Clinical Trials Research Unit, University of Leeds, Leeds, LS29JT, UK.
Bradford Institute of Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, BD9 6RJ, UK.
BMC Public Health. 2019 Jun 27;19(1):835. doi: 10.1186/s12889-019-7149-7.
Commissioning and monitoring of community-based interventions is a challenge due to the complex nature of the environment and the lack of any explicit cut-offs to guide decision making. At what point, for example, is participant enrolment to interventions, course completion or satisfaction deemed to be acceptable or sufficient for continued funding? We aimed to identify and quantify key progression criteria for fourteen early years interventions by (1) agreeing the top three criteria for monitoring of successful implementation and progress; and (2) agreeing boundaries to categorise interventions as 'meeting anticipated target' (green); 'falling short of targets' (amber) and 'targets not being met' (red).
We ran three workshops in partnership with the UK's Big Lottery Fund commissioned programme 'Better Start Bradford' (implementing more than 20 interventions to improve the health, wellbeing and development of children aged 0-3) to support decision making by agreeing progression criteria for the interventions being delivered. Workshops included 72 participants, representing a range of professional groups including intervention delivery teams, commissioners, intervention-monitoring teams, academics and community representatives. After discussion and activities, final decisions were submitted using electronic voting devices. All participants were invited to reconsider their responses via a post-workshop questionnaire.
Three key progression criteria were assigned to each of the 14 interventions. Overall, criteria that participants most commonly voted for were recruitment, implementation and reach, but these differed according to each intervention. Cut-off values used to indicate when an intervention moved to 'red' varied by criteria; the lowest being for recruitment, where participants agreed that meeting less than 65% of the targeted recruitment would be deemed as 'red' (falling short of target).
Our methodology for monitoring the progression of interventions has resulted in a clear pathway which will support commissioners and intervention teams in local decision making within the Better Start Bradford programme and beyond. This work can support others wishing to implement a formal system for monitoring the progression of public health interventions.
由于环境的复杂性和缺乏明确的决策指导界限，对基于社区的干预措施进行委托和监测是一项挑战。例如，在什么情况下，干预措施的参与者招募、课程完成或满意度被认为是可以接受或足以继续获得资金的？我们旨在通过以下方式确定和量化十四项早期干预措施的关键进展标准：(1) 就监测成功实施和进展的前三项标准达成一致；(2) 就干预措施归类为“达到预期目标”（绿色）、“未达到目标”（琥珀色）和“目标未达到”（红色）的界限达成一致。
我们与英国大彩票基金委托的“布拉德福德更好开端”项目（实施了 20 多项改善 0-3 岁儿童健康、福祉和发展的干预措施）合作，举办了三次研讨会，以支持通过就正在实施的干预措施的进展标准达成一致来做出决策。研讨会包括 72 名参与者，代表了包括干预措施实施团队、委托方、干预措施监测团队、学者和社区代表在内的各种专业群体。在讨论和活动之后，使用电子投票设备提交最终决定。所有参与者都被邀请通过研讨会后的问卷调查重新考虑他们的回应。
为 14 项干预措施中的每一项分配了三个关键进展标准。总体而言，参与者投票最多的标准是招募、实施和覆盖范围，但每个干预措施的标准不同。用于指示干预措施进入“红色”阶段的截止值因标准而异；最低的是招募，参与者同意，达到目标招募人数的 65%以下将被视为“红色”（未达到目标）。
我们用于监测干预措施进展的方法已经产生了一个明确的途径，这将支持布拉德福德更好开端计划和其他地方的委托人和干预团队在当地做出决策。这项工作可以为其他希望实施公共卫生干预措施进展监测正式系统的人提供支持。
