Critical considerations for the practical utility of health equity tools: a concept mapping study.

BACKGROUND: Promoting health equity within health systems is a priority and challenge worldwide. Health equity tools have been identified as one strategy for integrating health equity considerations into health systems. Although there has been a proliferation of health equity tools, there has been limited attention to evaluating these tools for their practicality and thus their likelihood for uptake. METHODS: Within the context of a large program of research, the Equity Lens in Public Health (ELPH), we conducted a concept mapping study to identify key elements and themes related to public health leaders and practitioners' views about what makes a health equity tool practical and useful. Concept mapping is a participatory mixed-method approach to generating ideas and concepts to address a common concern. Participants brainstormed responses to the prompt "To be useful, a health equity tool should…" After participants sorted responses into groups based on similarity and rated them for importance and feasibility, the statements were analyzed using multidimensional scaling, then grouped using cluster analysis. Pattern matching graphs were constructed to illustrate the relationship between the importance and feasibility of statements, and go-zone maps were created to guide subsequent action. RESULTS: The process resulted in 67 unique statements that were grouped into six clusters: 1) Evaluation for Improvement; 2) User Friendliness; 3) Explicit Theoretical Background; 4) Templates and Tools 5) Equity Competencies; and 6) Nothing about Me without Me- Client Engaged. The result was a set of concepts and themes describing participants' views of the practicality and usefulness of health equity tools. CONCLUSIONS: These thematic clusters highlight the importance of user friendliness and having user guides, templates and resources to enhance use of equity tools. Furthermore, participants' indicated that practicality was not enough for a tool to be useful. In addition to practical characteristics of the tool, a useful tool is one that encourages and supports the development of practitioner competencies to engage in equity work including critical reflections on power and institutional culture as well as strategies for the involvement of community members impacted by health inequities in program planning and delivery. The results of this study will be used to inform the development of practical criteria to assess health equity tools for application in public health.

Three new species of agathotanaids (Tanaidacea: Paratanaoidea: Tanaidomorpha) from the lower bathyal zone off southwestern Java, Indonesia, Indian Ocean with notes on the global distribution and diversity of Agathotanaidae.

Three new species of agathotanaids belonging to the genera Agathotanais, Bunburia and Paranarthrura are described. The descriptions were based on material collected from southwestern Java, Indonesia, Indian Ocean during the research cruise SJADES in 2018. The specimens were obtained using a box corer from lower bathyal depths of 8362,355 m. These three genera are recorded from Southeast Asia for the first time.

Two new species of paratanaoid tanaidaceans of the family incertae sedis (Crustacea: Peracarida) from polymetallic nodule fields in the eastern Clarion-Clipperton Fracture Zone.

This study describes a new genus and two new species of Tanaidacea that were collected from the Singaporean exploratory area (OMS) of the polymetallic nodule fields in the eastern end of the Clarion-Clipperton Fracture Zone, Pacific Ocean. The descriptions are based on material collected during the research cruise ABYSSLINE II, which was conducted in the year 2015, covering abyssal depths of 4041-4227 m. These new species are paratanaoideans belonging to the genera Unispinosus n. gen. and Portaratrum Guerrero-Kommritz, 2003 of the family incertae sedis.

Xenosinelobus balanocolus, a new tanaidid genus and species (Crustacea: Peracarida: Tanaidacea) from barnacles on intertidal rocky shores and seawalls in the Singapore Strait.

This study describes a new genus and new species of Tanaidacea that was collected from inside the tests of dead Tetraclita barnacles in Singapore. Xenosinelobus n. gen. is most similar to Sinelobus but can be distinguished by the (1) unusually short antennal fifth article, (2) tooth-like lacinia mobilis on right mandible, (3) long terminal seta on epignath, (4) plumose inner seta near dactylus insertion on cheliped propodus, (5) spiniform seta on pereopod 1 coxa, (6) presence of setae on inner margins of pereopod 1 propodus and dactylus, (7) claw-like terminal articles on pereopods 2 and 3, (8) row of setulose and flattened denticulate setae along distal margin of pereopod 6 propodus, (9) dorsal seta on claws of pereopods 4-6, (10) complete row of dorso-transverse setae on pleonites 1 and 2, (11) one seta on pleopod basis outer margin, (12) two or three setae on pleopod endopod inner margin and (13) three-articled uropod with final article 1.6 times as long as preceding article. A new diagnosis and key to genera is provided for the subfamily Sinelobinae.

Supporting successful implementation of public health interventions: protocol for a realist synthesis.

BACKGROUND: There is a growing emphasis in public health on the importance of evidence-based interventions to improve population health and reduce health inequities. Equally important is the need for knowledge about how to implement these interventions successfully. Yet, a gap remains between the development of evidence-based public health interventions and their successful implementation. Conventional systematic reviews have been conducted on effective implementation in health care, but few in public health, so their relevance to public health is unclear. In most reviews, stringent inclusion criteria have excluded entire bodies of evidence that may be relevant for policy makers, program planners, and practitioners to understand implementation in the unique public health context. Realist synthesis is a theory-driven methodology that draws on diverse data from different study designs to explain how and why observed outcomes occur in different contexts and thus may be more appropriate for public health. METHODS: This paper presents a realist review protocol to answer the research question: Why are some public health interventions successfully implemented and others not? Based on a review of implementation theories and frameworks, we developed an initial program theory, adapted for public health from the Consolidated Framework for Implementation Research, to explain the implementation outcomes of public health interventions within particular contexts. This will guide us through the review process, which comprises eight iterative steps based on established realist review guidelines and quality standards. We aim to refine this initial theory into a 'final' realist program theory that explains important context-mechanism-outcome configurations in the successful implementation of public health interventions. DISCUSSION: Developing new public health interventions is costly and policy windows that support their implementation can be short lived. Ineffective implementation wastes scarce resources and is neither affordable nor sustainable. Public health interventions that are not implemented will not have their intended effects on improving population health and promoting health equity. This synthesis will provide evidence to support effective implementation of public health interventions taking into account the variable context of interventions. A series of knowledge translation products specific to the needs of knowledge users will be developed to provide implementation support. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015030052.