Senter for helsefremmende forskning HiST/NTNU. EUROPEISKA UNIONEN Europeiska regionala utvecklingsfonden En investering för framtiden

Transcription

1 EUROPEISKA UNIONEN

2 Göran Hallman PODD-RA Project manager Head of Public Health Policy Regional Council of Jämtlands län Sweden

3 PODD-RA What on earth is that?? HUNT the survey we refer to WP1 Policy Labs WP2 Finding out WP3 Is it worth it WP5 Whats next? Summing up! Q:s??? EUROPEISKA UNIONEN

4 EUROPEISKA UNIONEN

5 WHY??

6 Politically initiated and supported Bridging gap between evidence and the political process of taking action on health Focus on providing tools for efficient policymaking Mapping the political reasoning process Measuring effects on decisions made by re-using research data Return on investment in health costs when no action is taken What s next due to the Scandinavian context - FP8

7 The HUNT Study

8 Nord-Trøndelag County ~ 135,000 citizens

9 % % %

10 Health data from 120,000 individuals

11 Measuring health EUROPEISKA UNIONEN

12 HUNT 1 HUNT 2 HUNT Key: The 11-digit personal identification number

13 Medial Birth Reg. HUNT 1 HUNT 2 HUNT 3 REGISTRIES Key: The 11-digit personal identification number Cause of death Cancer Family register Drug prescriptions Stroke Myocardial infarction Venous trombosis Dementia Multiple sclerosis Bipolar Scizofrenia

14 TRUST

15 WP 1 Policy-Labs Need of understanding HOW the political reasoning process/dialogue is taking place when the prioritysetting discussions happends Qualitative methodology (interviews) Grounded theory

16 Preliminary understanding First reflection over. Political decision impact it does have Complete knowledge we already know what the main challenges are give us the tools Cognitive therapeuthic situation

17 From the Atlantic coast to the eastern border of Finland the North Karelia Center for Public Health Building on established PH Centers in all three countries national and regional

18 A pilot study (WP 2) Evidence-based public health Advancing public health practice at local and regional level through public health surveillance

19 Key question: How can politicians and stakeholders get more knowledge about population health and determinants on a local/regional level?

20 The pilot project The creation of a minimum data set (MDS, 29) for a number of health related domains: Socio-demographics, self-reported health and morbidity, health related behaviour, QoL, participation in society (29 questions in total) Collection of individual level data by means of telephone interviews Checking the validity of data by comparing with the questionnaire-based HUNT3 study Dissemination

21 EUROPEISKA UNIONEN Study area (3 regions) Norway: Nord-Trøndelag (pop ) Sør-Trøndelag (pop ) Sweden: Jämtland (pop )

22 Sampled municipalities EUROPEISKA UNIONEN Norway (N=5) Sweden (N=3) Leka Vikna Nærøyy NamsskoganRøyrvik Høylandet Fosnes Namsos Grong Flatanger Overhalla Lierne OsenNamdalseid Roan Snåsa Strømsund Respondents Norway: Sweden: 1000 ÅfjordVerran Steinkjer Bjugn Frøya Inderøy Ørland Verdal RissaLeksvik Levanger Hitra Frosta Agdenes Snillfjord Stjørdal Trondheim Meråker Hemne Malvik OrkdalSkaunKlæbu Selbu Melhus Meldal Tydal Midtre Gauldal Rennebu Holtålen Oppdal Røros Åre Berg Krokom Østersund Ragunda Bräcke Ånge Härjedalen Örnsköldsvik Sollefteå Kramfors Härnösand Timrå Sundsvall Nordanstig Participation 24% Collected 2013 Ljusdal Kartforklaring Kommuner i Sør-Trøndelag, Nord-Trøndelag og Jämtland Pilotkommuner i Sør-Trøndelag, Nord-Trøndelag og Jämtland Hudiksvall

