Windle Alice, Javanparast Sara, Freeman Toby, Baum Fran
College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia.
School of Social Sciences, Faculty of Arts, Business, Law and Economics, Stretton Health Equity, The University of Adelaide, Adelaide, South Australia.
Health Res Policy Syst. 2025 Mar 11;23(1):31. doi: 10.1186/s12961-025-01308-w.
Use of evidence to inform health policy and planning decisions is important to ensure effective, efficient and equitable interventions, yet there has been little examination of decentralized, regional health bodies. This study aimed to examine the extent, purposes and sources of evidence used by Australian Primary Health Networks (PHNs) to inform regional primary health care planning, and explore conceptions of, and attitudes towards evidence.
We conducted document analysis of all 31 PHNs' Needs Assessments, Activity Work Plans and Annual Reports, and conducted 29 interviews with key stakeholders from a sample of five PHNs.
We found that PHNs used evidence to identify health needs to a far greater extent than to inform the planning and development of primary health care interventions. The evidence used largely consisted of quantitative data from government sources. There was very little use of evidence from research or evaluation documents. Evidence from community and other stakeholder consultation was useful for complementing quantitative data with localized knowledge but was of questionable rigour. Conceptions of evidence were generally broad. Interviewees tended to favour quantitative evidence, and the evidence that aligned with their professional background.
We recommend PHNs improve the use of intervention evidence and stakeholder engagement to inform effective, efficient and equitable local PHC initiatives. Developing more robust, transparent and standardized internal processes for evidence-informed program planning and evaluation, as well as maintaining and strengthening community and stakeholder participation in the planning process, will improve the robustness and effectiveness of planning.
利用证据为卫生政策和规划决策提供信息对于确保有效、高效和公平的干预措施至关重要，但对于分散的区域卫生机构的研究却很少。本研究旨在探讨澳大利亚初级卫生保健网络（PHN）用于为区域初级卫生保健规划提供信息的证据的范围、目的和来源，并探讨对证据的概念和态度。
我们对所有31个PHN的需求评估、活动工作计划和年度报告进行了文件分析，并对来自5个PHN样本的关键利益相关者进行了29次访谈。
我们发现，PHN在很大程度上利用证据来确定卫生需求，而不是为初级卫生保健干预措施的规划和发展提供信息。所使用的证据主要包括来自政府来源的定量数据。很少使用来自研究或评估文件的证据。来自社区和其他利益相关者咨询的证据有助于用本地化知识补充定量数据，但严谨性存疑。对证据的概念一般较为宽泛。受访者倾向于支持定量证据，以及与其专业背景相符的证据。
我们建议PHN改进干预证据的使用和利益相关者的参与，以为有效、高效和公平的地方初级卫生保健举措提供信息。为基于证据的项目规划和评估制定更强大、透明和标准化的内部流程，以及维持和加强社区及利益相关者对规划过程的参与，将提高规划的稳健性和有效性。
