实施基于证据的社区卫生工作者模式的障碍和促进者
Simone H Schriger1, Molly Knowles2,3, Talia Daglieri2,3
1Department of Psychology, University of Pennsylvania, Philadelphia.
JAMA health forum
|March 8, 2024
概括
扩大社区卫生工作者 (CHW) 计划面临资金和整合挑战等障碍. 促进者包括CHW技能和强大的计划设计,突出了可持续融资和政策支持的需求.
科学领域:
- 实施科学 实施科学
- 公共卫生 公共卫生
- 卫生公平性健康公平性
背景情况:
- 社区卫生工作者 (CHW) 计划显示出改善健康结果和降低医疗保健成本的潜力.
- 关于有效扩展基于证据的CHW计划的障碍和促进者的知识有限.
研究的目的:
- 确定实施基于证据的CHW模型的障碍和促进者,特别是以人为中心的目标 (IMPaCT) 计划的个性化管理.
- 为成功扩展和CHW倡议的可持续性制定策略.
主要方法:
- 通过采访项目工作人员和参与IMPaCT模型的患者,在美国各个卫生系统进行定性研究.
- 数据收集于2020年3月至2021年7月期间,使用快速定性分析技术进行分析,并根据实施研究综合框架进行分析.
主要成果:
- 关键障碍包括经济/政策限制 (资金,临床整合) 和项目特定问题 (定制材料,成本).
- 促进者包括CHW人际交往技能,程序证据库,支持团队和关系建设设计.
- COVID-19大流行,领导力,培训和忠诚被认为是障碍和促进者.
结论:
- 调查结果强调了CHW在促进健康公平和人口健康方面日益重要的重要性.
- 解决已识别的障碍需要改变政策和实践,重点是改善临床整合和为CHW项目提供可持续融资.
- 对这些因素的持续关注对于CHW员工的长期成功和影响至关重要.
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