School of Health, Te Herenga Waka - Victoria University of Wellington, Kelburn 6012, Wellington, New Zealand.
Weaving Insights, PO Box 147, Levin 5540, Horowhenua, New Zealand.
Health Place. 2024 May;87:103255. doi: 10.1016/j.healthplace.2024.103255. Epub 2024 May 5.
This article describes findings from the evaluation of Healthy Families NZ (HFNZ), an equity-driven, place-based community health initiative. Implemented in nine diverse communities across New Zealand, HFNZ aims to strengthen the systems that can improve health and well-being. Findings highlight local needs and priorities including the social mechanisms important for reorienting health and policy systems towards place-based communities. Lessons encompass the importance of local lived experience in putting evidence into practice; the strength of acting with systems in mind; the need for relational, learning, intentional, and well-resourced community organisation; examples of how to foster place-based 'community-up' leadership; and how to enable responsiveness between communities and local and national policy systems. A reconceptualisation of scaling in the context of complexity and systems change is offered, which recognises that relationships and agency are key to making progress on the determinants of health.
本文介绍了对新西兰健康家庭（HFNZ）的评估结果，这是一项以公平为导向、基于地点的社区健康倡议。HFNZ 在新西兰的九个不同社区实施，旨在加强可以改善健康和福祉的系统。调查结果突出了当地的需求和优先事项，包括对重新定位基于地点的社区的健康和政策系统至关重要的社会机制。经验教训包括将证据付诸实践的重要性；考虑到系统的行动的力量；对关系、学习、有意和资源充足的社区组织的需求；如何培养基于地点的“社区主导”领导力的例子；以及如何使社区与地方和国家政策系统之间保持响应能力。本文提供了在复杂性和系统变革背景下对扩展的重新概念化，这认识到关系和机构是在健康决定因素方面取得进展的关键。
