Methods of the Research Atlas

The Research Atlas is an interactive tool within the PHSM Knowledge Hub that organizes evidence according to the elements of the PHSM Conceptual Framework and themes of the Global PHSM Research Agenda. It offers users an intuitive gateway to research articles by topic of interest without the need to build complex search strategies. The search results can be refined by using filters (e.g. for certain diseases or settings). Graphs display the publication of research over time, illustrating gaps and emerging trends.

What is the PHSM Conceptual Framework?

During the COVID-19 pandemic, inconsistencies in defining and categorizing public health and social measures (PHSM) hampered policy monitoring, research and communication efforts. To address this, WHO and partners developed a conceptual framework for PHSM to harmonize the understanding and language used to describe how they work during health emergencies. It is the conceptual basis for a suite of tools to support PHSM decision-making, monitoring and research under the umbrella of the WHO Initiative to measure the effectiveness and impact of PHSM during health emergencies.

The PHSM Conceptual Framework aims to:

Guide coordinated, interdisciplinary research on PHSM effectiveness, unintended consequences and uptake and adherence.
Facilitate coherent, comparable PHSM policy monitoring.
Inform equitable, balanced and context specific PHSM decision-making and implementation.

The PHSM Conceptual Framework applies a “complex systems lens” to describe interventions, contextual factors, transmission-related outcomes, unintended consequences. The framework takes a holistic view on PHSM implementation emphasizing its dynamic and multi-sectoral nature.

It comprises of two levels with the first level highlighting the broader elements that need to be taken into consideration when making decisions about PHSM implementation and the second level spelling out what each of these elements are composed of.

PHSM Conceptual Framework Research Atlas

The PHSM Conceptual Framework Research Atlas is an interactive tool organizing evidence according to the elements of the PHSM Conceptual Framework. This enables users to intuitively search by topics of interest rather than applying a complex search strategy. The results of each search through the PHSM Conceptual Framework can be further tailored using filters, e.g. for certain diseases or settings. A visual display of the generation of evidence over time helps to identify research gaps and priorities relating to PHSM effectiveness, impact, and implementation. On a second tab, a list of references relating to the selected conceptual framework element is displayed.

The PHSM Conceptual Framework assumes the following definitions that also informed the search algorithm underlying the Research Atlas:

1. PHSM element: Composed of five PHSM high-level categories. Definitions for each high-level category are presented in Table 1, accompanied by second-level categories and examples.

Table 1. Classification matrix for monitoring public health and social measures

First-level PHSM category	Second-level PHSM category and High-level indicators
Active case-finding and contact identification measures. These are systems and actions implemented to identify, track, and manage potential and confirmed cases of disease. They may include case-finding, testing and contact-tracing, as well as isolation (i.e., to separate individuals with a confirmed or suspected infection) and quarantine (i.e., to separate individuals with an increased risk of infection from those at risk of becoming infected).	1. Active case-finding 1.1. Screening for symptoms 1.2. Test-based screening 1.3. Contact tracing 2. Case-specific measures 2.1. Isolation 3. Contact-specific measures 3.1 Quarantine
Personal protection measures These measures comprise personal protective equipment as well as personal hygiene behaviours that reduce the risk of individuals transmitting and/or becoming infected with a pathogen that has epidemic or pandemic potential.	4. Personal protective equipment 4.1. Mask 4.2. Gloves 4.3. Face shields 4.4. Bed nets 4.5. Long or other protective clothing 4.6. Barriers for safer sex 4.7. Repellents 5. Personal hygiene measures 5.1. Hand hygiene 5.2. Respiratory etiquette 5.3. Food safety measures 5.4. Safe handling of personal equipment and supplies 6. Safe breastfeeding practices
Environmental measures These measures target the physical infrastructure and environment, including the human–animal interface, through modifying, repurposing and/or appropriately maintaining existing or newly set up structures to limit transmission of a pathogen with epidemic or pandemic potential.	7. Physical infrastructure 7.1. Physical barriers (e.g. Plexiglass or Perspex screens, room dividers) 8. Vector control 8.1. Building and housing modifications (e.g. using window screens, closing eaves) 8.2. Spraying (e.g. indoor residual or outdoor) 8.3. Reservoir control (e.g. draining stagnant and standing water, covering water containers) 9. Water and sanitation safety 9.1. Disinfecting drinking water 9.2. Modification of access to safe drinking water 9.3. Wastewater management 9.4. Solid waste management 10. Surface cleaning 10.1. Safe handling of equipment and supplies 10.2. Surface disinfection 10.3. Surface decontamination 11. Indoor air quality 11.1. Ventilation 11.2. Air filtering 11.3. Humidity control 12. Animal–human interface 12.1. Culling 12.2. Safe handling of carrion and infected livestock/animals 12.3. Regulation of animal movement and products 12.4. Livestock quarantine 12.5. Livestock isolation 12.6. Restriction of farming, fishing, hunting and/or selling of animals
Social measures These are measures implemented at the national and subnational levels comprising (i) modifying social interactions between individuals and groups of people, including gatherings; (ii) adapting, cancelling, or modifying the timing of services or activities, or a combination of these; and (iii) adapting or restricting movement within and between specific settings and within or across national borders.	13. Social interactions and gatherings 13.1. Physical distancing 13.2. Restrictions or modifications of private gatherings/mass gatherings 13.3. Restrictions or modifications of public gatherings/mass gatherings 14. Domestic mobility 14.1. Stay-at-home order or curfew 14.2. Restrictions on public transport 14.3. Restrictions on movements (e.g. maximum distance people can be away from their home) 14.4. Entry restrictions (e.g. for districts, zones, settlements) 14.5. Exit restrictions (e.g. for districts, zones, settlements) 15. Modifications to activities and services 15.1. Modifications to access (e.g. closures of schools or businesses, restricting access to individuals with a vaccination certificate or individuals who test negative, extending holidays for schools) 15.2. Modifications to types of activities (e.g. implementing distance or online learning or teleworking; providing services online or remotely; cancelling school meals) 15.3. Safe burial practices
International travel and trade measures These measures follow a risk-based approach to reduce the travel- and trade-associated cross-border exportation, importation, and onward transmission of a pathogen with epidemic or pandemic potential.	16. Trade measures for imported goods 16.1. Restriction 16.2. Ban 16.3. Inspection 17. Trade measures for exported goods 17.1. Restriction 17.2. Ban 17.3. Inspection 18. Travel related screening or testing 18.1. Exit or entry screening for symptoms, or both 18.2. Exit or entry screening for vaccination or immunity, or both 18.3. Exit or entry screening for travel or contact history, or both 18.4. Exit or entry testing for infection, or both 19. International border measures 19.1. Ban on entry 19.2. Ban on exit 19.3. Entry restriction 19.4. Exit restriction 20. Quarantine upon arrival 20.1. Home quarantine 20.2. Hotel/non-health care-facility/institutional quarantine 20.3. Health care facility quarantine 21. Travel advice or warning 21.1. Travel advice 21.2. Travel warning

