Purpose: The purpose of this research was examine potential barriers and facilitators to the implementation of healthy public policy related to aging, specifically in municipal planning and transportation departments, in the suburban context. Research Questions: What are the factors which influence successful implementation of healthy public policy in municipal and, specifically, suburban contexts? How do suburban planning and transportation policies interface with policies aimed at physical environmental changes to shape the built environment in ways that are theorized to affect seniors health? Methods and Results: A qualitative case study approach was used to examine Strathcona Countys Older Adults Plan (2009a). Strathcona County is a municipality bordering Edmonton, Alberta, Canada. Data was collected through document reviews and 19 semi-structured interviews with 21 individuals involved in the development of the plan or potentially affected by its implementation. Results were triangulated in a final analysis of policy implementation capacity in Strathcona County.

No description available.

Many children live in circumstances which make it difficult for them to develop the capacities needed to succeed later in life. Previous research has focused on determining the risk factors for impaired outcomes and on evaluating the impact of specific programs. There has been a lack of research exploring the wisdom of people at the grassroots level and across programs. This research asked service providers and parents to describe the challenges that are faced by families with young children living in circumstances of disadvantage, the barriers preventing participation in programs, and the strategies that would address these challenges and barriers.<p> Three research approaches were incorporated into the design of this project; qualitative policy research, community-based participatory research, and knowledge transfer methodology. These approaches were applied in order to encourage the participation of community organizations, to produce information that would provide guidance to policy-makers, and to promote implementation of the strategies recommended by research participants.<p> In Phase One, 28 service providers from 24 Regina programs were interviewed. In Phase Two, the results from the service provider interviews were presented to focus groups of target parents to obtain their feedback. This process served to acknowledge the expertise of the parents as those with firsthand experience of their own reality.<p> The categories of challenges, barriers and strategies that were identified by participants were psychosocial (related to personal connections and mental well-being) and/or structural (concrete and tangible issues). Four themes emerged from these findings. First, interrelatedness and synergistic interaction among the social conditions faced by these families was evident. Second, instability was present at both familial and program delivery levels. Third, target families faced power imbalances from multiple sources. Finally, a lack of belonging or connectedness was experienced by families as a result of their circumstances of social exclusion.<p> The results point to the need for policies to address the following areas: adequate household income, childcare, funding of non-government organizations, housing, and mental health and addictions. By presenting the views of people at the grassroots level, it is hoped that these research results will provide direction to policy-makers.

Many children live in circumstances which make it difficult for them to develop the capacities needed to succeed later in life. Previous research has focused on determining the risk factors for impaired outcomes and on evaluating the impact of specific programs. There has been a lack of research exploring the wisdom of people at the grassroots level and across programs. This research asked service providers and parents to describe the challenges that are faced by families with young children living in circumstances of disadvantage, the barriers preventing participation in programs, and the strategies that would address these challenges and barriers.<p> Three research approaches were incorporated into the design of this project; qualitative policy research, community-based participatory research, and knowledge transfer methodology. These approaches were applied in order to encourage the participation of community organizations, to produce information that would provide guidance to policy-makers, and to promote implementation of the strategies recommended by research participants.<p> In Phase One, 28 service providers from 24 Regina programs were interviewed. In Phase Two, the results from the service provider interviews were presented to focus groups of target parents to obtain their feedback. This process served to acknowledge the expertise of the parents as those with firsthand experience of their own reality.<p> The categories of challenges, barriers and strategies that were identified by participants were psychosocial (related to personal connections and mental well-being) and/or structural (concrete and tangible issues). Four themes emerged from these findings. First, interrelatedness and synergistic interaction among the social conditions faced by these families was evident. Second, instability was present at both familial and program delivery levels. Third, target families faced power imbalances from multiple sources. Finally, a lack of belonging or connectedness was experienced by families as a result of their circumstances of social exclusion.