在全球不同卫生环境中扩大非传染性疾病干预措施的推动因素和障碍:使用实施研究综合框架进行定性研究
Zinzi Pardoel1, Ilona Folkertsma2, Anusha Ramani-Chander3
1Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands z.e.pardoel@umcg.nl.
BMJ open
|December 10, 2025
概括
扩大非传染性疾病 (NCD) 干预措施的规模需要适应当地环境并吸引利益相关者. 解决资源限制和文化适应是克服可持续全球健康解决方案障碍的关键.
科学领域:
- 实施科学 实施科学
- 全球健康 全球健康
- 非传染性疾病 (NCD) 是一种非传染性疾病.
背景情况:
- 扩大针对非传染性疾病 (NCD) 的干预措施对于全球卫生公平至关重要.
- 了解上下文因素对于在不同环境中成功扩大干预措施至关重要.
- 现有的研究往往缺乏对不同卫生系统的推动因素和障碍物的全面分析.
研究的目的:
- 确定影响全球NCD干预措施扩大规模的关键推动因素和障碍.
- 将这些已识别的因素与世界卫生组织 (WHO) 的卫生系统构建块进行映射.
- 为可持续的NCD干预扩大提供基于证据的建议.
主要方法:
- 采用实施研究综合框架 (CFIR) 的多方法定性研究.
- 分析了来自77份文件和18个利益相关者采访的数据,这些数据来自18个低收入和中等收入国家以及高收入国家.
- 专注于全球慢性病联盟 (GACD) 资助的实施研究项目,即将或已经完成扩展.
主要成果:
- 确定了20个推动因素 (例如,适应能力,利益相关者参与,地方赋权) 和25个障碍 (例如,资源限制,复杂性,倦怠).
- 环境调整,支持性治理和能力建设对于可持续性至关重要.
- 文化失调和社会政治不稳定成为扩大努力的重大障碍.
结论:
- 可持续的NCD扩展需要根据当地卫生系统量身定制干预措施,并确保利益相关者的共同所有权.
- 减轻利益相关者倦怠的策略对于长期成功至关重要.
- 未来的研究应该优先考虑文化适应,可持续融资和员工能力建设.
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