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在安全网环境中推动基于证据的干预措施的实施:洛杉矶南部的临床-社区合作项目

Catalyzing Implementation of Evidence-Based Interventions in Safety Net Settings: A Clinical-Community Partnership in South Los Angeles.

作者信息

Payán Denise D, Sloane David C, Illum Jacqueline, Vargas Roberto B, Lee Donzella, Galloway-Gilliam Lark, Lewis LaVonna B

机构信息

1 University of California, Los Angeles, CA, USA.

2 University of Southern California, Los Angeles, CA, USA.

出版信息

Health Promot Pract. 2017 Jul;18(4):586-597. doi: 10.1177/1524839917705418. Epub 2017 Apr 26.

Abstract

This study is a process evaluation of a clinical-community partnership that implemented evidence-based interventions in clinical safety net settings. Adoption and implementation of evidence-based interventions in these settings can help reduce health disparities by improving the quality of clinical preventive services in health care settings with underserved populations. A clinical-community partnership model is a possible avenue to catalyze adoption and implementation of interventions amid organizational barriers to change. Three Federally Qualified Health Centers in South Los Angeles participated in a partnership led by a local community-based organization (CBO) to implement hypertension interventions. Qualitative research methods were used to evaluate intervention selection and implementation processes between January 2014 and June 2015. Data collection tools included a key participant interview guide, health care provider interview guide, and protocol for taking meeting minutes. This case study demonstrates how a CBO acted as an external facilitator and employed a collaborative partnership model to catalyze implementation of evidence-based interventions in safety net settings. The study phases observed included initiation, planning, and implementation. Three emergent categories of organizational facilitators and barriers were identified (personnel capacity, professional development capacity, and technological capacity). Key participants and health care providers expressed a high level of satisfaction with the collaborative and the interventions, respectively. The CBO's role as a facilitator and catalyst is a replicable model to promote intervention adoption and implementation in safety net settings. Key lessons learned are provided for researchers and practitioners interested in partnering with Federally Qualified Health Centers to implement health promotion interventions.

摘要

本研究是对一个临床-社区伙伴关系的过程评估,该伙伴关系在临床安全网环境中实施了循证干预措施。在这些环境中采用和实施循证干预措施,有助于通过改善服务不足人群所在医疗保健机构的临床预防服务质量来减少健康差距。临床-社区伙伴关系模式是在变革的组织障碍中促进干预措施采用和实施的一条可能途径。南洛杉矶的三家联邦合格健康中心参与了由当地一个社区组织(CBO)牵头的伙伴关系,以实施高血压干预措施。采用定性研究方法评估2014年1月至2015年6月期间的干预措施选择和实施过程。数据收集工具包括关键参与者访谈指南、医疗保健提供者访谈指南以及会议记录协议。本案例研究展示了一个社区组织如何作为外部促进者,并采用合作伙伴关系模式在安全网环境中促进循证干预措施的实施。观察到的研究阶段包括启动、规划和实施。确定了三类新出现的组织促进因素和障碍(人员能力、专业发展能力和技术能力)。关键参与者和医疗保健提供者分别对合作关系和干预措施表示高度满意。社区组织作为促进者和催化剂的角色是一种可复制的模式,可用于在安全网环境中促进干预措施的采用和实施。为有兴趣与联邦合格健康中心合作实施健康促进干预措施的研究人员和从业者提供了关键经验教训。

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