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采用多部门方法促进亚利桑那州农村地区的健康公平:社区参与的调查开发与实施研究

Using a Multisectoral Approach to Advance Health Equity in Rural Arizona: Community-Engaged Survey Development and Implementation Study.

作者信息

Remiker Mark, Sabo Samantha, Jiménez Dulce, Samarron Longorio Alexandra, Chief Carmenlita, Williamson Heather, Teufel-Shone Nicolette

机构信息

Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States.

出版信息

JMIR Form Res. 2021 May 12;5(5):e25577. doi: 10.2196/25577.

Abstract

BACKGROUND

Over the past decade, public health research and practice sectors have shifted their focus away from identifying health disparities and toward addressing the social, environmental, and economic determinants of health equity. Given the complex and interrelated nature of these determinants, developing policies that will advance health equity requires collaboration across sectors outside of health. However, engaging various stakeholder groups, tapping into their unique knowledge systems, and identifying common objectives across sectors is difficult and time consuming and can impede collaborative efforts.

OBJECTIVE

The Southwest Health Equity Research Collaborative at Northern Arizona University, in partnership with an 11-member community advisory council, is addressing this need with a joint community-campus effort to develop and implement a Regional Health Equity Survey (RHES) designed to generate an interdisciplinary body of knowledge, which will be used to guide future multisectoral action for improving community health and well-being.

METHODS

Researchers and community partners used facilitated discussions and free listing techniques to generate survey items. The community partners pilot tested the survey instrument to evaluate its feasibility and duration before survey administration. Respondent-driven sampling was used to ensure that participants included leadership from across all sectors and regions of northern Arizona.

RESULTS

Over the course of 6 months, 206 participants representing 13 sectors across the 5 counties of northern Arizona were recruited to participate in an RHES. Survey response rates, completion percentage, and sector representation were used to assess the effectiveness and feasibility of using a community-engaged apporach for survey development and participant recruitment. The findings describe the current capacity to impact health equity by using a multisectoral approach in northern Arizona.

CONCLUSIONS

The Southwest Health Equity Research Collaborative effectively engaged community members to assist with the development and implementation of an RHES aimed at understanding and promoting multisectoral action on the root causes of health inequity. The results will help to build research and evaluation capacity to address the social, economic, and environmental conditions of health inequity in the region.

摘要

背景

在过去十年中,公共卫生研究和实践部门已将重点从识别健康差异转向解决健康公平的社会、环境和经济决定因素。鉴于这些决定因素的复杂性和相互关联性,制定促进健康公平的政策需要卫生领域以外各部门的合作。然而,让不同的利益相关者群体参与进来,利用他们独特的知识体系,并确定各部门的共同目标既困难又耗时,可能会阻碍合作努力。

目的

北亚利桑那大学的西南健康公平研究协作组织与一个由11名成员组成的社区咨询委员会合作,通过社区与校园的联合努力来满足这一需求,开发并实施一项区域健康公平调查(RHES),旨在生成一个跨学科的知识体系,用于指导未来改善社区健康和福祉的多部门行动。

方法

研究人员和社区合作伙伴采用促进性讨论和自由列举技术来生成调查项目。社区合作伙伴在进行调查之前对调查工具进行了预测试,以评估其可行性和时长。采用应答者驱动抽样以确保参与者包括北亚利桑那州所有部门和地区的领导层。

结果

在6个月的时间里,招募了代表北亚利桑那州5个县13个部门的206名参与者参与区域健康公平调查。调查回复率、完成百分比和部门代表性用于评估采用社区参与方法进行调查开发和参与者招募的有效性和可行性。研究结果描述了目前在北亚利桑那州采用多部门方法影响健康公平的能力。

结论

西南健康公平研究协作组织有效地让社区成员参与进来,协助开发和实施一项区域健康公平调查,旨在理解和促进针对健康不公平根源的多部门行动。研究结果将有助于建立研究和评估能力,以应对该地区健康不公平的社会、经济和环境状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc7b/8156115/6b5010080824/formative_v5i5e25577_fig1.jpg

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