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实施以赋权为基础的基层卫生工作者项目:初步研究。

Implementing empowerment-based Lay Health Worker programs: a preliminary study.

机构信息

School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Australia.

EACH Social & Community Health.

出版信息

Health Promot Int. 2019 Aug 1;34(4):726-734. doi: 10.1093/heapro/day023.

Abstract

Lay Health Worker (LHW) programs have been shown to be effective in engaging community members in health promotion. While successful LHW program implementation requires an understanding of factors influencing program effectiveness, evidence informing such understanding is lacking for empowerment and ecological theory-based LHW programs. This descriptive study explores how enablers and barriers, identified from LHW literature apply (from the LHWs' perspective) in the context of implementing an empowerment and ecological theory-based LHW model in Melbourne, Victoria. A qualitative case study was carried out. Data were collected from participating LHWs (n = 11) via anonymized online activity logs (n = 7) and semi-structured interviews (n = 7). Deductive-inductive thematic analysis was guided by five a priori themes identified from the literature: community relationships; intrinsic traits, values and motivations; capacity building; program design; and work conditions. Data supported the enablers and barriers to program effectiveness and implementation reported by previous research. Subthemes identified the importance of the LHW bridging role; the empowerment model; integrating the program; and program inclusiveness. This research contributes to the growing practice literature regarding how to effectively implement diverse LHW models in diverse settings. It also contributes to social ecological and complex systems-based health promotion practice evidence in suggesting LHWs to be potentially useful elements which may add to the effectiveness of ecologically based health promotion interventions.

摘要

健康促进员(LHW)项目已被证明可有效动员社区成员参与健康促进。虽然成功实施 LHW 项目需要了解影响项目效果的因素,但对于基于赋权和生态理论的 LHW 项目,缺乏此类知识。本描述性研究旨在探讨从 LHW 文献中确定的促进因素和障碍因素(从 LHW 的角度)如何适用于在维多利亚州墨尔本实施基于赋权和生态理论的 LHW 模型的情况。采用了定性案例研究方法。通过匿名在线活动日志(n=7)和半结构化访谈(n=7),从参与的 LHW 中收集数据(n=11)。从文献中确定的五个预设主题指导了演绎归纳主题分析:社区关系;内在特质、价值观和动机;能力建设;项目设计;和工作条件。数据支持了先前研究报告的项目效果和实施的促进因素和障碍因素。子主题确定了 LHW 桥梁角色的重要性;赋权模式;项目整合;以及项目包容性。这项研究为在不同环境中有效实施不同 LHW 模式的不断发展的实践文献做出了贡献。它还为基于社会生态学和复杂系统的健康促进实践证据做出了贡献,表明 LHW 可能是有用的元素,可以提高基于生态的健康促进干预措施的效果。

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