Atkinson Jo-An, O'Donnell Eloise, Wiggers John, McDonnell Geoff, Mitchell Jo, Freebairn Louise, Indig Devon, Rychetnik Lucie
The Australian Prevention Partnership Centre, Sax Institute, Sydney, NSW; School of Medicine, University of Sydney, NSW, Australia,
The Australian Prevention Partnership Centre, Sax Institute, Sydney, NSW.
Public Health Res Pract. 2017 Feb 15;27(1):2711707. doi: 10.17061/phrp2711707.
Development of effective policy responses to address complex public health problems can be challenged by a lack of clarity about the interaction of risk factors driving the problem, differing views of stakeholders on the most appropriate and effective intervention approaches, a lack of evidence to support commonly implemented and acceptable intervention approaches, and a lack of acceptance of effective interventions. Consequently, political considerations, community advocacy and industry lobbying can contribute to a hotly contested debate about the most appropriate course of action; this can hinder consensus and give rise to policy resistance. The problem of alcohol misuse and its associated harms in New South Wales (NSW), Australia, provides a relevant example of such challenges. Dynamic simulation modelling is increasingly being valued by the health sector as a robust tool to support decision making to address complex problems. It allows policy makers to ask 'what-if' questions and test the potential impacts of different policy scenarios over time, before solutions are implemented in the real world. Participatory approaches to modelling enable researchers, policy makers, program planners, practitioners and consumer representatives to collaborate with expert modellers to ensure that models are transparent, incorporate diverse evidence and perspectives, are better aligned to the decision-support needs of policy makers, and can facilitate consensus building for action. This paper outlines a procedure for embedding stakeholder engagement and consensus building in the development of dynamic simulation models that can guide the development of effective, coordinated and acceptable policy responses to complex public health problems, such as alcohol-related harms in NSW.
制定有效的政策应对措施以解决复杂的公共卫生问题可能会面临诸多挑战，比如驱动问题产生的风险因素之间的相互作用尚不明确，利益相关者对最合适、最有效的干预方法存在不同看法，缺乏支持普遍实施且可接受的干预方法的证据，以及有效干预措施未被接受。因此，政治考量、社区倡导和行业游说可能会引发关于最恰当行动方针的激烈争论；这可能会阻碍达成共识并引发政策阻力。澳大利亚新南威尔士州（NSW）酒精滥用及其相关危害问题就是此类挑战的一个相关实例。动态模拟建模日益受到卫生部门重视，被视为支持决策以解决复杂问题的有力工具。它使政策制定者能够提出“如果……会怎样”的问题，并在现实世界中实施解决方案之前，测试不同政策情景随时间推移可能产生的影响。参与式建模方法能让研究人员、政策制定者、项目规划者、从业者和消费者代表与专家建模师合作，以确保模型透明，纳入多样的证据和观点，更符合政策制定者的决策支持需求，并能促进就行动达成共识。本文概述了在动态模拟模型开发过程中融入利益相关者参与和共识构建的程序，该程序可指导制定针对复杂公共卫生问题（如新南威尔士州与酒精相关的危害）的有效、协调且可接受的政策应对措施。
