Ghiga Ioana, Pitchforth Emma, Lepetit Louise, Miani Celine, Ali Gemma-Clare, Meads Catherine
Analyst, Innovation, Health and Science, RAND Europe, K.
Senior Lecturer in Primary Care, Primary Care Research Group, University of Exeter Medical School, UK.
J Health Serv Res Policy. 2020 Jul;25(3):202-210. doi: 10.1177/1355819619888244. Epub 2020 Apr 6.
Community-based social innovations (CBSIs) are one type of intervention that may help to address the complex needs of ageing populations globally. The aim of this research was to assess evidence for the effectiveness and cost-effectiveness of CBSIs involving in such contexts.
We conducted a systematic review of CBSIs for healthy ageing in middle- and high-income countries, including any CBSI that aimed to empower people aged 50 and over by motivating them to take initiative for their own health and wellbeing. The protocol was registered with Prospero (CRD 42016051622). A comprehensive search was conducted in 15 academic databases and advanced search in Google. We included published studies from 2000 onwards in any language. Exploratory meta-analysis was conducted for quantitative studies reporting similar outcomes, and qualitative studies were analysed using thematic analysis. Narrative synthesis was conducted. Searches yielded 13,262 unique hits, from which 44 papers met the inclusion criteria.
Most studies reported interventions having positive impacts on participants, such as reduced depression, though the majority of studies were classified as being at medium or high risk of bias. There was no evidence on costs or cost-effectiveness and very little reporting of outcomes at an organization or system level. CBSIs have the potential for positive impacts, but with nearly half of studies coming from high-income urban settings (particularly the United Kingdom and the United States of America), there is a lack of generalizability of these findings.
Our research highlights the need to improve reporting of CBSIs as complex interventions, and for improved conceptualization of these interventions to inform research and practice.
基于社区的社会创新（CBSIs）是一种干预措施，可能有助于满足全球老龄化人口的复杂需求。本研究的目的是评估涉及此类背景的CBSIs的有效性和成本效益的证据。
我们对中高收入国家促进健康老龄化的CBSIs进行了系统评价，包括任何旨在通过激励50岁及以上人群主动关注自身健康和福祉来增强其能力的CBSI。该方案已在国际系统评价注册库（Prospero）注册（注册号CRD 42016051622）。在15个学术数据库中进行了全面检索，并在谷歌上进行了高级检索。我们纳入了2000年以后发表的任何语言的研究。对报告相似结果的定量研究进行探索性荟萃分析，对定性研究采用主题分析法进行分析。进行了叙述性综合分析。检索共获得13262条独特记录，其中44篇论文符合纳入标准。
大多数研究报告称干预措施对参与者有积极影响，如减轻抑郁，尽管大多数研究被归类为存在中度或高度偏倚风险。没有关于成本或成本效益的证据，在组织或系统层面报告结果的情况也很少。CBSIs有产生积极影响的潜力，但近一半的研究来自高收入城市地区（特别是英国和美国），这些研究结果缺乏普遍性。
我们的研究强调需要改进对作为复杂干预措施的CBSIs的报告，并改进这些干预措施的概念化，以为研究和实践提供信息。
