Frost Linda, Valaitis Ruta, Butt Michelle, Jack Susan M, Akhtar-Danesh Noori
School of Nursing - McMaster University, 1280 Main Street West, Hamilton, Ontario L8S4K1 Canada.
Z Gesundh Wiss. 2022 May 17:1-10. doi: 10.1007/s10389-022-01715-1.
Population-level prevention initiatives are the cornerstone of public health practice. However, despite this normative practice, sexual health programming within public health has not utilized this approach to the same extent as other public health programs. Understanding requirements to put a population-level approach into practice is needed. The objective of this study was to explore the barriers and facilitators experienced by sexual health programs and services within public health when implementing a population health approach.
The principles of qualitative description guided all sampling, data collection and analysis decisions. Data collection involved in-depth semi-structured interviews with 12 sexual health managers and/or supervisors from ten Ontario public health units. Directed content analysis was used to code and synthesize the data. Data collection and analysis was guided using constructs from the Consolidated Framework for Implementation Research.
Factors that served as either barriers and facilitators to implementing a population health approach, were mainly in the inner and outer setting domains of the Consolidated Framework for Implementation Research. Participants identified the presence of community partnerships, adequate staff training on population health, and access to data on population health served as facilitators. In comparison, barriers to implementation included a lack of resources (human, financial) and clinicians' value of and preferences for delivering services at the individual clinic level.
Some clear barriers and facilitators influenced if staff in sexual health programs and services could implement a population health approach. Results indicate where public health resources need to be enhanced to move toward a population health approach and provide insight into what worked and should be considered by public health organizations.
人群层面的预防举措是公共卫生实践的基石。然而，尽管这是常规做法，但公共卫生领域的性健康规划并未像其他公共卫生项目那样充分利用这种方法。我们需要了解将人群层面方法付诸实践的要求。本研究的目的是探讨公共卫生领域的性健康项目和服务在实施人群健康方法时所经历的障碍和促进因素。
定性描述原则指导了所有抽样、数据收集和分析决策。数据收集包括对来自安大略省十个公共卫生单位的12名性健康管理人员和/或主管进行深入的半结构化访谈。采用定向内容分析法对数据进行编码和综合。数据收集和分析以实施研究综合框架中的概念为指导。
作为实施人群健康方法的障碍或促进因素的因素，主要存在于实施研究综合框架的内部和外部环境领域。参与者确定社区伙伴关系的存在、对人群健康的充分员工培训以及获取人群健康数据是促进因素。相比之下，实施障碍包括缺乏资源（人力、财力）以及临床医生对在个体诊所层面提供服务的重视和偏好。
一些明确的障碍和促进因素影响了性健康项目和服务的工作人员是否能够实施人群健康方法。结果表明需要在哪些方面加强公共卫生资源以朝着人群健康方法迈进，并深入了解哪些措施有效以及公共卫生组织应考虑哪些方面。