<p> The results point to the need for policies to address the following areas: adequate household income, childcare, funding of non-government organizations, housing, and mental health and addictions. By presenting the views of people at the grassroots level, it is hoped that these research results will provide direction to policy-makers.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta pesquisa tem como objetivo geral, compreender as práticas desenvolvidas no cuidado realizado por enfermeiros nos Programas Nacionais de Saúde em uma unidade da rede básica de saúde no município do Rio de Janeiro. Este estudo corresponde ao desdobramento do projeto Práticas de cuidado no SUS: o papel do enfermeiro na Atenção Básica, apoiado por bolsa de produtividade em pesquisa da Universidade do Estado do Rio de Janeiro (UERJ/ Prociência). A presente dissertação trata-se de um estudo de caso realizado no âmbito da Atenção Básica, e, possui como cenário o Centro Municipal de Saúde (CMS) Milton Fontes Magarão. Os sujeitos da pesquisa corresponderam a oito enfermeiros, sendo sete entrevistas e um depoimento. Os instrumentos de coleta de dados utilizados, durante o período de julho a setembro de 2011, foram: observação sistemática, entrevista semi-estruturada, depoimento, formulário e pesquisa em fontes documentais. Para a avaliação dos resultados utilizou-se a técnica de análise temática, proposta por Minayo. No plano metodológico a análise foi qualitativa, no entanto, no tratamento dos dados, a análise aplicada se apropriou de elementos da abordagem quantitativa, com o objetivo de encontrar os núcleos de sentido contextualizados nas entrevistas. A partir dos resultados alcançados foi possível elaborar três categorias. A primeira categoria focou uma abordagem temática sobre as práticas desenvolvidas no cuidado realizado por enfermeiros nos Programas Nacionais. A segunda categoria buscou descrever a visão do enfermeiro sobre o desenvolvimento de suas práticas e do cuidado realizado, no qual, foram discutidas duas temáticas centrais: noções acerca das atividades realizadas pelos enfermeiros e noções dos enfermeiros acerca dos princípios e diretrizes para atenção à saúde. A terceira categoria direcionou-se para os fatores que interferem nas práticas e no cuidado realizado pelos enfermeiros. A prática e o cuidado realizados pelos enfermeiros foram analisados e discutidos, a partir dos relatos dos profissionais sobre suas vivências. Sendo assim, não coube a expressão de uma única forma de prática ou de uma única dimensão do cuidado, visto que essas práticas parecem estar entrelaçadas a diversos aspectos subjetivos, epistemológicos, culturais e sócio-econômicos. As práticas realizadas, independente do Programa Nacional de atuação dos enfermeiros, estão voltadas principalmente para a consulta de enfermagem, a prática educativa, a organização do fluxo de entrada, o sistema de referência e a visita domiciliar. Pôde-se inferir que diversos são os fatores que influenciam, de forma positiva ou negativa, o desenvolvimento das atividades diárias. Por fim, cabe ressaltar a necessidade de novos estudos sobre a temática a fim de estimular a construção de saberes teórico-práticos e a formulação de uma visão crítica sobre o cuidado profissional realizado pelo enfermeiro no âmbito da Atenção Básica. / This research has as a general goal to understand the practices developed in care performed by nurses in Health National Programs at a Basic Health Care unit in Rio de Janeiro city. This study corresponds to the unfolding of the project named Practices of care at SUS: the role of the nurse on Health Care, supported by research productivity grants from University of the State of Rio de Janeiro (UERJ/ Prosciences). The current dissertation is a case study performed at the scope of Health care, and the site is the Municipal Health Center (MHC) Milton Fontes Magarão. The research subjects were eight nurses, providing seven interviews and one testimony. Data sample tools used, during the period from July to September, 2011, were: systematic observation, semi-structured interview, testimony, form and research at documental sources. To the assessment of results the theme analysis technique was used, proposed by Minayo. Methodologically, the analysis was qualitative, however, in treatment of data, the analysis applied used elements from quantitative approach, in which the objective was to find meaning cores contextualized in the interviews. From the results achieved it was possible to elaborate three categories. First category focus was on the thematic approach about the practices which have been developed by nurses at National Programs. The second one aimed at describing the nurses view on the development of their practices as well as the care performed, in which, two core themes were discussed: notions about activities performed by nurses and their notions about principles and guidelines to basic Health Care. The third category was directed to factors that interfere on the practice and the care performed by nurses. Practice and care were analysed and discussed from the professionals reports about their life experiences. Thus, it was not suitable to structure a single form of practice or single care dimension, once such practices seem overlapped to diverse subjective, epistemological, cultural and socio-economic factors. Nurses performance practices, apart from the National Program are turned mainly to the nursing consultation, educational practice, organization of input, reference system and home visit. It can be inferred that a lot of factors influence - positively or negatively - on the development of daily activities. Finally, it is important to highlight the need of new studies on the subject in order to stimulate theoretical-practical knowledge and the formulation of a critical thinking about professional care from the nurse at the scope of basic Health Care.