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优化女性虚拟护理的公平部署:一项定性证据综合研究的方案,该研究考察患者和提供者的观点,并辅以原始定性数据。

Optimizing the Equitable Deployment of Virtual Care for Women: Protocol for a Qualitative Evidence Synthesis Examining Patient and Provider Perspectives Supplemented with Primary Qualitative Data.

作者信息

Goldstein Karen M, Patel Dhara B, Van Loon Katherine A, Shapiro Abigail, Rushton Sharron, Lewinski Allison A, Lanford Tiera J, Cantrell Sarah, Zullig Leah L, Wilson Sarah M, Shepherd-Banigan Megan, Alton Dailey Susan, Sims Catherine, Robinson Cheryl, Chawla Neetu, Bosworth Hayden B, Hamilton Alison, Naylor Jennifer, Gierisch Jennifer M

机构信息

VA Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, North Carolina, USA.

Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina, USA.

出版信息

Health Equity. 2023 Sep 13;7(1):570-580. doi: 10.1089/heq.2023.0089. eCollection 2023.

Abstract

INTRODUCTION

Women experience numerous barriers to patient-centered health care (e.g., lack of continuity). Such barriers are amplified for women from marginalized communities. Virtual care may improve equitable access. We are conducting a partner-engaged, qualitative evidence synthesis (QES) of patients' and providers' experiences with virtual health care delivery for women.

METHODS

We use a best-fit framework approach informed by the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework and Public Health Critical Race Praxis. We will supplement published literature with qualitative interviews with women from underrepresented communities and their health care providers. We will engage patients and other contributors through multiple participatory methods.

RESULTS

Our search identified 5525 articles published from 2010 to 2022. Sixty were eligible, of which 42 focused on women and 24 on provider experiences. Data abstraction and analysis are ongoing.

DISCUSSION

This work offers four key innovations to advance health equity: (1) conceptual foundation rooted in an antiracist action-oriented praxis; (2) worked example of centering QES on marginalized communities; (3) supplementing QES with primary qualitative information with populations historically marginalized in the health care system; and (4) participatory approaches that foster longitudinal partnered engagement.

HEALTH EQUITY IMPLICATIONS

Our approach to exploring virtual health care for women demonstrates an antiracist praxis to inform knowledge generation. In doing so, we aim to generate findings that can guide health care systems in the equitable deployment of comprehensive virtual care for women.

摘要

引言

女性在以患者为中心的医疗保健方面面临诸多障碍(例如缺乏连续性)。对于来自边缘化社区的女性而言,这些障碍更为突出。虚拟医疗可能会改善公平可及性。我们正在开展一项由合作伙伴参与的定性证据综合研究(QES),以了解患者和医疗服务提供者在为女性提供虚拟医疗服务方面的经历。

方法

我们采用最适合的框架方法,该方法以“未采用、放弃、扩大规模、传播和可持续性”框架以及公共卫生批判种族实践为依据。我们将通过对来自代表性不足社区的女性及其医疗服务提供者进行定性访谈,来补充已发表的文献。我们将通过多种参与式方法让患者和其他参与者参与进来。

结果

我们的检索共识别出2010年至2022年发表的5525篇文章。其中60篇符合条件,其中42篇关注女性,24篇关注医疗服务提供者的经历。数据提取和分析正在进行中。

讨论

这项工作为推进健康公平提供了四项关键创新:(1)基于反种族主义行动导向实践的概念基础;(2)以边缘化社区为中心进行定性证据综合研究的实例;(3)用医疗保健系统中历史上处于边缘化地位人群的原始定性信息补充定性证据综合研究;(4)促进长期合作参与的参与式方法。

对健康公平的影响

我们探索女性虚拟医疗的方法展示了一种反种族主义实践,以为知识生成提供信息。通过这样做,我们旨在得出能够指导医疗保健系统公平部署全面女性虚拟医疗服务的研究结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a041/10507937/8df557586144/heq.2023.0089_figure1.jpg

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