Wang Shuhong, Moss John R, Hiller Janet E
Department of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia.
Health Promot Int. 2006 Mar;21(1):76-83. doi: 10.1093/heapro/dai025. Epub 2005 Oct 25.
The context in which public health programmes operate can play an important role in influencing their implementation and effectiveness. An intervention that has been shown to be effective in one setting may turn out to be ineffective somewhere else, even supposing it can be implemented there. Therefore, systematic reviews of public health interventions should appraise the applicability of the intervention process and the transferability of the intervention effectiveness to other localities. However, applicability and transferability appraisal is seldom reported in systematic reviews of public health and health promotion interventions. This paper aims to introduce an innovative approach to bridging this gap. A list of attributes that may impact on applicability and transferability can be developed, based on knowledge of the proposed intervention. Then the applicability and transferability of the intervention to the local setting can be rated, and given a score, based on knowledge of the local setting. This approach provides a useful tool for evaluating public health interventions and provides a reliable basis for informed decision making in resource-poor settings, where rigorous primary studies are lacking and where very limited resources put a high demand on evidence-based approaches to health promotion.
公共卫生项目的运作环境在影响其实施和效果方面可能发挥重要作用。一种在某一环境中已被证明有效的干预措施，在其他地方可能会变得无效，即使它在那里能够得以实施。因此，对公共卫生干预措施的系统评价应评估干预过程的适用性以及干预效果向其他地区的可转移性。然而，在公共卫生和健康促进干预措施的系统评价中，很少报告适用性和可转移性评估情况。本文旨在介绍一种创新方法来弥补这一差距。基于对拟议干预措施的了解，可以制定一份可能影响适用性和可转移性的属性清单。然后，根据对当地环境的了解，对干预措施在当地环境中的适用性和可转移性进行评级并给出分数。这种方法为评估公共卫生干预措施提供了一个有用的工具，并为资源匮乏地区的明智决策提供了可靠依据，在这些地区，缺乏严格的原始研究，且资源非常有限，对基于证据的健康促进方法提出了很高的要求。
