Verified ACTION PACKET: A Framework for Accountable Decision Support and Communication in Digital Public Health Systems

Abstract

Public health decisions and their communication increasingly unfold across websites, dashboards, messaging systems, social media, and partner platforms. Across these channels, the evidence, recommendations, and messages supporting a decision must remain synchronized, traceable, accessible, and correctable through repeated revisions. Existing guidance largely evaluates decisions or messages at a single point in time and offers limited support for governing the full pathway from evidence and decision rationale to dissemination, revision, correction, and retirement. When evidence or guidance changes, decision rationales may become difficult to reconstruct, outdated versions persist, corrections fail to propagate, and provenance is lost. This study specifies the Verified ACTION PACKET Framework, a two-layer methodological framework for governing the last mile of public health decision support and communication from provenance through retirement, and presents an evidence-matched validation agenda. Developed through a design-oriented narrative synthesis and retrospective design audit, the framework draws on sources across eleven evidence domains and was positioned against a scoping review of 39 public health frameworks and an overview of 36 systematic reviews informing WHO-INTEGRATE. Recurring challenges in translating evidence into decisions and communications were converted into observable challenge-control pairs and organized as release-quality criteria, procedural governance controls, workflow phases, lifecycle states, and measures. Components were retained when they were consequential, conceptually distinct, assignable, observable, locally feasible, proportionate to risk, and empirically testable. The framework comprises a decision-and-communication governance layer and an implementation layer linked by a persistent, versioned ACTION PACKET. Six ACTION release-quality domains assess whether a communication product and its underlying decision basis are ready for release, while six dependency-ordered PACKET phases govern their development, approval, publication, monitoring, revision, correction, and retirement. Mnemonic labels were applied only after construct boundaries, required outputs, responsible roles, decision points, and evaluation targets had been specified. The result is a bounded, auditable specification for supporting public health decisions and governing their communication from provenance through retirement, while enabling local, multilingual, accessible, and correctable implementation. As a provisional architecture, it now advances to multidisciplinary and community appraisal, usability and inter-rater testing, feasibility implementation, and comparative evaluation of decision quality, communication effectiveness, and scale-up.