Department of Health Sciences, Faculty of Sciences, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Healthy Society, Windesheim University of Applied Sciences, Zwolle, The Netherlands.
PLoS One. 2020 Oct 20;15(10):e0240757. doi: 10.1371/journal.pone.0240757. eCollection 2020.
Since 2010, the Zwolle Healthy City approach, an integrated community-based approach, has been implemented in the Dutch municipality of Zwolle. This approach is proven successful in reducing health inequalities. However, the key elements of this approach are not clear. The current study aimed to identify key elements of this successful local community-based approach, according to the perspectives of various stakeholders.
Semi-structured interviews were carried out with 29 professionals who were involved in the approach in the period 2010-2018 and have occupations at the strategic (n = 4), tactical (n = 17) and operational level (n = 8). Data was analyzed using the thematic analysis approach.
We identified nine perceived key elements that contributed to the success of the approach aimed at reducing socioeconomic health inequalities. The respondents indicated the following key elements: (1) collaboration between a variety of local organizations that want to have impact on the health of citizens; (2) support for the approach on the strategic, tactical and operational level of involved organizations; (3) proper communication and coordination, both for the network and within the organizations; (4) embeddedness in organizations' policies and processes and (5) collaboration with private organizations is of added value, although there is no "one size fits all". Other key elements are (6) collaboration with citizens, (7) profiling the approach like a brand and (8) moving along with and taking advantage of opportunities. Finally, (9) continuous monitoring and evaluating goals and processes, and learning from the results, is important.
Nine key elements were identified that, according to various stakeholders, contributed to the success of the Zwolle Healthy City approach. These insights are important to further strengthen the Zwolle Healthy City approach but may also help and inspire other local integrated community-based approaches aimed at reducing socioeconomic health inequalities, to improve and adapt the approach within their specific local and dynamic context.
自 2010 年以来，荷兰兹沃勒市实施了一种综合的基于社区的方法——兹沃勒健康城市方法。该方法已被证明在减少健康不平等方面取得了成功。然而，该方法的关键要素尚不清楚。本研究旨在根据不同利益相关者的观点，确定这一成功的地方社区方法的关键要素。
对 2010 年至 2018 年间参与该方法的 29 名专业人员进行了半结构化访谈，这些专业人员的职业分布在战略层面（n=4）、战术层面（n=17）和操作层面（n=8）。采用主题分析方法对数据进行分析。
我们确定了九个被认为是该方法成功的关键要素，这些要素旨在减少社会经济健康不平等。受访者指出了以下关键要素：（1）各种希望对公民健康产生影响的当地组织之间的合作；（2）在参与组织的战略、战术和操作层面上对该方法的支持；（3）适当的沟通和协调，既在网络内部，也在组织内部；（4）嵌入组织的政策和流程中；（5）与私营组织的合作具有附加价值，尽管没有“一刀切”的方法。其他关键要素是（6）与公民的合作，（7）将方法描绘成一个品牌，（8）随着机会的出现而前进并利用这些机会。最后，（9）不断监测和评估目标和流程，并从结果中学习，这一点很重要。
根据不同的利益相关者，确定了九个有助于兹沃勒健康城市方法成功的关键要素。这些见解对于进一步加强兹沃勒健康城市方法很重要，但也可能为其他旨在减少社会经济健康不平等的地方综合社区方法提供帮助和启发，以改善和调整其在特定地方和动态环境下的方法。
