NC Institute for Public Health and Department of Maternal and Child Health, UNC Gillings School of Global Public Health, Chapel Hill NC, USA.
J Public Health Manag Pract. 2012 Nov;18(6):571-6. doi: 10.1097/PHH.0b013e31825ce8e2.
The objective of this article was to describe factors that contribute to successful translation of science into evidence-based practices and their implementation in public health practice agencies, based on a review of the literature and evidence from a series of case studies. The case studies involved structured interviews with key informants in 4 health departments and with 4 corresponding partners from academic institutions. Interviews were recorded and transcribed, coded by 2 independent, trained coders, using a standard codebook. A thematic analysis of codes was conducted. Coding was entered into Atlas TI software for further analysis. Results from the literature review indicated that only approximately half of programs implemented in state and local health departments were evidence based. Lack of time, inadequate funding, and absence of cultural and managerial support-including incentives-are among the most commonly cited barriers to implementing evidence-based practices. Findings from the case studies suggest that these health departments, successful in implementing evidence-based practices, have strong relationships and good communication channels established with their academic partner(s). There is strong leadership engagement from within the health department and in the academic institution. Implementation of evidence-based programs was most often related to high priority community needs and the availability of resources to address these needs. The practice agencies operate with a culture of quality improvement throughout the agency. Information technology, training, how the interventions are bundled, including their complexity and ability to be customized and resource requirements are all fruitful avenues for further research.
本文旨在通过文献回顾和一系列案例研究的证据,描述将科学转化为基于证据的实践并将其付诸公共卫生实践机构的因素。案例研究涉及对 4 个卫生部门的主要知情人以及来自学术机构的 4 个相应合作伙伴进行结构化访谈。访谈进行了录音和转写,并由 2 名独立的、经过培训的编码员使用标准编码本进行编码。对代码进行了主题分析。将编码输入 Atlas TI 软件进行进一步分析。文献综述的结果表明,州和地方卫生部门实施的项目中只有大约一半是基于证据的。缺乏时间、资金不足以及缺乏文化和管理支持(包括激励措施)是实施基于证据的实践的最常见障碍。案例研究的结果表明,这些成功实施基于证据的实践的卫生部门与他们的学术合作伙伴建立了牢固的关系和良好的沟通渠道。卫生部门内部和学术机构内部都有强烈的领导力参与。实施基于证据的项目通常与社区的高度优先需求以及解决这些需求的资源可用性有关。该实践机构在整个机构内都具有质量改进文化。信息技术、培训、干预措施的捆绑方式,包括它们的复杂性、可定制性和资源需求,都是进一步研究的有益途径。