Methods for targeting and evaluating public health interventions for people living in neighbourhoods where the burden of disease is high or the participation in organised screening is low

Research problem and specific questions: The aim of this programme is to develop, adapt and make available methods that will facilitate public health interventions at the small-residential-area level. We shall primarily focus on interventions linked to the Swedish healthcare system.

Specific questions are: Which statistical signals, based on data from the register infrastructure in Sweden, should be provided for defining areas where the burden of a disease is high and/or the uptake of an organised screening programme is low? Which evaluation design methods for targeted interventions should be applied?

Which barriers and facilitators impact on the implementation of a new information system for rational targeting?Data and method: We shall use sociodemographic data for small areas (DeSOs) provided by Statistics Sweden, and correspondingly geographically stratified disease and screening participation data from national and regional healthcare registers.

Our methodological research will cover 1) statistics on spatial and spatiotemporal variations in disease burdens and screening uptakes and 2) evaluation designs of small-area interventions.

Empirically, we put focus on two thematic areas aiming at A) improving participation in organised cancer screening programmes and B) strengthening preventive and health-promoting activities in dental healthcare for children and adolescents.Relevance and utilisation: By attracting attention to public health interventions at the small-area level and scientifically sound approaches to targeting, designing and evaluating such interventions, we anticipate that advances towards an equal and health-promoting healthcare system could be made.

Our ambition is to develop a nationwide information system that forms a basis for rationally targeted public health interventions and, also, to build knowledge about how to design and evaluate such interventions.Plan for programme realisation: Two work streams (WS) will be initiated: WS Surveillance and Targeting that shall develop a nationwide information system based on descriptive small-area statistics and spatial epidemiology and WS Evaluation and Implementation that shall address methods for scientific evaluations of targeted public health interventions and conduct studies to critically assess barriers and facilitators that impact on the implementation of the proposed information system.

Our group has created new ground by conducting nationwide and regional descriptive epidemiology studies based on DeSO-level data.

Our group also has extensive experience with applied and methodological research related to evaluation in public health and health economics, and implementation research. We shall involve stakeholders on leading positions within the Swedish healthcare organisation.

Targeted interventions within other thematic areas than A and B (mentioned above), not necessarily linked to the healthcare system, might be brought to the fore as the programme develops.