Workshop: Digital quality assurance of equitable public health interventions: why, how and examples
Authors:   Organised by: Region Västra Götaland Chair persons: Per-Olof Östergren - Sweden, Maria Magnusson - Sweden
Published: November 2019

Abstract

Objectives are to highlight knowledge and experiences of follow-up and evaluation of public health interventions with a focus on health equity. A digital instrument for planning, documentation and quality assurance, used in several Swedish settings, will be presented.
Health inequity emerges from structural issues. Public health interventions generally widen the health gap which is maintained and enforced by mechanisms on many levels in the societies. Interventions that aim to counteract health inequity need to take this into account and broaden the perspective to include not only life style habits but also discrimination, stigmatization, control, influence and power. Critical reflection is necessary to prevent interventions from consolidating current positions of power and to assure that communities and individuals - can influence goal-setting and measures taken. The Swedish Commission for Equity in Health highlighted the importance of methodological development and knowledge-based efforts including better follow-up, evaluation, research and dialogue. Mediators between measures taken and effects need to be clarified.
Health promotion needs to be evaluated systematically with a focus on how interventions function in relation to the task of closing the gap. However, interventions are often merged into other activities and the impact of a continuously changing society cannot be controlled for. Use of evidence-based methods including influence from participants are fundamental, as is critical reflection. Documented by a digital instrument, measures taken and reflected upon can form a database for continuous summative and formative evaluation, aiming at developing methods for effective public health work.
Added value
Presenting and discussing a digital instrument for planning, documentation and quality assurance will increase the potential for public health efforts to close the health gap. We use it for formative and summative evaluation. For 2018, 222 activity reports were launched and discussed by team members, leading to professional development. Issues for future development included the importance of giving time for shared values to consolidate and trust to emerge. Quantitive goals were reached.
Coherence
Presentation 1 will clarify why control, power and influence must be taken into consideration in interventions that aim at counteracting health inequity.
Presentation 2 will describe the instrument and how it draws on theories of health and critical reflection.
Presentation 3 will tell the story of an example from a Swedish dental public health care setting where the instrument has been used and point at strengths and areas for development.
Format
Presentation 15 minutes each. Followed by short discussions (5 minutes) in the audience who will then be asked to present short inputs on post-it notes that will be collected by the organizers. During the last 30 minutes there will be a general discussion using the post-it notes as starting point.

Key messages
A digital instrument for planning, documentation and quality assurance, with focus on health equity, will increase the positive impact of public health efforts. Public health interventions that use the instrument will be better equipped to increase health equity.