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Discussion: Selecting a Policy Analysis Framework

NURS 8100 Discussion: Selecting a Policy Analysis Frame

Discussion: Selecting a Policy Analysis Framework
The policy I have selected for this week’s discussion is the policy surrounding Genetic Data Privacy. In Colorado, this is one of the top 10 policies that will be focused on by legislators even though the top priority for the state remains economic recovery after the Covid-19 pandemic. This policy looks at the rights and obligations from two different perspectives; business obligations and consumer rights. Regulations need to be adhered to by businesses to prevent security breaches of the data they collect. Consumers have the right to access the data that has been collected and request it be deleted (Fording, 2021). The right to have an individual’s personal genetic data protected is not only important in the health care sector but is also emerging as a new issue in the public arena because of corporations like 23andMe and Ancestory.com. Like the bill that passed in California (senate bill 980) which required policies be developed to ensure private genetic information be kept from insurance companies which in turn would prevent denials of insurance, Colorado similarly is looking to ensure that genetic information is kept private.

The framework that applies to this particular issue is outlined in Fawcett and Russell’s (2001), Conceptual Model of Nursing and Health Policy. The model is divided into five levels of focus and outcomes. In this case, I believe that level five is the level that deals with the privacy of genetic information. The fifth level examines health from a global perspective, taking into consideration “social justice, the meaning of health, and a fair distribution of nursing and health resources” (p. 112). As mentioned earlier the need to keep genetic results private so insurance companies cannot use that information to deny coverage is a fair distribution issue. The other stages of this conceptual model could guide healthcare institutions, specifically at the department level, by using levels two and level three. In these levels, the development of policy that guides healthcare practice and the study of its effectiveness is the primary focus. Frameworks like this simplify the concept of policy development for those individuals who do not have a high degree of comfort with this type of work. Nurses are not usually found on the legislative floor discussing policy development so frameworks like this can assist in becoming part of policy development and revision a much more enticing proposition.

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References:

Fawcett, J., & Russell, G. (2001). A conceptual model of Nursing and health policy. Policy, Politics, & Nursing Practice2(2), 108–116. https://doi.org/10.1177/152715440100200205

Fording, A. (2021, February 25). Consumer Data Privacy Laws:2021 State Trends. Fiscal Note Blog.

https://fiscalnote.com/blog/2021-state-trends-the-rise-of-consumer-data-protectionwork

Thank you for presenting a new and insightful topic about the impact of  Genetic Data Privacy. I am unfamiliar with this topic, so your

Discussion Selecting a Policy Analysis Framework
Discussion Selecting a Policy Analysis Framework

discussion prompts further research into this topic. Genetic testing is a valuable resource for individuals seeking diagnostic or predictive health information for therapeutic or medical treatment (Bélisle-Pipon et al., 2019) because it provides health, disease risk, and other traits. Our  DNA is conceptualized as a unique identifier that can provide insight into a persons’ health, but it also implies revealing information of family members that are close or distant with similar ancestry (Clayton et al., 2019). I believe genetic testing is a personal decision that everyone should be able to make without concern of exploitation from businesses such as insurance companies. Consequently, people’s fear of unwanted disclosure to insurers impacts clinical research recruitment involving genetic testing (Bélisle-Pipon et al., 2019). Nonetheless, the misuse of genetic data can also be used unfairly in the workplace to discriminate against individuals on the jobs (Silvers, n.d.). For instance, employers may deny individual jobs or benefits due to having a particular genetic trait that has no impact on their ability to perform the job duties. Furthermore, special racial or ethnic groups with genetic traits may be disproportionately discriminated against(Silver, n.d.). Therefore, the technological privacy system and the laws governing privacy for all may fail to protect vulnerable populations, leading to questionable equitable privacy protections’ effectiveness (Ekstrand et al., 2018). Hence, this national issue warrants priority on the political agenda. So, I agree that the conceptual model for nursing and health policy is an excellent model to incorporate into the agenda-setting process for this issue. It will help the nursing discipline understand its relationship with genetic testing and its implication for supporting patients’ genetic information in the political arena. I can see genetic data used wrongfully against an individual because of a revealed genetic health risk disposition.

References

Bélisle-Pipon, J. C., Vayena, E., Green, R. C., & Cohen, I. G. (2019). Genetic testing, insurance discrimination and medical research: what the United States can learn from peer countries. Nature medicine25(8), 1198-1204.

Clayton, E. W., Evans, B. J., Hazel, J. W., & Rothstein, M. A. (2019). The law of genetic privacy: applications, implications, and limitations. Journal of Law and the Biosciences6(1), 1-36.

Ekstrand, M. D., Joshaghani, R., & Mehrpouyan, H. (2018). Privacy for all: Ensuring fair and equitable privacy protections. In Conference on Fairness, Accountability and Transparency (pp. 35-47). PMLR.

