Simpson Jean C, Morrison L G Luke, Langley John D, Memon P Ali
Injury Prevention Research Unit, University of Otago, New Zealand.
Health Promot Int. 2003 Sep;18(3):237-45. doi: 10.1093/heapro/dag019.
It has been argued that developing community projects is an effective means by which to reduce injury. Two pilot community injury prevention projects (CIPPs) were established in small communities in New Zealand based on the World Health Organization (WHO) Safe Community model. The process and impact of the implementation of these CIPPs was monitored over 3 years. The setting was two small New Zealand communities with populations of <10 000. An external process and impact evaluation was conducted, with data gathered from written documentation, informant interviews and observation. The WHO Safe Community criteria formed the basis of the evaluation framework used. Other essential factors included were identified through the literature and the projects themselves. Findings from each CIPP were considered independently, followed by an examination of the differences observed. The findings from the evaluation of the implementation of these CIPPs are reported in relation to the themes identified in the evaluation framework, namely: community context, ownership and participation, focus and planning, data collection, leadership, management, sustainability and external links. Despite the different contexts, a common conclusion was that if the CIPPs' success was dependent on achieving a meaningful reduction of injury, they were unlikely to succeed. There were, however, a number of strategies and outputs for achieving change that could contribute to increasing safety for the population of interest. These were closely linked to community development strategies and needed greater acknowledgement in the evolution of the CIPPs. Critical to the development of the CIPPs were community capacity and the context in which the projects were operating. These conclusions are likely to apply to other projects in such settings, irrespective of the health outcomes sought.
有人认为，开展社区项目是减少伤害的有效手段。基于世界卫生组织（WHO）的安全社区模式，在新西兰的小社区中设立了两个社区伤害预防试点项目（CIPPs）。对这些CIPPs实施过程及影响进行了为期3年的监测。研究背景为新西兰两个居民人数不足10000人的小社区。开展了外部过程及影响评估，通过书面文件、知情者访谈和观察收集数据。WHO安全社区标准构成了所使用评估框架的基础。通过文献和项目本身确定了其他包括的关键因素。对每个CIPP的结果进行独立考量，随后检查观察到的差异。根据评估框架中确定的主题，即：社区背景、所有权与参与、重点与规划、数据收集、领导力、管理、可持续性和外部联系，报告了这些CIPPs实施评估的结果。尽管背景不同，但一个共同的结论是，如果CIPPs的成功取决于能否切实减少伤害，那么它们不太可能成功。然而，有一些实现变革的策略和成果有助于提高目标人群的安全性。这些与社区发展策略密切相关，在CIPPs的发展过程中需要得到更多认可。CIPPs发展的关键在于社区能力以及项目运作的背景。这些结论可能适用于此类背景下的其他项目，无论所追求的健康结果如何。
