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PRECEDE-PROCEED 模型审计对伦巴第大区癌症筛查项目的影响：支持公平和质量改进。

Impact of PRECEDE-PROCEED Model Audits in Cancer Screening Programs in Lombardy Region: Supporting Equity and Quality Improvement.

机构信息

General Directorate of Welfare of the Lombardy Region, 20124 Milan, Italy.

School of Public Health, University Vita-Salute San Raffaele, 20132 Milan, Italy.

出版信息

Curr Oncol. 2024 Oct 3;31(10):5960-5973. doi: 10.3390/curroncol31100445.

DOI:10.3390/curroncol31100445
PMID:39451749
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11506358/
Abstract

BACKGROUND

Health disparities related to socio-economic factors impact access to preventive health interventions. The PRECEDE-PROCEED model, a multidimensional approach to health promotion, has been adapted to optimise cancer screening programs in Lombardy, Italy, addressing these disparities.

METHODS

This study evaluated the application of systemic audits based on the PRECEDE-PROCEED model across Lombardy cancer screening programs. A systematic region-wide audit was performed in 2019, and follow-up audits were performed in 2022-2023. Data were collected using structured analysis methodologies, including epidemiological, behavioural, and organisational assessments.

RESULTS

The 2019 audit showed strengths in participation and quality standards but identified challenges in cervical cancer screening coverage and waiting times for assessments. Improvements plans included the digitisation of processes and stakeholder engagement. The 2022-2023 audits reported increased coverage for breast and colorectal screenings, but a slight decline in participation rates and examination coverage. Organisational improvements were noted, yet gaps in training and equity-targeted actions remained.

CONCLUSION

The PRECEDE-PROCEED model audits led to notable improvements in the quality and equity of cancer screening programs in Lombardy. Sustained focus on digital integration, continuous re-training, and targeted equity interventions is essential for further progress.

摘要

背景

与社会经济因素相关的健康差异会影响人们获得预防保健干预的机会。PRECEDE-PROCEED 模型是一种多维的健康促进方法，已被意大利伦巴第地区采用，以优化癌症筛查计划，从而解决这些差异。

方法

本研究评估了基于 PRECEDE-PROCEED 模型的系统审计在伦巴第癌症筛查计划中的应用。2019 年进行了系统的全区域审计，并在 2022-2023 年进行了后续审计。数据收集采用了结构化分析方法，包括流行病学、行为和组织评估。

结果

2019 年的审计显示，在参与和质量标准方面具有优势，但在宫颈癌筛查覆盖率和评估等待时间方面存在挑战。改进计划包括流程数字化和利益相关者参与。2022-2023 年的审计报告显示，乳腺癌和结直肠癌筛查的覆盖率有所增加，但参与率和检查覆盖率略有下降。注意到了组织方面的改进，但在培训和针对公平性的行动方面仍存在差距。

结论

PRECEDE-PROCEED 模型审计导致了伦巴第癌症筛查计划在质量和公平性方面的显著改善。持续关注数字化整合、持续再培训和有针对性的公平性干预措施对于进一步的进展至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/2d7f56a9cd9f/curroncol-31-00445-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/72927c6ba154/curroncol-31-00445-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/97ce6acb7b2e/curroncol-31-00445-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/d1ee83b553c3/curroncol-31-00445-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/2d7f56a9cd9f/curroncol-31-00445-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/72927c6ba154/curroncol-31-00445-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/97ce6acb7b2e/curroncol-31-00445-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/d1ee83b553c3/curroncol-31-00445-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d90/11506358/2d7f56a9cd9f/curroncol-31-00445-g004.jpg

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