Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA, USA.
Sex Transm Dis. 2013 Aug;40(8):663-8. doi: 10.1097/OLQ.0000000000000002.
HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis in the United States remain major public health concerns. The current disease-specific prevention approach oftentimes has led to narrow success and missed opportunities for increasing program capacity, leveraging resources, addressing social and structural determinants, and accelerating health impact-suggesting a need for greater innovation to prevent related diseases. The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's Program Collaboration and Service Integration (PCSI) strategic priority aims to strengthen collaborative engagement across these disease areas and to integrate services at the client level. In this review, we articulate the 5 principles of PCSI-appropriateness, effectiveness, flexibility, accountability, and acceptability. Drawing upon these principles and published literature, we discuss the case for change that underlies PCSI, summarize advances in the field since 2007, and articulate key next steps. Although formal evaluation is needed to fully assess the health impact of PCSI, available evidence suggests that this approach is a promising tool to advance prevention goals.
在美国,艾滋病毒感染、病毒性肝炎、性传播疾病和结核病仍然是主要的公共卫生关注点。目前针对特定疾病的预防方法往往导致成效有限,错失了增加项目能力、利用资源、解决社会和结构性决定因素以及加快健康影响的机会——这表明需要更大的创新来预防相关疾病。美国国立卫生研究院下属的艾滋病、病毒性肝炎、性传播疾病和结核病预防中心的计划合作和服务整合(PCSI)战略重点旨在加强这些疾病领域的合作,并在客户层面整合服务。在这篇综述中,我们阐述了 PCSI 的 5 个原则——适宜性、有效性、灵活性、问责制和可接受性。借鉴这些原则和已发表的文献,我们讨论了构成 PCSI 的变革基础,总结了自 2007 年以来该领域的进展,并阐明了关键的下一步。虽然需要进行正式评估来全面评估 PCSI 的健康影响,但现有证据表明,这种方法是推进预防目标的有前途的工具。