Mathers Jonathan, Taylor Rebecca, Parry Jayne
Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
J Public Health (Oxf). 2017 Mar 1;39(1):139-144. doi: 10.1093/pubmed/fdv214.
The Health Trainers Service is one of the few public health policies where a bespoke database-the Data Collection and Reporting System (DCRS)-was developed to monitor performance. We seek to understand the context within which local services and staff have used the DCRS and to consider how this might influence interpretation of collected data.
In-depth case studies of six local services purposively sampled to represent the range of service provider arrangements, including detailed interviews with key stakeholders (n = 118).
Capturing detailed information on activity with clients was alien to many health trainers' work practices. This related to technical challenges, but it also ran counter to beliefs as to how a 'lay' service would operate. Interviewees noted the inadequacy of the dataset to capture all client impacts; that is, it did not enable them to input information about issues a client living in a deprived neighbourhood might experience and seek help to address.
The utility of the DCRS may be compromised both by incomplete ascertainment of activity and by incorrect data inputted by some Health Trainers. The DCRS is also underestimate the effectiveness of work health trainers have undertaken to address 'upstream' factors affecting client health.
健康培训师服务是少数几个开发了定制数据库——数据收集与报告系统（DCRS）以监测绩效的公共卫生政策之一。我们试图了解地方服务机构和工作人员使用DCRS的背景，并思考这可能如何影响对所收集数据的解读。
对六个地方服务机构进行深入案例研究，这些机构是经过有目的抽样选取的，以代表服务提供商安排的范围，包括对关键利益相关者进行详细访谈（n = 118）。
记录与客户活动的详细信息与许多健康培训师的工作习惯相悖。这既与技术挑战有关，也与对“非专业”服务运作方式的观念相抵触。受访者指出数据集不足以记录所有客户影响；也就是说，它无法让他们输入有关生活在贫困社区的客户可能遇到并寻求帮助解决的问题的信息。
DCRS的效用可能因活动记录不完整以及一些健康培训师输入错误数据而受到损害。DCRS也低估了健康培训师为解决影响客户健康的“上游”因素所开展工作的有效性。
