Department of Veterinary Sciences, University of Turin, Largo Braccini 2, 10050, Grugliasco, Italy.
Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, 8057, Zurich, Switzerland.
Eval Program Plann. 2021 Dec;89:101991. doi: 10.1016/j.evalprogplan.2021.101991. Epub 2021 Aug 18.
West Nile virus (WNV) is endemic in the Po valley area in northern Italy. Regional health authorities have implemented integrated WNV surveillance following a One Health approach, based on collaboration between human, animal and environmental health institutions. We evaluated this integrated WNV surveillance system in Emilia-Romagna, Lombardy and Piedmont regions by means of a process evaluation. We examined the system's implementation fidelity, dose delivered and received, reach, and we identified strengths and weaknesses in the system. Qualitative and semi-quantitative data were obtained from three regional focus groups. Data were discussed in a follow up focus group, where participants suggested recommendations for improving the surveillance system. Inter-institutional and interdisciplinary integration and the creation of a 'community of practice' were identified as key elements for effective surveillance. We identified differences in the degree of interdisciplinary integration in the three regions, likely due to different epidemiological situations and years of experience in surveillance implementation. Greater collaboration and sharing of information, public engagement and economic assessments of the integrated surveillance approach would facilitate its social recognition and guarantee its sustainability through dedicated funding. We demonstrate that a transdisciplinary research approach based on process evaluation has value for designing and fine-tuning integrated health surveillance systems.
西尼罗河病毒（WNV）在意大利北部的波河谷地区流行。区域卫生当局根据人类、动物和环境卫生机构之间的合作，采取了一种“同一健康”方法，实施了综合 WNV 监测。我们通过过程评估评估了艾米利亚-罗马涅、伦巴第和皮埃蒙特地区的综合 WNV 监测系统。我们检查了系统的实施保真度、提供和接收的剂量、覆盖范围，并确定了系统的优势和劣势。从三个区域焦点小组获得了定性和半定量数据。在后续焦点小组中讨论了数据，参与者提出了改进监测系统的建议。机构间和跨学科的整合以及“实践共同体”的创建被确定为有效监测的关键要素。我们发现三个地区的跨学科整合程度存在差异，这可能是由于不同的流行病学情况和实施监测的年限不同。加强协作和信息共享、公众参与以及对综合监测方法的经济评估将有助于其得到社会认可，并通过专门资金保障其可持续性。我们证明，基于过程评估的跨学科研究方法对于设计和微调综合卫生监测系统具有价值。
