在马来西亚社区卫生中心实施基于证据的原发性癌症预防干预措施:一个解释性的连续混合方法研究
Rebekka M Lee1, James G Daly2, Kamini Mallick2
1Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA. rlee@hsph.harvard.edu.
Implementation science communications
|August 24, 2023
概括
联邦合格卫生中心 (FQHCs) 显示了癌症预防干预措施的高度采用,但稳定的资金和人员配置对于广泛的患者接触至关重要. 建立社区伙伴关系可以加强实施努力.
科学领域:
- 公共卫生 公共卫生
- 预防癌症 预防癌症
- 健康 公平 卫生 公平
背景情况:
- 超过一半的癌症可以通过以证据为基础的干预措施 (EBI) 预防,重点是营养,体力活动和戒烟.
- 联邦合格卫生中心 (FQHC) 对于向超过3000万美国人提供这些EBI至关重要,促进健康公平.
- 本研究评估了马萨诸塞州FQHC中的EBI实施,以确定障碍物和促进者.
研究的目的:
- 确定在马萨诸塞州的FQHCs中对原发性癌症预防EBI实施的程度.
- 描述这些EBI的内部和社区合作实施过程.
- 确定影响FQHCs癌症预防策略的采用和可持续性的因素.
主要方法:
- 采用了一种解释性的顺序混合方法设计.
- 16个FQHC的定量调查 (n=34) 评估了EBI频率.
- 定性访谈 (n=12) 探索了实施过程,以"实施研究综合框架" (CFIR) 为指导.
主要成果:
- 所有FQHC都提供基于诊所的烟草干预措施;然而,工作人员认为某些饮食/体力活动EBI的透率很低.
- 实施受到干预复杂性,人员,资金,临床医生的动机和外部政策的影响.
- 很少有FQHC利用临床-社区联系来进行原发性癌症预防EBI,尽管它们的感知价值.
结论:
- 马萨诸塞州的FQHC显示了初级癌症预防EBI的高度采用.
- 持续的员工和资金对于接触所有符合条件的患者至关重要.
- 加强培训和建立社区伙伴关系的支持对于改善EBI实施至关重要.
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