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衡量大型综合医疗服务体系中基层项目的可持续性:“从战士到灵魂伴侣”项目

Measuring sustainability of a grassroots program in a large integrated health care delivery system: the Warrior to Soul Mate Program.

作者信息

Stolldorf Deonni P, Fortune-Britt Alice G, Nieuwsma Jason A, Gierisch Jennifer M, Datta Santanu K, Angel Clyde, Millspaugh Dick D, Jackson George L

机构信息

Vanderbilt University School of Nursing, Nashville, TN, USA.

Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA.

出版信息

J Mil Veteran Fam Health. 2018;4(2):81-90. doi: 10.3138/jmvfh.2017-0007. Epub 2018 Sep 10.

Abstract

INTRODUCTION

Veterans experience many physical and psychosocial adjustment problems that challenge personal relationships and social functioning and successful social reintegration. The Warrior to Soul Mate (W2SM) program uses a structured curriculum [i.e., the Practical Application of Intimate Relationships Skills (PAIRS)] to address veterans' interpersonal needs by teaching participants effective interpersonal skills. Veterans who attended the W2SM program reported lower anxiety levels, improvements in marital alterations and satisfaction, and increased intimacy, cohesion, and affection. Therefore, sustaining the W2SM program can have long-term positive effects for veterans, families, and the greater society. The purpose of this paper is to describe the sustainability of the W2SM program.

METHODS

The Model of Community-based Program Sustainability conceptually guided the evaluation. Twenty-three VA hospitals in the U.S. that offer W2SM programs completed a self-report survey to measure sustainability.

RESULTS

The highest scoring sustainability elements were "Demonstrating program results" (M=5.82, SD=1.23), "Staff involvement and integration" (M= 5.79, SD= 1.34), and "Program responsivity" (M=4.39, SD= 1.16); the lowest scoring element was "Strategic funding" (M=2.78, SD=1.75). Statistically significant associations were found between the global middle-range program results and three sustainability elements: leadership competence ( = .472, p = .023), effective collaboration ( = .470, p = .024), and strategic funding ( = .507, p = .014).

DISCUSSION

Efforts to sustain programs should focus on leaders planning for sustainability at the onset of program implementation, collaborators must be involved in program design, implementation and evaluation, and long-term funding sources must be secured to support program operations and continuation.

摘要

引言

退伍军人面临许多身体和心理社会适应问题,这些问题对个人关系、社会功能以及成功的社会重新融入构成挑战。“战士到灵魂伴侣”(W2SM)项目采用结构化课程[即亲密关系技能的实际应用(PAIRS)],通过教授参与者有效的人际交往技能来满足退伍军人的人际需求。参加W2SM项目的退伍军人报告称焦虑水平降低、婚姻状况和满意度有所改善,亲密感、凝聚力和情感也有所增强。因此,维持W2SM项目对退伍军人、家庭和更广泛的社会可能会产生长期的积极影响。本文的目的是描述W2SM项目的可持续性。

方法

基于社区的项目可持续性模型在概念上指导了评估。美国23家提供W2SM项目的退伍军人事务部医院完成了一项自我报告调查,以衡量可持续性。

结果

得分最高的可持续性要素是“展示项目成果”(M = 5.82,标准差 = 1.23)、“工作人员的参与和整合”(M = 5.79,标准差 = 1.34)和“项目响应能力”(M = 4.39,标准差 = 1.16);得分最低的要素是“战略资金”(M = 2.78,标准差 = 1.75)。在全球中等范围的项目成果与三个可持续性要素之间发现了具有统计学意义的关联:领导能力(r = 0.472,p = 0.023)、有效协作(r = 0.470,p = 0.024)和战略资金(r = 0.507,p = 0.014)。

讨论

维持项目的努力应集中在项目实施初期领导者对可持续性的规划上,合作者必须参与项目的设计、实施和评估,并且必须确保有长期资金来源以支持项目的运作和延续。

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