探索荷兰护理与体育连接器的影响。
Exploring the impact of the care sport connector in the Netherlands.
作者信息
Leenaars Karlijn E F, Smit Eva, Wagemakers Annemarie, Molleman Gerard R M, Koelen Maria A
机构信息
Department of Social Sciences, Health and Society Group, Wageningen University & Research Centre, P.O. Box 8130, 6700 EW, Wageningen, The Netherlands.
Academic Collaborative Centre AMPHI, Primary and Community Care, Radboud university medical center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
出版信息
BMC Public Health. 2017 Oct 16;17(1):813. doi: 10.1186/s12889-017-4830-6.
BACKGROUND
Regular physical activity (PA) is deemed to contribute to the primary and secondary prevention of several chronic diseases, like diabetes mellitus, cancer, cardiovascular diseases, and osteoporosis. In 2012, Care Sport Connectors (CSC), to whom a broker has been ascribed, were introduced in the Netherlands to stimulate PA and guide primary care patients towards local sport facilities. The aim of this study was to explore which structural embedding is the most promising for CSCs' work.
METHODS
In three rounds of interviews, 13 CSCs were followed for 2 years in their work. In these interviews, a network survey was used to identify organisations in the CSCs' network, whether they collaborated with these organisations, and the role of the organisations in the connection. Data from the network survey were analysed using the RE-AIM framework and disaggregated into how CSCs were structurally embedded (Type A: only PA sector; Type B: different sectors; Type C: partnership). A related samples Wilcoxon signed rank test was performed to study how the CSCs' network developed between 2014 and 2016.
RESULTS
All CSCs established a connection between the primary care and the PA sector in which the average number of organisations with which CSCs collaborated increased significantly between 2014 (8.3) and 2016 (19.8) (p = 0.002). However, differences were identified in the way CSCs were structurally embedded and in the way they established the connection. Type A CSCs established the connection mostly around their own activities, supported PA organisations with their activities, and collaborated with primary care and welfare professionals around their own activities. Type B and Type C CSCs established the connection by organising, supporting, and implementing different kinds of activities targeting different kinds of audiences, and collaborated mostly with primary care professionals around the referral of professionals' patients.
CONCLUSIONS
The results of this study suggest that adopting an integral approach (Type B and C) for the structural embedding of the CSC is more promising for reaching the desired outcomes. Whether CSCs really improve the target groups' PA level and health needs to be further studied.
TRIAL REGISTRATION
Dutch Trial Register NTR4986 . Registered 14 December 2014.
背景
定期进行体育活动（PA）被认为有助于多种慢性病的一级和二级预防，如糖尿病、癌症、心血管疾病和骨质疏松症。2012年，荷兰引入了由经纪人指定的“护理体育连接器”（CSC），以促进体育活动，并引导初级保健患者前往当地体育设施。本研究的目的是探讨哪种结构嵌入方式对CSC的工作最具前景。
方法
在三轮访谈中，对13名CSC进行了为期两年的跟踪调查。在这些访谈中，通过网络调查来识别CSC网络中的组织，他们是否与这些组织合作，以及这些组织在联系中的作用。使用RE-AIM框架对网络调查数据进行分析，并按CSC的结构嵌入方式进行分类（A类：仅体育活动部门；B类：不同部门；C类：伙伴关系）。进行相关样本Wilcoxon符号秩检验，以研究2014年至2016年期间CSC网络的发展情况。
结果
所有CSC都在初级保健和体育活动部门之间建立了联系，CSC合作的组织平均数量在2014年（8.3个）至2016年（19.8个）之间显著增加（p = 0.002）。然而，在CSC的结构嵌入方式以及他们建立联系的方式上存在差异。A类CSC主要围绕自身活动建立联系，为体育活动组织的活动提供支持，并围绕自身活动与初级保健和福利专业人员合作。B类和C类CSC通过组织、支持和开展针对不同受众的各种活动来建立联系，并且主要围绕专业人员患者的转诊与初级保健专业人员合作。
结论
本研究结果表明，采用整体方法（B类和C类）对CSC进行结构嵌入，对于实现预期结果更具前景。CSC是否真的能提高目标群体的体育活动水平和健康状况，还需要进一步研究。
试验注册
荷兰试验注册NTR4986。2014年12月14日注册。
Zotero 插件