Silvers, A. (n.d.). Genetic information in the Workplace. Encyclopedia of Business Ethics and Society. https://doi.org/10.4135/9781412956260.n367

Hello T…,

This is insightful. The policy surrounding Genetic Data Privacy is still being developed, but there are a few key issues to consider. First, who owns the data? Second, how will the data be used? And third, what are the implications of sharing genetic information? There is no easy answer to any of these questions, but it is important to have a discussion about them (Bennett & Raab, 2017). As more and more companies are collecting and storing genetic information, we need to make sure that our privacy is protected. Otherwise, we could end up in a world where our DNA is used against us – for example, in insurance or employment decisions. Apart from Fawcett and Russell’s (2001), Conceptual Model of Nursing and Health Policy, conceptual model of nursing developed by Jacqueline Fawcett and Gail Russell in 2001 can also be applied. This framework can alter the approaches in the analysis of the policy through the provision of more comprehensive approaches (Fawcett & Russell, 2019). Some key elements that should be considered in developing this policy framework include: – Establishing clear rules and regulations regarding who has access to genetic data and under what circumstances (e.g. only with consent from the individual concerned) (Fontaine, 2018). – Ensuring that individuals have the right to know how their genetic data is being used and/or shared, and that they are able to give or withhold consent for its use as they see fit.

References

Bennett, C. J., & Raab, C. D. (2017). The governance of privacy: Policy instruments in global perspective. Routledge.

Fawcett, J., & Russell, G. (2019). A conceptual model of Nursing and health policy. Policy, Politics, & Nursing Practice2(2), 108–116. https://doi.org/10.1177/152715440100200205

Fontaine, T. M. (2018). A Policy Analysis of the Provisions of the Patient Protection and Affordable Care Act Related to Access to Primary Care for Older Adults. https://doi.org/10.28971/532015FT149

The selected policy is the implementation of state agency worksite wellness programs, as directed by Texas Government Code, Section 664.053. The health of state employees affects the state’s healthcare expenditures and the productivity of state agencies. For example, obese individuals cost employers an average of $5,555 per year in covered medical, sick days, short-term disability, and workers’ compensation claims combined, whereas the average cost for an employee of recommended weight is $3,839 per year (Texas Department of State Health Services, 2020). Texas Government Code, Section 664.053 requires the Texas Department of State Health Services (DSHS) to designate a statewide wellness coordinator to create and promote a model wellness program for state agencies. The statute also directs DSHS to study the implementation and participation rates of state agency worksite wellness programs and report the findings to the Legislature biennially. In 2020, DSHS conducted two surveys, one asking agency wellness liaisons from across Texas state agencies about wellness programs at their respective worksites, and a second asking state employees about their use of wellness-related resources. Of the wellness liaisons surveyed, 65 out of 188 responded to the survey (a 35 percent response rate). Of the responding wellness liaisons, 99 percent reported that their agency has a wellness policy and 55 percent reported a wellness plan that involved implementing activities. However, 46 percent of liaisons reported their agency did not have a wellness budget. Most wellness activities implemented among state agencies required minimal resources so as to work within limited funds, time, agency size, and space. A total of 5,840 state employees out of 145,645 responded to the survey (a 4 percent response rate). A majority of respondents found wellness services and benefits useful but are not aware of the breadth of opportunities available. This indicates more work is needed to raise awareness of these benefits. DSHS leadership and the Statewide Wellness Coordinator will continue to provide technical assistance to wellness liaisons as they implement wellness programs at their agencies. They will also carry out statewide initiatives that align with the objectives of the model wellness program, Work Well Texas (Texas Department of State Health Services, 2020).

The framework is John Kingdon’s multiple streams theory. John Kingdon’s Agendas, Alternatives, and Public Policies advance theoretically by proposing a differentiation between the concepts of governmental agendas and decision agendas. The agenda is the list of subjects or problems to which governmental officials, and people outside of government closely associated with those officials, are paying some serious attention at any given time. For the author, an issue is placed on the governmental agenda when it catches the attention and the interest of policymakers. Kingdon expands the set of actors related to agenda-setting, considering not only decision-makers within the state but also individuals and groups related to them. In addition, given the complexity and the volume of questions facing policymakers, Kingdon reminds us that only a few issues are seriously considered within the governmental agenda at any given time. These issues correspond to the decision agenda: a subset of the governmental agenda where issues are ready for an active decision (Capella, 2020). In the highly competitive agenda-setting process, few issues move from the government agenda to the decision agenda. In his words, we should also distinguish the governmental agenda, the list of subjects that are getting attention, and the decision agenda, or the list of subjects within the governmental agenda that are up for an active decision. Kingdon explains how agendas change from time to time, proposing an explanatory model organized around three streams, the problems stream, the policy stream, and the political stream. The multiple streams model proposed by the author seeks to analyze the pre-decisional stages of the policy process by explaining policy formulation through three streams connected by a public policy entrepreneur who plays an important role when windows of opportunity make changes possible (Capella, 2020).

The policy is in the implementation stage. DSHS will focus on implementing statewide initiatives that align with the objectives of the model wellness program and will continue to support wellness liaisons as they implement related activities in their agencies. Additionally, DSHS plans to initiate demonstration projects at state agencies that currently do not participate in wellness programming. Such projects may include promoting lactation support policies, partnering with cafeteria/vending operators to increase healthy food options in state buildings, and maintaining annual initiatives such as the fitness challenge and wellness conference. Evidence-based, ready-to-implement activities will decrease the time and effort other agencies need to spend developing their own activities. State agencies would only need to make minor logistical changes to integrate activities into their system. Finally, through ongoing collaboration with the Employees Retirement System of Texas (ERS), DSHS will continue to address state-level issues related to improving employee health, raising awareness of available benefits, building wellness infrastructure across all agencies, and providing resources and technical assistance.

References

Capella, A. C. N. (2020). Policy agenda-setting studies: an overview of Brazilian research. Revista de Administração Pública54, 1498-1512.

Texas Department of State Health Services (2020). Implementation and Participation in State Agency Worksite Wellness

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