Mazzucca Stephanie, Arredondo Elva M, Hoelscher Deanna M, Haire-Joshu Debra, Tabak Rachel G, Kumanyika Shiriki K, Brownson Ross C
Brown School, Washington University in St. Louis, St. Louis, Missouri 63130, USA; email:
Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, California 92123-4311, USA; email:
Annu Rev Public Health. 2021 Apr 1;42:135-158. doi: 10.1146/annurev-publhealth-090419-102547. Epub 2021 Jan 19.
Chronic disease prevention continues to be inadequate, overall and in achieving health equity, in spite of the many evidence-based practices and policies (EBPPs) available to address risk behaviors such as unhealthful eating, lack of physical activity, and tobacco use. Although clinical settings are needed for EBPPs that involve medical procedures such as immunization or early detection, dissemination of EBPPs can be effective in a variety of settings such as schools and childcare centers, worksites, social service organizations, and religious organizations. More implementation research is needed to meet challenges of effective application of EBPPs in such community settings, in which primary missions, capacity, cultures, and values do not focus on health services delivery. To address health equity, consideration of social and economic contexts of people reached in these settings is essential. This review presents lessons learned from past studies to guide future implementation research and practice across diverse settings and geographies.
尽管有许多基于证据的实践和政策(EBPPs)可用于应对不健康饮食、缺乏体育活动和吸烟等风险行为,但总体而言,在实现健康公平方面,慢性病预防仍然不足。虽然涉及免疫接种或早期检测等医疗程序的EBPPs需要临床环境,但EBPPs在学校、儿童保育中心、工作场所、社会服务组织和宗教组织等各种环境中都可以有效传播。需要更多的实施研究来应对在这些社区环境中有效应用EBPPs的挑战,因为这些环境的主要使命、能力、文化和价值观并不专注于提供卫生服务。为了实现健康公平,必须考虑这些环境中所涉及人群的社会和经济背景。本综述介绍了过去研究的经验教训,以指导未来在不同环境和地区的实施研究与实践。