基于区域的干预措施对澳大利亚孕产妇和儿童健康评估接受情况的影响：一项社区试验。
The effects of an area-based intervention on the uptake of maternal and child health assessments in Australia: a community trial.
作者信息
Kelaher Margaret, Dunt David, Feldman Peter, Nolan Andrea, Raban Bridie
机构信息
Centre for Health Policy, Programs and Economics, School of Population Health, University of Melbourne, Melbourne, Australia.
出版信息
BMC Health Serv Res. 2009 Mar 25;9:53. doi: 10.1186/1472-6963-9-53.
BACKGROUND
Recognition of the importance of the early years in determining health and educational attainment and promotion of the World Health Organization Health for All (HFA) principles has led to an international trend towards community-based initiatives to improve developmental outcomes among socio-economically disadvantaged children. In this study we examine whether, Best Start, an Australian area-based initiative to improve child health was effective in improving access to Maternal and Child Health (MCH) services.
METHODS
The study compares access to information, parental confidence and annual 3.5 year Ages and Stages visiting rates before (2001/02) and after (2004/05) the introduction of Best Start. Access to information and parental confidence were measured in surveys of parents with 3 year old children. There were 1666 surveys in the first wave and 1838 surveys in the second wave. The analysis of visiting rates for the 3.5 year Ages and Stages visit included all eligible Victorian children. Best Start sites included 1,739 eligible children in 2001/02 and 1437 eligible children in 2004/05. The comparable figures in the rest of the state were and 45, 497 and 45, 953 respectively.
RESULTS
There was a significant increase in attendance at the 3.5 year Ages and Stages visit in 2004/05 compared to 2001/02 in all areas. However the increase in attendance was significantly greater at Best Start sites than the rest of the state. Access to information and parental confidence improved over the course of the intervention in Best Start sites with MCH projects compared to other Best Start sites.
CONCLUSION
These results suggest that community-based initiatives in disadvantaged areas may improve parents' access to child health information, improve their confidence and increase MCH service use. These outcomes suggest such programmes could potentially contribute to strategies to reduce child health inequalities.
背景
认识到早年生活对健康和教育成就的重要性，并推广世界卫生组织的全民健康（HFA）原则，已引发了一种国际趋势，即采取基于社区的举措来改善社会经济弱势儿童的发育成果。在本研究中，我们考察了澳大利亚一项旨在改善儿童健康的地区性举措“最佳开端”在改善母婴健康（MCH）服务可及性方面是否有效。
方法
该研究比较了“最佳开端”实施之前（2001/02年）和之后（2004/05年）获取信息的情况、家长的信心以及3.5岁儿童的年度年龄与阶段访查率。通过对有3岁孩子的家长进行调查来衡量获取信息的情况和家长的信心。第一波调查有1666份，第二波调查有1838份。对3.5岁年龄与阶段访查率的分析涵盖了所有符合条件的维多利亚州儿童。“最佳开端”项目地区在2001/02年有1739名符合条件的儿童，在2004/05年有1437名符合条件的儿童。该州其他地区的可比数字分别为45497名和45953名。
结果
与2001/02年相比，2004/05年所有地区3.5岁年龄与阶段访查的参与率都有显著提高。然而，“最佳开端”项目地区参与率的提高幅度明显大于该州其他地区。与其他“最佳开端”项目地区相比，在实施了母婴健康项目的“最佳开端”项目地区，干预过程中获取信息的情况和家长的信心有所改善。
结论
这些结果表明，在弱势地区开展基于社区的举措可能会改善家长获取儿童健康信息的机会，增强他们的信心，并增加对母婴健康服务的利用。这些成果表明，此类项目可能有助于减少儿童健康不平等现象的策略。
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