Chin Marshall H, Walters Amy E, Cook Scott C, Huang Elbert S
Section of General Internal Medicine, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA.
Med Care Res Rev. 2007 Oct;64(5 Suppl):7S-28S. doi: 10.1177/1077558707305413.
In 2005, the Robert Wood Johnson Foundation created Finding Answers: Disparities Research for Change, a program to identify, evaluate, and disseminate interventions to reduce racial and ethnic disparities in the care and outcomes of patients with cardiovascular disease, depression, and diabetes. In this introductory paper, we present a conceptual model for interventions that aim to reduce disparities. With this model as a framework, we summarize the key findings from the six other papers in this supplement on cardiovascular disease, diabetes, depression, breast cancer, interventions using cultural leverage, and pay-for-performance and public reporting of performance measures. Based on these findings, we present global conclusions regarding the current state of health disparities interventions and make recommendations for future interventions to reduce disparities. Multifactorial, culturally tailored interventions that target different causes of disparities hold the most promise, but much more research is needed to investigate potential solutions and their implementation.
2005年,罗伯特·伍德·约翰逊基金会发起了“寻找答案:促进变革的差异研究”项目,旨在识别、评估和推广干预措施,以减少心血管疾病、抑郁症和糖尿病患者在治疗及预后方面存在的种族和民族差异。在这篇引言性论文中,我们提出了一个旨在减少差异的干预措施概念模型。以该模型为框架,我们总结了本增刊中其他六篇论文的关键研究结果,这些论文分别涉及心血管疾病、糖尿病、抑郁症、乳腺癌、利用文化影响力的干预措施以及绩效薪酬和绩效指标的公开报告。基于这些研究结果,我们得出了关于健康差异干预措施现状的总体结论,并对未来减少差异的干预措施提出了建议。针对不同差异成因的多因素、文化定制干预措施最具前景,但仍需开展更多研究来探究潜在解决方案及其实施情况。