Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
Department of Nutrition Science, Purdue University, West Lafayette, Indiana.
Am J Prev Med. 2020 Jun;58(6):864-878. doi: 10.1016/j.amepre.2020.01.015.
Rural communities face unique challenges including fewer healthcare providers and restricted access to nutritious foods, likely leading to poor health outcomes. Community health coalitions are groups of local organizations partnering to address local health needs. Employing such coalitions is one strategy for implementing policy-system-environment changes for improving rural health. However, their success is variable without standardized evaluation. In this review, rural community health coalitions were retrospectively assessed using the W.K. Kellogg Foundation Logic Model. Community health coalition-reported pathways through this model were explored using market basket analysis.
During Spring 2018, PubMed, Web of Science, ScienceDirect, CINAHL, and PsycINFO were searched for (coalition) AND (rural) AND (health) AND (effectiveness OR impact OR outcome OR logic model). Full-text, peer-reviewed, English articles meeting PICOS criteria (Population, rural communities; Intervention, presence of a community health coalition; Comparator, the coalition over time; Outcomes, logic model pathways) were reviewed. During Summer and Fall 2018, coalition-reported pathways were categorized according to logic model inputs and resources; internal and external activities; outputs; short-, medium-, and long-term outcomes; and impact. Market basket analysis was conducted during Winter 2018.
The 10 most frequently reported pathway items were partner diversity; organizational structures; implementing pilot studies, programs, and interventions; funding; community engagement and outreach; university partners; holding regular meetings; having working groups and subcommittees; operating under or partnering with a regional research initiative; and conducting a community health and needs assessment. Half of community health coalitions reported 4 or more of the following: funding; partner diversity; university partners; organizational structures; community engagement and outreach; and implementing pilot studies, programs, and interventions.
Many rural community health coalitions reported inputs and capacity building; few impacted health. Recommending common early phase logic model pathways may facilitate downstream success.
农村社区面临着独特的挑战，包括医疗服务提供者较少，以及获得营养食品的机会受限，这可能导致健康状况不佳。社区卫生联盟是由当地组织合作组成的团体，旨在解决当地的健康需求。利用这种联盟是实施政策系统环境变化以改善农村健康的策略之一。但是，如果没有标准化的评估，它们的成功是可变的。在这项回顾中，使用 W.K. 凯洛格基金会逻辑模型对农村社区卫生联盟进行了回顾性评估。使用市场篮子分析探索了社区卫生联盟报告的通过该模型的途径。
在 2018 年春季，在 PubMed、Web of Science、ScienceDirect、CINAHL 和 PsycINFO 上搜索（联盟）和（农村）和（健康）和（效果或影响或结果或逻辑模型）。审查了符合 PICOS 标准（人群，农村社区；干预，存在社区卫生联盟；对照，随着时间的推移联盟；结果，逻辑模型途径）的全文同行评审英语文章。在 2018 年夏季和秋季，根据逻辑模型投入和资源；内部和外部活动；产出；短期、中期和长期结果；以及影响，对联盟报告的途径进行了分类。在 2018 年冬季进行了市场篮子分析。
报告的途径项目中最常出现的 10 个项目是合作伙伴多样性；组织结构；实施试点研究、计划和干预措施；资金；社区参与和外展；大学合作伙伴；定期举行会议；设立工作组和小组委员会；在区域研究倡议下运作或与之合作；以及进行社区健康和需求评估。一半的社区卫生联盟报告了 4 个或更多以下内容：资金；合作伙伴多样性；大学合作伙伴；组织结构；社区参与和外展；以及实施试点研究、计划和干预措施。
许多农村社区卫生联盟报告了投入和能力建设；很少有影响健康。建议常见的早期逻辑模型途径可能会促进下游的成功。
