Office of Public Health Studies, University of Hawai'i at Mānoa , Honolulu, HI , USA.
Front Public Health. 2015 Apr 27;2:140. doi: 10.3389/fpubh.2014.00140. eCollection 2014.
In 2006, funds were received to replicate Stanford's Chronic Disease Self-Management Program (CDSMP) among eldercare providers in Honolulu. This case study, conducted 1 year after the close of the initial 3-year replication grant, explored factors for sustaining the delivery of CDSMP, with an aim to create guidelines for cultivating sustainability. Face-to-face semi-structured interviews were conducted with one representative from each of eight eldercare agencies, with the representative specified by the agency. Representatives discussed the presence and strength (low, medium, or high) of sustainability factors, including readiness, champions, technical assistance, perceived fit of CDSMP with their agency, CDSMP modifiability, perceived benefits of CDSMP, and other. Only three of the eight agencies (38%) were still offering CDSMP by the end of 2010. Agencies who sustained CDSMP rated higher on all sustainability factors compared to those that did not sustain the program. Additional factors identified by representatives as important were funding and ongoing access to pools of elders from which to recruit program participants. When replicating evidence-based programs, sustainability factors must be consciously nurtured. For example, readiness must be cultivated, multiple champions must be developed, agencies must be helped to modify the program to best fit their clientele, evaluation findings demonstrating program benefit should be shared, and linkages to funding may be needed.
2006 年，我们获得了资金，用于在檀香山的老年护理机构中复制斯坦福大学的慢性病自我管理计划（CDSMP）。本案例研究是在最初的 3 年复制资助结束后 1 年进行的，旨在探讨维持 CDSMP 提供的因素，目的是制定培养可持续性的指导方针。我们与八家老年护理机构中的每一家机构的一名代表进行了面对面的半结构化访谈，代表由机构指定。代表们讨论了可持续性因素的存在和强度（低、中或高），包括准备情况、拥护者、技术援助、CDSMP 与机构的适配性、CDSMP 的可修改性、对 CDSMP 的益处的看法以及其他因素。到 2010 年底，只有八家机构中的三家（38%）仍在提供 CDSMP。与未维持该计划的机构相比，维持 CDSMP 的机构在所有可持续性因素上的得分都更高。代表们还认为，重要的额外因素包括资金以及持续获得招募计划参与者的老年人资源。在复制基于证据的计划时，必须有意识地培养可持续性因素。例如，必须培养准备情况，必须培养多个拥护者，必须帮助机构修改计划以最适合其客户群体，应该分享展示计划效益的评估结果，并且可能需要与资金建立联系。
