Public Health Interventions and Harmful Unintended Consequences: Towards a typology and understanding of underlying factors to inform intervention planning.
| atmire.migration.oldid | 1986 | |
| dc.contributor.advisor | Hatfield, Jennifer | |
| dc.contributor.author | Scott, Lisa Kathleen Allen | |
| dc.date.accessioned | 2014-04-23T17:11:51Z | |
| dc.date.embargolift | 2016-04-22T17:11:51Z | |
| dc.date.issued | 2014-04-23 | |
| dc.date.submitted | 2014 | en |
| dc.description.abstract | Background: Despite systematic inclusion of unintended harm evaluation and reporting in evidence-based medicine, this concept remains relatively unexplored in evidence-based public health. As harmful unintended consequences (UC) continue to emerge from well-meaning public health interventions (PHI), evidence of both the complex pathway to the generation of harmful UC and the types of harmful UC to be evaluated and reported are essential for public health planners and evaluators. This dissertation aims to address this gap by advancing both the theoretical and practical knowledge on this underrepresented topic. Objective: To develop a theoretical and practical foundation for identification and mitigation of harmful UC associated with PHI so that planning frameworks may be adapted for use in various contexts. Methods and Results: A scoping review was conducted to describe a typology and underlying factors associated with PHI harmful UC. The typology included consideration of physical, psychosocial, cultural, economic and environmental unintended harms. Next, a realist review was undertaken to investigate the usefulness of Merton’s (1936) underlying factors of UC, namely - ignorance, error, basic values, immediate interest and self-defeating prophecy for understanding how and why harmful UC associated with weight-focused PHI occur. When applied to weight-focused PHI, Merton’s theoretical framework, together with two emergent mechanisms of reductionism and false premises provide explanatory usefulness and subsequently were used to generate a conceptual framework for PHI associated harmful UC. The resulting framework was then examined using the population health approach as a lens to look critically at harmful UC associated with the presumptive diagnosis and treatment of malaria high-risk strategy. Finally, using the WHO (2009) systems thinking framework as a guide, practical discussion questions were proposed for a transdisciplinary group of public health planners to consider when attempting to reduce harmful UC associated with well-meaning PHI. Conclusions: This research provides important advancements in both harmful UC theoretical understanding and practical steps that can be implemented by public health planners to improve the ability to anticipate, rather than simply react to harmful UC associated with PHI. | en_US |
| dc.description.embargoterms | 2 years | en_US |
| dc.identifier.citation | Scott, L. K. (2014). Public Health Interventions and Harmful Unintended Consequences: Towards a typology and understanding of underlying factors to inform intervention planning. (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/27479 | en_US |
| dc.identifier.doi | http://dx.doi.org/10.11575/PRISM/27479 | |
| dc.identifier.uri | http://hdl.handle.net/11023/1425 | |
| dc.language.iso | eng | |
| dc.publisher.faculty | Graduate Studies | |
| dc.publisher.institution | University of Calgary | en |
| dc.publisher.place | Calgary | en |
| dc.rights | University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission. | |
| dc.subject | Public Health | |
| dc.subject.classification | Public Health Intervention | en_US |
| dc.subject.classification | Unintended Harm | en_US |
| dc.subject.classification | Planning | en_US |
| dc.subject.classification | Evaluation | en_US |
| dc.subject.classification | Theory | en_US |
| dc.title | Public Health Interventions and Harmful Unintended Consequences: Towards a typology and understanding of underlying factors to inform intervention planning. | |
| dc.type | doctoral thesis | |
| thesis.degree.discipline | Community Health Sciences | |
| thesis.degree.grantor | University of Calgary | |
| thesis.degree.name | Doctor of Philosophy (PhD) | |
| ucalgary.item.requestcopy | true |