地方卫生部门基于证据的糖尿病预防与控制项目及政策
Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments.
作者信息
Zwald Marissa, Elliott Lindsay, Brownson Ross C, Skala Mahree
机构信息
Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri (Ms Zwald, Ms Elliott, Dr Brownson)
Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri (Dr Brownson)
出版信息
Diabetes Educ. 2015 Dec;41(6):755-62. doi: 10.1177/0145721715601736. Epub 2015 Aug 21.
PURPOSE
The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments, (2) assess feasibility of non-implemented diabetes prevention and control EBPPs, and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs.
METHODS
An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation.
RESULTS
One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members, increased fruit and vegetable access in community settings, and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs.
CONCLUSIONS
Local health departments are on the "front line" of public health, and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities.
目的
本研究的目的是：（1）评估地方卫生部门中与糖尿病预防和控制相关的循证项目及政策（EBPPs）的实施情况；（2）评估未实施的糖尿病预防和控制EBPPs的可行性；（3）考察与糖尿病预防和控制EBPPs实施相关的个人层面和组织层面因素。
方法
2015年1月对密苏里州所有地方卫生部门的主要代表进行了一项在线调查。使用描述性统计来描述20项糖尿病预防和控制EBPPs的实施情况及感知到的可行性。使用逻辑回归来考察个人因素和组织因素与糖尿病预防和控制EBPPs实施之间的关联。
结果
100个地方卫生部门参与了在线调查（回复率为89%）。地方卫生部门最常实施的与糖尿病相关的EBPPs包括：为机构或社区成员提供营养教育、增加社区环境中水果和蔬菜的可及性，以及开展全社区范围的促进身体活动的运动。更多地鼓励部门内其他人采用循证决策以及机构激励措施来帮助员工采用循证决策与糖尿病预防和控制EBPPs的实施呈正相关。
结论
地方卫生部门处于公共卫生的“前线”，本研究表明了这些组织在实施糖尿病预防和控制EBPPs中所发挥的重要作用。在地方卫生部门更广泛地采用与糖尿病相关的EBPPs的潜在杠杆点包括开展关于循证决策的教育并鼓励循证决策，以及给予组织激励措施促使员工将循证决策纳入其糖尿病预防和控制活动中。
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