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This study aims to explore the Facebook communication strategies of Spanish hospitals during health emergencies, focusing on their role in crisis management and public information dissemination.

Automatic topic modelling and deep learning sentiment analysis were applied to analyse 151,738 posts from 274 hospital Facebook pages (March 2020–Feb 2022). Regression analyses were used to explore the relationships between topics, sentiment scores and hospital characteristics.

The analysis revealed nine main topics, with the three most prevalent related to COVID-19: vaccine information, security measures and situational updates. This indicates that Spanish hospitals significantly relied on Facebook to manage the emergency. The communication strategies dynamically adapted to the intensity of the pandemic and varied across hospital types. Sentiment analysis showed a negative tone for posts about security measures and situational updates. These findings align with the Agenda-Setting Theory, suggesting that hospitals influenced public discourse. Vaccine information posts were more positive, resonating with the Uses and Gratifications Theory by fulfilling the audience’s need for reassurance and guidance.

Using replicable machine learning techniques, this study elucidates the communication strategies employed by Spanish hospitals to manage healthcare emergencies, such as the COVID-19 pandemic. It highlights factors that potentially influence these strategies and provides theoretical justifications for them. The variation in communication strategies on Facebook among different hospital categories underscores the imperative for stricter guidelines and regulations to guarantee consistent and reliable communication during emergencies. This research provides valuable insights for practitioners and policymakers aimed at developing effective health communication strategies on social media.

This study uses autoethnography to examine the impact of the Misuse of Drugs Act 1971 on policing and public health in the UK. Bridging the gap between scholarly discourse and practical law enforcement insights, this paper aims to highlight the cognitive dissonance experienced by frontline officers when using policing methods that conflict with evidence-based practices and personal values. It critiques routine police procedures, highlighting the ineffectiveness of criminal sanctions in reducing drug offences and the resultant damage to community trust and police legitimacy.

Using autoethnography and critical reflection that combines personal narrative and ethnographic observation, this paper presents a practitioner's perspective on the challenges of enforcing low-level drug offences. It integrates the author's experiences as a neighbourhood police officer in Camden Town, London, with theoretical analysis to highlight the practical realities of drug law enforcement at the intersection of law enforcement and public health.

This research reveals contradictions between current drug law enforcement strategies and public health objectives, and the consequences for law enforcement. It highlights the risks of limiting police discretion and preventing their ability to respond appropriately to complex needs. The paper emphasises the need for public health and trauma-informed policing strategies to mitigate the adverse effects on vulnerable and disadvantaged communities.

Improved public health outcomes: prioritising treatment and support over punishment. Adoption of trauma-informed practices: reducing marginalisation, stigma and improved experiences of police interaction. Improved trust and legitimacy: when the public perceive policing as fair and aligned with community values, it strengthens procedural justice and police legitimacy. Enhanced officer well-being: an improved working environment and experience, through more meaningful, impactful work and improved interactions and relationships with the public. Policy change: policymakers should recognise the discretionary role of police when developing drug policy and acknowledge the risks associated with enforcement approaches that conflict with community needs and broader policing objectives.

Offering a novel critique of prohibitionist drug policies within the British context, this paper advocates for a cultural shift towards public health and trauma-informed approaches in UK policing. It emphasises the importance of recognising police officers' discretionary role as “citizen-agents” and the integration law enforcement approaches with harm reduction initiatives for enhanced procedural justice and police legitimacy.

Governments faced formidable challenges in coordinating public health responses to the COVID-19 pandemic. This study aims to enhance the understanding of effective organizational leadership during crises by investigating the factors influencing the turnover of health leaders during the COVID-19 pandemic in Brazil.

Using primary data encompassing all appointments and dismissals of federal and state health secretaries, this paper conducted a quantitative analysis of the relational and reputational factors that contributed to leader turnover during the COVID-19 pandemic. This paper also examined whether leaders’ management and public health experience increase the duration of tenure.

States encountered significant challenges in retaining experienced and effective leadership during the health emergency, primarily due to political conflicts in policymaking and, to a lesser extent, allegations of corruption. Furthermore, leaders with expertise in public health were found to be less likely to be removed from office. However, managerial experience did not prolong the tenure of state health secretaries during the emergency.

Since most health leaders have public health and management experience, the contributions of each factor to the duration of a secretary’s tenure are difficult to separate and analyze separately.

This study provides empirical insights into what factors drive health leader turnover during major health emergencies.

During major health emergencies, health leaders often strongly disagree with elected officials on the response. This paper test how crisis leadership theories help explain state health leaders’ duration in one of the world’s largest public health systems during the COVID-19 pandemic. This paper find that policy disagreements contributed to significant turnover.

To the best of the authors’ knowledge, this paper is the first that are aware of that uses novel primary data on public health executive leader characteristics and turnover causes in the context of the COVID-19 pandemic. It provides empirical evidence contributing to the crisis leadership literature by examining health leader turnover in one of the world’s largest public health systems.

Norway, like other welfare states, seeks to leverage data to transform its pressured public healthcare system. While managers will be central to doing so, we lack knowledge about how specifically they would do so and what constraints and expectations they operate under. Public sources, like the Norwegian policy documents investigated here, provide important backdrops against which such managerial work emerges. This article therefore aims to analyze how key Norwegian policy documents construe data use in health management.

We analyzed five notable policy documents using a “practice-oriented” framework, considering these as arenas for “organizing visions” (OVs) about managerial use of data in healthcare organizations. This framework considers documents as not just texts that comment on a topic but as discursive tools that formulate, negotiate and shape issues of national importance, such as expectations about data use in health management.

