在异构环境中和跨越异构环境中可视化上下文决定因素:对结构化学校健康促进实施的定性研究
Katharina Sterr1, Deborah Cragun2, Filip Mess3
1TUM School of Medicine and Health, Department of Health and Sport Sciences, Technical University of Munich, Am Olympiacampus 11, 80809, Munich, Germany. katharina.sterr@tum.de.
Implementation science communications
|January 16, 2026
概括
具有先前结构化经验的学校发现,使用计划-做-学习-行动 (PDSA) 周期更容易实施健康促进. 这表明,定制支持对于建立学校组织能力和促进公平健康至关重要.
科学领域:
- 公共卫生 公共卫生
- 教育管理教育管理
- 实施科学 实施科学
背景情况:
- 学校对于从小就促进公平健康至关重要.
- 组织能力是持续健康促进工作的关键.
- 像PDSA循环这样的结构化改进方法可以加强这种能力,但影响其在学校使用的上下文因素尚未得到充分理解.
研究的目的:
- 检查PDSA周期在学校健康促进中的可实施性的上下文决定因素.
- 了解这些决定因素在不同的学校环境中如何不同.
主要方法:
- 九所德国小学有意为异质性取样.
- 与学校工作人员和家长进行了半结构化的定性小组访谈.
- 基于实施研究综合框架 (CFIR) 的框架方法用于分析.
- 一个彩色编码的矩阵热图可视化了背景因素以进行交叉案例比较.
主要成果:
- 在CFIR领域 (外部设置,内部设置,个人) 中出现了15个上下文因素.
- 具有先前结构化流程经验的学校报告了更多的促进者 (例如,沟通结构) 和更少的障碍 (例如,财务限制).
- 常见的障碍包括有限的家长参与和人员短缺;领导支持和计划兼容性是一致的促进者.
结论:
- 之前的结构化经验似乎与在学校感知PDSA周期的实施性有关.
- 调查结果表明,根据学校的先前经验量身定制实施支持对于能力建设至关重要.
- 结合的框架方法和矩阵热图方法有效地可视化了未来研究的上下文异质性.
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