Faculty of Medicine Health and Molecular Science, James Cook University, Townsville, Qld 4814, Australia.
School of Public Health and Preventive Medicine, Monash University (Alfred Campus), Melbourne, Vic. 3004, Australia.
Health Promot J Austr. 2013 Dec;24(3):163-9. doi: 10.1071/HE13082.
Reorientation of the workforce in primary health care is a complex process and requires specific strategies and interventions. Primary health care providers are a key health care workforce that is expected to deliver tangible outcomes from disease prevention and health promotion strategies. This paper describes a training intervention that occurred as part of a broader participatory action research process for building health promotion capacity in the primary health care workforce.
Participatory action research (PAR) was conducted over six action and reflection cycles in a two-year period (2001-02) in an urban community health setting in the Northern Territory. One of the PAR cycles was a training intervention that was identified as a need from a survey in the first action and reflection cycle. This training was facilitated by a health promotion specialist, face-to-face and comprised five 3.5-h sessions over a 5-month period. A pre-post questionnaire was used to measure the knowledge and skills components of the training intervention.
The results reinforced the importance of using a participatory approach that involved the primary health care providers themselves. Multiple strategies such as workforce development within capacity building frameworks assisted in shifting work practice more upstream. Additionally, these strategies encouraged more reflective practice and built social capital within the primary health care workforce.
Lessons from practice reinforce that workforce development influenced work practice change and is an important element in building the health promotion capacity of primary health care centres. SO WHAT?: Workforce development is critical for reorienting health services. Health promotion specialists play an important role in reorienting practice, which is only effective when combined with other strategies, and driven and led by the primary health care workforce.
初级卫生保健中的劳动力再定位是一个复杂的过程，需要特定的策略和干预措施。初级卫生保健提供者是一支关键的卫生保健劳动力，预计将从疾病预防和健康促进策略中产生切实的成果。本文描述了一项培训干预措施，该措施是在参与式行动研究过程的一部分，旨在增强初级卫生保健劳动力的健康促进能力。
参与式行动研究（PAR）在北领地的一个城市社区卫生环境中进行了六个行动和反思周期，为期两年（2001-02 年）。PAR 周期之一是培训干预措施，该措施是根据第一个行动和反思周期中的调查确定的需求。该培训由一名健康促进专家以面对面的方式进行，共 5 个月，分 5 次，每次 3.5 小时。使用预-后调查问卷来衡量培训干预措施的知识和技能组成部分。
结果强调了使用参与式方法的重要性，该方法涉及初级卫生保健提供者本身。多种策略，如能力建设框架内的劳动力发展，有助于将工作实践更多地上游转移。此外，这些策略鼓励更多的反思实践，并在初级卫生保健劳动力中建立社会资本。
实践中的经验教训强化了劳动力发展对工作实践变革的影响，是建立初级卫生保健中心健康促进能力的重要因素。那么，什么是重要的呢？劳动力发展对于重新定位卫生服务至关重要。健康促进专家在重新定位实践方面发挥着重要作用，只有与其他策略相结合，并由初级卫生保健劳动力驱动和领导，这种实践才是有效的。
