Kaplan Sue A, Calman Neil S, Golub Maxine, Ruddock Charmaine, Billings John
Robert F. Wagner Graduate School of Public Service, New York University, USA.
J Health Care Poor Underserved. 2006 May;17(2 Suppl):9-19. doi: 10.1353/hpu.2006.0088.
Although many public health initiatives have been implemented through collaborations with faith-based institutions, little is known about best practices for developing such programs. Using a community-based participatory approach, this case study examines the implementation of an initiative in the Bronx, New York, that is designed to educate community members about health promotion and disease management and to mobilize church members to seek equal access to health care services. The study used qualitative methods, including the collaborative development of a logic model for the initiative, focus groups, interviews, analysis of program reports, and participant observation. The paper examines three key aspects of the initiative's implementation: (1) the engagement of the church leadership; (2) the use of church structures as venues for education and intervention; and (3) changes in church policies. Key findings include the importance of pre-existing relationships within the community and the prominent agenda-setting role played by key pastors, and the strength of the Coalition's dual focus on health behaviors and health disparities. Given the churches' demonstrated ability to pull people together, to motivate and to inspire, there is great potential for faith-based interventions, and models developed through such interventions, to address health disparities.
尽管许多公共卫生倡议是通过与基于信仰的机构合作实施的,但对于制定此类项目的最佳实践知之甚少。本案例研究采用基于社区的参与式方法,考察了纽约布朗克斯区一项倡议的实施情况,该倡议旨在向社区成员宣传健康促进和疾病管理知识,并动员教会成员寻求平等获得医疗服务的机会。该研究采用了定性方法,包括为该倡议共同制定逻辑模型、焦点小组讨论、访谈、项目报告分析以及参与观察。本文考察了该倡议实施的三个关键方面:(1)教会领导层的参与;(2)利用教会结构作为教育和干预的场所;(3)教会政策的变化。主要发现包括社区内既有关系的重要性、关键牧师所发挥的突出议程设定作用,以及该联盟对健康行为和健康差距的双重关注的力度。鉴于教会已展现出凝聚人群、激励和鼓舞的能力,基于信仰的干预措施以及通过此类干预措施开发的模式在解决健康差距方面具有巨大潜力。