Addressing the Health Needs of an Aging America: New Opportunities for Evidence-Based Policy Solutions

This report systematically maps research findings to policy proposals intended to improve the health of the elderly. The study identified promising evidence-based policies, like those supporting prevention and care coordination, as well as areas where the research evidence is strong but policy activity is low, such as patient self-management and palliative care. Future work of the Stern Center will focus on these topics as well as long-term care financing, the health care workforce, and the role of family caregivers

Using agriculture for development: Supply- and demand-side approaches

For most poor countries of today, using agriculture for development is widely recognized as a promising strategy. Yet, in these countries, investment in agriculture has mostly been lagging relative to international norms and recommendations. Current wisdom on how to use agriculture for development is that it requires asset building for smallholder farmers, productivity growth in staple foods, an agricultural transformation (diversification of farming systems toward high value crops), and a rural transformation (value addition through rural non-farm activities linked to agriculture). This sequence has too often been hampered by extensive market and government failures. We outline a theory of change where the removal of market and government failures to use this Agriculture for Development strategy can be addressed through two contrasted and complementary approaches. One is from the “supply-side” where public and social agents (governments, international and bilateral development agencies, NGOs, donors) intervene to help farmers overcome the major constraints to adoption: liquidity, risk, information, and access to markets. The other is from the “demand-side” where private agents (entrepreneurs, producer organizations) create incentives for smallholder farmers to modernize through contracting and vertical coordination in value chains. We review the extensive literature that has explored ways of using Agriculture for Development through these two approaches. We conclude by noting that the supply-side approach has benefited from extensive research but met with limited success. The demand-side approach has promise, but received insufficient attention and is in need of additional rigorous research which we outline

Inefficiencies in Digital Advertising Markets

Digital advertising markets are growing and attracting increased scrutiny. This article explores four market inefficiencies that remain poorly understood: ad effect measurement, frictions between and within advertising channel members, ad blocking, and ad fraud. Although these topics are not unique to digital advertising, each manifests in unique ways in markets for digital ads. The authors identify relevant findings in the academic literature, recent developments in practice, and promising topics for future research

Risk, Security and Robust Solutions

The aim of this paper is to develop a decision-theoretic approach to security management of uncertain multi-agent systems. Security is defined as the ability to deal with intentional and unintentional threats generated by agents. The main concern of the paper is the protection of public goods from these threats allowing explicit treatment of inherent uncertainties and robust security management solutions. The paper shows that robust solutions can be properly designed by new stochastic optimization tools applicable for multicriteria problems with uncertain probability distributions and multivariate extreme events

Towards Systemic Evaluation

Problems of conventional evaluation models can be understood as an impoverished ‘conversation’ between realities (of non-linearity, indeterminate attributes, and ever-changing context), and models of evaluating such realities. Meanwhile, ideas of systems thinking and complexity science—grouped here under the acronym STCS—struggle to gain currency in the big ‘E’ world of institutionalized evaluation. Four evaluation practitioners familiar with evaluation tools associated with STCS offer perspectives on issues regarding mainstream uptake of STCS in the big ‘E’ world. The perspectives collectively suggest three features of practicing systemic evaluation: (i) developing value in conversing between bounded values (evaluations) and unbounded reality (evaluand), with humility; (ii) developing response-ability with evaluand stakeholders based on reflexivity, with empathy; and (iii) developing adaptive rather than mere contingent use(fulness) of STCS ‘tools’ as part of evaluation praxis, with inevitable fallibility and an orientation towards bricolage (adaptive use). The features hint towards systemic evaluation as core to a reconfigured notion of developmental evaluation

Randomised controlled trials of complex interventions and large-scale transformation of services

Complex interventions and large-scale transformations of services are necessary to meet the health-care challenges of the 21st century. However, the evaluation of these types of interventions is challenging and requires methodological development. Innovations such as cluster randomised controlled trials, stepped-wedge designs, and non-randomised evaluations provide options to meet the needs of decision-makers. Adoption of theory and logic models can help clarify causal assumptions, and process evaluation can assist in understanding delivery in context. Issues of implementation must also be considered throughout intervention design and evaluation to ensure that results can be scaled for population benefit. Relevance requires evaluations conducted under real-world conditions, which in turn requires a pragmatic attitude to design. The increasing complexity of interventions and evaluations threatens the ability of researchers to meet the needs of decision-makers for rapid results. Improvements in efficiency are thus crucial, with electronic health records offering significant potential