Injury Research Center, Medical College of Wisconsin, Milwaukee, 53226, USA.
Am J Public Health. 2012 Apr;102(4):617-24. doi: 10.2105/AJPH.2011.300468. Epub 2012 Feb 16.
There is a tension between 2 alternative approaches to implementing community-based interventions. The evidence-based public health movement emphasizes the scientific basis of prevention by disseminating rigorously evaluated interventions from academic and governmental agencies to local communities. Models used by local health departments to incorporate community input into their planning, such as the community health improvement process (CHIP), emphasize community leadership in identifying health problems and developing and implementing health improvement strategies. Each approach has limitations. Modifying CHIP to formally include consideration of evidence-based interventions in both the planning and evaluation phases leads to an evidence-driven community health improvement process that can serve as a useful framework for uniting the different approaches while emphasizing community ownership, priorities, and wisdom.
在实施基于社区的干预措施方面,存在两种替代方法之间的紧张关系。循证公共卫生运动强调通过将严格评估的干预措施从学术和政府机构传播到当地社区,来为预防提供科学依据。地方卫生部门用来将社区意见纳入其规划的模型,如社区卫生改善过程(CHIP),强调社区领导在确定健康问题以及制定和实施健康改善策略方面的作用。每种方法都有其局限性。将 CHIP 进行修改,使其在规划和评估阶段都正式考虑基于证据的干预措施,从而形成一个循证的社区卫生改善过程,这可以作为一个有用的框架,将不同的方法统一起来,同时强调社区的所有权、重点和智慧。