School of Public Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Health Promot Int. 2012 Jun;27(2):208-19. doi: 10.1093/heapro/dar032. Epub 2011 Jun 10.
There is a need for public health interventions to be based on the best available evidence. Unfortunately, well-conducted studies from settings similar to that in which an intervention is to be implemented are often not available. Therefore, health practitioners are forced to make judgements about proven effective interventions in one setting and their suitability to make a difference in their own setting. The framework of Wang et al. has been proposed to help with this process. This paper provides a case study on the application of the framework to a decision-making process regarding antenatal care in Aboriginal and Torres Strait Islander communities in Queensland. This method involved undertaking a systematic search of the current available evidence, then conducting a second literature search to determine factors that may affect the applicability and transferability of these interventions into these communities. Finally, in consideration of these factors, clinical judgement decisions on the applicability and transferability of these interventions were made. This method identified several interventions or strategies for which there was evidence of improving antenatal care or outcomes. By using the framework, we concluded that several of these effective interventions would be feasible in Aboriginal and Torres Strait Islander communities within Queensland.
需要基于最佳现有证据来制定公共卫生干预措施。不幸的是,在将要实施干预措施的环境中进行的精心设计的研究往往无法获得。因此,卫生从业者必须对在一个环境中已被证实有效的干预措施及其在自己环境中产生影响的适宜性做出判断。Wang 等人提出了一个框架来帮助这个过程。本文提供了一个案例研究,说明该框架在昆士兰州原住民和托雷斯海峡岛民社区产前护理决策中的应用。该方法包括对现有证据进行系统搜索,然后进行第二次文献搜索,以确定可能影响这些干预措施在这些社区的适用性和可转移性的因素。最后,根据这些因素,对这些干预措施的适用性和可转移性做出临床判断。该方法确定了一些证据表明可以改善产前护理或结果的干预措施或策略。通过使用该框架,我们得出结论,昆士兰州的原住民和托雷斯海峡岛民社区中可以实施其中一些有效的干预措施。