Subject(s)
COVID-19 , Masks , Humans , COVID-19/prevention & control , COVID-19/transmission , SARS-CoV-2ABSTRACT
OBJECTIVE: To evaluate the personal protective effects of wearing versus not wearing surgical face masks in public spaces on self-reported respiratory symptoms over a 14 day period. DESIGN: Pragmatic randomised superiority trial. SETTING: Norway. PARTICIPANTS: 4647 adults aged ≥18 years: 2371 were assigned to the intervention arm and 2276 to the control arm. INTERVENTIONS: Participants in the intervention arm were assigned to wear a surgical face mask in public spaces (eg, shopping centres, streets, public transport) over a 14 day period (mask wearing at home or work was not mentioned). Participants in the control arm were assigned to not wear a surgical face mask in public places. MAIN OUTCOME MEASURES: The primary outcome was self-reported respiratory symptoms consistent with a respiratory infection. Secondary outcomes included self-reported and registered covid-19 infection. RESULTS: Between 10 February 2023 and 27 April 2023, 4647 participants were randomised of whom 4575 (2788 women (60.9%); mean age 51.0 (standard deviation 15.0) years) were included in the intention-to-treat analysis: 2313 (50.6%) in the intervention arm and 2262 (49.4%) in the control arm. 163 events (8.9%) of self-reported symptoms consistent with respiratory infection were reported in the intervention arm and 239 (12.2%) in the control arm. The marginal odds ratio was 0.71 (95% confidence interval (CI) 0.58 to 0.87; P=0.001) favouring the face mask intervention. The absolute risk difference was -3.2% (95% CI -5.2% to -1.3%; P<0.001). No statistically significant effect was found on self- reported (marginal odds ratio 1.07, 95% CI 0.58 to 1.98; P=0.82) or registered covid-19 infection (effect estimate and 95% CI not estimable owing to lack of events in the intervention arm). CONCLUSION: Wearing a surgical face mask in public spaces over 14 days reduces the risk of self-reported symptoms consistent with a respiratory infection, compared with not wearing a surgical face mask. TRIAL REGISTRATION: ClinicalTrials.gov NCT05690516.
Subject(s)
COVID-19 , Masks , SARS-CoV-2 , Self Report , Humans , Female , Male , COVID-19/prevention & control , COVID-19/epidemiology , Middle Aged , Norway/epidemiology , Adult , Respiratory Tract Infections/prevention & control , Aged , Pandemics/prevention & control , Coronavirus Infections/prevention & control , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Pneumonia, Viral/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , BetacoronavirusABSTRACT
Material perteneciente a las Herramientas SUPPORT para la toma de decisiones en políticas de salud informada por la evidencia, Lavis JN, Wilson M, Oxman AD, Lewin S, Fretheim A: SUPPORT Tools for evidence-informed health Policymaking (STP). 4. Using research evidence to clarify a problem. Health Research Policy and Systems; 2009, 7(Suppl 1):S4 doi:10.1186/1478-4505-7-S1-S4. http://www.health-policy-systems.com/content/pdf/1478-4505-7-S1-s4.pdf. Este artículo fue traducido al español por el Centro Rosarino de Estudios Perinatales (CREP) con el apoyo de Canadian Health Services Research Foundation (CHSRF) www.chsrf.ca, Centro Rosarino de Estudios Perinatales (CREP) www.crep.org.ar, y Organización Panamericana de la Salud (OPS) (www.paho.org/researchportal).
Subject(s)
Problem Solving , Social Problems , Delivery of Health Care , Decision Support TechniquesABSTRACT
Les dialogues sur les politiques permettent dexaminer les données de recherche parallèlement aux perspectives, aux expériences et aux connaissances tacites des personnes qui participent à la prise de décisions relatives à une question hautement prioritaire, ou qui sont touchées par de telles décisions. Plusieurs facteurs contribuent à lintérêt croissant pour lutilisation des dialogues sur les politiques: 1. la reconnaissance du besoin daide à la décision adaptée au contexte local pour les responsables de politiques et les autres parties intéressées; 2. la reconnaissance du fait que les données de recherche ne constituent quun élément des processus décisionnels adoptés par les responsables de politiques et les autres parties intéressées.
Subject(s)
Humans , Health Systems/organization & administration , Health Research Plans and Programs , Policy MakingABSTRACT
This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers have limited resources for developing ? or supporting the development of ? evidence-informed policies and programmes. These required resources include staff time, staff infrastructural needs (such as access to a librarian or journal article purchasing), and ongoing professional development. They may therefore prefer instead to contract out such work to independent units with more suitably skilled staff and appropriate infrastructure. However, policymakers may only have limited financial resources to do so. Regardless of whether the support for evidence-informed policymaking is provided in-house or contracted out, or whether it is centralised or decentralised, resources always need to be used wisely in order to maximise their impact.
