理解复杂干预措施中社区和学术合作伙伴之间的协作实施：一项定性描述性研究。
Understanding collaborative implementation between community and academic partners in a complex intervention: a qualitative descriptive study.
机构信息
McMaster University, 100 Main Street West, L8P 1H6, Hamilton, ON, Canada.
Canadian Red Cross, 5700 Cancross Court, Mississauga, ON, L5R 3E9, Canada.
出版信息
BMC Health Serv Res. 2023 Jun 9;23(1):606. doi: 10.1186/s12913-023-09617-y.
BACKGROUND
Community-academic partnerships (CAPs) can improve the relevance, sustainability, and uptake of new innovations within the community. However, little is known about what topics CAPs focus on and how their discussions and decisions impact implementation at ground level. The objectives of this study were to better understand the activities and learnings from implementation of a complex health intervention by a CAP at the planner/decision-maker level, and how that compared to experiences implementing the program at local sites.
METHODS
The intervention, Health TAPESTRY, was implemented by a nine-partner CAP including academic, charitable organizations, and primary care practices. Meeting minutes were analyzed using qualitative description, latent content analysis, and a member check with key implementors. An open-answer survey about the best and worst elements of the program was completed by clients and health care providers and analyzed using thematic analysis.
RESULTS
In total, 128 meeting minutes were analyzed, 278 providers and clients completed the survey, and six people participated in the member check. Prominent topics of discussion categories from the meeting minutes were: primary care sites, volunteer coordination, volunteer experience, internal and external connections, and sustainability and scalability. Clients liked that they learned new things and gained awareness of community programs, but did not like the volunteer visit length. Clinicians liked the regular interprofessional team meetings but found the program time-consuming.
CONCLUSIONS
An important learning was about who had "voice" at the planner/decision-maker level: many of the topics discussed in meeting minutes were not identified as issues or lasting impacts by clients or providers; this may be due to differing roles and needs, but may also identify a gap. Overall, we identified three phases that could serve as a guide for other CAPs: Phase (1) recruitment, financial support, and data ownership; Phase (2) considerations for modifications and adaptations; Phase (3) active input and reflection.
背景
社区学术伙伴关系（CAP）可以提高社区内新创新的相关性、可持续性和采用率。然而，对于 CAP 关注的主题以及它们的讨论和决策如何影响基层实施知之甚少。本研究的目的是更好地了解 CAP 在规划者/决策者层面实施复杂健康干预的活动和学习，以及与在当地地点实施该计划的经验相比如何。
方法
干预措施 Health TAPESTRY 由包括学术、慈善组织和初级保健实践在内的九个合作伙伴 CAP 实施。使用定性描述、潜在内容分析和与主要实施者的成员检查对会议记录进行分析。客户和医疗保健提供者完成了一份关于该计划最佳和最差元素的开放式回答调查，并使用主题分析进行分析。
结果
总共分析了 128 次会议记录，278 名提供者和客户完成了调查，6 人参加了成员检查。会议记录中突出的讨论主题类别包括：初级保健场所、志愿者协调、志愿者体验、内部和外部联系以及可持续性和可扩展性。客户喜欢他们学习新事物并提高对社区计划的认识，但不喜欢志愿者访问的长度。临床医生喜欢定期的跨专业团队会议，但发现该计划很耗时。
结论
一个重要的学习是关于谁在规划者/决策者层面有“发言权”：会议记录中讨论的许多主题并没有被客户或提供者视为问题或持久影响；这可能是由于角色和需求的不同，但也可能存在差距。总的来说，我们确定了三个阶段，可以作为其他 CAP 的指南：阶段 (1) 招聘、财务支持和数据所有权；阶段 (2) 考虑修改和调整；阶段 (3) 积极投入和反思。
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