使用多方面的实施策略,在初级保健中实现健康促进实践:一个非随机的平行组研究.
Ylva Elisabet Nilsagård1, Daniel Robert Smith2, Fredrik Söderqvist3
1University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, 701 82, Örebro, Sweden. ylva.nilsagard@oru.se.
多方面实施战略显著增加了瑞典初级保健中的健康促进活动. 这种方法通过加强基于证据的建议的采用,改善了患者的护理.
科学领域:
- 公共卫生 公共卫生
- 医疗保健实施科学 医疗保健实施科学
- 提高初级保健实践的改善
背景情况:
- 针对生活方式因素 (烟草,酒精,体力活动,饮食) 的基于证据的建议在瑞典的初级保健中得到了很低的接受.
- 这种差距限制了潜在的患者益处的实现.
- 为了解决这个问题,制定了一项多方面的实施战略.
研究的目的:
- 评估一项为期12个月的多方面实施战略对初级医疗保健健康促进实践的有效性.
- 确定干预中心与控制中心相比,是否会显著增加和维持健康促进实践.
主要方法:
- 一项非随机并行组研究比较了5个干预中心和5个匹配的控制中心.
- 干预涉及使用辅导员和强调领导责任的12个月战略.
- 在两年内,每月收集健康促进活动和生活方式查的医疗记录数据.
主要成果:
- 干预地点显示,与实施前相比,实施后的健康促进活动的相对吸收率在统计学上显著地更高.
- 干预地点的吸收率分别在1个月和12个月后是对照地点的1.07倍和2.0倍.
- 这种效应在干预后在很大程度上保持,在7个月后观察到显著的绝对效应.
结论:
- 多方面的实施策略成功地建立了更有利于健康的实践.
- 这些发现支持使用这种策略来改善在初级保健中提供基于证据的生活方式干预措施.
- 该研究已在临床试验.gov (NCT04799860) 下注册.
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