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1. Improving health across sectors: Best practices for the implementation of health in all policies approaches

Author

Rachael Cain, Jacey A. Greece, Sandro Galea, Erin K. Knight, Allison Manco, Amar Parikh, and David K. Jones

Subjects
Health in All Policies, Cross-sector, Communications, Flexibility, Medicine
Abstract

Health is influenced by a broad range of factors beyond the typical remit of public health. It is therefore increasingly recognized that multiple sectors need to be engaged to improve population health. Health in All Policies (HiAP) is an approach to systematically consider health across policies and programs. This study assessed best practices and gaps in HiAP operationalization to inform practitioners aiming to incorporate HiAP in their work. We used Delaware as a model state to examine operationalization factors in a jurisdiction planning to implement HiAP.Methods included document review, key informant interviews, focus groups, and a questionnaire conducted in Delaware and virtually. Thematic analysis was used to analyze qualitative data to provide information on best practices and gaps in existing HiAP programs and context in Delaware. Descriptive statistics were used to examine collaboration in Delaware and to support or refute qualitative findings.We identified two gaps that can hinder HiAP implementation: 1) HiAP practitioners do not adequately use strategic communications to increase buy-in across sectors; 2) practitioners do not fully recognize the importance of being adaptable throughout HiAP implementation, which hinders sustainability. Qualitative findings from Delaware offer insight to these gaps and opportunities to address them.Refining the essential elements of HiAP to add: 1) strategic communications across sectors and 2) flexibility throughout HiAP implementation may point the way to more successful adoption of HiAP approaches across jurisdictions. This research demonstrated the importance of examining local perspectives on HiAP before implementation based on a jurisdiction’s context.

Published
2022
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2. Our Voices Matter: Using Lived Experience to Promote Equity in Problem Gambling Prevention

Author

Lorena Lama, Rachael Cain, Rebecca Bishop, Victor Ortiz, Scott W. Formica, and Haner Hernández

Subjects
medicine.medical_specialty, business.industry, Public health, Field (Bourdieu), media_common.quotation_subject, Lived experience, Equity (finance), 030508 substance abuse, Public relations, Social justice, Racism, Health equity, 03 medical and health sciences, Psychiatry and Mental health, Clinical Psychology, 0302 clinical medicine, Harm, medicine, 030212 general & internal medicine, 0305 other medical science, Psychology, business, media_common
Abstract

Purpose of Review The field of problem gambling has been historically disconnected from the community experience of gambling and people of color, leading to a lack of integration of those with lived experience into programming. The aim of this article is to describe community-centered efforts to prevent and mitigate harm from problem gambling in Massachusetts—including a pilot program, the Massachusetts Ambassador Project, which is grounded within public health and lived experience frameworks. Recent Findings To engage Massachusetts communities in problem gambling prevention, planning processes were conducted to develop culturally appropriate prevention strategies. One of the recurrent themes was the desire of men in the substance misuse recovery community to share their knowledge with others, specifically, men of color who experience racism and health disparities. This finding informed the development of the Ambassador Project, a novel, peer-based, community-centered, and culturally responsive approach for men of color who have a history of substance misuse to engage other men of color in problem gambling prevention. Two organizations pilot tested the project and reached 4388 individuals. The pilot led to several findings in the design and implementation of related projects. Lessons are shared in three categories: structure, support, and implementation. Summary This article demonstrates an innovative approach to connect the field of problem gambling prevention to the community experience, using a public health and social justice lens. Others in the field should acknowledge the disconnect between problem gambling and the lived experience of those disproportionately impacted by creating opportunities for community voice to be at the center of programming.

Published
2021

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