An effectiveness hierarchy of preventive interventions: Neglected paradigm or self-evident truth?



Capewell, S ORCID: 0000-0003-3960-8999 and Capewell, A
(2017) An effectiveness hierarchy of preventive interventions: Neglected paradigm or self-evident truth? Journal of Public Health (United Kingdom), 40 (2). 350 - 358.

[img] Text
Capewell~Effectiveness Hierarchy ~JPH ~Author accepted MS 2017.pdf - Accepted Version

Download (435kB) | Preview

Abstract

© The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. Non-communicable disease prevention strategies usually target the four major risk factors of poor diet, tobacco, alcohol and physical inactivity. Yet, the most effective approaches remain disputed. However, increasing evidence supports the concept of an effectiveness hierarchy. Thus entive activities targeting individuals (such as 1:1 personal advice, health education, 'nudge' or primary prevention medications) consistently achieve a smaller population health impact than interventions aimed further 'upstream' (for instance, smoke-free legislation, alcohol minimum pricing or regulations eliminating dietary transfats). These comprehensive, policy-based interventions reach all parts of the population and do not depend on a sustained 'agentic' individual response. They thus tend to be more effective, more rapid, more equitable and also cost-saving. This effectiveness hierarchy is self-evident to many professionals working in public health. Previously neglected in the wider world, this effectiveness hierarchy now needs to be acknowledged by policy makers.

Item Type: Article
Depositing User: Symplectic Admin
Date Deposited: 20 Jan 2020 10:26
Last Modified: 25 Feb 2020 09:13
DOI: 10.1093/pubmed/fdx055
URI: http://livrepository.liverpool.ac.uk/id/eprint/3050193