Models for organizational innovation give an idea of the dimensions that need to be considered to strengthen the integration of equity into organizations and to support the changes in practice that result from using the tool. They provide a reminder that a health equity tool cannot be the cornerstone of an organizational strategy to fight against SIH; rather, it must be incorporated as part of a systemic strategy of professional and organizational development.
— Read on academic.oup.com/heapro/advance-article-abstract/doi/10.1093/heapro/day047/5068642
A useful contribution, if perhaps self-evident. I don’t think many people arguing for the use of health equity decision support tools imagine their use alone will make the changes required to address inequities. Clearly related organisational and workforce development, resourcing, and leadership are all required as well.
Findings of research by Professor Lupton and colleagues with 66 participants:
No participants had yet found any benefit or use for My Health Record. It was viewed more as a repository for the use of healthcare professionals than for women’s own active use as contributors and users of their data.
Source: What do Australian women think of My Health Record? | This Sociological Life
We should therefore reject the myth that policy-making is purely technical, legal or scientific, and can be conducted in a vacuum. Most policy-making has to rely in some way on consultation with citizens to determine what public values should steer policy.
Source: Australia’s public servants: dedicated, highly trained … and elitist
Some interesting points in this US National Academies report:
Health literacy, cultural competence, and language access services are distinct but inextricably linked concepts for delivering equitable care to all members of the increasingly diverse population of the United States. These concepts are linked, but they developed via different paths, and each has its own unique focus with regard to enabling every individual to obtain the ability to process and understand basic health information and services needed to make appropriate health care decisions.
Source: A Proposed Framework for Integration of Quality Performance Measures for Health Literacy, Cultural Competence, and Language Access Services: Proceedings of a Workshop | The National Academies Press
A guide to monitoring and evaluating policy influence
A useful and, more importantly, comprehensible guide to aligning types evaluation activities with the anticipated mechanisms of policy influence:
- evidence and advice
- public campaigns and advocacy
- lobbying and negotiation.
There’s also some recognition of the messiness of attribution in the context of policy change, and that even policy actors themselves rarely fully appreciate the forces that determine and shape policy implementation.
This schema is worth revisiting in the context of the typology of HIA, i.e. mandated, decision support, advocacy, and community empowerment, because it may provide an alternate lens for understanding why HIAs gain traction or not.