Population Health Innovation Lab, Public Health Institute, Oakland, California, USA.
Health Serv Res. 2024 Feb;59 Suppl 1(Suppl 1):e14258. doi: 10.1111/1475-6773.14258. Epub 2023 Nov 14.
To explore how Accountable Communities of/for Health (ACHs), a type of health-focused multisector collaborative, are developing strategies to address health equity with diverse partners.
Interview and focus group participants were recruited from a purposive sample of 22 ACH participant organizations in Washington (n = 9 ACHs) and California (n = 13 ACH).
Interview and focus group data were thematized using constant comparison analysis.
Interviews were conducted to learn how each ACH's system context, collaboration processes, and goals influence its progress toward health equity. Focus groups were conducted to gain a deeper understanding of how local context and power dynamics influence an ACH's ability to make progress toward health equity. There were 22 focus group participants and 65 interview participants.
Results indicate that ACHs advance health equity across the social-ecological spectrum of health with approaches targeting the individual, community, and societal levels. Specific approaches used by ACHs to collaboratively address health equity include providing equity education to participating organizations and community groups; including diverse community voices in collaborative decision-making; changing practices in their participant's daily operations; improving existing services and developing new services; and actively promoting a culture of keeping equity at the center of ACH efforts.
This study identifies strategies for advancing health equity in multisector collaboratives. ACHs in Washington and California are devoting resources to ensure health equity is central to their work. The numerous approaches ACHs use to advance health equity are important to ensure everyone can reach their full health potential. While current literature argues that multisector health initiatives are integral for advancing health equity, there is a lack of research on how these initiatives advance equity in practice. Thus, this paper provides generalizable strategies that can be further investigated to optimize progress toward health equity.
探讨以健康为重点的多部门合作组织——负责任的社区（ACH）如何与多元化合作伙伴一起制定解决公平问题的策略。
从华盛顿（n=9 个 ACH）和加利福尼亚（n=13 个 ACH）的 22 个 ACH 参与组织中，通过目的性抽样选取了访谈和焦点小组参与者。
使用恒定比较分析对访谈和焦点小组数据进行主题分析。
访谈旨在了解每个 ACH 的系统背景、合作过程和目标如何影响其在公平方面的进展。焦点小组旨在深入了解地方背景和权力动态如何影响 ACH 在公平方面取得进展的能力。共有 22 名焦点小组成员和 65 名访谈参与者。
结果表明，ACH 通过针对个人、社区和社会层面的方法，在整个社会生态健康谱上推进公平。ACH 用于共同解决公平问题的具体方法包括向参与组织和社区团体提供公平教育；让不同的社区声音参与合作决策；改变其参与组织的日常运营实践；改进现有服务和开发新服务；积极促进将公平置于 ACH 工作中心的文化。
本研究确定了在多部门合作中推进公平的策略。华盛顿和加利福尼亚的 ACH 正在投入资源，确保公平成为其工作的核心。ACH 用于推进公平的众多方法对于确保每个人都能充分发挥其健康潜力至关重要。尽管当前的文献认为多部门健康倡议是推进公平的重要组成部分，但缺乏关于这些倡议如何在实践中推进公平的研究。因此，本文提供了可进一步研究的可推广策略，以优化公平方面的进展。
