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社区优先(ComFi)研究:一项前瞻性对照准实验研究的方案,旨在评估区域全面复兴对贫困社区心理健康和社会凝聚力的影响。

The communities first (ComFi) study: protocol for a prospective controlled quasi-experimental study to evaluate the impact of area-wide regeneration on mental health and social cohesion in deprived communities.

作者信息

White James, Greene Giles, Dunstan Frank, Rodgers Sarah, Lyons Ronan A, Humphreys Ioan, John Ann, Webster Chris, Palmer Stephen, Elliott Eva, Phillips Ceri J, Fone David

机构信息

South East Wales Trials Unit (SEWTU), School of Medicine, Cardiff, UK.

Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Medicine, Cardiff, UK.

出版信息

BMJ Open. 2014 Oct 14;4(10):e006530. doi: 10.1136/bmjopen-2014-006530.

Abstract

INTRODUCTION

Recent systematic reviews have highlighted the dearth of evidence on the effectiveness of regeneration on health and health inequalities. 'Communities First' is an area-wide regeneration scheme to improve the lives of people living in the most deprived areas in Wales (UK). This study will evaluate the impact of Communities First on residents' mental health and social cohesion.

METHODS AND ANALYSIS

A prospective controlled quasi-experimental study of the association between residence in Communities First regeneration areas in Caerphilly county borough and change in mental health and social cohesion. The study population is the 4226 residents aged 18-74 years who responded to the Caerphilly Health and Social Needs Study in 2001 (before delivery) and 2008 (after delivery of Communities First). Data on the location, type and cost of Communities First interventions will be extracted from records collected by Caerphilly county borough council. The primary outcome is the change in mental health between 2001 and 2008. Secondary outcomes are changes: in common mental disorder case status (using survey and general practice data), social cohesion and mental health inequalities. Multilevel models will examine change in mental health and social cohesion between Communities First and control areas, adjusting for individual and household level confounding factors. Further models will examine the effects of (1) different types of intervention, (2) contamination across areas, (3) length of residence in a Communities First area, and (4) population migration. We will carry out a cost-consequences analysis to summarise the outcomes generated for participants, as well as service utilisation and utility gains.

ETHICS AND DISSEMINATION

This study has had approval from the Information Governance Review Panel at Swansea University (Ref: 0266 CF). Findings will be disseminated through peer-review publications, international conferences, policy and practice partners in local and national government, and updates on our study website (http://medicine.cardiff.ac.uk/clinical-study/communities-first-regeneration-programme/).

摘要

引言

近期的系统评价凸显了关于再生对健康及健康不平等影响的证据匮乏。“社区优先”是一项全区域的再生计划,旨在改善生活在威尔士(英国)最贫困地区人们的生活。本研究将评估“社区优先”对居民心理健康和社会凝聚力的影响。

方法与分析

一项前瞻性对照准实验研究,探讨卡菲利郡行政区“社区优先”再生区域的居住情况与心理健康及社会凝聚力变化之间的关联。研究对象为4226名年龄在18 - 74岁之间的居民,他们分别在2001年(项目实施前)和2008年(“社区优先”项目实施后)参与了卡菲利健康与社会需求研究。“社区优先”干预措施的地点、类型和成本数据将从卡菲利郡行政区议会收集的记录中提取。主要结局是2001年至2008年期间心理健康的变化。次要结局包括:常见精神障碍病例状态的变化(使用调查和全科医疗数据)、社会凝聚力以及心理健康不平等。多层次模型将检验“社区优先”区域与对照区域之间心理健康和社会凝聚力的变化,并对个体和家庭层面的混杂因素进行调整。进一步的模型将检验以下因素的影响:(1)不同类型的干预措施;(2)区域间的交叉影响;(3)在“社区优先”区域的居住时长;(4)人口迁移。我们将进行成本后果分析,以总结为参与者产生的结局,以及服务利用情况和效用增益。

伦理与传播

本研究已获得斯旺西大学信息治理审查小组的批准(参考编号:0266 CF)。研究结果将通过同行评审出版物、国际会议、地方和国家政府的政策与实践伙伴以及我们研究网站(http://medicine.cardiff.ac.uk/clinical - study/communities - first - regeneration - programme/)的更新进行传播。

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