Monika Schaffner1, Ursula Rochau1, Igor Stojkov1, Vjollca Qerimi Rushaj1,2, Henry Völzke3, Georg Marckmann4, John H Lazarus5, Wilhelm Oberaigner1, Uwe Siebert1,6,7. 1. Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria. 2. Faculty of Pharmacy, School of PhD Studies, Ss. Cyril and Methodius University, Skopje, Macedonia. 3. Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. 4. Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany. 5. Thyroid Research Group, Cardiff University Medical School, University Hospital of Wales, Cardiff, United Kingdom. 6. Department of Health Policy and Management, Center for Health Decision Science, Harvard Chan School of Public Health, Boston, Massachusetts, USA. 7. Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
Background: Although substantial progress has been made in recent decades in eliminating iodine deficiency, iodine deficiency disorders (IDDs) are still prevalent in European countries. Challenges include ineffective public health programs and discontinuation of IDD prevention. However, the barriers against the implementation and continuation of prevention and monitoring of IDD remain unclear. Therefore, the objective of our study was to identify potential barriers against pan-European IDD prevention and monitoring programs and to find solutions for the different challenges. Methods: We conducted a Delphi study consisting of three rounds. We identified potential participants with expertise and experience in relevant fields from all European countries, including policy makers, health care professionals, health scientists, and patient representatives. The Delphi method was conducted with open-ended questions and item ranking to achieve group consensus on potential barriers against national and pan-European IDD prevention and monitoring programs and related solutions to overcome those barriers. The answers of the Delphi rounds were analyzed using qualitative content analysis and descriptive analysis methods. In addition, we conducted two expert interviews to analyze and discuss the study results. Results: Eighty experts from 36 countries and different fields of work participated in the first Delphi round, 52 in the second, and 46 in the third. Potential barriers include challenges in the fields of knowledge and information, implementation and management, communication and cooperation, political support, and differences between the European countries. Ranked solutions addressing these barriers include cooperation with different stakeholders, gaining knowledge, sharing information, the development of a European program with national specification, European guidelines/recommendations, and European monitoring. The ranking gives a first overview as to which of these barriers would need to be solved most urgently and which solutions may be most helpful. Conclusion: In our study, we derived key information and first insights with regard to barriers against IDD prevention programs from a broad range of stakeholders. Most barriers were found in the category of implementation and management. Also a lack of political support seems to play an important role. The findings of our study may help decision makers in health policy to develop more effective IDD prevention and monitoring strategies.
Background: Although substantial progress has been made in recent decades in eliminating iodine deficiency, iodine deficiency disorders (IDDs) are still prevalent in European countries. Challenges include ineffective public health programs and discontinuation of IDD prevention. However, the barriers against the implementation and continuation of prevention and monitoring of IDD remain unclear. Therefore, the objective of our study was to identify potential barriers against pan-European IDD prevention and monitoring programs and to find solutions for the different challenges. Methods: We conducted a Delphi study consisting of three rounds. We identified potential participants with expertise and experience in relevant fields from all European countries, including policy makers, health care professionals, health scientists, and patient representatives. The Delphi method was conducted with open-ended questions and item ranking to achieve group consensus on potential barriers against national and pan-European IDD prevention and monitoring programs and related solutions to overcome those barriers. The answers of the Delphi rounds were analyzed using qualitative content analysis and descriptive analysis methods. In addition, we conducted two expert interviews to analyze and discuss the study results. Results: Eighty experts from 36 countries and different fields of work participated in the first Delphi round, 52 in the second, and 46 in the third. Potential barriers include challenges in the fields of knowledge and information, implementation and management, communication and cooperation, political support, and differences between the European countries. Ranked solutions addressing these barriers include cooperation with different stakeholders, gaining knowledge, sharing information, the development of a European program with national specification, European guidelines/recommendations, and European monitoring. The ranking gives a first overview as to which of these barriers would need to be solved most urgently and which solutions may be most helpful. Conclusion: In our study, we derived key information and first insights with regard to barriers against IDD prevention programs from a broad range of stakeholders. Most barriers were found in the category of implementation and management. Also a lack of political support seems to play an important role. The findings of our study may help decision makers in health policy to develop more effective IDD prevention and monitoring strategies.
Authors: Line Tang Møllehave; Marie Holm Eliasen; Ieva Strēle; Allan Linneberg; Rodrigo Moreno-Reyes; Ludmila B Ivanova; Zvonko Kusić; Iris Erlund; Till Ittermann; Endre V Nagy; Ingibjorg Gunnarsdottir; Jonathan Eli Arbelle; Aaron Milton Troen; Valdis Pīrāgs; Lisbeth Dahl; Alicja Hubalewska-Dydejczyk; Malgorzata Trofimiuk-Müldner; João Jacome de Castro; Mafalda Marcelino; Simona Gaberšček; Katja Zaltel; Manuel Puig-Domingo; Lluis Vila; Sofia Manousou; Helena Filipsson Nyström; Michael Bruce Zimmermann; Karen R Mullan; Jayne Valerie Woodside; Henry Völzke; Betina Heinsbæk Thuesen Journal: Endocr Connect Date: 2022-03-10 Impact factor: 3.335