一种类型学来描述当地公共卫生服务系统中的社区环境和人口健康活动
Lois Dankwa1, Darrell J Gaskin, Keshia M Pollack Porter
1Author Affiliations: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Dankwa, Gaskin, Pollack Porter, and Marsteller); Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Gaskin); Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Bower); and Johns Hopkins University School of Nursing, Baltimore, Maryland (Dr Bower).
当地卫生部门 (LHDs) 对人口健康活动的方法各不相同. 只有20%的企业表现出色,而许多企业在实施方面遇到了困难,特别是那些企业缺乏量身定制的计划,尽管获得了社区支持.
科学领域:
- 公共卫生 公共卫生
- 卫生系统研究 卫生系统研究
- 社区健康评估
背景情况:
- 当地卫生部门 (LHDs) 对于解决社区卫生需求至关重要.
- 了解LHD采取的各种方法对于改善人口健康结果至关重要.
- 现有的类型学可能无法完全捕捉到LHD活动及其上下文驱动因素的细微差别.
研究的目的:
- 开发LHD及其合作伙伴开展的人口健康活动的类型.
- 确定与不同方法的人口健康活动相关的上下文因素.
- 为提高LHD在解决社区卫生优先事项中的有效性制定战略提供信息.
主要方法:
- 隐性类别分析被用来根据10项人口健康活动的优先级和表现对LHD进行分类.
- 一个隐性类回归模型检查了县级特征如何影响LHD类成员.
- 变量包括提供者比例,收入不平等,社会协会和人口统计因素 (例如种族,语言).
主要成果:
- 3类类型出现了:未充分利用的网络 (41%),社区需求和实施专注 (39%),健康差异,实施和评估专注 (20%).
- 第1类LHD报告表现不佳;第2类报告表现可变;第3类报告表现好/优秀.
- 较高的社会成员数量增加了第一类的可能性,而非西班牙裔黑人居民的比例增加了第三类的可能性.
结论:
- 只有20%的LHDs表现出对社区健康优先事项的响应水平很高.
- 许多LHD在减少健康差距至关重要的活动中表现不佳.
- 拥有社交网络但缺乏量身定制计划的LHDs难以有效地优先考虑和执行人口健康活动.
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