Massoudi Barbara L, Marcial Laura H, Haque Saira, Bailey Robert, Chester Kelley, Cunningham Shellery, Riley Amanda, Soper Paula
RTI International.
EGEMS (Wash DC). 2014 Oct 24;2(3):1093. doi: 10.13063/2327-9214.1093. eCollection 2014.
The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community.
The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery.
Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies.
Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7-14) present for each Beacon compared to barriers (range = 4-6).
Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value.
A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach to evaluation at the beginning of implementation made the work more effective. Supporting evaluation to inform future implementations is important.
公共卫生灯塔社区（BCPH）项目于2011年启动，旨在更深入了解灯塔社区目前在人群健康和公共卫生领域开展的各类活动。该项目突出了这些努力的成功之处与挑战，目的是在公共卫生界广泛分享这些信息。
灯塔社区计划旨在展示以技术为支撑、基于社区的改善成果的举措，重点关注：构建和强化健康信息技术（IT）基础设施及信息交换能力；将健康IT方面的投资转化为成本、质量和人群健康方面可衡量的改善；以及开发绩效评估、技术和护理提供方面的创新方法。
基于一个经过修改的社会技术框架进行了四项多方法案例研究，以更多地了解灯塔社区中公共卫生举措的实施与应用情况。我们的方法包括文献回顾和半结构化关键信息人访谈。采用全国城市和郡卫生官员协会（NACCHO）示范实践项目标准来选择案例研究中纳入的公共卫生举措。
尽管各案例研究存在差异，但在社会技术框架应用的所有领域，包括结构、人员、技术、任务、总体考量和可持续性方面，都发现了共同的障碍和促进因素。总体而言，与障碍（范围为4 - 6个）相比，每个灯塔社区的促进因素（范围为7 - 14个）更多。
通过这项工作确定了四项有影响力的、有前景的实践做法：建立强大且可持续的伙伴关系；确保良好的任务 - 技术匹配以及灵活且迭代的设计；促进技术接受；以及提供教育并展示价值。
一个共同的弱点是灯塔社区评估工作缺乏框架或模型。在实施之初共享评估框架或方法能使工作更有效。支持评估以指导未来的实施很重要。
