Challenges for prevention research

Challenges for prevention research The European Journal of Public Health, Vol. 28, No. 1, 1 The Author 2018. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. doi:10.1093/eurpub/ckx117 ......................................................................................................... Editorials ......................................................................................................... Franc¸ois Alla School of Public Health, Universite de Lorraine, Nancy, France Correspondence: Franc¸ois Alla, Tel: +33 (0)383852163 e-mail: Francois.alla@univ-lorraine.fr ......................................................................................................... ost of the burden of disease is linked to factors accessible to (3) Third challenge: transmit Public health research has a cognitive objective, i.e. research, but M prevention. On this subject, in many European countries, also an interventional objective. Public health research therefore there is a contrast between the quality of health systems and the only makes any sense when it integrates the concerns of weakness of prevention policies. For example, the WHO European decision-makers and practitioners and when it is comprises, Region has the highest rates of alcohol consumption and tobacco right from the design step, a dynamic of transfer to practice smoking in the world. It is thus satisfactory to observe that a and decision-making. This integration must be thought out political awareness of this issue is emerging in Europe. In France, and encouraged. It is composed of interactions between practi- for example, the new President and the Minister of Health have tioners and researchers. These interactions arise from interfaces announced prevention as a priority of the new health policy. organized in the two environments—research and decision- However, prevention challenges are also research challenges: Why making/practice—and are essential to integration of these two is smoking not declining in the most underprivileged populations? environments, which have a natural tendency to remain distinct. Why are population so suspicious about vaccination? Why is the use Because this knowledge transfer is a complex process, it also of organized screening programmes declining? What urban policies constitutes a research challenge: what determines whether or can promote physical activity among seniors? What are the most not practitioners and decision-makers use the knowledge effective interventions in the fight against overweight and obesity derived from research? Under what conditions is this transfer possible? To achieve what changes in policies and practices? in adolescents? What is the return on investment of nicotine replace- ment therapy? To what extent could smart objects and e-health ap- plications constitute prevention tools? Answers to these examples of To address these three challenges, we need to have real prevention research questions could help to improve the efficacy and efficiency research strategies integrated into health policies. In this way, in of prevention policies. Prevention research therefore needs to be France for example, the creation of a national public health reinforced to addressing three main challenges: research programme, with multi-annual funding, is currently proposed to implement the national ambition to invest in health (1) First challenge: explain prevention, to improve the efficacy and efficiency of the health This first challenge consists of identifying and understanding the system and to reduce health inequalities. It is essential that this complex causal chains, the dynamics during life, the interactions strategy be built from an international perspective and as part of between individual biological and behavioural, environmental an international partnership. and social factors, and the biological mechanisms by which exposures result in pathological phenomena. In particular— Conflicts of interest: None declared. beyond just a simple description—we need to explain the patho- genesis of social inequalities in health. This understanding will References be based on interdisciplinary interactions associating biological sciences and population sciences—medical science and human 1 GBD 2013 Risk Factors Collaborators. Global, regional, and national comparative and social sciences. risk assessment of 79 behavioural, environmental and occupational, and metabolic (2) Second challenge: act risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the In addition to a better understanding of the determinants of Global Burden of Disease Study 2013. Lancet 2015;386:2287–323. health, the second challenge consists of developing and 2 The European health report 2015. Targets and Beyond—Reaching New Frontiers in evaluating innovative interventions designed to modify the Evidence. Copenhagen: WHO Regional Office for Europe; 2015. Available at: http:// current situation. In a perspective of scaling-up and transfer- www.euro.who.int/en/data-andevidence/european-health-report2015 (22 July 2017, ability, intervention research must be contextualized, as the date last accessed). results are dependent on both the intervention and the socio- 3 Rutter H, Savona N, Glonti K, et al. The need for a complex systems model of cultural and organizational context with which it interacts. In evidence for public health. Lancet 2017;17:31267–9. other words, this research must consider the intervention not as an external contribution to the environment, but as an evolving 4 Langer L, Tripney J, Gough D. The Science of Using Science: Researching the Use system that transforms the environment in which it is of Research Evidence in Decision-Making. London?: EPPI-Centre, Social Science conducted. Research Unit, UCL Institute of Education, University College London, 2016. Downloaded from https://academic.oup.com/eurpub/article-abstract/28/1/1/4811963 by Ed 'DeepDyve' Gillespie user on 16 March 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The European Journal of Public Health Oxford University Press