Subject(s)
Humans , Personnel Management/economics , Healthcare Financing , Evidence-Informed Policy , Health Workforce/economicsABSTRACT
This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers and those supporting them often find themselves in situations that spur them on to work out how best to define a problem. These situations may range from being asked an awkward or challenging question in the legislature, through to finding a problem highlighted on the front page of a newspaper. The motivations for policymakers wanting to clarify a problem are diverse. These may range from deciding whether to pay serious attention to a particular problem that others claim is important, through to wondering how to convince others to agree that a problem is important. Debates and struggles over how to define a problem are a critically important part of the policymaking process.
Subject(s)
Humans , Evidence-Informed Policy , Health Priorities , Diagnosis of Health SituationABSTRACT
This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Policymakers and those supporting them may find themselves in one or more of the following three situations that will require them to characterise the costs and consequences of options to address a problem. These are: 1. A decision has already been taken and their role is to maximise the benefits of an option, minimise its harms, optimise the impacts achieved for the money spent, and (if there is substantial uncertainty about the likely costs and consequences of the option) to design a monitoring and evaluation plan, 2. A policymaking process is already underway and their role is to assess the options presented to them, or 3.
Subject(s)
Humans , Decision Making , Evidence-Informed Policy , Policy MakingABSTRACT
This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. After a policy decision has been made, the next key challenge is transforming this stated policy position into practical actions. What strategies, for instance, are available to facilitate effective implementation, and what is known about the effectiveness of such strategies? We suggest five questions that can be considered by policymakers when implementing a health policy or programme.
Subject(s)
Humans , Health Systems/organization & administration , Health Plan Implementation , Policy Making , Evidence-Informed PolicyABSTRACT
This article is part of a series written for people responsible for making decisions about health policies and programmes and for those who support these decision makers. Systematic reviews are increasingly seen as a key source of information in policymaking, particularly in terms of assisting with descriptions of the impacts of options. Relative to single studies they offer a number of advantages related to understanding impacts and are also seen as a key source of information for clarifying problems and providing complementary perspectives on options. Systematic reviews can be undertaken to place problems in comparative perspective and to describe the likely harms of an option. They also assist with understanding the meanings that individuals or groups attach to a problem, how and why options work, and stakeholder views and experiences related to particular options. A number of constraints have hindered the wider use of systematic reviews in policymaking.
Subject(s)
Humans , Policy Making , Health Systems/organization & administration , Health Programs and Plans/organization & administration , Health Research Plans and ProgramsABSTRACT
En este artículo abordamos el uso de la evidencia para aportar información sobre el balance entre los pros y los contras de las opciones de políticas y programas. Sugerimos cinco preguntas que pueden tenerse en cuenta cuando se emiten estas opiniones. Éstas son: 1. ¿Cuáles son las opciones que están siendo comparadas? 2. ¿Cuáles son los resultados potenciales más importantes de las opciones que están siendo comparadas? 3. ¿Cuál es la mejor estimación del impacto de las opciones que están siendo comparadas para cada resultado importante? 4. ¿Cuánta confianza en los impactos estimados pueden tener los responsables de la toma de decisiones en políticas y otras personas? 5. ¿Es posible que un modelo económico formal facilite la toma de decisiones?
Subject(s)
Humans , Policy Making , Diagnosis of Health SituationABSTRACT
Neste artigo, trataremos do problema de tomar de decisões em situações nas quais há evidências insuficientes disponíveis. Geralmente, os formuladores de políticas têm poucas evidências para realmente conhecer os impactos futuros de uma opção de política ou programa de saúde mas devem, ainda assim, tomar decisões. Sugerimos quatro questões a serem consideradas quando não houver evidências suficientes para ter certeza dos impactos da implementação de uma opção. Estas são: 1. Existe uma revisão sistemática dos impactos da opção? 2. A evidência inconclusiva foi mal interpretada como evidência sem efeito? 3. E possível ter certeza de uma decisão mesmo com a falta de evidências? 4. A opção é potencialmente prejudicial, ineficiente ou não compensa o custo?
Subject(s)
Humans , Policy Making , Health Research Plans and Programs , Health PolicyABSTRACT
Neste artigo, abordamos o uso de evidências para informar julgamentos sobre a avaliação dos prós e contras das opções de políticas e programas. Sugerimos cinco questões que podem ser consideradas ao fazer estes julgamentos. Estas são: 1. Que opções estão sendo comparadas? 2. Quais são os resultados potenciais mais importantes das opções sendo comparadas? 3. Qual é a melhor estimativa de impacto das opções sendo comparadas para cada resultado importante? 4. Qual o grau de confiabilidade dos formuladores de políticas e de outros nos impactos estimados? 5. É um modelo econômico formal susceptível de facilitar processos de tomada de decisões?