2. PHSM Operating Mechanisms: The framework contains two sets of measures categorized by their operating mechanism: measures that reduce exposure and those seeking to make exposure safer. Table 2 presents definitions for each accompanied by examples.

Table. 2 PHSM operating mechanism measures

Mechanism	Definition	Example
Measures reducing exposure	Measures reducing exposure reduce the opportunity for transmission-relevant encounters during direct or indirect contact, e.g. human-to-human transmission, animal-to-human, vector-to-human contact and transmission through contact with contaminated objects, surfaces, food or water. In the context of human-to-human transmission, those measures reduce face-to-face/in-person interactions between individuals or groups of people, e.g. through modifying services, social interactions and movement of individuals or groups.	Quarantine, isolation, daily testing, school closures, business closures, cancellation of large gatherings, suspension of international and domestic flights, mobility restrictions, use of bed nets, culling of animals, livestock quarantine/isolation, vector-control measures.
Measures which make exposure safer	Measures intended to make situations, in which exposure occurs, safer, hence reducing the likelihood of transmission.	Environmental measures, personal protection measures, testing.

3. PHSM implementation package: The framework includes three elements required for an equitable and context-specific implementation of PHSM. Table 3 presents definitions for each element accompanied by examples.

Element	Definition	Example
Bundle of context-specific PHSM.	Combination of PHSM tailored to the specific epidemiological situation and implementation context.	e.g. multi-component interventions including so-called lockdown, domestic mobility restrictions, testing, quarantine/isolation and contact tracing to contain an outbreak in a certain area.
Enabling functions.	Actions and interventions directed at communities to promote the uptake of and adherence to PHSM.	e.g. risk communication and community engagement, infodemic management interventions, knowledge translation activities etc.
Mitigation measures	Measures to reduce or mitigate the unintended negative health and socio-economic consequences of PHSM implementation.	e.g. social protection policies and programs, community-based or community-led initiatives.

4. PHSM outcomes: These comprise those directly related to transmission (i.e., cases, hospitalizations, morbidity during and/or post-infection and deaths) as well as indirect or more broadly unintended consequences for health and society.

Uptake and adherence: Engagement in and compliance with PHSM recommendations and policies. Usually, indicators of attitude, knowledge, acceptance, and behavior of the general public or population groups affected by PHSM.
Transmission-related outcomes: This includes all epidemiological outcomes related to disease transmission, such as prevalence, incidence, reproduction numbers, transmission rates, hospitalizations, mortality, and disability.
Health, social, and economic consequences: This includes all health and socio-economic outcomes resulting from the implementation of PHSM that do not relate to the transmission of the disease in question and were, hence, not the primary objective of the implementation of PHSM.