对一个复杂,多中心,多干预方案的修改后的现实评估
C Greenhalgh1, G Williams1, A Harrison1
1Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PT, UK.
Journal of public health (Oxford, England)
|December 21, 2023
概括
惠尔诺斯计划使用了修改后的现实主义评估,以了解复杂的健康干预措施在各种环境中如何工作. 这种方法为改善健康公平和减少失业率的有效策略提供了洞察力.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康的社会经济决定因素
背景情况:
- "北方健康计划" (Well North) 是英格兰北部的一个大型,多个地点的倡议,旨在减少健康不平等.
- 它的重点是改善弱势群体的健康状况,增强性,减少失业率.
- 当地网站有自主权根据社区需求实施定制干预措施.
研究的目的:
- 为了评估复杂的北方健康改善计划.
- 通过适应现实主义的方法,了解什么是有效的,对谁有效,在什么情况下有效.
- 为程序适应和改进提供代反.
主要方法:
- 使用了修改后的现实主义评估框架.
- 定性和定量方法被整合到快速循环评估中.
- 背景,机制和结果 (CMO) 被确定并以代方式理论化.
主要成果:
- 该研究确定了各种干预措施的关键上下文,机制和结果 (CMO) 配置.
- 一个中等范围的理论被开发和通过连续验证改进.
- 对现实主义方法的调整是必要的,以适应程序的复杂性.
结论:
- 现实主义的方法,虽然需要修改,证明有效的评估复杂的健康计划.
- 代方法促进了程序的学习和适应.
- 评估为通过有针对性的干预措施解决健康不平等提供了有价值的见解.
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