Department of Population Health, Azrieli Faculty of Medicine, Bar-Ilan University, POB 1589, Henrietta Szold 8, 1311502, Safed, Israel.
BMC Public Health. 2020 Jun 10;20(1):898. doi: 10.1186/s12889-020-08990-1.
Bottom-up approaches to disparity reduction present a departure from traditional service models where health services are traditionally delivered top-down. Raphael, a novel bottom-up social incubator, was developed in a disadvantaged region with the aim of 'hatching' innovative health improvement interventions through academia-community partnership.
Community organizations were invited to submit proposals for incubation. Selection was made using the criteria of innovation, population neediness and potential for health impact and sustainability. Raphael partnered with organizations to pilot and evaluate their intervention with $5000 seed-funding. The evaluation was guided by the conceptual framework of technological incubators. Outcomes and sustainability were ascertained through qualitative and quantitative analysis of records and interviews at 12 months and 3-5 years, and the Community Impact of Research Oriented Partnerships (CIROP) questionnaire was administered to community partners.
Ninety proposals were submitted between 2013 and 2015 principally from non-governmental organizations (NGOs). Thirteen interventions were selected for 'incubation'. Twelve successfully 'hatched': three demonstrated sustainability with extension locally or nationally through acquiring external competitive funding; six continued to have influence within their organizations; three failed to continue beyond the pilot. Benefits to the organisations included acquisition of skills including advocacy, teaching and health promotion, evaluation skills and ability to utilize acquired knowledge for implementation. CIROP demonstrated that individuals' research skills were reported to improve (mean ± sd) 4.80 ± 2.49 along with confidence in being able to use knowledge acquired in everyday practice (5.50 ± 1.38) and new connections were facilitated (5.33 ± 2.25).
Raphael, devised as a 'social incubator', succeeded in nurturing novel ideas engendered by community organizations that aimed to impact on health disparities. Judging by success rates of technological incubators its goals were realized to a considerable degree.
从传统的服务模式（即传统上自上而下提供卫生服务）出发，减少差异的方法有很多种。Raphael 是一种新颖的自下而上的社会孵化器，它是在一个劣势地区开发的，旨在通过学术界-社区伙伴关系“孵化”创新的改善健康的干预措施。
社区组织被邀请提交孵化提案。选择是根据创新、人口需求和对健康影响和可持续性的潜力等标准进行的。Raphael 与组织合作，为他们的干预措施提供 5000 美元的种子资金进行试点和评估。评估是根据技术孵化器的概念框架进行的。通过对 12 个月和 3-5 年的记录和访谈进行定性和定量分析，以及对社区伙伴进行社区导向的伙伴关系影响问卷（CIROP）调查，确定了结果和可持续性。
2013 年至 2015 年期间共提交了 90 份提案，主要来自非政府组织（NGO）。有 13 项干预措施被选中进行“孵化”。有 12 项成功“孵化”：其中 3 项通过获得外部竞争资金在当地或全国范围内实现了可持续性；6 项继续在其组织内产生影响；3 项试点后未能继续。组织获得的收益包括获得了包括宣传、教学和健康促进、评估技能以及将获得的知识用于实施的能力等技能。CIROP 表明，个人的研究技能据报告有所提高（平均值±标准差）4.80±2.49，以及对能够在日常实践中运用所学知识的信心（5.50±1.38）也有所提高，并且还促进了新的联系。
Raphael 作为一种“社会孵化器”，成功地培育了社区组织提出的旨在影响健康差异的新想法。从技术孵化器的成功率来看，它的目标在很大程度上实现了。
