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美国社区参与计划生育:一项系统综述。

Community Engagement in Family Planning in the U.S.: A Systematic Review.

作者信息

Carter Marion W, Tregear Michelle L, Lachance Christina R

机构信息

Division of Reproductive Health, CDC, Atlanta, Georgia.

Manila Consulting Group, Inc., McLean, Virginia.

出版信息

Am J Prev Med. 2015 Aug;49(2 Suppl 1):S116-23. doi: 10.1016/j.amepre.2015.03.029.

Abstract

CONTEXT

Community engagement may include activities that involve community members in the design, implementation, and evaluation of services. The objective of this systematic review was to evaluate the evidence on this kind of community engagement in U.S. family planning programs, including its effects on various health outcomes, its perceived value, and the barriers and facilitators to implementation.

EVIDENCE ACQUISITION

Using an analytic approach drawn from U.S. Preventive Services Task Force, multiple databases were searched for articles published from 1985 through February 2011 that described studies about community engagement related to family planning. In 2011, relevant articles were reviewed, summarized, and assessed for potential bias using a standardized abstraction process. An updated, targeted review for the 2011-2014 period was conducted in early 2015.

EVIDENCE SYNTHESIS

Eleven papers related to family planning were included. All were qualitative, descriptive, and at high risk for bias. Engagement strategies involved various methods for developing educational materials, program development, or program evaluation. All studies reported benefits to community engagement, such as more-appropriate educational materials or more community support for programs. Barriers to engagement included the substantial time and resources required. Four more articles were identified in the targeted, additional search.

CONCLUSIONS

Community engagement is described as beneficial across the included studies, but the body of evidence for community engagement in family planning is relatively small. Given the high value ascribed to community engagement, more research and documentation of the various approaches taken and their relative strengths and weaknesses are needed.

摘要

背景

社区参与可能包括让社区成员参与服务的设计、实施和评估等活动。本系统评价的目的是评估美国计划生育项目中此类社区参与的证据,包括其对各种健康结果的影响、其感知价值以及实施的障碍和促进因素。

证据获取

采用美国预防服务工作组的分析方法,在多个数据库中检索1985年至2011年2月发表的描述与计划生育相关的社区参与研究的文章。2011年,对相关文章进行了审查、总结,并使用标准化的提取过程评估潜在偏倚。2015年初对2011 - 2014年期间进行了更新的针对性审查。

证据综合

纳入了11篇与计划生育相关的论文。所有论文均为定性、描述性研究,且存在较高的偏倚风险。参与策略涉及开发教育材料、项目开发或项目评估的各种方法。所有研究都报告了社区参与的益处,如更合适的教育材料或社区对项目的更多支持。参与的障碍包括所需的大量时间和资源。在针对性的额外搜索中又确定了4篇文章。

结论

在所纳入的研究中,社区参与被描述为有益的,但计划生育中社区参与的证据相对较少。鉴于社区参与具有很高的价值,需要对所采取的各种方法及其相对优势和劣势进行更多的研究和记录。

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