评估南非糖尿病群体赋权和培训 (GREAT) 实施情况:融合混合方法
Robert James Mash1, Darcelle Schouw2
1Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa rm@sun.ac.za.
BMJ open
|May 28, 2024
概括
糖尿病组授权和培训 (GREAT) 是南非2型糖尿病自我管理的可行干预措施. 实施需要解决背景因素,以便在初级保健机构成功扩大规模.
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
- 糖尿病管理 糖尿病管理
背景情况:
- 在南非,2型糖尿病对健康造成重大负担.
- 初级保健机构在支持患者自我管理和改变生活方式方面面临挑战.
- 针对糖尿病的群体赋权和培训 (GREAT) 提出了一个可行且具有成本效益的干预措施.
研究的目的:
- 评估南非初级保健设施中GREAT糖尿病计划的实施情况.
- 评估各种实施结果,包括可接受性,适当性,采用性,可行性,忠实性,覆盖范围和成本.
- 为GREAT干预的扩大和缩小提供信息.
主要方法:
- 采用了融合混合方法研究设计.
- 通过与34个关键利益相关者和35名患者的重点小组进行半结构面试,收集了定性数据.
- 从九个省份的十个初级保健机构收集了关于实施结果和成本的定量数据.
主要成果:
- 国家卫生部和设施管理人员认为GREAT是可以接受和适当的,尽管采用率因省份而异 (5/9采用).
- 可行性受到物理空间,人员,资源,健康信息系统和适应护理模式等因素的影响.
- 尽管有COVID-19的干扰,但14个设施实施了GREAT,达到588名高忠度患者 (66%-94%),每家设施增加494美元的成本.
结论:
- 确定了在中等收入国家实施群体糖尿病教育计划的关键教训.
- 使用卫生系统框架开发了一个程序理论,以指导未来的实施和扩展努力.
- 背景因素对于成功实施和扩展群体糖尿病教育计划至关重要.
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