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病気の予防のパラドックス:原則として祝われ,実際は抵抗される
1Institute of Medicine, Washington, DC 20001, USA. fineberg@nas.edu
JAMA
|July 4, 2013
まとめ
疾病予防の課題を克服するには,戦略的介入が必要です. 経済的インセンティブ,職場のウェルネスプログラム,政策変更の実施は,より健康的な行動を促進し,健康文化に予防を組み込むことができます.
科学分野:
- 公衆衛生は公衆衛生である.
- 健康政策 保健政策 保健政策
- 行動科学は,行動科学である.
背景:
- 疾病予防は,成功の目に見えないこと,利益の延期,財政的インセンティブの不一致など,大きな障害に直面しています.
- 社会的規範,認知的バイアス (例えば,手数料バイアス),および商用または個人的な信念の対立は,予防措置の広範な採用を妨げます.
- 現在の医療制度では,予防よりも治療を優先し,予防を費用対効果的というより,純金利が求められるものとして見ています.
研究 の 目的:
- 疾病予防戦略の実践的実施における主要な障壁を特定する.
- これらの障害を克服し,予防的な健康行動を促進するための実行可能な戦略を提案する.
- 予防の統合を,より広範な社会的な健康文化に統合することを探求する.
主な方法:
- この研究は,疾患予防の課題と促進要因に関する既存の文献と専門家の分析をまとめています.
- それは,特定された障壁に対処し,予防的慣行の採用を強化するために設計された6つのコア戦略を概説します.
- このアプローチは,金融,政策,行動変化のメカニズムを含む多面的な介入を強調しています.
主要な成果:
- 6つの主要な戦略が提案されています: (1) 予防サービスの直接的な支払い, (2) 個人のための金銭的報酬, (3) 雇用主主導の職場保健イニシアチブ, (4) 予防を容易にするためのシステム再設計, (5) 予防選択の政策強化, (6) マルチチャネルメディア教育.
- これらの戦略は,予防をより目に見えるもの,有益なものとし,日常生活に統合し,個人の意志的な行動への依存を減らすことを目的としています.
- 病気の予防の成功は,これらの戦略を健康のサポート文化に組み込むことに依存しています.
結論:
- 病気の予防に対する多面的な障壁に対処するには,財政的,政策的,システム的な変化を含む包括的なアプローチが必要です.
- 予防サービスを医療システムに統合し,健康的な行動を奨励することは,長期的な成功に不可欠です.
- 社会の健康文化を育成することは,疾病予防の継続的な効果のために極めて重要です.
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