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群体儿童保健概念框架:指导实施、评估和研究的工具。

A Conceptual Framework for Group Well-Child Care: A Tool to Guide Implementation, Evaluation, and Research.

机构信息

Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21231, USA.

Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA.

出版信息

Matern Child Health J. 2023 Jun;27(6):991-1008. doi: 10.1007/s10995-023-03641-4. Epub 2023 Apr 4.

Abstract

OBJECTIVE

To use scoping review methods to construct a conceptual framework based on current evidence of group well-child care to guide future practice and research.

METHODS

We conducted a scoping review using Arksey and O'Malley's (2005) six stages. We used constructs from the Consolidated Framework for Implementation Research and the quadruple aim of health care improvement to guide the construction of the conceptual framework.

RESULTS

The resulting conceptual framework is a synthesis of the key concepts of group well-child care, beginning with a call for a system redesign of well-child care to improve outcomes while acknowledging the theoretical antecedents structuring the rationale that supports the model. Inputs of group well-child care include health systems contexts; administration/logistics; clinical setting; group care clinic team; community/patient population; and curriculum development and training. The core components of group well-child care included structure (e.g., group size, facilitators), content (e.g., health assessments, service linkages). and process (e.g., interactive learning and community building). We found clinical outcomes in all four dimensions of the quadruple aim of healthcare.

CONCLUSION

Our conceptual framework can guide model implementation and identifies several outcomes that can be used to harmonize model evaluation and research. Future research and practice can use the conceptual framework as a tool to standardize model implementation and evaluation and generate evidence to inform future healthcare policy and practice.

摘要

目的

使用范围综述方法,基于当前群体儿童保健的证据构建一个概念框架,以指导未来的实践和研究。

方法

我们采用 Arksey 和 O'Malley(2005 年)的六个阶段进行了范围综述。我们使用实施研究综合框架和医疗保健改善的四重目标的结构来指导概念框架的构建。

结果

由此产生的概念框架是群体儿童保健关键概念的综合,首先呼吁对儿童保健进行系统重新设计,以改善结果,同时承认构成支持该模型的理论前提的结构。群体儿童保健的投入包括卫生系统环境;管理/后勤;临床环境;群体保健诊所团队;社区/患者人群;以及课程开发和培训。群体儿童保健的核心组成部分包括结构(例如,群体规模、促进者)、内容(例如,健康评估、服务联系)和过程(例如,互动学习和社区建设)。我们在医疗保健四重目标的所有四个维度中都发现了临床结果。

结论

我们的概念框架可以指导模型的实施,并确定了几个可用于协调模型评估和研究的结果。未来的研究和实践可以使用概念框架作为工具来规范模型的实施和评估,并生成证据,为未来的医疗保健政策和实践提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/585b/10071241/e6c6507b9a0c/10995_2023_3641_Fig1_HTML.jpg

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