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta pesquisa tem como objetivo geral, compreender as práticas desenvolvidas no cuidado realizado por enfermeiros nos Programas Nacionais de Saúde em uma unidade da rede básica de saúde no município do Rio de Janeiro. Este estudo corresponde ao desdobramento do projeto Práticas de cuidado no SUS: o papel do enfermeiro na Atenção Básica, apoiado por bolsa de produtividade em pesquisa da Universidade do Estado do Rio de Janeiro (UERJ/ Prociência). A presente dissertação trata-se de um estudo de caso realizado no âmbito da Atenção Básica, e, possui como cenário o Centro Municipal de Saúde (CMS) Milton Fontes Magarão. Os sujeitos da pesquisa corresponderam a oito enfermeiros, sendo sete entrevistas e um depoimento. Os instrumentos de coleta de dados utilizados, durante o período de julho a setembro de 2011, foram: observação sistemática, entrevista semi-estruturada, depoimento, formulário e pesquisa em fontes documentais. Para a avaliação dos resultados utilizou-se a técnica de análise temática, proposta por Minayo. No plano metodológico a análise foi qualitativa, no entanto, no tratamento dos dados, a análise aplicada se apropriou de elementos da abordagem quantitativa, com o objetivo de encontrar os núcleos de sentido contextualizados nas entrevistas. A partir dos resultados alcançados foi possível elaborar três categorias. A primeira categoria focou uma abordagem temática sobre as práticas desenvolvidas no cuidado realizado por enfermeiros nos Programas Nacionais. A segunda categoria buscou descrever a visão do enfermeiro sobre o desenvolvimento de suas práticas e do cuidado realizado, no qual, foram discutidas duas temáticas centrais: noções acerca das atividades realizadas pelos enfermeiros e noções dos enfermeiros acerca dos princípios e diretrizes para atenção à saúde. A terceira categoria direcionou-se para os fatores que interferem nas práticas e no cuidado realizado pelos enfermeiros. A prática e o cuidado realizados pelos enfermeiros foram analisados e discutidos, a partir dos relatos dos profissionais sobre suas vivências. Sendo assim, não coube a expressão de uma única forma de prática ou de uma única dimensão do cuidado, visto que essas práticas parecem estar entrelaçadas a diversos aspectos subjetivos, epistemológicos, culturais e sócio-econômicos. As práticas realizadas, independente do Programa Nacional de atuação dos enfermeiros, estão voltadas principalmente para a consulta de enfermagem, a prática educativa, a organização do fluxo de entrada, o sistema de referência e a visita domiciliar. Pôde-se inferir que diversos são os fatores que influenciam, de forma positiva ou negativa, o desenvolvimento das atividades diárias. Por fim, cabe ressaltar a necessidade de novos estudos sobre a temática a fim de estimular a construção de saberes teórico-práticos e a formulação de uma visão crítica sobre o cuidado profissional realizado pelo enfermeiro no âmbito da Atenção Básica. / This research has as a general goal to understand the practices developed in care performed by nurses in Health National Programs at a Basic Health Care unit in Rio de Janeiro city. This study corresponds to the unfolding of the project named Practices of care at SUS: the role of the nurse on Health Care, supported by research productivity grants from University of the State of Rio de Janeiro (UERJ/ Prosciences). The current dissertation is a case study performed at the scope of Health care, and the site is the Municipal Health Center (MHC) Milton Fontes Magarão. The research subjects were eight nurses, providing seven interviews and one testimony. Data sample tools used, during the period from July to September, 2011, were: systematic observation, semi-structured interview, testimony, form and research at documental sources. To the assessment of results the theme analysis technique was used, proposed by Minayo. Methodologically, the analysis was qualitative, however, in treatment of data, the analysis applied used elements from quantitative approach, in which the objective was to find meaning cores contextualized in the interviews. From the results achieved it was possible to elaborate three categories. First category focus was on the thematic approach about the practices which have been developed by nurses at National Programs. The second one aimed at describing the nurses view on the development of their practices as well as the care performed, in which, two core themes were discussed: notions about activities performed by nurses and their notions about principles and guidelines to basic Health Care. The third category was directed to factors that interfere on the practice and the care performed by nurses. Practice and care were analysed and discussed from the professionals reports about their life experiences. Thus, it was not suitable to structure a single form of practice or single care dimension, once such practices seem overlapped to diverse subjective, epistemological, cultural and socio-economic factors. Nurses performance practices, apart from the National Program are turned mainly to the nursing consultation, educational practice, organization of input, reference system and home visit. It can be inferred that a lot of factors influence - positively or negatively - on the development of daily activities. Finally, it is important to highlight the need of new studies on the subject in order to stimulate theoretical-practical knowledge and the formulation of a critical thinking about professional care from the nurse at the scope of basic Health Care.

