预防为主的综合电子健康方法在社会经济地位较低个体中的应用：一项实际评价研究方案。

A preventive integrated eHealth approach for individuals with a low socioeconomic position: protocol for a realist evaluation.

机构信息

Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA, the Netherlands.

出版信息

BMC Public Health. 2024 Oct 3;24(1):2700. doi: 10.1186/s12889-024-20113-8.

DOI:10.1186/s12889-024-20113-8

PMID:39363257

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11451197/

Abstract

BACKGROUND

Adoption of standalone eHealth tools is low among persons in lower socioeconomic groups. The preventive integrated eHealth approach combines blended care with an active and personal approach to facilitate access to local care, tailored to the needs of the participant. We describe the four step preventive integrated eHealth approach for individuals with a low socioeconomic position and the realist evaluation protocol of the intervention and implementation. The realist evaluation centers around the question, 'what works for whom in what circumstances and why'.

METHODS

The study population will consist of adult individuals with a low socioeconomic position, who participate in the preventive integrated eHealth approach in one of the participating locations in the Netherlands. The four-step intervention consists of: (1) a proactive invitation of participants by care professionals, (2) the use of an eHealth tool that produces a personalized health report, (3) a personal consultation with a care professional to discuss the personalized health report and set a goal to work on, and (4) active referral to local social and health care. An initial program theory theorized from literature and stakeholder involvement is presented. Qualitative and quantitative data collection and analysis with participants (survey at zero, three and twelve months and focus groups at six months) and professionals (interviews at three months) will inform the realist evaluation and serves to test and refine the initial program theory.

DISCUSSION

Our mixed-methods realist evaluation on the effect and implementation of a personal and active blended care approach will elucidate what elements trigger the mechanisms and responses of how individuals with a low socioeconomic position experience the preventive integrated eHealth approach. This will inform the way a preventative health check incorporating eHealth can be used to its full potential for low socioeconomic positioned groups to help close the digital divide and contribute to reduce health disparities.

摘要

背景

社会经济地位较低的人群采用独立的电子健康工具的比例较低。预防综合电子健康方法将混合护理与积极的个性化方法相结合，以促进获得当地护理，根据参与者的需求进行定制。我们描述了针对社会经济地位较低的个体的四步预防综合电子健康方法，以及干预措施和实施的现实主义评估方案。现实主义评估围绕着“在什么情况下对谁有效以及为什么有效”的问题展开。

方法

研究人群将包括社会经济地位较低的成年个体，他们将参与荷兰参与地点之一的预防综合电子健康方法。四步干预措施包括：（1）护理专业人员主动邀请参与者，（2）使用电子健康工具生成个性化健康报告，（3）与护理专业人员进行个人咨询，讨论个性化健康报告并设定要解决的目标，（4）积极转介至当地社会和卫生保健机构。提出了一个从文献和利益相关者参与中推断出的初始方案理论。对参与者（零、三、十二个月的调查和六个月的焦点小组）和专业人员（三个月的访谈）进行定性和定量数据收集和分析，将为现实主义评估提供信息，并有助于测试和完善初始方案理论。