基于证据的健康促进和疾病预防干预措施的实施:可转移性概念对决策和转移过程的理论和实践意义。

Implementation of evidence-based health promotion and disease prevention interventions: theoretical and practical implications of the concept of transferability for decision-making and the transfer process.

机构信息

Department of International Health, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD, Maastricht, Limburg, The Netherlands.

Head of Division "Effectiveness and Efficiency of Health Education", Federal Centre for Health Education (BZgA), Cologne, North Rhine-Westphalia, Germany.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021 May;64(5):534-543. doi: 10.1007/s00103-021-03324-x. Epub 2021 Apr 23.

Abstract

Evidence-based health promotion and disease prevention require incorporating evidence of the effectiveness of interventions into policy and practice. With the entry into force of the German Act to Strengthen Health Promotion and Prevention (PrävG), interventions that take place in people's everyday living environments have gained in importance. Decision-makers need to assess whether an evidence-based intervention is transferable to their specific target context. The Federal Centre for Health Education (BZgA) recommends that transferability of an intervention should be clarified before any decision to implement it. Furthermore, transferability needs to be finally determined after an evaluation in the target context. In this article, we elaborate on theoretical and practical implications of the concept of transferability for health promotion and disease prevention based on the Population-Intervention-Environment-Transfer Models of Transferability (PIET-T). We discuss how decision-makers can anticipate transferability prior to the intervention transfer with the help of transferability criteria and how they can take transferability into account in the further process. This includes the steps of the analysis of a health problem and identification of effective interventions, the steps of the initial transferability assessment and identification of the need for adaptation, and the steps of the implementation and evaluation. Considering transferability is a complex task that comes with challenges. But it offers opportunities to select a suitable intervention for a target context and, in the transfer process, to understand the conditions under which the intervention works in this context. This knowledge helps to establish an evidence base, which is practically relevant.

摘要

循证健康促进和疾病预防需要将干预措施的有效性证据纳入政策和实践中。随着《德国加强健康促进和预防法案》(PrävG)的生效,在人们日常生活环境中开展的干预措施变得越来越重要。决策者需要评估基于证据的干预措施是否可以转移到其特定的目标环境中。联邦健康教育中心(BZgA)建议,在决定实施干预措施之前,应明确干预措施的可转移性。此外,在目标环境中进行评估后,最终需要确定可转移性。本文基于可转移性的人群-干预-环境-转移模型(PIET-T),阐述了健康促进和疾病预防中可转移性概念的理论和实践意义。我们讨论了决策者如何在干预措施转移之前,借助可转移性标准来预测可转移性,以及他们如何在后续过程中考虑可转移性。这包括分析健康问题和确定有效干预措施的步骤、初步可转移性评估和适应需求的步骤,以及实施和评估的步骤。考虑可转移性是一项复杂的任务,存在挑战,但它为选择适合目标环境的干预措施提供了机会,并在转移过程中,帮助理解干预措施在该环境中起作用的条件。这些知识有助于建立具有实际意义的循证基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d18/8087543/c1f1235658d0/103_2021_3324_Fig1_HTML.jpg

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