Multi-step evidence synthesis for policymaking processes: a novel methodology to inform large-scale health policies in Chile: The National Plan for Childhood Obesity

Session: 

Oral session: Knowledge translation and communicating evidence (7)

Date: 

Thursday 24 October 2019 - 16:00 to 17:30

Location: 

All authors in correct order:

Mansilla C1, Navarro-Rosenblatt D1, Garcia-Celedon P1, Pacheco J1, Sepulveda D1
1 Ministry of Health, Chile
Presenting author and contact person

Presenting author:

Deborah Navarro-Rosenblatt

Contact person:

Abstract text
Background: overweight and obesity are a global epidemic, with rates risen to alarming levels in most countries. Chile is no exception, with sharp increases in obesity prevalence, especially among school-age children, affecting almost 40% of six-year-old children. In this context, the Ministry of Health (MoH) has decided to develop a ‘National Plan for Childhood Obesity’, for the next decade. In this presentation, we report the methodology used to inform the design and implementation of this process, where scientific evidence was used in each step of the process.

Objectives: the Department of Health Technology Assessment and Evidence-based Medicine created an innovative methodology to consistently incorporate scientific evidence, aiming to identify and evaluate interventions that tackle childhood obesity.

Methods: the methodology of this process has five main steps: 1) defining the problem and the population affected; 2) identifying factors explaining the problem, 3) identifying interventions that tackle each of the factors; 4) evaluating the effectiveness of the identified interventions, and 5) evaluating the implementation considerations of the interventions that are finally selected. We defined the problem after collecting information from academia and policy experts, and searching evidence from the literature. In steps 2, 3 and 4 we developed a literature review to identify systematic reviews, supporting the inclusion of factors underlying the problem, and the effectiveness of health policy and systems interventions.

Results: from an original search providing 6670 systematic reviews, we finally selected 166 articles from which we created a causal tree of prioritized factors that could explain obesity in children. The factors identified were: intake; physical activity; being sedentary; breastfeeding; perinatal factors; metabolism; and mental health. The analysis of intervention effectiveness will be shown at the Colloquium.

Conclusions: this innovative approach shows how systematic reviews could have a central role in the design of national health policies, by informing each one of the steps in the policymaking process. The use of this methodology for the National Plan for Childhood Obesity is a window of opportunity that brings together the strength of an academic systematic review, with the time pressure that policymakers have and the need of delivering evidence-based answers to stakeholders. The results showed here will be an important model for the policymaking of a broad variety of health policies, especially for institutionalize the use of scientific evidence on health policymaking processes.

Patient or healthcare consumer involvement: no patients were involved in this project, and healthcare consumer involvement was not required.