Battaglia Tracey A, Murrell Samantha S, Bhosrekar Sarah Gees, Caron Sarah E, Bowen Deborah J, Smith Eugenia, Kalish Richard, Rorie Jo-Anna
Women's Health Unit, Section of General Internal Medicine, and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, USA.
Prog Community Health Partnersh. 2012 Fall;6(3):239-48. doi: 10.1353/cpr.2012.0035.
Despite close proximity to community health centers, public housing residents are at increased risk of uncontrolled chronic disease, in part because of underutilization of routine health care.
To assist in program planning, the Partners in Health and Housing Prevention Research Center (PHH-PRC) used the Community Readiness Model to compare readiness of public housing developments and community health centers to address community-identified health priorities. The model assumes that program success to affect change depends on matching the community's level of readiness to address the issue.
Key respondent interviews were conducted across 15 communities: Eight housing developments and seven health centers. Interviews were scored across six dimensions on an anchored, 9-point scale and averaged to provide a composite readiness score. Higher scores indicate increasing levels of readiness. Interview transcripts were reviewed for consistent themes.
Health centers scored significantly higher (mean, 5.88) than housing developments (mean, 3.33), corresponding with the Preparation stage of readiness compared with the Vague Awareness stage, respectively. Both scored highest in Existing Programs and Resources and lowest in Knowledge of Efforts. Qualitative analysis revealed a lack of existing partnerships between housing developments and health centers as well as significant social barriers preventing housing residents from engaging in care.
We found a mismatch in readiness to address community health priorities. Although health centers have programs to address health issues, community awareness of programs is limited and barriers to engaging in care persist. The model provided a useful tool for engaging communities into shared program planning.
尽管公共住房居民距离社区卫生中心很近，但他们患慢性病控制不佳的风险却有所增加，部分原因是常规医疗保健利用不足。
为协助项目规划，健康与住房伙伴预防研究中心（PHH-PRC）使用社区准备度模型，比较公共住房开发项目和社区卫生中心解决社区确定的健康优先事项的准备度。该模型假定，影响变革的项目成功与否取决于是否与社区解决该问题的准备度水平相匹配。
在15个社区进行了关键信息提供者访谈：8个住房开发项目和7个卫生中心。访谈在六个维度上按照固定的9分制进行评分，并取平均值以提供综合准备度得分。得分越高表明准备度越高。对访谈记录进行了审查，以找出一致的主题。
卫生中心的得分（平均5.88分）显著高于住房开发项目（平均3.33分），分别对应于准备度的准备阶段和模糊意识阶段。两者在现有项目和资源方面得分最高，在努力知识方面得分最低。定性分析表明，住房开发项目和卫生中心之间缺乏现有的伙伴关系，并且存在重大社会障碍，阻碍住房居民接受护理。
我们发现解决社区健康优先事项的准备度不匹配。尽管卫生中心有解决健康问题的项目，但社区对这些项目的认识有限，接受护理的障碍依然存在。该模型为让社区参与共同的项目规划提供了一个有用的工具。
