Institute for Health and Human Development, University of East London, London, UK.
Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.
BMJ Open. 2019 Feb 3;9(2):e023810. doi: 10.1136/bmjopen-2018-023810.
To provide an up-to-date overview of health assets in a global context both from a theoretical perspective and its practical applications to address health inequalities and achieve sustainable health.
A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
A comprehensive search, including 10 electronic bibliographic databases and hand searches, was undertaken to capture the wide range of terms associated with 'health assets' and 'asset-based approaches to health'.
Any peer-reviewed published and grey literature in English related to 'health assets' or 'assets' in a 'health' context was included without any date, country or study design restrictions and the quality of evidence was appraised according to the Oxford Level of Evidence.
A broad consideration of all outcome measures including clinical outcomes, patient-level, community-level and population-level impacts and costs, was adopted.
478 publications were included. Health assets were researched in 40 countries, predominantly in the West such as the USA and the UK. A number of broad health assets were identified including community and individual assets. Even though research was conducted in a number of different settings, most occurred in the community, clinical, care or educational settings. A wide variety of interventions and approaches were implemented, most commonly related to education and/or training, asset mapping or asset approaches.
Globally, authors most often referred to general 'health assets', 'assets' or some form of 'community asset' in relation to health. Overall, the idea of health assets is framed within a positive paradigm focusing on health creation rather than curative approaches. The sustained credibility of the global 'health assets' literature depends on future research on definitional, theoretical and evaluative issues in order to convince policy-makers and service commissioners of its necessity and added value to the traditional deficit approach.
从理论角度和实际应用角度提供全球范围内健康资产的最新概述,以解决健康不平等问题并实现可持续健康。
根据系统评价和荟萃分析的首选报告项目进行系统评价。
进行了全面的搜索,包括 10 个电子书目数据库和手工搜索,以捕捉与“健康资产”和“基于资产的健康方法”相关的广泛术语。
纳入任何与“健康资产”或“健康背景下的资产”相关的、经过同行评审的已发表和灰色文献,无任何日期、国家或研究设计限制,并根据牛津证据水平评估证据质量。
采用了广泛考虑所有结果测量指标,包括临床结果、患者层面、社区层面和人口层面的影响和成本。
共纳入 478 篇文献。健康资产在 40 个国家进行了研究,主要集中在西方,如美国和英国。确定了一些广泛的健康资产,包括社区和个人资产。尽管在许多不同的环境中进行了研究,但大多数研究发生在社区、临床、护理或教育环境中。实施了各种各样的干预措施和方法,最常见的是与教育和/或培训、资产映射或资产方法有关。
在全球范围内,作者最常提到与健康相关的一般“健康资产”、“资产”或某种形式的“社区资产”。总体而言,健康资产的概念框架是基于积极的范式,侧重于健康创造,而不是治疗方法。全球“健康资产”文献的持续可信度取决于未来对定义、理论和评估问题的研究,以使政策制定者和服务管理者相信其必要性及其对传统缺陷方法的附加值。