Allen Peg, Sequeira Sonia, Best Leslie, Jones Ellen, Baker Elizabeth A, Brownson Ross C
Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, 621 Skinker Blvd, St. Louis, MO, 63130-4838. Telephone: 314-935-0116. E-mail:
Washington University in St. Louis, St. Louis, Missouri.
Prev Chronic Dis. 2014 May 8;11:E76. doi: 10.5888/pcd11.130350.
Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding.
A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ(2) tests, and analysis of variance were conducted.
The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges "lack of communication across programs" (P = .02) and "funding might be reduced" differed by program area (P < .001).
Findings can be used by funding agencies and state health departments for planning, training, and technical assistance. The information on perceived challenges demonstrates the need to improve communication across programs, enhance organizational support for coordinated approaches, and create benefits for organizational partners.
从历史上看，慢性病预防工作一直是根据疾病或风险因素进行分类资助的。联邦机构现在正逐步开始资助综合项目以应对常见风险。本研究的目的是通过了解对协调资助方式的感知益处和挑战的看法，为向协调的慢性病预防过渡提供信息。
2013年3月至5月，对从事慢性病预防工作的州卫生部门员工（N = 865）进行了一项基于循证公共卫生的全国性调查。参与者被要求从提供的列表中对协调慢性病方法的前三大益处和前三大挑战进行排序，并可提供其他回答。进行了描述性分析、χ²检验和方差分析。
慢性病预防协调方法最常见的感知益处是改善健康结果、更好地应对常见风险因素以及减少项目工作的重复。最常见的感知挑战是资金限制，如针对特定疾病的绩效指标；相互竞争的优先事项；各项目之间缺乏沟通；资金可能会减少；机构没有为项目协调构建结构；以及失去特定疾病伙伴的支持。不同州和参与者角色对益处和挑战的排名相似；“各项目之间缺乏沟通”（P = 0.02）和“资金可能会减少”这两个感知挑战因项目领域而异（P < 0.001）。
资助机构和州卫生部门可利用研究结果进行规划、培训和技术援助。关于感知挑战的信息表明，需要改善各项目之间的沟通，加强对协调方法的组织支持，并为组织伙伴创造益处。