The OVs we identify anticipate a bold future for health management, where data use is supported through interconnected information systems that provide relevant information on demand. These OVs are similar to discourse on “evidence-based management,” but differ in important ways. Managers are consistently framed as key stakeholders that can benefit from using secondary data, but this requires better data integration across the health system. Despite forward-looking OVs, we find considerable ambiguity regarding the practical, social and epistemic dimensions of data use in health management. Our analysis calls for a reframing, by moving away from the hype of “data-driven” health management toward an empirically-oriented, “data-centric” approach that recognizes the situated and relational nature of managerial work on secondary data.

By exploring OVs in the Norwegian health policy landscape, this study adds to our growing understanding of expectations towards healthcare managers' use of data. Given Norway's highly digitized health system, our analysis has relevance for health services in other countries.

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

To explore the mechanisms of the implementation strategy, “oilcloth sessions” and understand and explain the ripple effects of oilcloth sessions as a strategy to implement a new emergency department.

A qualitative design was used whereby data were collected using field notes from an ethnographic study of the oilcloth sessions and follow-up semi-structured interviews with staff, managers and key employees who participated in the oilcloth sessions. The data analysis was inspired by the realist evaluation approach of generative causality proposed by Pawson and Tilley.

The primary ripple effect was that the oilcloth sessions were used for different purposes than the proposed program theory, including being used as: (1) a stage, (2) a battlefield, (3) a space for imagination and (4) a strategic management tool influencing the implementation outcomes. The results bring essential knowledge that may help to explain why and how a well-defined implementation strategy has unplanned outcomes.

Unintended outcomes of implementation strategies are an underexplored issue. This study may help implementation researchers rethink the activities required to reduce unintended negative outcomes or explore potential unplanned outcomes and, in this way, hinder or enhance outcomes, effectiveness and sustainability. Future studies within implementation research should incorporate attention to unintended outcomes to fully understand the impact of implementation strategies.

Mental health champions (MHCs) and young health ambassadors (YHAs) are two innovative public health interventions. MHCs are practitioners who work in schools and other youth settings and aim to be the “go to” person for mental health in these settings. YHAs are a linked parallel network of young people, who champion mental health and advocate for youth involvement, which was co-produced with young people across all stages of development implementation. This paper aims to identify the potential benefits, barriers and facilitators of these interventions.

Semi-structured qualitative interviews (n = 19) were undertaken with a purposive sample of n = 13 MHCs, and n = 6 YHAs, between June 2021 and March 2022. Interviews were audio-recorded, transcribed, anonymised and then analysed following a thematic approach. Ethical approval was granted by Newcastle University’s Faculty of Medical Sciences Ethics Committee.

The findings are organised under five key themes: motivating factors and rewards for MHCs and YHAs; outcomes for children and young people (CYP) and others; impact on youth settings and culture; facilitators of successful implementation; and implementation challenges and opportunities.

These findings are intended to be of relevance to practice and policy, particularly to those exploring the design, commissioning or implementation of similar novel and low-cost interventions, which aim to improve mental health outcomes for CYP, within the context of youth settings.

The interventions reported on in the present paper are novel and innovative. Little research has previously been undertaken to explore similar approaches, and the individual experiences of those involved in the delivery of these types of interventions.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy.

The study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software.

Three themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother’s keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality.

Through first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.

This study aims to understand the utility of personas and illustrate, through a case study, how a persona-building exercise in a Community Based Prevention Marketing (CBPM) training of community leaders elicited important insights that complemented findings from ongoing formative research on vaccine hesitancy in the Hispanic/Latino population in the USA during COVID-19 pandemic.

An exploratory concurrent parallel qualitative study design compared three personas created by community-based organization members (n = 37) to transcripts from five formative research focus groups (n = 30) from the same project. All participants in this study were recruited by the National COVID-19 Resiliency Network as part of their capacity-building and formative research activities. Grounded theory guided the content analysis.

This study found personas and focus groups to be complementary. A high degree of co-occurrence was observed when investigating the uptake of the COVID-19 vaccine under the categories of barriers, culture and communication. Between the two methods, the authors found strong associations between fear, disruption to the value system, work-related barriers, inaccessibility to health care and information sources and misinformation. Areas of divergence were negligible.

While personas provided background information about the population and sharing “how” to reach the priority population, focus groups provided the “why” behind the behavior, followed by “how”.

A community-driven persona-building process built on cultural community knowledge and existing data can build community capacity, provide rich information to assist in the creation of tailored messages, strategies and overall interventions during a public health crisis and provide user-centered, evidence-based information about a priority population while researchers and practitioners wait on the results from formative research.

This case study provided a unique opportunity to analyze the complementary effectiveness of two methods acting in tandem to understand the priority population: stakeholder-informed persona-building and participant-informed focus group interviews. Understanding their complementary nature addresses a time gap that often exists between researchers and practitioners during times of crises and builds on recommendations associated with bringing rigor into practice, promoting academic contribution to real-world issues and building collaborative partnerships. Finally, it supports the utility of a nimble tool that improves social marketers’ ability to know more about their audience for intervention design when time is of the essence and formative research is ongoing.

The ‘fit healthy’ body has been invoked in popular discourse as far less vulnerable to communicable diseases like the novel coronavirus both in mainstream accounts of the pandemic and in more fringe anti-vaccine discourse. Those opposed to vaccination argue the management of the body through diet and exercise allows for natural immune processes to manage COVID-19. This chapter interrogates anti-vaccine sentiment in Western countries such as Australia, Canada, the United Kingdom and the United States to demonstrate the pervasiveness of discourses that position the maintenance of a ‘fit healthy’ ideal body as an alternative to preventative medicine such as vaccines. Drawing on several key examples, this conceptual chapter explores the ways bodily ‘wellness’ became a part of vaccine hesitancy discourse during the pandemic, as risk is balanced through calculations of what vaccines might ‘do’ to a body and the body’s capacity to respond to illness.