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定性评估:职业卫生与安全研究所与服务不足社区的合作,以提高医疗服务的可及性和利用率。

Qualitative Assessment CIH Institutions' Engagement With Underserved Communities to Enhance Healthcare Access and Utilization.

作者信息

Malika Nipher, Herman Patricia M, Whitley Margaret, Coulter Ian, Maiers Michele, Chesney Margaret, Rogers Rhianna

机构信息

RAND Corporation, Santa Monica, CA, USA.

Northwestern Health Sciences University, Bloomington, MN, USA.

出版信息

Glob Adv Integr Med Health. 2024 Mar 26;13:27536130241244759. doi: 10.1177/27536130241244759. eCollection 2024 Jan-Dec.

Abstract

BACKGROUND

In North America, there is a notable underutilization of complementary and integrative health approaches (CIH) among non-White and marginalized communities.

OBJECTIVES

This study sought to understand how CIH educational instutitions are proactively working to redress this disparity in access and utilization among these communities.

METHODS

We conducted interviews with 26 key informants, including presidents, clinicians, and research deans across 13 CIH educational institutions across the US and Canada. Thematic analysis included deductive codes based on the interview guide during interview scripts review.

RESULTS

Six themes were identified: (1) CIH institutions often had a long and varied history of community engaged care through partnerships to increase access and utilization; (2) CIH institutions' long-standing community outreach had been intentionally designed; (3) CIH institutions provided an array of services to a wide range of demographics and communities; (4) addressing healthcare access and utilization through community partnerships had a strong positive impact; (5) funding, staffing and COVID-19 were significant challenges that impeded efforts to increase CIH access through community engaged work; (6) identified gaps in community partnerships and services to increase access and utilization were recognized.

CONCLUSION

These findings underscore significant efforts made to enhance healthcare access and utilization among marginalized, underserved, and racial and ethnic communities. However, barriers such as funding constraints, resource allocation, and the need for proper measurement and accountability hinder proactive initiatives aimed at redressing disparities in CIH utilization within these communities.

摘要

背景

在北美,非白人和边缘化社区对补充与整合健康方法(CIH)的利用明显不足。

目的

本研究旨在了解CIH教育机构如何积极努力纠正这些社区在获取和利用方面的差异。

方法

我们对26名关键信息提供者进行了访谈,包括美国和加拿大13所CIH教育机构的校长、临床医生和研究主任。主题分析包括在访谈脚本审查期间基于访谈指南的演绎编码。

结果

确定了六个主题:(1)CIH机构通常通过伙伴关系在社区参与护理方面有着悠久而多样的历史,以增加获取和利用;(2)CIH机构长期的社区外展活动是经过精心设计的;(3)CIH机构为广泛的人口群体和社区提供了一系列服务;(4)通过社区伙伴关系解决医疗保健获取和利用问题产生了强烈的积极影响;(5)资金、人员配备和新冠疫情是阻碍通过社区参与工作增加CIH获取的重大挑战;(6)认识到在社区伙伴关系和服务方面存在差距,以增加获取和利用。

结论

这些发现强调了为提高边缘化、服务不足以及种族和族裔社区的医疗保健获取和利用所做出的重大努力。然而,资金限制、资源分配以及适当衡量和问责的需求等障碍阻碍了旨在纠正这些社区在CIH利用方面差异的积极举措。

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