Hafez Sali, Ismail Sharif A, Zibwowa Zandile, Alhamshary Nadin, Elsayed Reem, Dhaliwal Mandeep, Samuels Fiona, Fakoya Ade
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
The Nuffield Centre for International Health and Development, School of Medicine, The University of Leeds, Leeds, United Kingdom.
PLOS Glob Public Health. 2024 May 6;4(5):e0002758. doi: 10.1371/journal.pgph.0002758. eCollection 2024.
Community action is broadly recognised as central to comprehensive and effective system responses to pandemics. However, there is uncertainty about how and where communities can be best supported to bolster long-term resilience and preparedness. We applied a typology of community interventions (Community Informing, Consulting, Involving, Collaborating or Empowering-or CICICE) to cover the diverse range of interventions identified across the literature and used this to structure a scoping review addressing three linked topics: (i) how CICICE interventions have been understood and applied in the literature on epidemic and pandemic preparedness; (ii) the spectrum of interventions that have been implemented to strengthen CICICE and (iii) what evidence is available on their effectiveness in influencing preparedness for current and future emergencies. We drew on peer-reviewed and grey literature from the HIV (from 2000) and COVID-19 pandemics and recent public health emergencies of international concern (from 2008), identified through systematic searches in MEDLINE, Scopus, the Cochrane Collaboration database, supplemented by keyword-structured searches in GoogleScholar and websites of relevant global health organisations. Following screening and extraction, key themes were identified using a combined inductive/deductive approach. 130 papers met the criteria for inclusion. Interventions for preparedness were identified across the spectrum of CICICE. Most work on COVID-19 focused on informing and consulting rather than capacity building and empowerment. The literature on HIV was more likely to report interventions emphasising human rights perspectives and empowerment. There was little robust evidence on the role of CICICE interventions in building preparedness. Evidence of effect was most robust for multi-component interventions for HIV prevention and control. Much of the reporting focused on intermediate outcomes, including measures of health service utilisation. We put forward a series of recommendations to help address evidence shortfalls, including clarifying definitions, organising and stratifying interventions by several parameters and strengthening evaluation methods for CICICE.
社区行动被广泛认为是对大流行病做出全面有效系统应对的核心。然而,对于如何以及在何处能够最好地支持社区以增强长期恢复力和备灾能力,仍存在不确定性。我们应用了一种社区干预类型学(社区告知、咨询、参与、协作或赋权,即CICICE)来涵盖文献中确定的各种干预措施,并以此构建了一项范围综述,涉及三个相关主题:(i)CICICE干预措施在流行病和大流行防范文献中是如何被理解和应用的;(ii)为加强CICICE而实施的干预措施范围;(iii)关于它们在影响当前和未来突发事件备灾方面有效性的现有证据。我们借鉴了来自艾滋病毒(从2000年起)和新冠疫情以及近期国际关注的突发公共卫生事件(从2008年起)的同行评审文献和灰色文献,这些文献通过在MEDLINE、Scopus、考克兰协作数据库中的系统检索确定,并辅以在谷歌学术和相关全球卫生组织网站上的关键词结构化检索。经过筛选和提取,使用归纳/演绎相结合的方法确定了关键主题。130篇论文符合纳入标准。在CICICE的整个范围内都确定了备灾干预措施。关于新冠疫情的大多数工作集中在告知和咨询上,而不是能力建设和赋权。艾滋病毒方面的文献更有可能报告强调人权视角和赋权的干预措施。关于CICICE干预措施在建立备灾能力方面的作用,几乎没有有力的证据。对于艾滋病毒预防和控制的多成分干预措施,效果证据最为有力。大部分报告集中在中间结果上,包括卫生服务利用指标。我们提出了一系列建议,以帮助解决证据不足的问题,包括明确定义、按几个参数对干预措施进行组织和分层,以及加强对CICICE的评估方法。