Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal. / Élaboration de critères définissant les pratiques prometteuses en promotion de la santé et en prévention des maladies pour le Portail canadien des pratiques exemplaires.

INTRODUCTION: In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. METHODS: The promising practices criteria were developed using the Public Health Agency of Canada's (PHAC's) existing best practices criteria as the foundation. They were modified and pilot tested (three rounds) using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. RESULTS: The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. CONCLUSION: While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal's screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

INTRODUCTION: Dans le domaine de la promotion de la santé et de la prévention des maladies chroniques, tant les pratiques exemplaires que les pratiques prometteuses peuvent fournir des renseignements cruciaux sur les interventions qui améliorent les résultats sur la santé des individus et des collectivités, notamment leur mode d'action et les raisons de leur efficacité dans différents contextes. MÉTHODOLOGIE: Nous avons établi des critères de définition des pratiques prometteuses sur la base des critères de l'Agence de la santé publique du Canada (ASPC) pour les pratiques exemplaires. Nous avons modifié et mis à l'épreuve (en trois phases) ces critères en nous servant d'interventions décrites dans des publications. Nous avons résolu les questions et les difficultés d'ordre théorique et méthodologique grâce à des consultations et des discussions approfondies avec un groupe de travail. RÉSULTATS: L'équipe a établi un ensemble de critères relatifs aux pratiques prometteuses qui diffèrent sur six plans des critères relatifs aux pratiques exemplaires. CONCLUSION: Bien que plusieurs difficultés complexes se soient présentées pendant l'élaboration des critères, des discussions et des débats exhaustifs nous ont permis de les surmonter. Les critères de sélection du Portail canadien des pratiques exemplaires permettent de repérer les pratiques exemplaires et prometteuses dans les domaines de la santé publique, de la promotion de la santé et de la prévention des maladies chroniques, voire éventuellement dans d'autres domaines.

Evidence for the value of health promotion interventions in natural disaster management.

A rapid review of literature was conducted to identify effective health promotion (HP) intervention strategies that relate to the management of disasters from natural hazards, including prevention, preparedness, response and recovery measures. Searches were conducted in formal literature from 2000 to 2011 and then updated to 2013. Out of 719 relevant abstracts, 57 studies were selected for more detailed review. In total, 16 studies were annotated for the narrative synthesis; these articles all reported an outcome-oriented evaluation of an HP-related intervention in a natural disaster situation in low- and middle-income countries (LMIC) or vulnerable populations in high-income countries (HIC). These 16 studies were also assessed for quality of their evaluation design. Although it was not possible to select only strong study designs, LMIC weak designs were matched with stronger designs in HIC most of the time. A narrative synthesis was conducted to report the results. In the preparedness and mitigation stages, there were six articles referring to four HP strategies. In the response and recovery phases, there were 10 articles referring to an additional four HP strategies. HP plays a role in regaining a sense of control after disaster through: engaging victims of disaster in group decisions (including children), collaboration and networking, recognition of local strengths and assets, conducting community needs assessments, respecting local knowledge, training local resources as part of an ongoing system and use of pre-existing community focal points or organizations as trusted locations for community services and reconnections.

Implementing a national health research for development platform in a low-income country - a review of Malawi's Health Research Capacity Strengthening Initiative.

BACKGROUND: National health research for development (R4D) platforms in lower income countries (LICs) are few. The Health Research Capacity Strengthening Initiative (HRCSI, 2008-2013) was a national systems-strengthening programme in Malawi involved in national priority setting, decision-making on funding, and health research actor mobilization. METHODS: We adopted a retrospective mixed-methods evaluation approach, starting with information gleaned from reports (HRCSI and Malawian) and databases (HRCSI). A framework of a health research system (actors and components) guided report review and interview guide development. From a list of 173 individuals involved in HRCSI, 30 interviewees were selected within categories of stakeholders. Interviews were conducted face-to-face or via telephone/Skype over 1 month, documented with extensive notes. Analysis of emerging themes was iterative among co-evaluators, with synthesis according to the implementation stage. RESULTS: Major HRCSI outputs included (1) National research priority-setting: through the production of themed background papers by Malawian health researchers and broad consultation, HRCSI led the development of a National Health Research Agenda (2012-2016), widely regarded as one of HRCSI's foremost achievements. (2) Institutional research capacity: there was an overwhelming view that HRCSI had produced a step-change in the number of high calibre scientists in Malawi and in fostering research interest among young Malawians, providing support for around 56 MSc and PhD students, and over 400 undergraduate health-related projects. (3) Knowledge sharing: HRCSI supported research dissemination through national and institutional meetings by sponsoring attendance at conferences and through close relationships with individuals in the print media for disseminating information. (4) Sustainability: From 2011-2013, HRCSI significantly improved research systems, processes and leadership in Malawi, but further strengthening was needed for HRCSI to be effectively integrated into government structures and sustained long-term. Overall, HRCSI carried out many components relevant to a national health research system coordinating platform, and became competent at managing over half of 12 areas of performance for research councils. Debate about its location and challenges to sustainability remain open questions. CONCLUSIONS: More experimentation in the setting-up of national health R4D platforms to promote country 'ownership' is needed, accompanied by evaluation processes that facilitate learning and knowledge exchange of better practices among key actors in health R4D systems.