Foresight in public health: a tutorial on application and insights on challenges from the PHIRI foresight exercise

The application of foresight to the field of public health is limited. There is growing need to anticipate uncertain future trends and to plan for them. Foresight provides tools to experts and policymakers to discuss and plan for possible futures. Hence, the aim of this study is to illustrate how the foresight six-step approach can be applied in public health, and to provide recommendations on dealing with challenges, drawn from the Population Health Information Research Infrastructure (PHIRI) foresight exercise.

In this tutorial, we describe the six-step approach as part of foresight methodology and give examples of possible challenges. Step 1 comprises the formulation of study objectives. Step 2 focuses on developing a conceptual model and applying the Demographic Economic Sociocultural Technological Ecological and Political-Institutional (DESTEP) framework to identify and prioritize driving forces for the topic of interest. In Step 3, a time horizon and spatial level are defined. Step 4 discusses scenario logics. Steps 5 and 6 discuss different types of scenarios and associated tools for analyses. Possible challenges encountered whilst applying the foresight methodology at each of the steps, were drawn from experiences during PHIRI foresight exercise.

Challenges associated with applying the foresight six-step approach included: formulating concise objectives, developing a conceptual model, understanding driving forces and uncertainty and difficulties in building scenarios.

Understanding concepts used in the six-step approach and how they relate to each other remained difficult. Support from foresight experts, conducting more foresight exercises, tutorials and guidelines can enhance understanding and support building capacity.