Haynes Emily, Palermo Claire, Reidlinger Dianne P
Faculty of Health Science & Medicine, Bond University, Gold Coast, Queensland, Australia.
Monash University, Clayton, Victoria, Australia.
BMJ Open. 2016 Sep 6;6(9):e011788. doi: 10.1136/bmjopen-2016-011788.
Until now, industry and government stakeholders have dominated public discourse about policy options for obesity. While consumer involvement in health service delivery and research has been embraced, methods which engage consumers in health policy development are lacking. Conflicting priorities have generated ethical concern around obesity policy. The concept of 'intrusiveness' has been applied to policy decisions in the UK, whereby ethical implications are considered through level of intrusiveness to choice; however, the concept has also been used to avert government regulation to address obesity. The concept of intrusiveness has not been explored from a stakeholder's perspective. The aim is to investigate the relevance of intrusiveness and autonomy to health policy development, and to explore consensus on obesity policy priorities of under-represented stakeholders.
The Policy-Delphi technique will be modified using the James Lind Alliance approach to collaborative priority setting. A total of 60 participants will be recruited to represent three stakeholder groups in the Australian context: consumers, public health practitioners and policymakers. A three-round online Policy-Delphi survey will be undertaken. Participants will prioritise options informed by submissions to the 2009 Australian Government Inquiry into Obesity, and rate the intrusiveness of those proposed. An additional round will use qualitative methods in a face-to-face discussion group to explore stakeholder perceptions of the intrusiveness of options. The novelty of this methodology will redress the balance by bringing the consumer voice forward to identify ethically acceptable obesity policy options.
Ethical approval was granted by the Bond University Health Research Ethics Committee. The findings will inform development of a conceptual framework for analysing and prioritising obesity policy options, which will be relevant internationally and to ethical considerations of wider public health issues. The findings will be disseminated through peer-reviewed publications, conference presentations and collaborative platforms of policy and science.
到目前为止,业界和政府利益相关者主导了关于肥胖症政策选择的公共讨论。虽然消费者参与医疗服务提供和研究已得到认可,但让消费者参与健康政策制定的方法却很缺乏。相互冲突的优先事项引发了围绕肥胖症政策的伦理关注。“侵扰性”概念已应用于英国的政策决策,即通过对选择的侵扰程度来考虑伦理影响;然而,这一概念也被用于避免政府为解决肥胖问题而进行监管。尚未从利益相关者的角度探讨侵扰性概念。目的是研究侵扰性和自主性与健康政策制定的相关性,并就代表性不足的利益相关者在肥胖症政策优先事项上达成共识。
将采用詹姆斯·林德联盟协作确定优先事项的方法对政策德尔菲技术进行修改。将招募60名参与者,以代表澳大利亚背景下的三个利益相关者群体:消费者、公共卫生从业者和政策制定者。将开展三轮在线政策德尔菲调查。参与者将根据提交给2009年澳大利亚政府肥胖问题调查的意见对选项进行优先排序,并对所提议选项的侵扰性进行评分。另一轮将在面对面讨论小组中使用定性方法,以探讨利益相关者对选项侵扰性的看法。这种方法的新颖之处在于通过突出消费者的声音来纠正平衡,以确定符合伦理的可接受肥胖症政策选项。
邦德大学健康研究伦理委员会已批准该研究的伦理申请。研究结果将为分析肥胖症政策选项并确定其优先顺序的概念框架的制定提供参考,该框架将在国际上具有相关性,并适用于更广泛公共卫生问题的伦理考量。研究结果将通过同行评审出版物、会议报告以及政策与科学协作平台进行传播。