Prescott Cheryl, Shahram Sana Z, Ogilvie Gina, Hassam Noorjean, Franks Alison Swalwell, Pauly Bernie
Sexual Health and Blood Borne Infections, Population Public Health, Fraser Health Authority, 400 - 13450 - 102nd Avenue, Surrey, BC, V3T 0H1, Canada.
Canadian Institute for Substance Use Research (CISUR), University of Victoria, Victoria, BC, Canada.
Can J Public Health. 2020 Aug;111(4):610-616. doi: 10.17269/s41997-019-00285-2. Epub 2020 Feb 21.
There is a multitude of health equity tools but little guidance on how to effectively use these tools in public health nursing practice. In BC, public health nurses who are certified in sexually transmitted infection care utilize guidelines authorized by the nursing regulatory body.
As part of the Equity Lens in Public Health (ELPH) research project, an assessment of the nursing guideline, Sexually Transmitted Infection (STI) Assessment Decision Support Tool, was undertaken using the Assessing Equity in Clinical Practice Guidelines health equity assessment tool. The chosen tool is intended for use by health care providers, is broadly applicable to clinical practice guidelines, can be used retrospectively, and falls within the category of equity checklists and audits.
Overall, the tool was useful in assessing the inclusion and omission of an equity focus in the guideline. However, there were several challenges: the identification of an appropriate health equity tool; the absence of an evaluation of the chosen tool; the tool's focus on chronic disease versus communicable disease; and the difficulty of obtaining client perspectives.
For an improved equity lens in the STI Assessment Decision Support Tool, future revisions should be equity focused and include perspectives from affected populations, an emphasis on the determinants of health that perpetuate inequities for populations who experience a disproportionate burden of STI, information on provincially available resources, and service delivery models that improve timely and equitable access to treatment and care.
有大量的健康公平工具,但在公共卫生护理实践中如何有效使用这些工具的指导却很少。在不列颠哥伦比亚省,获得性传播感染护理认证的公共卫生护士会使用护理监管机构授权的指南。
作为公共卫生公平视角(ELPH)研究项目的一部分,使用临床实践指南健康公平评估工具对《性传播感染(STI)评估决策支持工具》这一护理指南进行了评估。所选工具供医疗保健提供者使用,广泛适用于临床实践指南,可用于回顾性分析,属于公平检查表和审计类别。
总体而言,该工具在评估指南中公平重点的纳入和遗漏方面很有用。然而,存在一些挑战:确定合适的健康公平工具;未对所选工具进行评估;该工具侧重于慢性病而非传染病;以及获取客户观点的困难。
为了在性传播感染评估决策支持工具中改进公平视角,未来的修订应以公平为重点,纳入受影响人群的观点,强调那些使性传播感染负担过重人群的不平等现象长期存在的健康决定因素,提供省级可用资源的信息,以及改善及时和公平获得治疗与护理的服务提供模式。