Beenstock Jane, Sowden Sarah, Hunter David J, White Martin
Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK.
Fuse, UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
J Public Health (Oxf). 2015 Sep;37(3):461-9. doi: 10.1093/pubmed/fdu073. Epub 2014 Oct 15.
Since 1 April 2013, local authority (LA) health and well-being boards (HWBs) in England are required to publish a health and well-being strategy (HWS). HWSs should identify how population health needs are to be addressed. The extent to which this has been achieved is not known. We analysed HWSs to assess how LAs have interpreted statutory guidance, how evidence has been used within HWSs and the relationship of HWSs to Joint Strategic Needs Assessments (JSNAs).
Qualitative thematic content analysis of a random sample of one-third of upper tier LA HWSs in 2013-14.
Fifty out of 152 LAs were sampled and 47 HWSs analysed. Strategies varied in timescale, length and structure. The term 'evidence' was used most commonly referring to local need, rather than evidence of effectiveness. All, except two, referred to JSNAs.
HWSs are dominated by evidence of need and could be strengthened by greater use of evidence of effectiveness for public health interventions. Public health agencies and academics can support the development of effective HWSs by improving the accessibility of evidence and conducting research when evidence is absent. To strengthen HWSs' impact, the statutory guidance should clarify the distinction between evidence of need and evidence of effectiveness.
自2013年4月1日起，英格兰地方当局（LA）的健康与福祉委员会（HWBs）须发布健康与福祉战略（HWS）。健康与福祉战略应明确如何满足人群的健康需求。目前尚不清楚这一目标的实现程度。我们对健康与福祉战略进行了分析，以评估地方当局如何解读法定指南、健康与福祉战略中如何运用证据以及健康与福祉战略与联合战略需求评估（JSNAs）之间的关系。
对2013 - 2014年三分之一的上层地方当局健康与福祉战略进行随机抽样的定性主题内容分析。
从152个地方当局中抽取了50个，分析了47份健康与福祉战略。各战略在时间跨度、篇幅和结构上各不相同。“证据”一词最常指的是当地需求，而非有效性证据。除两份外，所有战略均提及联合战略需求评估。
健康与福祉战略以需求证据为主导，若更多地运用公共卫生干预措施的有效性证据，这些战略将得到加强。公共卫生机构和学者可通过提高证据的可及性以及在缺乏证据时开展研究，来支持有效的健康与福祉战略的制定。为增强健康与福祉战略的影响力，法定指南应明确需求证据与有效性证据之间的区别。
