SUPPORT Tools for evidence-informed health Policymaking (STP) 4: Using research evidence to clarify a problem
SUPPORT Tools for evidence-informed health Policymaking (STP) 4: Using research evidence to clarify a problem
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DOI：
10.1186/1478-4505-7-s1-s4
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发表时间：
2009-12-16
影响因子：
4
通讯作者：
Fretheim, Atle
中科院分区：
文献类型：
--
作者：
Lavis, John N.;Wilson, Michael G.;Fretheim, Atle
政策制定者和支持他们的人经常发现自己所处的情况促使他们找出如何最好地定义问题。这些情况可能包括在立法机关被问到一个尴尬或具有挑战性的问题，也可能是在报纸头版上发现一个突出的问题。政策制定者想要澄清问题的动机是多种多样的。这些问题的范围可能从决定是否认真关注别人认为重要的特定问题，到想知道如何说服别人同意一个问题是重要的。关于如何定义问题的辩论和斗争是决策过程中至关重要的一部分。这些辩论和斗争的结果将影响决策者是否以及如何采取行动解决问题。通过对同时发生的事态发展的理解来澄清问题的努力更有可能产生行动。这些同时发生的事态发展可能涉及政策和方案选择（例如，发表一份报告，说明某一选择的有效性），也可能涉及政治事件（例如，任命一位个人对某一问题感兴趣的新卫生部长）。在这篇文章中，我们提出了一些问题，可以用来指导那些参与识别问题和描述其特征的人。这些建议是：有什么问题吗？2.这个问题是如何引起注意的，这个过程是否影响了解决这个问题的前景？3.可以使用或收集哪些指标来确定问题的严重程度和衡量解决问题的进展情况？4.可以进行哪些比较来确定问题的严重性和衡量解决问题的进展？5.如何以一种能激励不同群体的方式来构建（或描述）问题？
Policymakers and those supporting them often find themselves in situations that spur them on to work out how best to define a problem. These situations may range from being asked an awkward or challenging question in the legislature, through to finding a problem highlighted on the front page of a newspaper. The motivations for policymakers wanting to clarify a problem are diverse. These may range from deciding whether to pay serious attention to a particular problem that others claim is important, through to wondering how to convince others to agree that a problem is important. Debates and struggles over how to define a problem are a critically important part of the policymaking process. The outcome of these debates and struggles will influence whether and, in part, how policymakers take action to address a problem. Efforts at problem clarification that are informed by an appreciation of concurrent developments are more likely to generate actions. These concurrent developments can relate to policy and programme options (e.g. the publication of a report demonstrating the effectiveness of a particular option) or to political events (e.g. the appointment of a new Minister of Health with a personal interest in a particular issue). In this article, we suggest questions that can be used to guide those involved in identifying a problem and characterising its features. These are: I. What is the problem? 2. How did the problem come to attention and has this process influenced the prospect of it being addressed? 3. What indicators can be used, or collected, to establish the magnitude of the problem and to measure progress in addressing it? 4. What comparisons can be made to establish the magnitude of the problem and to measure progress in addressing it? 5. How can the problem be framed (or described) in a way that will motivate different groups?