages staff to use everyday interactions with patients to discuss healthy lifestyle changes as part of the ‘Making Every Contact Count’ (MECC) approach. Although healthcare, government and public health organisations are now expected to adopt this approach, evidence is lacking about how MECC is currently implemented in practice. This study explored the views and experiences of those involved in designing, delivering and evaluating MECC.

Methods
We conducted a qualitative study using semi-structured interviews with 13 public health practitioners with a range of roles in implementing MECC across England. Interviews were conducted via telephone, transcribed verbatim and analysed using an inductive thematic approach.

Results
Four key themes emerged identifying factors accounting for variations in MECC implementation: (i) ‘design, quality and breadth of training’, (ii) ‘outcomes attended to and measured’, (iii) ‘engagement levels of trainees and trainers’ and (iv) ‘system-level influences’.

Conclusions
MECC is considered a valuable public health approach but because organisations interpret MECC differently, staff training varies in nature. Practitioners believe that implementation can be improved, and an evidence-base underpinning MECC developed, by sharing experiences more widely, introducing standardization to staff training and finding better methods for assessing meaningful outcomes.

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Childhood obesity: time for action

By House of Commons Health Committee (2018)

The government is expected to publish shortly a refreshed version of the childhood obesity plan first published in summer 2016. This report calls for an effective childhood obesity plan with a joined-up, whole systems approach and one that focuses particularly on tackling the ever-widening health inequality due to childhood obesity between the richest and poorest area.

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Essential Practice for Infection Prevention and Control Guidance for nursing staff

By Royal College of Nursing (2017)

This publication provides important information and guidance on the essential principles of infection prevention and control and highlights why other issues, such as nutrition and hydration, should be viewed as an essential complementary component of nursing practice. This guidance is not intended as an in-depth reference document, but instead provides an overview of the core elements and rationale for infection prevention practice and associated
activities. It is applicable to all nurses, midwives and health care assistants, regardless of their practice setting.

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Health economics: a guide for public health teams

By Public Health England (2018)

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Resources to help local commissioners achieve value for money by estimating the return on investment (ROI) and cost-effectiveness of public health programmes. There are various resources including:

The cost-effectiveness of specific topic areas

PHE’s Health Economics team has produced a number of resources which can be used to estimate the value of investing in prevention and early diagnosis in your area. They pull together the best available evidence on costs, savings, and health benefits for specific topic areas in a single place, thus simplifying the process of commissioning cost-effective services.

The interactive tools produced by PHE are:

Public Health Consequences of E-Cigarettes

By National Academies of Sciences, Engineering, and Medicine et al. (2018)

Millions of Americans use e-cigarettes. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults. Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes.

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Economic evaluations of system‐based obesity interventions – the case for a new approach

Sonntag. D.  et al. Obesity Reviews, 2018; 19(5)

System‐based interventions are of increasing interest as they seek to modify environments (e.g. socio‐cultural system, transport system or policy system) that promote development of conditions such as obesity and its related risk factors. In our commentary, we draw attention to features of the system‐based approach that may explain the relative absence of economic evaluations of the cost‐effectiveness of these interventions, needed to guide decision‐making on which to deploy. We present and discuss potentially applicable methods and alternative approaches based on our experiences in two major system‐based interventions currently underway (in Melbourne, Australia and Gaggenau, Germany) that begin to fill this gap. We feel the issues and potential solutions outlined in this commentary are important for a broad range of stakeholders (e.g. clinicians, interventionalists, policy makers) to consider as they seek to address the issue of obesity.

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The Prioritisation Framework: making the most of your budget

By Public Health England (2018)

Local public health teams are facing increasingly complex and challenging decisions over what services to invest in and disinvest from. The Prioritisation Framework is designed to help local authorities conduct a systematic prioritisation exercise, by greatly reducing the burden and complexity of the task.

The approach is based on Multi Criteria Decision Analysis, a recognised decision support technique which has been successfully used in a variety of contexts.

Throughout the tool, users are provided with extensive guidance and links to other relevant resources. A supporting materials pack is available from the PHE Health Economics team at healtheconomics@phe.gov.uk.

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