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[基于证据的政策与知识的可持续转化:德国健康促进的一个视角]

[Evidence-based policy and sustainable translation of knowledge: a perspective for health promotion in Germany].

作者信息

Rütten A, Gelius P

机构信息

Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg.

出版信息

Gesundheitswesen. 2012 Apr;74(4):224-8. doi: 10.1055/s-0032-1308978. Epub 2012 Apr 16.

Abstract

This article proposes to shift the focus of our view on evidence-based policy towards a comprehensive "policy orientation". While previous contributions on policy making in public health have already recognised that the evidence-based medicine paradigm is inappropriate for the specificities of the policy context, they still have primarily dealt with evidence of the policy content, i. e. with research to inform policy makers about "what works" in public health (e. g. evidence-based interventions on health determinants). However, they have widely neglected issues pertaining to the policy process, i. e. knowledge concerning "what works" in policy making (e. g. key determinants of policy development and policy implementation in order to build policy capacities and to improve policy outcomes). A broader perspective including the policy process will allow us to contextualise theory and research in a way more appropriate to the process of policy making and will help improve approaches of applied science and knowledge translation in public health. We will illustrate the differences be-tween a content orientation and a policy process orientation in public health by reviewing previous discourses on 3 closely related topics: (1) the production of evidence for policy making, (2) the conditions for the utilisation of evidence in policy making, and (3) the translation of evidence into policy making. We conclude that future public health theory and research, while continuing to broaden the evidence base on health determinants and health interventions, should increasingly focus on research concerning processes of public health policy development and implementation, building frameworks, developing methodologies, and conducting the necessary empirical research.

摘要

本文提议将我们基于证据的政策观点的重点转向全面的“政策导向”。虽然先前关于公共卫生政策制定的论述已经认识到循证医学范式不适用于政策背景的特殊性,但它们主要仍处理政策内容的证据,即旨在告知政策制定者公共卫生领域“什么有效”的研究(例如基于证据的健康决定因素干预措施)。然而,它们广泛忽视了与政策过程相关的问题,即关于政策制定中“什么有效”的知识(例如政策制定和政策实施的关键决定因素,以便建设政策能力并改善政策成果)。一个包括政策过程的更广阔视角将使我们能够以更适合政策制定过程的方式将理论和研究置于背景之中,并将有助于改进公共卫生领域应用科学和知识转化的方法。我们将通过回顾先前关于3个密切相关主题的论述来说明公共卫生中内容导向和政策过程导向之间的差异:(1)政策制定的证据生成,(2)政策制定中证据利用的条件,以及(3)证据转化为政策制定。我们得出结论,未来的公共卫生理论和研究,在继续扩大健康决定因素和健康干预措施的证据基础的同时,应越来越关注关于公共卫生政策制定和实施过程的研究,构建框架,开发方法,并进行必要的实证研究。

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