预防性护理建议,以促进健康公平
Nav Persaud1, Areesha Sabir2, Hannah Woods2
1MAP Centre for Urban Health Solutions (Persaud, Sabir, Woods); Department of Family and Community Medicine (Persaud, Lofters), University of Toronto; Department of Family and Community Medicine (Persaud), St Michael's Hospital, Unity Health Toronto; Women's College Hospital Research Institute (Sayani, Lofters), Women's College Hospital, Toronto, Ont.; Peter Gilgan Centre for Women's Cancers (Lofters), Women's College Hospital, Toronto, Ont.; Division of General Internal Medicine (Agarwal), Department of Medicine, McMaster University, Hamilton, Ont.; Department of Health Research Methods, Evidence and Impact (Agarwal), McMaster University, Hamilton, Ont.; Dalhousie University (Chowdhury), Halifax, NS; College of Nursing (de Leon-Demare), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Family Medicine (Ibezi), Saskatoon, Sask.; Department of Family Medicine (Jan, LaFortune, Onyekwelu), McGill University, Montréal, Que.; Community Health Sciences and Family Medicine (Katz), Max Rady College of Medicine, University of Manitoba, Winnipeg, Man.; Port Elgin & Region Health Centre, Horizon Health Network (Lewis Peters), Port Elgin, NB; Black Physicians' Association of Ontario (McFarlane), Brampton, Ont.; Northern Ontario School of Medicine University (Oberai), Sudbury, Ont.; African Cancer Support Group (Oladele), Calgary, Alta.; Parkdale Queen West Community Health Centre (Wong), Toronto, Ont. nav.persaud@utoronto.ca.
优先考虑弱势加拿大人的预防护理可以减少健康不平等. 这包括针对结直肠癌,心血管疾病和HPV和HIV等疾病的查,以及改善初级保健准入.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 研究 健康 公平 研究
- 预防医学 预防医学
背景情况:
- 在加拿大公共资助的医疗保健系统中存在持续的健康结果差异.
- 显著的投资并没有完全消除可以避免的健康不平等.
- 需要有针对性的预防护理策略来解决不利因素.
研究的目的:
- 制定基于证据的预防护理建议,促进健康公平.
- 优先考虑对经历社会经济或健康相关不利情况的人群进行干预.
- 引导临床医生,政策制定者和医疗保健组织解决健康差异问题.
主要方法:
- 准则的制定涉及初级保健提供者,患者和专家.
- 系统审查和随机对照试验为推提供了信息.
- 使用了推评级,评估,开发和评估 (GRADE) 和研究和评估指南评估 (AGREE II) 的框架.
主要成果:
- 开发了15个查和预防护理建议和一个政策建议.
- 优先推广结直肠癌查 (从45岁开始) 和心血管疾病风险评估.
- 建议包括HPV自我检测,艾滋病毒自我检测,结核病查,抑郁症,吸毒,亲密伴侣暴力和贫困的查.
- 建议为弱势群体自动连接到初级保健.
结论:
- 有效的预防性护理干预措施可以减轻健康不平等,当专注于弱势群体时.
- 基于证据的行动对于临床医生,医疗保健组织和政府来说至关重要,以促进健康公平.
- 追踪在加拿大促进健康公平方面的进展至关重要.
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