This qualitative comparative case study examined factors related to politics that might explain the notably different active transportation (AT - walking, cycling, and public transit use) rates achieved in Helsinki, Finland (a leading European city in AT, where 77 per cent of people use primarily AT for daily transportation) and Ottawa, Canada (a leading North American city in AT, but where the AT rate is 28.5 per cent). Applying the Advocacy Coalition Framework (ACF) - a policy process theory - individual focused interviews were conducted with 47 active transportation experts from the two cities. Document review was employed as a secondary method. The results are discussed in three articles written for peer reviewed journals – the first two concentrating on the findings from Helsinki and Ottawa respectively, and the third article comparing the findings from both cities. Overall, differences stemming from the ACF category of relatively stable parameters (i.e., stable background-level factors) including land use, transportation planning traditions, and political systems were identified as likely important in explaining the discrepancy in AT rates.

<p>The World Health Organization (WHO) states that working intersectorally and internationally with health issues is crucial in creating a change towards healthy public policy at a local level. Healthy Cities is one of the programmes where WHO uses a health governance approach (governing through networks) to try to reach this objective. The aim of this bachelor thesis is to identify the factors that make member cities of the WHO European Healthy Cities Network successful in reorienting local public policy towards healthy public policy. An analysis of nine documents corresponding to the selection criteria set up by the authors was conducted. These documents consisted of reports published by WHO on the Healthy Cities programme, but also of independent research articles and one thesis published on other networks similar to Healthy Cities. Also, further data was collected through telephone interviews with contact persons in four member cities. The interviews were transcribed word by word. Both data (documents and interviews) were analysed using a qualitative content analysis.</p><p> </p><p>The results show that the four key “elements for action” (political commitment, leadership, readiness for institutional change and intersectoral collaboration) crystallized by WHO for creating healthy public policy were mainly confirmed in this research study. Therefore, the authors draw the conclusion that WHO has succeeded in making the member cities commit to the Healthy Cities philosophy and in spreading the idea of health governance in Europe. However, additional factors were found both in the document analysis and in the interviews. When looking at the top four frequently occurring factors in the documents, community participation and status were highlighted. The two additional factors found in the interview data was holistic thinking and systematic, goal-oriented work. Also, the importance of political commitment was questioned by a minority of the respondents. This might indicate that the four key “elements for action” crystallized by WHO might not have as big of an effect in creating change at a local level as has been made out by WHO. Furthermore, respondents stated that difficulties existed in translating theory into practice at a local level. This might indicate that potential changes made in the member cities after joining the Healthy Cities programme are mainly ideological. Despite this, the attitudes among the respondents towards membership in the WHO European Healthy Cities Network were overall positive, and even though difficulties still exist, the respondents maintained that Healthy Cities enables them in taking the next step towards healthy public policy at a local level.<strong></strong></p>

The World Health Organization (WHO) states that working intersectorally and internationally with health issues is crucial in creating a change towards healthy public policy at a local level. Healthy Cities is one of the programmes where WHO uses a health governance approach (governing through networks) to try to reach this objective. The aim of this bachelor thesis is to identify the factors that make member cities of the WHO European Healthy Cities Network successful in reorienting local public policy towards healthy public policy. An analysis of nine documents corresponding to the selection criteria set up by the authors was conducted. These documents consisted of reports published by WHO on the Healthy Cities programme, but also of independent research articles and one thesis published on other networks similar to Healthy Cities. Also, further data was collected through telephone interviews with contact persons in four member cities. The interviews were transcribed word by word. Both data (documents and interviews) were analysed using a qualitative content analysis.   The results show that the four key “elements for action” (political commitment, leadership, readiness for institutional change and intersectoral collaboration) crystallized by WHO for creating healthy public policy were mainly confirmed in this research study. Therefore, the authors draw the conclusion that WHO has succeeded in making the member cities commit to the Healthy Cities philosophy and in spreading the idea of health governance in Europe. However, additional factors were found both in the document analysis and in the interviews. When looking at the top four frequently occurring factors in the documents, community participation and status were highlighted. The two additional factors found in the interview data was holistic thinking and systematic, goal-oriented work. Also, the importance of political commitment was questioned by a minority of the respondents. This might indicate that the four key “elements for action” crystallized by WHO might not have as big of an effect in creating change at a local level as has been made out by WHO. Furthermore, respondents stated that difficulties existed in translating theory into practice at a local level. This might indicate that potential changes made in the member cities after joining the Healthy Cities programme are mainly ideological. Despite this, the attitudes among the respondents towards membership in the WHO European Healthy Cities Network were overall positive, and even though difficulties still exist, the respondents maintained that Healthy Cities enables them in taking the next step towards healthy public policy at a local level.