Health Policy
Applying Chronic Illness Care, Implementation Science, and Self-Management Support to HIV
At the 1989 international AIDS meeting in Montreal, the director of the National Cancer Institute announced that HIV/AIDS had evolved into a chronic disease and that cancer treatment should be used as a learning model for HIV/AIDS, with a focus on better disease management on the part of both individuals and healthcare organizations.1 This announcement reflected the success of therapeutics that can stabilize patients with HIV, allowing for improved quality of life and longer life span. Very recently, the U.S.An Evidence Integration Triangle for Aligning Science with Policy and Practice
Over-reliance on decontextualized, standardized implementation of efficacy evidence has contributed to slow integration of evidence-based interventions into health policy and practice. This article describes an “evidence integration triangle” (EIT) to guide translation, implementation, prevention efforts, comparative effectiveness research, funding, and policymaking. The EIT emphasizes interactions among three related components needed for effective evidence implementation: (1) practical evidence-based interventions; (2) pragmatic, longitudinal measures of progress; and (3) participatory implementation processes.Behavior Matters
Behavior has a broad and central role in health. Behavioral interventions can be effectively used to prevent disease, improve management of existing disease, increase quality of life, and reduce healthcare costs. A summary is presented of evidence for these conclusions in cardiovascular disease/diabetes, cancer, and HIV/AIDS as well as with key risk factors: tobacco use, poor diet, physical inactivity, and excessive alcohol consumption. For each, documentation is made of (1) moderation of genetic and other fundamental biological influences by behaviors and social–environmental factors; (2) impacts of behaviors on health; (3) success of behavioral interventions in prevention; (4) disease management; (5) quality of life, and (6) improvements in the health of populations through behavioral health promotion programs.
