Quantitative measures of health policy implementation determinants and outcomes: A systematic review

BACKGROUND: Public policy has tremendous impacts on population health. While policy development has been extensively studied, policy implementation research is newer and relies largely on qualitative methods. Quantitative measures are needed to disentangle differential impacts of policy implementation determinants (i.e., barriers and facilitators) and outcomes to ensure intended benefits are realized. Implementation outcomes include acceptability, adoption, appropriateness, compliance/fidelity, feasibility, penetration, sustainability, and costs. This systematic review identified quantitative measures that are used to assess health policy implementation determinants and outcomes and evaluated the quality of these measures. METHODS: Three frameworks guided the review: Implementation Outcomes Framework (Proctor et al.), Consolidated Framework for Implementation Research (Damschroder et al.), and Policy Implementation Determinants Framework (Bullock et al.). Six databases were searched: Medline, CINAHL Plus, PsycInfo, PAIS, ERIC, and Worldwide Political. Searches were limited to English language, peer-reviewed journal articles published January 1995 to April 2019. Search terms addressed four levels: health, public policy, implementation, and measurement. Empirical studies of public policies addressing physical or behavioral health with quantitative self-report or archival measures of policy implementation with at least two items assessing implementation outcomes or determinants were included. Consensus scoring of the Psychometric and Pragmatic Evidence Rating Scale assessed the quality of measures. RESULTS: Database searches yielded 8417 non-duplicate studies, with 870 (10.3%) undergoing full-text screening, yielding 66 studies. From the included studies, 70 unique measures were identified to quantitatively assess implementation outcomes and/or determinants. Acceptability, feasibility, appropriateness, and compliance were the most commonly measured implementation outcomes. Common determinants in the identified measures were organizational culture, implementation climate, and readiness for implementation, each aspects of the internal setting. Pragmatic quality ranged from adequate to good, with most measures freely available, brief, and at high school reading level. Few psychometric properties were reported. CONCLUSIONS: Well-tested quantitative measures of implementation internal settings were under-utilized in policy studies. Further development and testing of external context measures are warranted. This review is intended to stimulate measure development and high-quality assessment of health policy implementation outcomes and determinants to help practitioners and researchers spread evidence-informed policies to improve population health. REGISTRATION: Not registered

Barack Obama and The Daily Show's comic critique of whiteness: the intersection of popular and political discourse

Master of ArtsDepartment of Communication Studies, Theatre, and DanceTimothy R. SteffensmeierThe 2008 presidential campaign controversy surrounding Rev. Jeremiah Wright’s sermons had the potential to derail Barack Obama’s candidacy. At the heart of the controversy was race, specifically Whiteness. Obama’s speech “A More Perfect Union” is perhaps one of the most significant political speeches addressing race to date, and warrants analysis. However, Barry Brummett’s book Rhetorical Dimensions of Popular Culture (1991) argues the critic should not be limited to discrete traditional texts, rather should be able to break outside such traditional speaker-focused boundaries. Brummett’s mosaic model allows an exploration of the intersection between popular and political rhetoric of Obama and The Daily Show. I will argue from the intersection we see the emergence of the comic frame as a homology that links the disparate texts of Obama and TDS. I will argue the reason the comic frame emerges from the texts is because there is a societal mandate for the comic frame. Thus, I will ultimately argue the mandate for the comic frame can be better understood as a social movement. However, it is a movement comprised of numerous individual movements, and warrants a new term: meta-movement. Obama and TDS are not leaders of this meta-movement, but instead should be seen as contributors. Brummett urges the critic to consider “the political or ideological interests served by ordering a rhetorical transaction in a certain way” (1991, p. 98). I will argue constructing the rhetoric of Obama and TDS with the comic frame serves the ideological interests of those who are fighting for social justice and working to subvert Whiteness. Thus, I have named the meta-movement to which Obama and TDS contribute a critical optimist movement, because the comic frame provides the tools to be critical of hegemony while ultimately reinforcing the optimistic assumption of the comic frame: all humans are ultimately both flawed and good

The Daily Show and Rhetoric Arguments, Issues, and Strategies

The Daily Show and Rhetoric approaches the popular program from a scholarly, rhetorical perspective to uncover the rhetorical nature of the show. Using a variety of rhetorical methods, the book, taken as a whole, concludes that The Daily Show is more that just a show designed to make the audience laugh; it's designed to make the audience think.Intro -- Contents -- Acknowledgments -- Introduction: The Daily Show and Rhetoric-Arguments, Issues, and Strategies -- I: The Nature of the Beast -- 1 The Arete of Amusement: An Aristotelian Perspective on the Ethos of The Daily Show -- 2 Before and After The Daily Show: Freedom and Consequences in Political Satire -- 3 Cramer vs. (Jon Stewart's Characterization of) Cramer: Image Repair Rhetoric, Late Night Political Humor, and The Daily Show -- II: Arguments -- 4 The (not-so) Laughable Political Argument: A Close-Textual Analysis of The Daily Show with Jon Stewart -- 5 Models of Democratic Deliberation: Pharmacodynamic Agonism in The Daily Show -- 6 Purifying Laughter: Carnivalesque Self-Parody as Argument Scheme in The Daily Show with Jon Stewart -- 7 The Voice of the People: Jon Stewart, Public Argument, and Political Satire -- III: Strategies -- 8 We Frame to Please: A Preliminary Examination of The Daily Show's Use of Frames -- 9 Breaking News: A Postmodern Rhetorical Analysis of The Daily Show -- 10 Visual Aspects of The Daily Show with Jon Stewart -- IV: Issues -- 11 Gaywatch: A Burkean Frame Analysis of The Daily Show's Treatment of Queer Topics -- 12 Modern Hebrew Prophets? The Daily Show and Religious Satire -- 13 The Daily Show and Barack Obama's Comic Critique of Whiteness: An Intersection of Popular and Political Rhetoric -- Index -- About the ContributorsThe Daily Show and Rhetoric approaches the popular program from a scholarly, rhetorical perspective to uncover the rhetorical nature of the show. Using a variety of rhetorical methods, the book, taken as a whole, concludes that The Daily Show is more that just a show designed to make the audience laugh; it's designed to make the audience think.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries