Fraser Health Authority, Surrey, BC, Canada.
University of British Columbia, Vancouver, BC, Canada.
Int J Public Health. 2019 Jun;64(5):691-701. doi: 10.1007/s00038-018-1190-7. Epub 2018 Dec 24.
To better understand how social pediatric initiatives (SPIs) enact equitable, integrated, embedded approaches with high-needs children and families while facilitating proportionate distribution of health resources.
The realist review method incorporated the following steps: (1) identifying the review question, (2) formulating the initial theory, (3) searching for primary studies, (4) selecting and appraising study quality, (5) synthesizing relevant data and (6) refining the theory.
Our analysis identified four consistent patterns of care that may be effective in social pediatrics: (1) horizontal partnerships based on willingness to share status and power; (2) bridged trust initiated through previously established third party relationships; (3) knowledge support increasing providers' confidence and skills for engaging community; and (4) increasing vulnerable families' self-reliance through empowerment strategies.
This research is unique because it focused on "how" outcomes are achieved and offers insight into the knowledge, skills and philosophical orientation clinicians need to effectively deliver care in SPIs. Research insights offer guidance for organizational leaders with a mandate to address child and youth health inequities and may be applicable to other health initiatives.
更好地理解社会儿科举措 (SPIs) 如何针对高需求儿童和家庭实施公平、综合和嵌入式方法，同时促进卫生资源的合理分配。
采用现实主义审查方法，包括以下步骤：(1)确定审查问题，(2)制定初始理论，(3)搜索原始研究，(4)选择和评估研究质量，(5)综合相关数据，(6)完善理论。
我们的分析确定了社会儿科学中可能有效的四种一致的护理模式：(1)基于分享地位和权力意愿的水平伙伴关系；(2)通过先前建立的第三方关系建立的桥梁信任；(3)知识支持通过增强提供者在社区中参与的信心和技能；(4)通过赋权策略提高弱势家庭的自力更生能力。
这项研究是独特的，因为它专注于“如何”实现结果，并深入了解临床医生在 SPIs 中有效提供护理所需的知识、技能和哲学方向。研究洞察为有任务解决儿童和青年健康不平等问题的组织领导者提供了指导，并且可能适用于其他卫生倡议。
