通过电子决策支持工具,为社区卫生工作者的能力建设提供帮助:混合方法研究
Anton Elepaño1,2, Carol Stephanie Tan-Lim3,4, Clare Bankhead1
1Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
JMIR formative research
|January 7, 2026
概括
社区卫生工作者 (CHW) 认为UpToDate是可以接受的,但由于基础设施和工作负载的挑战,持续使用下降了. 该工具更像是一种学习辅助,而不是临床决策支持,突出了对综合支持系统的需求.
科学领域:
- 在初级保健中采用数字健康.
- 农村和偏远地区的卫生系统研究.
- 社区卫生工作者能力建设.
背景情况:
- 在农村/偏远的初级保健场所,向社区卫生工作者 (CHW) 提供了免费的UpToDate订阅.
- 最初的可行性评估表明,尽管存在基础设施障碍,但UpToDate是可以接受的.
研究的目的:
- 评估CHWs中UpToDate的纵向采用情况.
- 检查对工具使用的社会文化,政治和环境影响.
- 了解复杂卫生系统中扩展,传播和可持续性的挑战.
主要方法:
- 混合方法设计使用使用/程序日志,报告和焦点组.
- 对日志 (2021-2023) 进行定量分析,使用描述性统计,CI和千平方测试.
- 使用反射主题分析对重点小组和报告进行定性分析.
主要成果:
- 随着时间的推移,UpToDate的使用量适度和下降;每月活跃使用量从2021年的3.57%下降到2022年的1.07%.
- 农村与偏远地区的参与度更高;与计划活动相关的使用,受到外部因素的干扰.
- 医疗保健机构使用UpToDate作为学习辅助和专业信誉;社区使用往往没有记录.
结论:
- 可接受性不能保证持续使用;登录等采用指标是不够的.
- UpToDate的价值在于能力建设,而不是医疗保健点的决策支持.
- 未来的评估需要学习/社会资本指标;决策者必须解决基础设施和适应数字健康的成功.
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