在低资源环境中推进可持续性:为基于证据的干预和计划开发和验证一个可持续性工具
Chisom Obiezu-Umeh1, Divya S Subramaniam2, Ucheoma Nwaozuru3
1Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Frontiers in health services
|August 8, 2025
概括
为非洲环境开发了一种新的可持续性工具,用于评估基于证据的干预和计划 (STEPS). 这种经过验证的工具衡量了医疗保健干预可持续性的多层次决定因素,有助于长期的项目收益.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 全球健康 全球健康
背景情况:
- 由于可持续性挑战,医疗保健干预措施的长期益处尚未得到充分探索.
- 现有的可持续发展措施可能不适合低收入和中等收入国家 (LMICs).
- 需要一个特定于环境的工具来评估非洲环境中的干预可持续性.
研究的目的:
- 开发和验证可持续性工具,以评估基于证据的干预和计划 (STEPS).
- 为评估可持续性的多层次决定因素提供基于理论的衡量标准.
- 调整该工具以供前线卫生工作者和LMICs的实施从业人员使用.
主要方法:
- 关于非洲地区可持续发展的文献综述,以产生领域和项目.
- 专家评价与来自非洲9个国家的12名专家进行了相关性.
- 在尼日利亚对10名医疗保健工作者进行了面部验证.
- 内容有效性和共识方法,将规模精细化为31项.
- 在尼日利亚,STEPS在256名医疗保健工作者身上进行试点测试.
- 探索性因素分析 (EFA) 和可靠性分析.
主要成果:
- EFA揭示了STEPS的强大的四个因素,31个项目结构.
- 四个分级是:干预特征,组织能力,实施背景和价值观,社会文化和社区背景.
- STEPS表现出良好的内部一致性 (克朗巴赫α=0.97) 和足够的内容有效性.
结论:
- STEPS是评估非洲环境中基于证据的干预和计划的可持续性的一种上下文相关的工具.
- 结果有助于实施科学,提供了一种评估影响长期干预交付和效益的因素的手段.
- 该工具可以被LMIC的研究人员和程序员利用,以提高程序的可持续性.
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