Matheson Anna, Walton Mat, Gray Rebecca, Wehipeihana Nan, Wistow Jonathon
School of Health, Victoria University of Wellington, New Zealand.
Institute for Environmental Science and Research (ESR), New Zealand.
Health Promot Int. 2020 Oct 1;35(5):947-957. doi: 10.1093/heapro/daz092.
This article presents the findings from the first 3 years of the evaluation of Healthy Families NZ, a systems-change intervention to prevent chronic diseases in 10 communities. The initiative, which builds on existing prevention activities, aims to strengthen the health prevention system through evidence-driven action to enable people to make good food choices, be physically active, smoke-free and free from alcohol-related harm. Key investment areas are a dedicated systems thinking and acting health promotion workforce, and activating leaders who can influence transformational change. The evaluation to date has found the initiative is being implemented with integrity. Evidence indicates a shift towards greater action on prevention, and the prevention system being strengthened. Māori ownership has been enabled, and prioritizing equity has led teams to utilize methods that amplify diverse local perspectives. There is progress on developing a flexible workforce through adaptive learning, flexible resources, professional development and a responsive National team. There is also progress in activating local leadership and empowering local teams. The initiative design has explicitly taken into account the context of complexity within which it is being implemented. It has evolved to focus on action that can accelerate sharing information and practices within communities, and between policy and decision-makers. Healthy Families NZ and its evaluation have been refunded to 2022. This provides an important opportunity to gather further insight into effective ways to strengthen the community agency and trust needed to promote and deliver evidence-based action on prevention.
本文介绍了对“新西兰健康家庭”项目头三年评估的结果。该项目是一项系统变革干预措施，旨在预防10个社区的慢性病。该倡议以现有的预防活动为基础，旨在通过基于证据的行动加强健康预防系统，使人们能够做出健康的食物选择、积极锻炼身体、戒烟并免受与酒精相关的危害。关键投资领域是一支专注于系统思考和行动的健康促进工作队伍，以及激活能够影响变革性变化的领导者。迄今为止的评估发现，该倡议正在得到切实执行。有证据表明，在预防方面的行动正在朝着更大的力度转变，预防系统也在得到加强。毛利人的自主权得到了保障，对公平的重视促使各团队采用能够放大不同地方观点的方法。通过适应性学习、灵活的资源、专业发展和反应迅速的国家团队，在培养灵活的工作队伍方面取得了进展。在激活地方领导力和赋予地方团队权力方面也取得了进展。该倡议的设计明确考虑到了其实施所处的复杂背景。它已演变为专注于能够加速社区内部以及政策制定者和决策者之间信息和实践共享的行动。“新西兰健康家庭”项目及其评估已延期至2022年。这提供了一个重要机会，以便进一步深入了解加强社区机构和信任的有效方法，而这对于促进和实施基于证据的预防行动是必要的。
