Departments of Medicine and Epidemiology, University of Washington, Seattle, WA.
HIV/STD Program, Public Health-Seattle & King County, Seattle, WA.
J Acquir Immune Defic Syndr. 2019 Dec;82 Suppl 3(Suppl 3):S279-S285. doi: 10.1097/QAI.0000000000002194.
The evidence-practice gap in HIV prevention and the care continuum in the United States often reflects a mismatch between the perspectives of researchers and public health practitioners. The traditional research paradigm of sequential progress from efficacy research to implementation in practice and widespread scale-up is not well-aligned with the reality of health department program implementation.
This article focuses on public health practice carried out by state and local health departments in the United States and the research intended to inform it.
In this narrative review, we discuss approaches to HIV prevention and care continuum research that are shaped by and responsive to public health practice implementation priorities and what is needed to promote productive and successful university-health department research partnerships. We review research methods of particular relevance to health departments to evaluate the effectiveness of HIV prevention and care continuum interventions and how these approaches diverge from traditional research approaches. Finally, we highlight the roles of federal agencies in supporting practice-driven HIV implementation research.
Health departments are key stakeholders, consumers, and generators of the evidence base for public health practice. High-impact research to improve HIV prevention and the care continuum is informed by health department priorities and current practice from the start. Long-term, equitable relationships between universities and health departments are crucial to advance practice-driven research.
在美国,艾滋病毒预防和护理连续体方面的证据实践差距常常反映了研究人员和公共卫生从业人员观点之间的不匹配。从疗效研究到实践中的实施以及广泛扩大规模的传统研究范式,与卫生部门计划实施的现实并不完全一致。
本文重点介绍美国州和地方卫生部门开展的公共卫生实践以及旨在为其提供信息的研究。
在这篇叙述性评论中,我们讨论了受公共卫生实践实施优先事项影响并对其做出响应的艾滋病毒预防和护理连续体研究方法,以及促进富有成效和成功的大学-卫生部门研究伙伴关系所需的条件。我们审查了与卫生部门特别相关的研究方法,以评估艾滋病毒预防和护理连续体干预措施的有效性,以及这些方法如何与传统研究方法有所不同。最后,我们强调了联邦机构在支持以实践为导向的艾滋病毒实施研究方面的作用。
卫生部门是公共卫生实践证据基础的重要利益相关者、消费者和生成者。从一开始就根据卫生部门的优先事项和当前实践为改进艾滋病毒预防和护理连续体提供高影响力的研究。大学和卫生部门之间的长期、平等的关系对于推进以实践为导向的研究至关重要。