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促进身体活动和健康饮食的基于社区的干预措施的实施和评估的障碍和促进因素:阿根廷的一项混合方法研究。

Barriers and Facilitators for the Implementation and Evaluation of Community-Based Interventions to Promote Physical Activity and Healthy Diet: A Mixed Methods Study in Argentina.

机构信息

Instituto de Efectividad Clinica y Sanitaria (IECS), Dr. Emilio Ravignani 2024, C1414CPV Buenos Aires, Argentina.

Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, 06097 Halle (Saale), Germany.

出版信息

Int J Environ Res Public Health. 2019 Jan 14;16(2):213. doi: 10.3390/ijerph16020213.

Abstract

: Obesogenic environments promote sedentary behavior and high dietary energy intake. The objective of the study was to identify barriers and facilitators to the implementation and impact evaluation of projects oriented to promote physical activity and healthy diet at community level. We analyzed experiences of the projects implemented within the Healthy Municipalities and Communities Program (HMCP) in Argentina. : A mixed methods approach included (1) in-depth semi-structured interviews, with 44 stakeholders; and (2) electronic survey completed by 206 individuals from 96 municipalities across the country. : The most important barriers included the lack of: adequate funding (43%); skilled personnel (42%); equipment and material resources (31%); technical support for data management and analysis (20%); training on project designs (12%); political support from local authorities (17%) and acceptance of the proposed intervention by the local community (9%). Facilitators included motivated local leaders, inter-sectorial participation and seizing local resources. Project evaluation was mostly based on process rather than outcome indicators. : This study contributes to a better understanding of the difficulties in the implementation of community-based intervention projects. Findings may guide stakeholders on how to facilitate local initiatives. There is a need to improve project evaluation strategies by incorporating process, outcome and context specific indicators.

摘要

肥胖环境促进久坐行为和高能量饮食摄入。本研究旨在确定促进社区层面身体活动和健康饮食的项目实施和影响评估的障碍和促进因素。我们分析了阿根廷健康城市和社区计划 (HMCP) 中实施的项目的经验。

一种混合方法包括

(1) 对 44 名利益相关者进行深入的半结构化访谈;(2) 对全国 96 个城市的 206 人进行电子调查。

最重要的障碍包括缺乏

充足的资金 (43%);熟练的人员 (42%);设备和材料资源 (31%);数据管理和分析的技术支持 (20%);项目设计培训 (12%);地方当局的政治支持 (17%)和当地社区对拟议干预措施的接受程度 (9%)。促进因素包括有积极性的地方领导、跨部门参与和利用当地资源。项目评估主要基于过程指标,而不是结果指标。

本研究有助于更好地理解基于社区的干预项目实施中的困难。研究结果可以为利益相关者提供如何促进地方举措的指导。需要通过纳入过程、结果和特定于上下文的指标来改进项目评估策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a141/6352269/5cc3d8822fc1/ijerph-16-00213-g001.jpg

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