23 Validity of data collected in telephone interviews Leka Comparison with the HUNT3 study ( ) 2 selected municipalities (N=600) 26 identical questions Vikna Nærøyy NamsskoganRøyrvik Høylandet Fosnes Namsos Grong Flatanger Overhalla Lierne OsenNamdalseid Roan Snåsa Strømsund ÅfjordVerran Steinkjer Bjugn Frøya Inderøy Ørland Verdal Rissa Krokom Leksvik Levanger Hitra Frosta Agdenes Snillfjord Stjørdal Trondheim Meråker Hemne Malvik Åre OrkdalSkaunKlæbu Selbu Østersund Melhus Ragunda Meldal Tydal Midtre Gauldal Rennebu Holtålen Berg Bräcke Oppdal Røros Ånge Härjedalen Ljusdal Kartforklaring Kommuner i Sør-Trøndelag, Nord-Trøndelag og Jämtland Pilotkommuner i Sør-Trøndelag, Nord-Trøndelag og Jämtland Örnsköldsvik Sollefteå Kramfors Härnösand Timrå Sundsvall Nordanstig Hudiksvall

24 Descriptive results (municipality A)

25 Preliminary findings and future development In general the telephone interviews seems to be valid Some of the questions were significantly different between HUNT 3 and telephone interviews Different data collection modes (mode effects)? Questionnaires vs telephone interviews Temporal changes? HUNT 3 ( ) Telephone interviews in 2013 Indications of selection bias (education) Future analyses: propensity score matching Scientific article in preparation (open access article)

26 WP 3 Quantification of intervention impacts

27 No. Efficiency of Interventions? Example Obesity Systematic Review (excerpt) EUROPEISKA UNIONEN Intervention 7 DIMDI Systematic Literature Review: 1649 abstracts Outcome / Comments General Observations No / unsharp success criteria, few details of programs No or little impact Only 29 did meet the quality criteria: -> 10 primary RCTs (with 7 interventions) + 19 reviews selected: ( Failed Policy? Interventions = waste of money?

28 Environment - Physical Activity EUROPEISKA UNIONEN [5] [4]

29 Environment - Food EUROPEISKA UNIONEN Source: Download oz = 1,24 l 7 oz = 0,2 l (1 oz = 0,0295 l)

30 Mean Sedentary Leisure Hours per day, Data: HUNT3 EUROPEISKA UNIONEN

31 Individual Health Individual Responsibility?

32 Policy Right! Health Plan Right! Still Many Points to Fail Health Policy Health Plan Intervention Communication Measurement Implementation Outcomes Health Compliance

33 Example Obesity: EUROPEISKA UNIONEN BMI = f(t, x1, x2, xn), regional focus, HUNT-data Epidemiological Data Predictions HUNT 1 HUNT 2 HUNT BMI = f(t, x 1, x 2, x n ) 25,2 26,35 27,2

34 30,0 28,0 Projection Percentage of population BMI 30+ % of Population, Region of Trønderlag EUROPEISKA UNIONEN Male SC0, SC1 0% Compliance) 26,0 24,0 22,0 20,0 Female SC0, SC1 0% Compliance) Female SC2 Female SC1 (100% compliance) 18,0 16,0 14,0 12,0 Scenario 0: Baseline, Doing Nothing Scenario 1: 50% of work-time use of a high desk at work Scenario 2: - 16% Media time Male SC2 Male SC1 (100% compliance)

35 No. Efficiency of Interventions? Example Obesity Systematic Review (excerpt) EUROPEISKA UNIONEN Intervention 7 DIMDI Systematic Literature Review: 1649 abstracts Only 29 did meet the quality criteria: -> 10 primary RCTs (with 7 interventions) + 19 reviews selected: ( Outcome / Comments General Observations No / unsharp success criteria, few details of programs No or little impact {Froschl:2009fx} Failed Policy? Interventions = waste of money? No, and Yes

36 Summing up The PODD-RA project will be finalised in August 2014 The result shows that: Politicly driven request to analyse better ways of using research (evidence) based results in the decision processes. Tools to meausure effects of made decisions (yearly) Tools to analyse and meausure health economical investments Is right now focusing on our application to the Horizon 2020 programme 4Phact

37 Thank you from the PODD-RA project We are now ready for your questions!