gms | German Medical Science

Workshop organizers: Dr. Jan M. Stratil, Renke Biallas, Dr. Ani Movsisyan, Prof. Hajo Zeeb, Prof. Eva A. Rehfuess

Inviting organizations:

• Deutsche Gesellschaft für Public Health (DGPH)
• UMIT TIROL – University for Health Sciences and Technology
• Pettenkofer School of Public Health, IBE, LMU Munich

Introduction: Despite the best intentions, public health (PH) interventions may lead to adverse effects and other unintended consequences (AUCs). While often neglected, the COVID-19 pandemic has raised awareness about the significance of such consequences. To support researchers and decision-makers, we developed the Consequences of PH Interventions (CONSEQUENT) framework1 using a systematic review and best-fit framework synthesis approach based on theoretical and empirical studies. The framework intends to facilitate classification and conceptualization of AUCs during the development and evaluation of, as well as decision-making on PH interventions.

Learning objectives: Participants will:

• Become aware of the numerous potential AUCs of PH interventions
• Describe potential AUCs of PH interventions
• Recognize that AUCs may be perceived as positive or negative, depending on the stakeholder group
• Apply the novel framework to conceptualize AUCs of PH interventions

Interaction with participants: The workshop combines short presentations and hands-on work in small groups in line with the principles of problem-based learning. Participants engage with the AUCs of a PH intervention through guided group discussions and creating graphical depictions (i.e. logic models, stakeholder maps).

Part 1: Introducing the CONSEQUENT framework (10 minutes + 5 minutes for Q&A): We introduce the CONSEQUENT framework, explaining its two components. The consequences component serves to categorize AUCs, while the (supplementary) mechanisms component describes pathways through which AUCs may arise.

Part 2: Applying the CONSEQUENT framework (55 minutes):

2.1 Presenting the use case (5 minutes): First, participants are provided with the use case of school closures during the COVID-19 pandemic and guided through the individual steps of framework application. They are then divided into groups of 5-8.

2.2 Creating an initial logic model (10 minutes): Second, the groups create an initial logic model of how the intervention is intended to work, with support of the organizers. This initial logic model, depicts the (intended) impacts of the interventions, along with the assumed causal pathways.

2.3 Mapping affected stakeholders (15 minutes): Third, the groups develop a stakeholder map, intended to show which stakeholder groups are directly or indirectly affected by the intervention.

2.4 Conceptualizing AUCs and mechanisms leading to them (25 minutes): Fourth, the groups expand the initial logic model by thinking through which AUCs could arise from the intervention. Using the consequences component – a generic list of potential AUCs – and their stakeholder map they deliberate potential AUCs from different perspectives (e.g. which AUCs for teachers could arise from school closures?). Time permitting, using the mechanisms component they think through processes that could be triggered by introducing the intervention into the given context.

Part 3: Summarizing findings and reflecting on the CONSEQUENT framework (20 minutes): We invite groups to take the perspective of one of the identified stakeholder groups and give a brief statement on the AUCs they consider most important for decision-making. Thereby, we gradually create a comprehensive map of the potential AUCs of school closures. We then ask participants to reflect on the added value of and challenges with applying the CONSEQUENT framework and their experience with the workshop.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.