Subject(s)
Humans , Policy Making , Evidence-Informed Policy , Impacts of Polution on HealthABSTRACT
Dans le présent article, nous examinons la prise de décisions dans un contexte où les données probantes sont insuffisantes. En pareille situation, les responsables de politiques sont souvent incapables de prévoir avec certitude les répercussions dune proposition de politique ou de programme de santé, mais ils doivent tout de même prendre des décisions. Nous proposons quatre questions à envisager lorsque la rareté des données probantes ne permet pas de sassurer des répercussions de la mise en oeuvre dune proposition : 1. Une étude méthodique des impacts de la proposition a-t-elle été menée? 2. Sest-on fondé sur des données probantes réfutables pour conclure à labsence de répercussions 3. Est-il possible dêtre convaincu du bien-fondé dune décision malgré le manque de données probantes.
Subject(s)
Humans , Health Research Plans and Programs , Health Systems Plans/organization & administration , Impacts of Polution on Health , Health PolicyABSTRACT
En este artículo abordamos el tema de la toma de decisiones en situaciones donde no se cuenta con suficiente evidencia disponible. Los responsables de la toma de decisiones en políticas a menudo no tienen suficiente evidencia para saber con certeza cuáles serán los impactos de una opción de programa o política de salud pero deben, igualmente, tomar decisiones. Sugerimos cuatro preguntas que pueden tenerse en cuenta cuando no hay suficiente evidencia en la que tener confianza sobre los impactos de implementar una opción. Éstas son: 1. ¿Existe una revisión sistemática de los impactos de la opción? 2. ¿La evidencia no concluyente ha sido mal interpretada como evidencia de no efecto? 3. ¿Es posible tener confianza sobre una decisión a pesar de la falta de evidencia? 4. ¿La opción es potencialmente perjudicial, inefectiva o no vale el costo?
Subject(s)
Humans , Policy Making , Health Policy , Indicators (Statistics) , Public Health SystemsABSTRACT
Le terme surveillance sert généralement à décrire le processus qui consiste à recueillir des données de façon systématique pour que les responsables de politiques, les gestionnaires et dautres parties intéressées puissent sassurer quune nouvelle politique ou un nouveau programme est mis en oeuvre conformément à leurs attentes. La surveillance repose sur des indicateurs qui permettent de juger, par exemple, si lon a atteint les objectifs ou si les fonds alloués sont dépensés comme il se doit. Les termes évaluation et surveillance sont parfois utilisés de façon interchangeable, mais le premier est habituellement signe dune plus grande préoccupation datteindre des résultats.
Subject(s)
Humans , Data Collection/methods , Cost Allocation/economics , Health Research Plans and ProgramsABSTRACT
El término monitoreo se utiliza normalmente para describir el proceso por el cual se recolectan de manera sistemática datos para informar a responsables de la toma de decisiones en políticas, gestores y otras partes interesadas (stakeholders) si una nueva política o programa se está implementando según sus expectativas. Se utilizan indicadores con fines de monitoreo para juzgar, por ejemplo, si se están cumpliendo los objetivos o si se están administrando adecuadamente los fondos asignados. Algunas veces, los términos monitoreo y evaluación se utilizan indistintamente pero, por lo general, el segundo sugiere un enfoque más sólido en el logro de los resultados.
Subject(s)
Humans , Health Research Plans and Programs , Health Information Exchange , Evidence-Informed Policy , Policy MakingABSTRACT
Dans le présent article, nous abordons des stratégies destinées à informer le public et à susciter sa participation à l´élaboration et à la mise en´uvre de politiques. L´importance de l´engagement du public (tant les patients que les citoyens) à tous les niveaux des systèmes de santé est largement reconnue. Au bout du compte, ce sont eux qui subissent les conséquences souhaitables et indésirables des politiques publiques et nombre de gouvernements et dorganismes reconnaissent limportance de les faire participer à lélaboration de politiques éclairées par les données probantes. Cette approche comporte plusieurs avantages potentiels, notamment l´adoption de politiques qui tiennent compte de leurs idées et de leurs préoccupations ainsi que lamélioration de la mis.
Subject(s)
Humans , Policy Making , Health Systems/organization & administration , Health Research Plans and ProgramsABSTRACT
Cette série d´articles a été préparée dans le cadre du projet SUPPORT, parrainé par le programme INCO du sixième programme cadre de la Commission européenne, numéro de contrat 031939. L´Agence norvégienne de coopération pour le développement (NORAD), l´Alliance pour la recherche sur les politiques et les systèmes de santé et le Milbank Memorial Fund ont financé une réunion visant l´examen par des pairs d´une version initiale de la série. John Lavis a touché un salaire de la Chaire de recherche du Canada sur le transfert et l´échange des connaissances. NORAD, la composante norvégienne du groupe Cochrane Effective Practice and Organisation of Care (EPOC), le Centre norvégien de connaissances pour les services de santé de santé, l´AHPSR, la Fondation canadienne de (mais)