Ebbesen Lori S, Heath Stephanie, Naylor Patti-Jean, Anderson Donna
Saskatchewan Heart Health Program, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Health Promot Int. 2004 Mar;19(1):85-94. doi: 10.1093/heapro/dag408.
Significant international progress has been made researching and addressing the economic and social burden of cardiovascular disease, advanced particularly by international conferences and subsequent declarations, and the Canadian Heart Health Initiative (CHHI). The implementation focus of the CHHI on building capacity for heart health promotion is paralleled by efforts to measure capacity. Through the collective experience of Heart Health Programs in Nova Scotia, Saskatchewan, Alberta and British Columbia, critical issues in measuring health promotion capacity are identified and strategies for addressing them are presented. The provincial contexts for the programs vary, as do the conceptualizations of capacity and intervention strategies to build capacity. Yet, despite such differences across provinces, shared issues influencing measuring capacity number many. These include: multiple understandings of terms; evolving understanding of capacity; invisibility of capacity building; detecting change within a dynamic system; staff turnover; time course required for change; attribution for change in capacity; understanding a process through 'snap-shot' measurements; lack of existing 'gold standard' measurement tools; validity and credibility of instruments; evolving nature of measurement tools; gathering perspectives from multiple levels within organizations; dealing with conflicting perspectives; and managing and disseminating sensitive data. A number of strategies have been devised or adopted to address measurement issues, ranging from adopting participatory processes to the development of monitoring systems. Understanding and addressing issues in measuring capacity deserve attention as they may be potent influences in the dynamic interplay between research and intervention in the process of capacity building in the context of health promotion generally, and/or heart health specifically.
在研究和应对心血管疾病的经济和社会负担方面，国际上已取得重大进展，这尤其得益于国际会议及后续宣言，以及加拿大心脏健康倡议（CHHI）。CHHI在增强心脏健康促进能力方面的实施重点，与测量能力的努力并行。通过新斯科舍省、萨斯喀彻温省、艾伯塔省和不列颠哥伦比亚省心脏健康项目的集体经验，确定了测量健康促进能力中的关键问题，并提出了解决这些问题的策略。这些项目的省级背景各不相同，能力的概念以及增强能力的干预策略也有所不同。然而，尽管各省存在这些差异，但影响测量能力的共同问题却很多。这些问题包括：对术语的多种理解；对能力的不断演变的理解；能力建设的无形性；在动态系统中检测变化；人员流动；变化所需的时间进程；能力变化的归因；通过“快照”测量理解过程；缺乏现有的“金标准”测量工具；工具的有效性和可信度；测量工具的不断演变的性质；从组织内多个层面收集观点；处理相互冲突的观点；以及管理和传播敏感数据。为解决测量问题，已设计或采用了一些策略，从采用参与式方法到开发监测系统不等。理解和解决测量能力方面的问题值得关注，因为它们可能在健康促进总体背景下，特别是心脏健康背景下的能力建设过程中，对研究与干预之间的动态相互作用产生重大影响。
