Bridges John F P, Joy Susan M, Blauvelt Barri M, Yan Weili, Marsteller Jill A
Department of Health Policy and Management and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA, Institute for Global Health, University of Massachusetts, Amhurst, MA 01003, USA and Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA and Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, MD 21202, USA
Department of Health Policy and Management and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA, Institute for Global Health, University of Massachusetts, Amhurst, MA 01003, USA and Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA and Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, MD 21202, USA.
Health Policy Plan. 2015 Jun;30(5):645-55. doi: 10.1093/heapol/czu044. Epub 2014 Jun 27.
The World Health Organization offers clear guidance on the development of national cancer control programmes based on a country's level of resources, yet the motivation to implement such programmes may be driven by factors other than resources.
To compare stakeholder motivation to implement a national liver cancer control programme and assess if variation in motivation was associated with stakeholder characteristics or with national indicators of need and resources.
Relevant stakeholders were purposively selected from 13 countries (Australia, China, France, Germany, Italy, Japan, Nigeria, South Korea, Spain, Taiwan, Thailand, Turkey and USA) to participate in a structured survey on liver cancer control. Respondents included 12 individuals working in clinical, 5 in policy and 3 in advocacy roles from each country. Stakeholders' motivation was measured using a scale grounded in expectancy theory and knowledge gained during previous qualitative interviews. Comparisons across countries and respondent characteristics were conducted using hierarchical regression. Country level motivation scores, holding constant individual level covariates, were correlated with indicators of need and resources and tested using Pearson's correlation coefficients.
In total, 260 stakeholders, equally drawn from the study countries, completed the survey (45% response rate). At the national level, motivation was highest in Nigeria, Thailand and China (P < 0.001), and lowest in Italy (P < 0.001) and Germany (P = 0.003). Higher motivation was observed among stakeholders working at the international level relative to the local level (P = 0.017). Motivation was positively associated with a country's relative burden of liver cancer (P = 0.015) and negatively associated with their level of resources (P = 0.018).
This study provides the first empirical evidence on the motivation of stakeholders to implement national cancer control programmes. Furthermore, we demonstrate that motivation is more clearly associated with a country's cancer control needs rather than resources.
世界卫生组织根据一个国家的资源水平，为国家癌症控制规划的制定提供了明确的指导意见，然而实施此类规划的动机可能受资源以外的因素驱动。
比较利益相关者实施国家肝癌控制规划的动机，并评估动机的差异是否与利益相关者特征或国家需求及资源指标相关。
从13个国家（澳大利亚、中国、法国、德国、意大利、日本、尼日利亚、韩国、西班牙、台湾地区、泰国、土耳其和美国）有目的地选取相关利益者，参与一项关于肝癌控制的结构化调查。每个国家的受访者包括12名临床工作人员、5名政策制定者和3名倡导者。使用基于期望理论和先前定性访谈所获知识的量表来衡量利益相关者的动机。采用分层回归对各国及受访者特征进行比较。在个体层面协变量保持不变的情况下，将国家层面的动机得分与需求和资源指标进行相关分析，并使用Pearson相关系数进行检验。
共有260名来自各研究国家的利益相关者完成了调查（回复率为45%）。在国家层面，尼日利亚、泰国和中国的动机最高（P<0.001），意大利（P<0.001）和德国（P = 0.003）的动机最低。相对于地方层面的利益相关者，国际层面的利益相关者动机更高（P = 0.017）。动机与一个国家的肝癌相对负担呈正相关（P = 0.015），与资源水平呈负相关（P = 0.018）。
本研究提供了关于利益相关者实施国家癌症控制规划动机的首个实证证据。此外，我们证明动机与一个国家的癌症控制需求而非资源更密切相关。
Zotero 插件