Literature Review and Evidence-Based Interventions

Literature Review, Interventions, Systems Thinking, Health Policy and Programs

1. 1. Provide a clear brief description of literature search for evidenced-based interventions
   2. Databases (CINAHL, OVID etc.) you searched. search terms used and rationale for search and selection decisions
   3. Provide 4-5 evidence-based interventions that include screening, health promotion and disease management that you found in from your search.
   4. At least two interventions must operate at the non-individual level (e.g., family, community, system, or policy level).
   5. Outline systems thinking and the ethical principles that influence program and policy implementation and change.
   6. Describe the ethical responsibilities of all healthcare providers to ensure interventions and changes in policy improve healthcare outcomes without causing harm or increasing disparities due to unintended consequences
   7. Discuss how the healthcare system, healthcare policy and population-focused programs, impacts health equity both nationally and globally.
   8. Discuss how you will identify, engage, and collaborate with stakeholders to implement change

Literature Review and Evidence-Based Interventions:

1. Description of Literature Search: For this literature review, a comprehensive search was conducted in multiple databases including CINAHL, PubMed, and OVID. The search aimed to identify evidence-based interventions focusing on screening, health promotion, and disease management. Search terms included combinations of keywords such as “evidence-based interventions,” “health promotion,” “disease management,” “screening,” “public health,” “population health,” and “community health.” The rationale for selecting these databases was to ensure access to a wide range of healthcare literature spanning clinical, public health, and community-oriented perspectives.
2. Databases and Search Terms:
   • CINAHL: Searched using terms like “evidence-based interventions,” “health promotion,” “disease management,” “screening,” and various combinations thereof.
   • PubMed: Employed similar search terms as CINAHL, with a focus on retrieving peer-reviewed articles and systematic reviews.
   • OVID: Utilized for accessing a diverse range of healthcare literature, particularly focusing on health policy and program implementation.
3. Evidence-Based Interventions: a. Community-Based Diabetes Prevention Program: This intervention involves community health workers conducting screenings for diabetes risk factors in underserved neighborhoods, followed by targeted health education sessions on lifestyle modifications and access to healthy food options.

   b. School-Based Mental Health Promotion: Implemented within schools, this intervention integrates mental health screenings for students along with psychoeducation sessions on stress management and emotional well-being. Additionally, it provides resources for school counselors and teachers to support students’ mental health needs.

   c. Smoke-Free Workplace Policy: Operating at the policy level, this intervention involves the implementation of smoke-free workplace policies aimed at reducing exposure to secondhand smoke and promoting smoking cessation among employees. It includes provision for smoking cessation resources and support within the workplace.

   d. Healthy Cities Initiative: At the community level, this intervention involves collaboration between local government, healthcare providers, and community organizations to implement policies and programs promoting healthy lifestyles. This includes initiatives such as creating walkable neighborhoods, increasing access to parks and recreational facilities, and implementing nutritional guidelines in local schools and restaurants.

Systems Thinking and Ethical Principles: Systems thinking involves understanding the interconnectedness and complexity of various components within a healthcare system, recognizing that changes in one part of the system can have ripple effects across others. Ethical principles such as beneficence, non-maleficence, justice, and autonomy guide program and policy implementation and change. Beneficence requires interventions to promote the well-being of individuals and communities, while non-maleficence ensures that interventions do not cause harm. Justice demands equitable distribution of resources and access to healthcare services, and autonomy respects individuals’ right to make informed decisions about their health.

Ethical Responsibilities of Healthcare Providers: Healthcare providers have a duty to ensure that interventions and policy changes are implemented ethically, with careful consideration of potential unintended consequences. This includes conducting thorough assessments of potential risks and benefits, engaging stakeholders in decision-making processes, and monitoring outcomes to address disparities and minimize harm. Healthcare providers must also advocate for policies and programs that promote health equity and address underlying social determinants of health.

Impact of Healthcare Systems and Policies on Health Equity: Healthcare systems and policies play a significant role in shaping health equity both nationally and globally. Disparities in access to healthcare services, socioeconomic factors, and structural inequalities can contribute to inequities in health outcomes. Population-focused programs can help mitigate these disparities by targeting vulnerable populations, addressing social determinants of health, and promoting equitable access to healthcare services. However, systemic barriers such as limited resources, institutional discrimination, and inadequate healthcare infrastructure can hinder efforts to achieve health equity.

Stakeholder Engagement and Collaboration: Identifying, engaging, and collaborating with stakeholders is essential for implementing meaningful change in healthcare systems and policies. This includes involving diverse stakeholders such as healthcare providers, policymakers, community organizations, and affected populations in decision-making processes. Effective stakeholder engagement requires building trust, fostering open communication, and incorporating diverse perspectives into program planning and implementation. Collaboration across sectors and disciplines is crucial for addressing complex health challenges and promoting health equity on a local, national, and global scale.