Challenges for prevention research

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Oxford University Press
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© The Author 2018. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
ISSN
1101-1262
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1464-360X
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10.1093/eurpub/ckx117
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Abstract

The European Journal of Public Health, Vol. 28, No. 1, 1 The Author 2018. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. doi:10.1093/eurpub/ckx117 ......................................................................................................... Editorials ......................................................................................................... Franc¸ois Alla School of Public Health, Universite de Lorraine, Nancy, France Correspondence: Franc¸ois Alla, Tel: +33 (0)383852163 e-mail: Francois.alla@univ-lorraine.fr ......................................................................................................... ost of the burden of disease is linked to factors accessible to (3) Third challenge: transmit Public health research has a cognitive objective, i.e. research, but M prevention. On this subject, in many European countries, also an interventional objective. Public health research therefore there is a contrast between the quality of health systems and the only makes any sense when it integrates the concerns of weakness of prevention policies. For example, the WHO European decision-makers and practitioners and when it is comprises, Region has the highest rates of alcohol consumption and tobacco right from the design step, a dynamic of transfer to practice smoking in the world. It is thus satisfactory to observe that a and decision-making. This integration must be thought out political awareness of this issue is emerging in Europe. In France, and encouraged. It is composed of interactions between practi- for example, the new President and the Minister of Health have tioners and researchers. These interactions arise from interfaces announced prevention as a priority of the new health policy. organized in the two environments—research and decision- However, prevention challenges are also research challenges: Why making/practice—and are essential to integration of these two is smoking not declining in the most underprivileged populations? environments, which have a natural tendency to remain distinct. Why are population so suspicious about vaccination? Why is the use Because this knowledge transfer is a complex process, it also of organized screening programmes declining? What urban policies constitutes a research challenge: what determines whether or can promote physical activity among seniors? What are the most not practitioners and decision-makers use the knowledge effective interventions in the fight against overweight and obesity derived from research? Under what conditions is this transfer possible? To achieve what changes in policies and practices? in adolescents? What is the return on investment of nicotine replace- ment therapy? To what extent could smart objects and e-health ap- plications constitute prevention tools? Answers to these examples of To address these three challenges, we need to have real prevention research questions could help to improve the efficacy and efficiency research strategies integrated into health policies. In this way, in of prevention policies. Prevention research therefore needs to be France for example, the creation of a national public health reinforced to addressing three main challenges: research programme, with multi-annual funding, is currently proposed to implement the national ambition to invest in health (1) First challenge: explain prevention, to improve the efficacy and efficiency of the health This first challenge consists of identifying and understanding the system and to reduce health inequalities. It is essential that this complex causal chains, the dynamics during life, the interactions strategy be built from an international perspective and as part of between individual biological and behavioural, environmental an international partnership. and social factors, and the biological mechanisms by which exposures result in pathological phenomena. In particular— Conflicts of interest: None declared. beyond just a simple description—we need to explain the patho- genesis of social inequalities in health. This understanding will References be based on interdisciplinary interactions associating biological sciences and population sciences—medical science and human 1 GBD 2013 Risk Factors Collaborators. Global, regional, and national comparative and social sciences. risk assessment of 79 behavioural, environmental and occupational, and metabolic (2) Second challenge: act risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the In addition to a better understanding of the determinants of Global Burden of Disease Study 2013. Lancet 2015;386:2287–323. health, the second challenge consists of developing and 2 The European health report 2015. Targets and Beyond—Reaching New Frontiers in evaluating innovative interventions designed to modify the Evidence. Copenhagen: WHO Regional Office for Europe; 2015. Available at: http:// current situation. In a perspective of scaling-up and transfer- www.euro.who.int/en/data-andevidence/european-health-report2015 (22 July 2017, ability, intervention research must be contextualized, as the date last accessed). results are dependent on both the intervention and the socio- 3 Rutter H, Savona N, Glonti K, et al. The need for a complex systems model of cultural and organizational context with which it interacts. In evidence for public health. Lancet 2017;17:31267–9. other words, this research must consider the intervention not as an external contribution to the environment, but as an evolving 4 Langer L, Tripney J, Gough D. The Science of Using Science: Researching the Use system that transforms the environment in which it is of Research Evidence in Decision-Making. London?: EPPI-Centre, Social Science conducted. Research Unit, UCL Institute of Education, University College London, 2016. Downloaded from https://academic.oup.com/eurpub/article-abstract/28/1/1/4811963 by Ed 'DeepDyve' Gillespie user on 16 March 2018

Journal

The European Journal of Public HealthOxford University Press

Published: Feb 1, 2018

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