The Australian Prevention Partnership Centre, The Sax Institute, 235 Jones Street, Ultimo, NSW, 2007, Australia.
Sydney School of Public Health, the University of Sydney, Sydney, NSW, 2006, Australia.
Health Res Policy Syst. 2022 Apr 7;20(1):37. doi: 10.1186/s12961-022-00843-0.
Population health prevention programmes are needed to reduce the prevalence of chronic diseases. Nevertheless, sustaining programmes at a population level is challenging. Population health is highly influenced by social, economic and political environments and is vulnerable to these system-level changes. The aim of this research was to examine the factors and mechanisms contributing to the sustainment of population prevention programmes taking a systems thinking approach.
We conducted a qualitative study through interviews with population health experts working within Australian government and non-government agencies experienced in sustaining public health programs at the local, state or national level (n = 13). We used a deductive thematic approach, grounded in systems thinking to analyse data.
We identified four key barriers affecting program sustainment: 1) short term political and funding cycles; 2) competing interests; 3) silo thinking within health service delivery; and 4) the fit of a program to population needs. To overcome these barriers various approaches have centred on the importance of long-range planning and resourcing, flexible program design and management, leadership and partnerships, evidence generation, and system support structures.
This study provides key insights for overcoming challenges to the sustainment of population health programmes amidst complex system-wide changes.
需要开展人群健康预防项目来降低慢性病的发病率。然而，在人群层面维持项目具有挑战性。人群健康受社会、经济和政治环境的高度影响，容易受到这些系统层面变化的影响。本研究旨在通过对澳大利亚政府机构和非政府机构中从事地方、州或国家层面公共卫生项目维持工作的人群健康专家（n=13）进行访谈，采用系统思维方法，从系统层面来探讨有助于人群预防项目维持的因素和机制。
我们采用了一种定性研究方法，通过对澳大利亚政府机构和非政府机构中从事地方、州或国家层面公共卫生项目维持工作的人群健康专家（n=13）进行访谈，使用系统思维为基础的演绎主题方法来分析数据。
我们确定了影响项目维持的四个关键障碍：1）短期政治和资金周期；2）利益冲突；3）卫生服务提供方面的思维局限；4）项目与人群需求的契合度。为了克服这些障碍，各种方法都集中在长期规划和资源配置、灵活的项目设计和管理、领导力和伙伴关系、证据生成以及系统支持结构的重要性上。
本研究为克服人群健康项目维持所面临的挑战提供了重要的见解，这些挑战存在于复杂的全系统变化之中。
