Morris Zoë Slote, Clarkson Peter John
Engineering Design Centre, Department of Engineering, University of Cambridge, Trumpington Street, Cambridge CB21PZ, UK.
Health Policy. 2009 Jul;91(2):135-41. doi: 10.1016/j.healthpol.2008.11.009. Epub 2009 Jan 14.
We argue that social marketing can be used as a generic framework for analysing barriers to the take-up of clinical guidelines, and planning interventions which seek to enable this change.
We reviewed the literature on take-up of clinical guidelines, in particular barriers and enablers to change; social marketing principles and social marketing applied to healthcare. We then applied the social marketing framework to analyse the literature and to consider implications for future guideline policy to assess its feasibility and accessibility.
There is sizeable extant literature on healthcare practitioners' non-compliance with clinical guidelines. This is an international problem common to a number of settings. The reasons for poor levels of take up appear to be well understood, but not addressed adequately in practice. Applying a social marketing framework brings new insights to the problem."
We show that a social marketing framework provides a useful solution-focused framework for systematically understanding barriers to individual behaviour change and designing interventions accordingly. Whether the social marketing framework provides an effective means of bringing about behaviour change remains an empirical question which has still to be tested in practice. The analysis presented here provides strong motivation to begin such testing.
我们认为社会营销可作为一个通用框架，用于分析临床指南应用的障碍，并规划旨在促成这种改变的干预措施。
我们回顾了关于临床指南应用的文献，特别是变革的障碍和促进因素；社会营销原则以及应用于医疗保健领域的社会营销。然后，我们应用社会营销框架来分析文献，并思考对未来指南政策的影响，以评估其可行性和可及性。
现有大量关于医疗从业者不遵守临床指南的文献。这是一个在多个环境中普遍存在的国际性问题。指南应用水平低下的原因似乎已广为人知，但在实践中并未得到充分解决。应用社会营销框架为该问题带来了新的见解。
我们表明，社会营销框架为系统地理解个体行为改变的障碍并据此设计干预措施提供了一个有用的以解决方案为导向的框架。社会营销框架是否提供了促成行为改变的有效手段仍是一个实证问题，有待在实践中进行检验。此处呈现的分析为开展此类检验提供了强大动力。
