McFarlane K, Judd J, Devine S, Watt K
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld 4811, Australia.
Division of Tropical Health and Medicine, James Cook University, Townsville, Qld 4811, Australia.
Health Promot J Austr. 2016 Aug;27(2):118-133. doi: 10.1071/HE15078.
Issue addressed Primary healthcare settings are important providers of health promotion approaches. However, organisational challenges can affect their capacity to deliver these approaches. This review identified the common enablers and barriers health organisations faced and it aimed to explore the experiences health organisations, in particular Aboriginal organisations, had when increasing their health promotion capacity. Methods A systematic search of peer-reviewed literature was conducted. Articles published between 1990-2014 that focused on a health care-settings approach and discussed factors that facilitated or hindered an organisation's ability to increase health promotion capacity were included. Results Twenty-five articles met the inclusion criteria. Qualitative (n=18) and quantitative (n=7) study designs were included. Only one article described the experiences of an Aboriginal health organisation. Enablers included: management support, skilled staff, provision of external support to the organisation, committed staffing and financial resources, leadership and the availability of external partners to work with. Barriers included: lack of management support, lack of dedicated health promotion staff, staff lacking skills or confidence, competing priorities and a lack of time and resources allocated to health promotion activities. Conclusions While the literature highlighted the importance of health promotion work, barriers can limit the delivery of health promotion approaches within primary healthcare organisations. A gap in the literature exists about how Aboriginal health organisations face these challenges. So what? Primary healthcare organisations wanting to increase their health promotion capacity can pre-empt the common barriers and strengthen identified enablers through the shared learnings outlined in this review.
探讨的问题 基层医疗保健机构是健康促进方法的重要提供者。然而，组织方面的挑战可能会影响其实施这些方法的能力。本综述确定了卫生组织面临的常见促进因素和障碍，并旨在探究卫生组织，特别是原住民组织在提高其健康促进能力时的经历。方法 对同行评审文献进行了系统检索。纳入了1990年至2014年间发表的、聚焦于医疗保健机构方法并讨论了促进或阻碍组织提高健康促进能力的因素的文章。结果 25篇文章符合纳入标准。其中包括定性研究（n = 18）和定量研究（n = 7）。只有一篇文章描述了一个原住民卫生组织的经历。促进因素包括：管理支持、熟练的员工、向组织提供外部支持、敬业的员工和财政资源、领导力以及有外部合作伙伴与之合作。障碍包括：缺乏管理支持、缺乏专门的健康促进工作人员、员工缺乏技能或信心、相互竞争的优先事项以及分配给健康促进活动的时间和资源不足。结论 虽然文献强调了健康促进工作的重要性，但障碍可能会限制基层医疗保健组织内健康促进方法的实施。关于原住民卫生组织如何应对这些挑战，文献中存在空白。那又如何？希望提高其健康促进能力的基层医疗保健组织可以通过本综述中概述的共同经验教训来预先应对常见障碍并强化已确定的促进因素。
