Identifying opportunities for upstream evaluations relevant to child and maternal health: a UK policy-mapping review.
Identifying opportunities for upstream evaluations relevant to child and maternal health: a UK policy-mapping review.
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DOI：
10.1136/archdischild-2022-325219
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发表时间：
2023-07
影响因子：
5.2
通讯作者：
Dundas, Ruth
中科院分区：
文献类型：
--
作者：
Stewart, Emma;Pearce, Anna;Given, Joanne;Gilbert, Ruth;Brophy, Sinead;Cookson, Richard;Hardelid, Pia;Harron, Katie L.;Leyland, Alastair;Wood, Rachael;Dundas, Ruth
采取干预措施，解决健康的社会决定因素，可以改善怀孕和幼儿期的结果，从而改善整个生命过程的健康状况。联合王国4个国家的政策在内容、时间和执行方面存在差异，因此可以进行评价。我们进行了政策映射审查（1981年至2021年），以确定相关的英国早年政策的健康框架的社会决定因素，并确定合适的候选人进行评估，使用行政数据。我们使用了英国和下放政府网站的开放关键字和类别搜索，并手动搜索政策评论。采用五个标准对政策进行评级和纳入：（1）政策影响孕产妇和儿童健康结果的潜力;（2）联合王国各地的执行差异;（3）人口覆盖范围和预期效应大小;（4）在行政数据中识别暴露/合格群体的能力;（5）影响健康不平等的潜力。一个专家共识研讨会确定了最后的入围名单。确定了336项政策和306项战略文件。由于标准2-4，保单主要被排除在外，剩下88份。协商一致的研讨会确定了三个政策领域，作为使用行政数据进行自然实验评估的合适候选人：怀孕赠款，早期教育和儿童保育，以及普遍信贷。我们的全面政策审查确定了评估社会结构对母亲和儿童结果影响的宝贵机会。然而，许多潜在的影响力政策被排除在外。这可能会导致逆证据定律，即被认为最有效的政策的证据最少。这可以通过更好地获取行政数据、分阶段实施未来政策或替代评估方法来改善。
Interventions to tackle the social determinants of health can improve outcomes during pregnancy and early childhood, leading to better health across the life course. Variation in content, timing and implementation of policies across the 4 UK nations allows for evaluation. We conducted a policy-mapping review (1981–2021) to identify relevant UK early years policies across the social determinants of health framework, and determine suitable candidates for evaluation using administrative data. We used open keyword and category searches of UK and devolved Government websites, and hand searched policy reviews. Policies were rated and included using five criteria: (1) Potential for policy to affect maternal and child health outcomes; (2) Implementation variation across the UK; (3) Population reach and expected effect size; (4) Ability to identify exposed/eligible group in administrative data; (5) Potential to affect health inequalities. An expert consensus workshop determined a final shortlist. 336 policies and 306 strategy documents were identified. Policies were mainly excluded due to criteria 2–4, leaving 88. The consensus workshop identified three policy areas as suitable candidates for natural experiment evaluation using administrative data: pregnancy grants, early years education and childcare, and Universal Credit. Our comprehensive policy review identifies valuable opportunities to evaluate sociostructural impacts on mother and child outcomes. However, many potentially impactful policies were excluded. This may lead to the inverse evidence law, where there is least evidence for policies believed to be most effective. This could be ameliorated by better access to administrative data, staged implementation of future policies or alternative evaluation methods.
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影响因子：
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作者：
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通讯作者：
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