Haggis Callista, Sims-Gould Joanie, Winters Meghan, Gutteridge Kaitlyn, McKay Heather A
Centre for Hip Health and Mobility, 2635 Laurel Street, Vancouver, BC V5Z 1M9, Canada.
BMC Public Health. 2013 Sep 27;13:892. doi: 10.1186/1471-2458-13-892.
Compelling evidence supports the cost effectiveness and potential impact of physical activity on chronic disease prevention and health promotion. Quality of evidence is one piece, but certainly not the sole determinant of whether public health interventions, physical activity focused or otherwise, achieve their full potential for impact. Health promotion at both population and community levels must progress beyond health intervention models that isolate individuals from social, environmental, and political systems of influence.We offer a critical evaluation of lessons learned from two successful research initiatives to provide insights as to how health promotion research contributes to sustained impact. We highlight factors key to success including the theoretical and methodological integration of: i) a social ecological approach; ii) participatory action research (PAR) methods; and iii) an interdisciplinary team.
To identify and illustrate the key elements of our success we layered an evaluation of steps taken atop a review of relevant literature.
In the school-based case study (Action Schools! BC), the success of our approach included early and sustained engagement with a broad cross-section of stakeholders, establishing partnerships across sectors and at different levels of government, and team members across multiple disciplines. In the neighbourhood built environment case study, the three domains guided our approach through study design and team development, and the integration of older adults' perspectives into greenway design plans. In each case study we describe how elements of the domains serve as a guide for our work.
To sustain and maximize the impact of community-based public health interventions we propose the integration of elements from three domains of research that acknowledge the interplay between social, environmental and poilitical systems of influence. We emphasize that a number of key factors determine whether evidence from public health interventions in school and built environment settings is applied in practice and policy sectors. These include relationship building at individual, community, and societal levels of the social ecological model, using participatory action research methods, and involving an engaged and committed interdisciplinary team.
有力证据支持体育活动在慢性病预防和健康促进方面的成本效益及潜在影响。证据质量是一方面，但肯定不是以体育活动为重点或其他公共卫生干预措施能否充分发挥其潜在影响的唯一决定因素。在人群和社区层面的健康促进必须超越将个体与社会、环境和政治影响系统隔离开来的健康干预模式。我们对两项成功的研究倡议所吸取的经验教训进行了批判性评估，以深入了解健康促进研究如何有助于产生持续影响。我们强调成功的关键因素，包括以下方面的理论和方法整合：i）社会生态方法；ii）参与式行动研究（PAR）方法；iii）跨学科团队。
为了识别和阐明我们成功的关键要素，我们在对相关文献进行综述的基础上，对所采取的步骤进行了分层评估。
在以学校为基础的案例研究（“行动学校！不列颠哥伦比亚省”）中，我们方法的成功之处包括与广泛的利益相关者进行早期和持续的接触，跨部门和不同政府层面建立伙伴关系，以及跨多个学科的团队成员。在社区建成环境案例研究中，这三个领域通过研究设计和团队发展指导我们的方法，并将老年人的观点纳入绿道设计计划。在每个案例研究中，我们都描述了这些领域的要素如何指导我们的工作。
为了维持并最大化基于社区的公共卫生干预措施的影响，我们建议整合来自三个研究领域的要素，这些要素承认社会、环境和政治影响系统之间的相互作用。我们强调，有许多关键因素决定了学校和建成环境环境中公共卫生干预措施的证据是否应用于实践和政策部门。这些因素包括在社会生态模型的个人、社区和社会层面建立关系，使用参与式行动研究方法，以及组建一个积极参与且坚定的跨学科团队。
