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模拟建模作为卫生政策环境中知识调动的工具:一项案例研究方案

Simulation modelling as a tool for knowledge mobilisation in health policy settings: a case study protocol.

作者信息

Freebairn L, Atkinson J, Kelly P, McDonnell G, Rychetnik L

机构信息

ACT Health, GPO Box 825, Canberra, ACT 2601, Australia.

The Australian Prevention Partnership Centre, Sax Institute, PO Box K617, Haymarket, NSW, 1240, Sydney, Australia.

出版信息

Health Res Policy Syst. 2016 Sep 21;14(1):71. doi: 10.1186/s12961-016-0143-y.

Abstract

BACKGROUND

Evidence-informed decision-making is essential to ensure that health programs and services are effective and offer value for money; however, barriers to the use of evidence persist. Emerging systems science approaches and advances in technology are providing new methods and tools to facilitate evidence-based decision-making. Simulation modelling offers a unique tool for synthesising and leveraging existing evidence, data and expert local knowledge to examine, in a robust, low risk and low cost way, the likely impact of alternative policy and service provision scenarios. This case study will evaluate participatory simulation modelling to inform the prevention and management of gestational diabetes mellitus (GDM). The risks associated with GDM are well recognised; however, debate remains regarding diagnostic thresholds and whether screening and treatment to reduce maternal glucose levels reduce the associated risks. A diagnosis of GDM may provide a leverage point for multidisciplinary lifestyle modification interventions. This research will apply and evaluate a simulation modelling approach to understand the complex interrelation of factors that drive GDM rates, test options for screening and interventions, and optimise the use of evidence to inform policy and program decision-making.

METHODS/DESIGN: The study design will use mixed methods to achieve the objectives. Policy, clinical practice and research experts will work collaboratively to develop, test and validate a simulation model of GDM in the Australian Capital Territory (ACT). The model will be applied to support evidence-informed policy dialogues with diverse stakeholders for the management of GDM in the ACT. Qualitative methods will be used to evaluate simulation modelling as an evidence synthesis tool to support evidence-based decision-making. Interviews and analysis of workshop recordings will focus on the participants' engagement in the modelling process; perceived value of the participatory process, perceived commitment, influence and confidence of stakeholders in implementing policy and program decisions identified in the modelling process; and the impact of the process in terms of policy and program change.

DISCUSSION

The study will generate empirical evidence on the feasibility and potential value of simulation modelling to support knowledge mobilisation and consensus building in health settings.

摘要

背景

基于证据的决策对于确保卫生项目和服务有效且物有所值至关重要;然而,证据使用方面的障碍依然存在。新兴的系统科学方法和技术进步正在提供新的方法和工具,以促进基于证据的决策。模拟建模提供了一种独特工具,可综合利用现有证据、数据和专家本地知识,以稳健、低风险和低成本的方式审视替代政策和服务提供方案可能产生的影响。本案例研究将评估参与式模拟建模,以为妊娠期糖尿病(GDM)的预防和管理提供信息。与GDM相关的风险已得到充分认识;然而,关于诊断阈值以及降低母体血糖水平的筛查和治疗是否能降低相关风险仍存在争议。GDM的诊断可能为多学科生活方式改变干预提供一个切入点。本研究将应用并评估一种模拟建模方法,以了解驱动GDM发病率的因素之间的复杂相互关系,测试筛查和干预选项,并优化证据的使用,为政策和项目决策提供信息。

方法/设计:本研究设计将采用混合方法来实现目标。政策、临床实践和研究专家将合作开发、测试和验证澳大利亚首都直辖区(ACT)GDM的模拟模型。该模型将用于支持与不同利益相关者进行基于证据的政策对话,以管理ACT的GDM。定性方法将用于评估模拟建模作为一种证据综合工具,以支持基于证据的决策。访谈和对研讨会记录的分析将侧重于参与者在建模过程中的参与情况;参与式过程的感知价值、利益相关者在实施建模过程中确定的政策和项目决策方面的感知承诺、影响力和信心;以及该过程在政策和项目变化方面的影响。

讨论

该研究将生成关于模拟建模在卫生环境中支持知识传播和共识建立的可行性和潜在价值的实证证据。

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