School of Nursing, McMaster University, Hamilton, Canada.
Can J Nurs Res. 2023 Sep;55(3):319-332. doi: 10.1177/08445621221143019. Epub 2023 Feb 20.
This study investigated the extent of and factors influencing implementation of a population health approach within sexual health programming in public health.
This sequential multi-phase mixed methods study combined findings from a quantitative survey assessing the extent that a population health approach was implemented in sexual health programs in Ontario public health units and qualitative interviews with sexual health managers and/or supervisors. Interviews explored factors influencing implementation and were analyzed using directed content analysis.
Staff from fifteen of 34 public health units completed surveys and ten interviews were completed with sexual health managers/supervisors. From the 8 Population Health Key Elements Template, 6 elements were moderately implemented and 2 had low implementation. Qualitative findings focused on enablers and barriers to implementing a population health approach in sexual health programs and services and explained most of the quantitative results. However, some of the quantitative findings were not explained by qualitative data (e.g., low implementation of using the principles of social justice).
Qualitative findings revealed factors influencing the implementation of a population health approach. A lack of resources available to health units, differing priorities between health units and community stakeholders, and access to evidence around population-level interventions influenced implementation.
本研究旨在调查在公共卫生领域的性健康规划中,实施人群健康方法的程度和影响因素。
本研究采用顺序多阶段混合方法,结合了一项定量调查的结果,该调查评估了安大略省公共卫生部门的性健康规划中实施人群健康方法的程度,以及对性健康管理人员和/或主管的定性访谈。访谈探讨了实施的影响因素,并采用有针对性的内容分析进行了分析。
来自 34 个公共卫生部门中的 15 个部门的工作人员完成了调查,10 名性健康管理人员/主管完成了访谈。在 8 个人群健康关键要素模板中,有 6 个要素得到了中等程度的实施,有 2 个要素的实施程度较低。定性研究结果主要集中在实施性健康规划和服务人群健康方法的促进因素和障碍因素,并解释了大部分定量结果。然而,一些定量结果无法用定性数据解释(例如,使用社会公正原则的实施程度较低)。
定性研究结果揭示了影响人群健康方法实施的因素。卫生部门可获得的资源有限、卫生部门和社区利益相关者之间的优先事项不同,以及获取人群干预措施方面的证据的机会,都影响了实施。