Stanley Fiona, Glauert Rebecca, McKenzie Anne, O'Donnell Melissa
Director, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia.
Project Manager, Developmental Pathways Project, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia.
Healthc Policy. 2011 Jan;6(Spec Issue):63-73.
Modern societies are challenged by "wicked problems" - by definition, those that are difficult to define, multi-causal and hard to treat. Problems such as low birth weight, obesity, mental ill health, teenage pregnancy, educational difficulties and juvenile crime fit this category. Given the complex nature of these problems, they require the best data in order to measure them, guide policy frameworks and evaluate whether the steps taken to address them are actually making a difference. What such problems really require are joined-up approaches to enable effective solutions. In this paper, we describe a unique initiative to encourage a more preventive, whole-of-government approach to these problems - the Developmental Pathways Project, which has enabled the linkage of a large number of de-identified administrative databases in order to explore the pathways into and out of the negative outcomes affecting our children and youth. This project has not only enabled the linkage of agency data, but also of agency personnel, in order to improve and promote cross-agency research, policy and preventive solutions. Through the use of these linkages we are attempting to shift the paradigm to encourage agencies to appreciate that these "wicked problems" demand a preventive approach, as well as the provision of effective services for those already affected.
现代社会面临着“棘手问题”的挑战——从定义上讲，这些问题难以界定、具有多重成因且难以解决。低出生体重、肥胖、心理健康问题、青少年怀孕、教育困难和青少年犯罪等问题都属于这一范畴。鉴于这些问题的复杂性，需要最好的数据来衡量它们、指导政策框架并评估为解决这些问题所采取的措施是否真的产生了影响。此类问题真正需要的是联合起来的方法以实现有效的解决方案。在本文中，我们描述了一项独特的倡议，以鼓励针对这些问题采取更具预防性的、政府整体参与的方法——发展路径项目，该项目实现了大量去识别化行政数据库的关联，以便探索影响我们儿童和青少年的负面结果的产生和消除路径。该项目不仅实现了机构数据的关联，还实现了机构人员的关联，以改进和促进跨机构研究、政策及预防性解决方案。通过利用这些关联，我们正试图转变范式，鼓励各机构认识到这些“棘手问题”既需要预防性方法，也需要为那些已经受到影响的人提供有效服务。
