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综合社区卫生的不断变化的术语:基于主体的方法的批判评价。

Synthesising the shifting terminology of community health: A critiquing review of agent-based approaches.

机构信息

Institute for Risk and Disaster Reduction, University College London, London, UK.

Institute for Global Health, University College London, London, UK.

出版信息

Glob Public Health. 2022 Aug;17(8):1492-1506. doi: 10.1080/17441692.2021.1938169. Epub 2021 Jun 7.

Abstract

The field of community health promotion encompasses a wide range of approaches, including bottom-up approaches that recognise and build on the agency and strengths of communities to define and pursue their health goals. Momentum towards agent-based approaches to community health promotion has grown in recent years, and several related but distinct conceptual and methodological bodies of work have developed largely in isolation from each other. The lack of a cohesive collection of research, practice, and policy has made it difficult to learn from the innovations, best practices, and shortcomings of these approaches, which is exacerbated by the imprecise and inconsistent use of related terms. This article provides a review of three agent-based approaches to promoting community health: asset-based approaches, capacity building, and capabilities approaches, noting the theoretical origins and fundamental concepts, applications and methodologies, and limitations and critiques of each. This article discusses their commonalities and differences in terms of how they conceptualise and approach the promotion of community health, including a critical consideration of their limitations and where they may prove to be counterproductive. This article argues that agent-based approaches to community health must be met with meaningful opportunities to disengage from the structures that constrain their health.

摘要

社区健康促进领域涵盖了广泛的方法,包括自下而上的方法,这些方法承认并利用社区的机构和优势来定义和追求他们的健康目标。近年来,基于代理的社区健康促进方法的势头越来越大,几个相关但不同的概念和方法体系在很大程度上相互独立地发展起来。由于缺乏凝聚力的研究、实践和政策集合,很难从这些方法的创新、最佳实践和缺点中吸取教训,相关术语使用不精确和不一致加剧了这种情况。本文回顾了三种基于代理的促进社区健康的方法:资产为基础的方法、能力建设和能力方法,指出了它们的理论起源和基本概念、应用和方法,以及各自的局限性和批评。本文讨论了它们在促进社区健康方面的概念和方法上的异同,包括对其局限性的批判性思考,以及它们在哪些方面可能适得其反。本文认为,必须为社区健康的基于代理的方法提供有意义的机会,以摆脱限制其健康的结构。

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