Hendryx Michael, Guerra-Reyes Lucia, Holland Benjamin D, McGinnis Michael Dean, Meanwell Emily, Middlestadt Susan E, Yoder Karen M
Department of Environmental and Occupational Health, Indiana University, Bloomington, Indiana, USA.
Department of Applied Health Science, Indiana University, Bloomington, Indiana, USA.
BMJ Open. 2017 Oct 11;7(10):e017370. doi: 10.1136/bmjopen-2017-017370.
To test a positive deviance method to identify counties that are performing better than statistical expectations on a set of population health indicators.
Quantitative, cross-sectional county-level secondary analysis of risk variables and outcomes in Indiana. Data are analysed using multiple linear regression to identify counties performing better or worse than expected given traditional risk indicators, with a focus on 'positive deviants' or counties performing better than expected.
Counties in Indiana (n=92) constitute the unit of analysis.
Per cent adult obesity, per cent fair/poor health, low birth weight per cent, per cent with diabetes, years of potential life lost, colorectal cancer incidence rate and circulatory disease mortality rate.
County performance that outperforms expectations is for the most part outcome specific. But there are a few counties that performed particularly well across most measures.
The positive deviance approach provides a means for state and local public health departments to identify places that show better health outcomes despite demographic, social, economic or behavioural disadvantage. These places may serve as case studies or models for subsequent investigations to uncover best practices in the face of adversity and generalise effective approaches to other areas.
测试一种正向偏差方法，以识别在一系列人群健康指标方面表现优于统计预期的县。
对印第安纳州的风险变量和结果进行定量的县级横断面二次分析。使用多元线性回归分析数据，以识别在给定传统风险指标的情况下表现优于或劣于预期的县，重点关注“正向偏差县”或表现优于预期的县。
印第安纳州的县（n = 92）构成分析单位。
成人肥胖百分比、健康状况一般/较差百分比、低出生体重百分比、糖尿病患者百分比、潜在寿命损失年数、结直肠癌发病率和循环系统疾病死亡率。
表现优于预期的县的情况在很大程度上因结果而异。但有几个县在大多数指标上表现特别出色。
正向偏差方法为州和地方公共卫生部门提供了一种手段，以识别尽管存在人口、社会、经济或行为方面的不利因素，但仍有较好健康结果的地区。这些地区可作为案例研究或模型，用于后续调查，以揭示面对逆境时的最佳做法，并将有效方法推广到其他地区。
