Assignment 1

– Due Feb-9th
58

• In the @rst assignment you will document the nature and scope of a policy problem and make a case for
  its importance.
• You will also apply the 3-I (Instuons, Ideas, Interests) framework and explore connecons between the
  problem you’ve iden@ed and the Canada Health Act.
• Provide background necessary to understand the problem and why it is important, including:
• Descripon of the problem, including discussion of any populaons parcularly aEected and
  implicaons for health equity
• Explanaon of its importance, including stascs or other informaon to describe its magnitude
• Demonstrate applicaon of the 3-Is framework, including:
• Iden@caon and explanaon of relevant ideas, instuons, and interests
• Discussion of how the 3-Is may help understand how this problem came to be.
• Idenfy and explain any connecons between the problem and relevant principles of the Canada
  Health Act (CHA)
  Assignment 1 – Finding Topics
  (Problems)
  59
• Make sure you are focusing on problems at this stage – soluons can, and will come later in the
  semester
• Pick something relevant to the BC context – most of our educaon in this class is on BC instuons and
  legal frameworks
• Ideally, keep it focused (speci@caon to a certain geography, populaon, etc.); The more focused you are,
  the easier it will be to come up with speci@c Ideas, Interests, and Instuons that are relevant to your
  policy problem
• Consider some of the following ideas:
  a) Gaps in care connuity
  b) Need for culturally/linguiscally responsive services
  c) Wait mes for speci@c services
  d) Lack of mental health or substance use supports
  e) Workforce issues – supply, distribuon, mix, etc.
  f) Something else?
  Assignment 1 – Finding Topics
  (Problems)
  60
  Assignment 1 – Finding Sources
  61
  Do your best to @nd informaon speci@c to your problem/populaon/context, but it may not always be
  possible to line things up correctly
  Where to look for sources:
• Start with newspapers, and other reliable websites targeng non-specialist audiences
• Where possible track down the original source of informaon
• News arcles are mainly appropriate for rapidly developing scenarios, and @rst-hand experiences; other
  mes they will cite recently published research, or use CIHI stats to back up their story
• Reports and stats can be found also through agencies like CIHI
• Academic journals
  Academic Journals
  62
  Canadian Journals
• Healthcare Policy
• Canadian Medical Associaon Journal (CMAJ), and other journals targeng physicians like Canadian
  Family Physician (CFP), Canadian Journal of Psychiatry (CJP)
  Internaonal Health Policy Journals
• Health Policy (not to be confused with Healthcare Policy!)
• Health Policy and Planning
• Internaonal Journal of Health Policy and Management
• Health AEairs (US-focused)
  Internaonal Medical Journals
• BMJ
• NEJM
• JAMA
  Assignment 1
  ◦Word count?
  ◦Limit of 1,500 but ideally not shorter than 1,000
  ◦Grading rubric?
  ◦Included in syllabus (pg. 9), but also in following slide
  ◦Vancouver-style citaons?
  ◦Citaons are marked in-text with numbers (either as superscripts1,2,3, or in brackets
  [1,2,3])
  ◦For Vancouver-style citaon guide, see:
  h;ps://www.scribbr.co.uk/referencing/vancouver-style/
  ◦For free citaon so=ware, see: Zotero, quick-start guide
  ◦For other quesons on citaons, research resources, see SFU library

Further Example of 3-I
Framework
◦Bashir, N. S., & Ungar, W. J. (2015). The 3-I framework: A framework for developing public policies
regarding pharmacogenomics (PGx) tesng in Canada. Genome, 58(12), 527–540.
h;ps://doi.org/10.1139/gen-2015-0100
◦Pharmacogenomic tesng: “deGned as the study of variaons of DNA and RNA characteriscs as related
to drug response. An example is the tesng of genec variants in the gene that codes for the enzyme
responsible for the metabolism of warfarin, an ancoagulant drug prescribed to prevent thromboembolic
events”
◦Policy Problem: “While personalized medicine has just begun to be incorporated into clinical pracce and
funding for research is increasing, policies are lacking to enable personalized medicine and PGx tesng as
a roune service in the Canadian health care system. Who will be providing and nancing services, who
should be able to requision the technology, and how the informaon will be used are quesons that do
not have dened answers today at a federal or provincial level. Not having clear guidelines and policies in
place before the technology permeates extensively into clinical pracce may have detrimental economic,
ethical, and operaonal eKects, but also gives health care providers, consumers, and service providers
free reign in the procurement and use of tesng.”
Further Example of 3-I
Framework
◦Ideas: genec discriminaon, informed consent and the tradional model of clinical trials,
conGdenality and privacy, paent and professional knowledge about PGx, stakeholder roles
in PGx, value and clinical ulity of PGx tesng
◦Interests: paents, healthcare providers, PGx service providers, insurance companies,
pharmaceucal companies, provincial ministries of health
◦Instuons: PIPEDA (Personal Informaon Protecon and Electronic Documents Act), PHIPA
(Personal Health Informaon Protecon Act in Ontario), Health Canada guidance on PGx
tesng results in clinical trials, etc.
◦Fundamental problem that there isn’t much in the way of legislaon around PGx – formal
policies and legislaon do not exist to speciGcally govern PGx tesng, hence an unusual set of
instuons
◦Canada Health Act: consider issues around accessibility (genec discriminaon?), public
administraon (who’s going to be providing PGx tesng? Will paents be charged for it?)
Further Example of 3-I
Framework
◦Health Policy Analysis in Midwifery (
h;ps://ecampusontario.pressbooks.pub/cmroleofmidwifery/chapter/health-policy-analysis-inmidwifery/
)
◦Managing Tests Policy in Ontario (h;ps://www.cfp.ca/content/67/9/644.long)
◦PGx Tesng Connued: Consideraons for developing regulaons for direct to consumer ‑ ‑
genec tesng: a scoping review using the 3 I framework ( ‑
h;ps://doi.org/10.1007/s12687-022-00582-3)
◦Reconceptualising the study of alcohol policy decision-making: the contribuon of polical
science (h;ps://doi.org/10.1080/16066359.2020.1773445)
◦Shared care: the barriers encountered by community-based palliave care teams in Ontario,
Canada (h;ps://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1365-2524.2012.01060.x)
◦Most examples of academic wring should be available through SFU’s library Catalogue