Department of Quality of Care and Health Economics, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
Tilburg School of Social and Behavioural Sciences, Tranzo, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
Health Res Policy Syst. 2023 Oct 17;21(1):106. doi: 10.1186/s12961-023-01057-8.
Population health management (PHM) initiatives are more frequently implemented as a means to tackle the growing pressure on healthcare systems in Western countries. These initiatives aim to transform healthcare systems into sustainable health and wellbeing systems. International studies have already identified guiding principles to aid this development. However, translating this knowledge to action remains a challenge. To help address this challenge, the study aims to identify program managers' experiences and their expectations as to the use of this knowledge to support the development process of PHM initiatives.
Semi-structured interviews were held with program managers of ten Dutch PHM initiatives. These Dutch PHM initiatives were all part of a reflexive evaluation study and were selected on the basis of their variety in focus and involved stakeholders. Program managers were asked about their experiences with, and expectations towards, knowledge use to support the development of their initiative. The interviews with the program managers were coded and clustered thematically.
Three lessons for knowledge use for the development of PHM initiatives were identified: (1) being able to use knowledge regarding the complexity of PHM development requires (external) expertise regarding PHM development and knowledge about the local situation regarding these themes; (2) the dissemination of knowledge about strategies for PHM development requires better guidance for action, by providing more practical examples of actions and consequences; (3) a collective learning process within the PHM initiative is needed to support knowledge being successfully used for action.
Disseminating and using knowledge to aid PHM initiatives is complex due to the complexity of the PHM development itself, and the different contextual factors affecting knowledge use in this development. The findings in this study suggest that for empirical knowledge to support PHM development, tailoring knowledge to only program managers' use might be insufficient to support the initiatives' development, as urgency for change amongst the other involved stakeholders is needed to translate knowledge to action. Therefore, including more partners of the initiatives in knowledge dissemination and mobilization processes is advised.
人口健康管理 (PHM) 计划越来越多地被实施，作为应对西方国家医疗保健系统压力增大的一种手段。这些计划旨在将医疗保健系统转变为可持续的健康和福利系统。国际研究已经确定了指导原则来帮助这一发展。然而，将这些知识转化为行动仍然是一个挑战。为了帮助解决这一挑战，本研究旨在确定计划经理的经验以及他们对使用这些知识来支持 PHM 计划发展的期望。
对十个荷兰 PHM 计划的计划经理进行了半结构化访谈。这些荷兰 PHM 计划都是一个反思性评估研究的一部分，根据其关注焦点和涉及的利益相关者的多样性选择。计划经理被问及他们在使用知识以支持其计划发展方面的经验和期望。对计划经理的访谈进行了编码，并按主题进行了聚类。
确定了三个用于 PHM 计划发展的知识应用经验教训：(1)能够使用有关 PHM 发展复杂性的知识需要（外部）有关 PHM 发展的专业知识以及有关这些主题的当地情况的知识；(2) 为了更好地指导行动，需要传播有关 PHM 发展策略的知识，提供更多实际行动和后果的例子；(3)需要在 PHM 计划内进行集体学习过程，以支持成功将知识用于行动。
由于 PHM 发展本身的复杂性以及影响知识在这种发展中使用的不同背景因素，传播和使用知识以帮助 PHM 计划是复杂的。本研究的结果表明，为了支持 PHM 发展的实证知识，仅针对计划经理的使用来调整知识可能不足以支持计划的发展，因为需要改变其他相关利益相关者的紧迫性，将知识转化为行动。因此，建议让更多的计划合作伙伴参与知识传播和动员过程。
