Kirk Chris Michael, Johnson-Hakim Sharon, Anglin Ashley, Connelly Catherine
Prog Community Health Partnersh. 2017;11(2):167-173. doi: 10.1353/cpr.2017.0021.
The community health needs assessment (CHNA) mandate of the Patient Protection and Affordable Care Act (ACA) has the potential to make significant and sustainable change in the health of communities. However, to date many hospital-led assessments have used traditional, top-down data collection approaches that overemphasize individualized community member deficits and underutilize collaboration across sectors.
The purpose of this paper is to present the principles of community-based participatory research (CBPR) as a framework for conducting CHNAs in a way that mitigates the potential for harm, waste, and misrepresentation of community assets and needs that characterizes many existing CHNA processes, illustrating the power of applying CBPR partnerships to this process.
CBPR is a framework to engage community members directly in research design, the collection and analysis of data, and the creation of action plans that address research findings. Key principles include collaborative involvement, establishment of empowering processes, and long-term commitment. A case example of an innovative community partnership demonstrates the power and challenges of taking a CBPR approach to the CHNA process.
CBPR has incredible potential to be incorporated into ACA-mandated hospital CHNAs, leading to increased impact and shared power with community members.
《患者保护与平价医疗法案》(ACA)规定的社区健康需求评估(CHNA)有潜力给社区健康带来重大且可持续的改变。然而,到目前为止,许多由医院主导的评估采用的是传统的自上而下的数据收集方法,这种方法过度强调社区个体成员的缺陷,而未充分利用跨部门协作。
本文旨在介绍基于社区的参与性研究(CBPR)的原则,以此作为开展CHNA的框架,以减轻许多现有CHNA流程中存在的对社区资产和需求造成损害、浪费及错误表述的可能性,阐明将CBPR伙伴关系应用于此过程的作用。
CBPR是一个让社区成员直接参与研究设计、数据收集与分析以及制定解决研究结果的行动计划的框架。关键原则包括协作参与、建立赋权流程以及长期承诺。一个创新社区伙伴关系的案例展示了采用CBPR方法进行CHNA过程的作用与挑战。
CBPR极有可能被纳入ACA规定的医院CHNA中,从而增强影响力并与社区成员共享权力。