TY - JOUR
T1 - An international comparison of stakeholder motivation to implement liver cancer control
AU - Bridges, John F.P.
AU - Joy, Susan M.
AU - Blauvelt, Barri M.
AU - Yan, Weili
AU - Marsteller, Jill A.
N1 - Publisher Copyright:
© 2014 The Author; all rights reserved.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Background The World Health Organization offers clear guidance on the development of national cancer control programmes based on a country's level of resources, yet the motivation to implement such programmes may be driven by factors other than resources. Objectives To compare stakeholder motivation to implement a national liver cancer control programme and assess if variation in motivation was associated with stakeholder characteristics or with national indicators of need and resources. Methods Relevant stakeholders were purposively selected from 13 countries (Australia, China, France, Germany, Italy, Japan, Nigeria, South Korea, Spain, Taiwan, Thailand, Turkey and USA) to participate in a structured survey on liver cancer control. Respondents included 12 individuals working in clinical, 5 in policy and 3 in advocacy roles from each country. Stakeholders' motivation was measured using a scale grounded in expectancy theory and knowledge gained during previous qualitative interviews. Comparisons across countries and respondent characteristics were conducted using hierarchical regression. Country level motivation scores, holding constant individual level covariates, were correlated with indicators of need and resources and tested using Pearson's correlation coefficients. Results In total, 260 stakeholders, equally drawn from the study countries, completed the survey (45% response rate). At the national level, motivation was highest in Nigeria, Thailand and China (P<0.001), and lowest in Italy (P<0.001) and Germany (P=0.003). Higher motivation was observed among stakeholders working at the international level relative to the local level (P=0.017). Motivation was positively associated with a country's relative burden of liver cancer (P=0.015) and negatively associated with their level of resources (P=0.018). Conclusions This study provides the first empirical evidence on the motivation of stakeholders to implement national cancer control programmes. Furthermore, we demonstrate that motivation is more clearly associated with a country's cancer control needs rather than resources.
AB - Background The World Health Organization offers clear guidance on the development of national cancer control programmes based on a country's level of resources, yet the motivation to implement such programmes may be driven by factors other than resources. Objectives To compare stakeholder motivation to implement a national liver cancer control programme and assess if variation in motivation was associated with stakeholder characteristics or with national indicators of need and resources. Methods Relevant stakeholders were purposively selected from 13 countries (Australia, China, France, Germany, Italy, Japan, Nigeria, South Korea, Spain, Taiwan, Thailand, Turkey and USA) to participate in a structured survey on liver cancer control. Respondents included 12 individuals working in clinical, 5 in policy and 3 in advocacy roles from each country. Stakeholders' motivation was measured using a scale grounded in expectancy theory and knowledge gained during previous qualitative interviews. Comparisons across countries and respondent characteristics were conducted using hierarchical regression. Country level motivation scores, holding constant individual level covariates, were correlated with indicators of need and resources and tested using Pearson's correlation coefficients. Results In total, 260 stakeholders, equally drawn from the study countries, completed the survey (45% response rate). At the national level, motivation was highest in Nigeria, Thailand and China (P<0.001), and lowest in Italy (P<0.001) and Germany (P=0.003). Higher motivation was observed among stakeholders working at the international level relative to the local level (P=0.017). Motivation was positively associated with a country's relative burden of liver cancer (P=0.015) and negatively associated with their level of resources (P=0.018). Conclusions This study provides the first empirical evidence on the motivation of stakeholders to implement national cancer control programmes. Furthermore, we demonstrate that motivation is more clearly associated with a country's cancer control needs rather than resources.
KW - Cancer control
KW - Health policy
KW - Implementation
KW - Liver neoplasms
KW - Motivation
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U2 - 10.1093/heapol/czu044
DO - 10.1093/heapol/czu044
M3 - Article
C2 - 24974105
AN - SCOPUS:84941953534
VL - 30
SP - 645
EP - 655
JO - Health Policy and Planning
JF - Health Policy and Planning
SN - 0268-1080
IS - 5
ER -