Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
Int J Equity Health. 2013 Feb 26;12:15. doi: 10.1186/1475-9276-12-15.
The residents of many Australian rural and remote communities do not have the essential infrastructure and services required to support healthy living conditions and community members choosing healthy lifestyle options. Improving these social determinants of health is seen to offer real opportunities to improve health among such disadvantaged populations. In this paper, we describe the development and trialling of a tool to measure, monitor and evaluate key social determinants of health at community level.
The tool was developed and piloted through a multi-phase and iterative process that involved a series of consultations with community members and key stakeholders and trialling the tool in remote Indigenous communities in the Northern Territory of Australia.
The indicators were found to be robust, and by testing the tool on a number of different levels, face validity was confirmed. The scoring system was well understood and easily followed by Indigenous and non-Indigenous study participants. A facilitated small group process was found to reduce bias in scoring of indicators.
The Healthy Community Assessment Tool offers a useful vehicle and process to help those involved in planning, service provision and more generally promoting improvements in community social determinants of health. The tool offers many potential uses and benefits for those seeking to address inequities in the social determinants of health in remote communities. Maximum benefits in using the tool are likely to be gained with cross-sector involvement and when assessments are part of a continuous quality improvement program.
许多澳大利亚农村和偏远社区的居民缺乏支持健康生活条件的基本基础设施和服务，社区成员也无法选择健康的生活方式。改善这些健康的社会决定因素被认为是为这些弱势群体改善健康状况提供了真正的机会。本文介绍了一种用于衡量、监测和评估社区层面关键社会决定因素的工具的开发和试用情况。
该工具是通过多阶段和迭代过程开发和试用的，该过程涉及与社区成员和利益相关者进行一系列磋商，并在澳大利亚北部的偏远土著社区试用该工具。
发现这些指标具有很强的稳健性，通过在多个不同层面上测试该工具，确认了其表面效度。评分系统得到了土著和非土著研究参与者的很好理解和遵循。事实证明，通过小组讨论来促进评分，可以减少指标评分的偏差。
健康社区评估工具为那些参与规划、服务提供以及更广泛地促进社区健康社会决定因素改善的人提供了一个有用的工具和流程。该工具为那些寻求解决偏远社区健康社会决定因素不平等问题的人提供了许多潜在的用途和好处。最大限度地利用该工具的好处可能需要跨部门参与，并且评估应成为持续质量改进计划的一部分。
