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评估南方农村地区健康公平进展的评估设计

Evaluation Design for : Assessing Progress Toward Health Equity in the Rural South.

作者信息

Kegler Michelle C, Hermstad April, Haardörfer Regine, Arriola Kimberly Jacob, Gauthreaux Nicole, Tucker Samantha, Nelson Gary

机构信息

Emory University, Atlanta, GA, USA.

Healthcare Georgia Foundation, Atlanta, GA, USA.

出版信息

Health Educ Behav. 2023 Apr;50(2):268-280. doi: 10.1177/10901981211060330. Epub 2022 Mar 19.

Abstract

As persistent inequities in health gained increased attention nationally due to COVID-19 and racial justice protests in 2020, it has become increasingly important to evaluate both the process and outcomes associated with coalition-based efforts to address health inequities. supports coalitions in 11 rural counties to (1) achieve greater health equity, (2) improve health and health care, (3) build healthier rural communities and improve social conditions that impact the health of rural populations, and (4) build community, organizational, and individual leadership capacity for health equity. Rural communities suffer significant health disparities relative to urban areas, and also experience internal inequities by race and poverty level. The evaluation framework for provides a comprehensive mixed methods approach to evaluating both processes and outcomes. Early results related to community readiness and capacity to address health inequities, measured through a coalition member survey ( = 236) conducted at the end of the planning phase, suggest coalitions were in the preparation stage, with higher levels of readiness among coalition members and organizations/groups similar to the coalition members' own, lower levels among public officials and other leaders, and the lowest levels among county residents. In addition, coalition members reported more experience with downstream drivers (e.g., access to care) of health than upstream drivers (e.g., affordable housing, environmental or racial justice). By providing a logic model, evaluation questions and associated indicators, as well as a range of data collection methods, this evaluation approach may prove practical to others aiming to evaluate their efforts to address health equity.

摘要

由于2020年的新冠疫情和种族正义抗议活动,健康方面长期存在的不平等现象在全国范围内受到了越来越多的关注,因此评估与基于联盟的解决健康不平等问题的努力相关的过程和结果变得越发重要。[具体项目名称]为11个农村县的联盟提供支持,以(1)实现更大程度的健康公平,(2)改善健康状况和医疗保健,(3)建设更健康的农村社区并改善影响农村人口健康的社会条件,以及(4)建设社区、组织和个人在健康公平方面的领导能力。相对于城市地区,农村社区存在显著的健康差距,并且在种族和贫困水平方面也存在内部不平等。[具体项目名称]的评估框架提供了一种全面的混合方法,用于评估过程和结果。通过在规划阶段结束时进行的联盟成员调查(n = 236)来衡量的与社区应对健康不平等的准备情况和能力相关的早期结果表明,联盟处于准备阶段,联盟成员以及与联盟成员类似的组织/团体的准备程度较高,公职人员和其他领导者的准备程度较低,而县居民的准备程度最低。此外,联盟成员报告称,他们在健康的下游驱动因素(如获得医疗服务)方面的经验比上游驱动因素(如经济适用房、环境或种族正义)更多。通过提供一个逻辑模型、评估问题和相关指标,以及一系列数据收集方法,这种评估方法可能对其他旨在评估其解决健康公平问题努力的人具有实际意义。

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