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与社区共同创建基于证据的卫生公平政策。

Cocreating evidence-informed health equity policy with community.

机构信息

Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA.

Tacoma-Pierce County Health Department, Tacoma, Washington, USA.

出版信息

Health Serv Res. 2022 Jun;57 Suppl 1(Suppl 1):137-148. doi: 10.1111/1475-6773.13940. Epub 2022 Mar 3.

Abstract

OBJECTIVE

To explore the feasibility of a rapid, community-engaged strategy to prioritize health equity policy options as informed by research evidence, community-voiced needs, and public health priorities.

DATA SOURCES

Data came from residents in a midsized, demographically, and geographically diverse county over a period of 8 months in 2020 and an evidence review of the health equity policy literature during the same time period.

STUDY DESIGN

A descriptive case study is used to explore the feasibility and potential value of a community codesigned approach to establish community priorities for health equity policy.

DATA COLLECTION/EXTRACTION METHODS: Evidence synthesis of health equity policy was conducted parallel to 15 community listening sessions across the county to elicit information on health needs. We used scoping review methods to obtain literature from academic databases and scholarly public health and policy organizations. This information was cross walked with themes from the listening sessions to identify 10 priority policy areas, which were taken back to the community for 15 participatory discussion and ranking sessions.

PRINCIPAL FINDINGS

The process appeared to authentically engage the input of 200 community members representative of minoritized groups while identifying 99 evidence-informed policy levers to promote health equity. Discussion and ranking activities were successful in facilitating community discussion and policy decision making. Remote platforms may have limited the engagement of some residents while promoting the participation of others. Conducting information integration within the research team prior to community policy ranking sessions limited the community ownership over how policies were interpreted and communicated.

CONCLUSIONS

A combination of information integration and community ranking activities can be used to achieve community-engaged policy prioritization of options in a fairly rapid period of time. While this process provides an example of authentic community ownership of policy prioritization, the compressed timeline limited the community's engagement in the information integration phase.

摘要

目的

探索一种快速的、以社区为基础的策略,以便根据研究证据、社区呼声和公共卫生重点来确定健康公平政策选项的优先顺序。

资料来源

数据来自于 2020 年 8 个月期间一个中等规模、人口统计学和地理上多样化的县的居民,以及同一时期健康公平政策文献的证据审查。

研究设计

使用描述性案例研究来探索社区共同设计的方法来确定健康公平政策的社区优先事项的可行性和潜在价值。

资料收集/提取方法:平行于全县 15 个社区听力会议进行健康公平政策的证据综合,以获取有关健康需求的信息。我们使用范围综述方法从学术数据库和公共卫生与政策学术组织中获取文献。将这些信息与听力会议的主题交叉,以确定 10 个优先政策领域,然后将这些领域带回社区进行 15 次参与式讨论和排名会议。

主要发现

这一过程似乎真实地吸引了 200 名代表少数群体的社区成员的投入,同时确定了 99 个以证据为基础的促进健康公平的政策杠杆。讨论和排名活动成功地促进了社区讨论和政策决策。远程平台可能限制了一些居民的参与,同时促进了其他人的参与。在社区政策排名会议之前,在研究小组内进行信息整合限制了社区对政策解释和沟通的所有权。

结论

信息整合和社区排名活动的结合可以用于在相当短的时间内实现社区参与的政策优先化。虽然这一过程为政策优先化提供了社区所有权的范例,但压缩的时间表限制了社区在信息整合阶段的参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52c4/9108222/2036346d05aa/HESR-57-137-g001.jpg

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