Centre for Primary Care and Mental Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK.
Andalusian School of Public Health, Granada, Spain.
BMJ Open. 2021 May 24;11(5):e040043. doi: 10.1136/bmjopen-2020-040043.
Asset-based community development (ABCD) is a strategy aimed at strengthening communities of interest through the identification and enhancement of those protective resources (also called 'health assets') that contribute to improve population health. Although primary care is specially well placed to contribute to ABCD by facilitating patients' access to community health assets, the implementation of ABCD approaches is limited, in part due to training deficiencies amongst general practitioners. In this study, we will develop a training programme on ABCD aimed at general practice trainees and evaluate its implementation and scale-up in Andalusia, Spain. We will also investigate whether the programme may contribute to strengthen the community orientation of the primary care practices involved in the study.
We will undertake a mixed methods, multilevel and multicentric action research study drawing on theoretical frameworks relevant to learning (pedagogy) and community health promotion. The intervention will be implemented and evaluated in eight different study areas over 48 months. It will comprise a classroom-based session and a practical exercise, which will involve general practice trainees producing a map of community health assets relevant to common health conditions. In each study area, we will set up a stakeholder group to guide our study. We will run the intervention sequentially across the eight study areas, and modify and refine it iteratively by incorporating the findings from the evaluation. We will employ qualitative (interviews and focus groups with general practice trainees, primary care workers, members of the teaching units and policymakers) and quantitative methods (self-administered questionnaires with an approximate sample of 157 general practice trainees and 502 primary care workers).
Ethics approval from the Andalusian Regional Health Council has been granted (6/2020). It is envisaged that this research will provide relevant, evidence-based guidance on how best to incorporate learning on ABCD into the general practice training curriculum. Findings will be disseminated in an ongoing manner and will target the following audiences: (1) general practice trainees, primary care workers and members of the teaching units, (2) policymakers and strategic decision makers and (3) the academic community.
基于资产的社区发展(ABCD)是一种旨在通过识别和增强那些有助于改善人口健康的保护资源(也称为“健康资产”)来加强利益共同体的策略。尽管初级保健特别适合通过促进患者获得社区健康资产来为 ABCD 做出贡献,但由于全科医生培训不足,ABCD 方法的实施受到限制。在这项研究中,我们将为全科医生培训生开发一项关于 ABCD 的培训计划,并在西班牙安达卢西亚评估其实施和推广情况。我们还将研究该计划是否有助于加强参与研究的初级保健实践的社区定位。
我们将进行一项混合方法、多层次和多中心的行动研究,借鉴与学习(教育学)和社区健康促进相关的理论框架。该干预措施将在 48 个月内在八个不同的研究区域实施和评估。它将包括一个课堂会议和一个实践练习,其中包括全科医生培训生制作与常见健康状况相关的社区健康资产地图。在每个研究区域,我们将成立一个利益相关者小组来指导我们的研究。我们将在八个研究区域中依次开展干预措施,并通过纳入评估结果对其进行迭代修改和完善。我们将采用定性(与全科医生培训生、初级保健工作者、教学单位成员和政策制定者进行访谈和焦点小组讨论)和定量方法(对大约 157 名全科医生培训生和 502 名初级保健工作者进行自填式问卷)。
安达卢西亚地区卫生委员会已批准了伦理许可(2020 年 6 月)。预计这项研究将为如何将 ABCD 的学习纳入全科医生培训课程提供相关的循证指导。研究结果将以持续的方式传播,并针对以下受众:(1)全科医生培训生、初级保健工作者和教学单位成员,(2)政策制定者和战略决策者,(3)学术界。