Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
Health Educ Res. 2012 Aug;27(4):717-28. doi: 10.1093/her/cyr088. Epub 2011 Oct 19.
Dissemination of prevention-focused evidence-based programs (EBPs) from research to community settings may improve population health and reduce health disparities, but such flow has been limited. Academic-community partnerships using community-based participatory research (CBPR) principles may support increased dissemination of EBPs to community-based organizations (CBOs). This qualitative study examined the EBP-related perceptions and needs of CBOs targeting underserved populations. As part of PLANET MassCONECT, a CBPR study, we conducted six key informant interviews with community leaders and four focus groups with CBO staff members in Boston, Worcester and Lawrence, Massachusetts, in 2008. Working definitions of EBPs among CBO staff members varied greatly from typical definitions used by researchers or funders. Key barriers to using EBPs included: resource constraints, program adaptation challenges and conflicts with organizational culture. Important facilitators of EBP usage included: program supports for implementation and adaptation, collaborative technical assistance and perceived benefits of using established programs. This exploratory study highlights differences among key stakeholders regarding the role of evidence in program planning and delivery. An updated perspective should better incorporate CBO perspectives on evidence and place greater, and much needed, emphasis on the impact of context for EBP dissemination in community settings.
将以预防为重点的循证实践方案(EBP)从研究推广到社区环境中可能会改善人群健康并减少健康差异,但这种推广一直受到限制。使用基于社区的参与式研究(CBPR)原则的学术-社区伙伴关系可能会支持将 EBP 更广泛地推广到社区组织(CBO)。本定性研究调查了针对服务不足人群的 CBO 对 EBP 的相关看法和需求。作为 CBPR 研究 PLANET MassCONECT 的一部分,我们于 2008 年在马萨诸塞州波士顿、伍斯特和劳伦斯市对社区领导进行了 6 次重点知情人访谈,并对 CBO 工作人员进行了 4 次焦点小组讨论。CBO 工作人员对 EBP 的工作定义与研究人员或资助者常用的定义有很大不同。使用 EBP 的主要障碍包括:资源限制、方案适应挑战以及与组织文化的冲突。使用 EBP 的重要促进因素包括:实施和适应方案的支持、协作技术援助以及使用既定方案的好处。这项探索性研究强调了关键利益相关者在证据在方案规划和实施中的作用方面的差异。更新的观点应更好地纳入 CBO 对证据的看法,并更加重视 EBP 在社区环境中传播的背景影响,这是非常必要的。