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制定澳大利亚北领地顶端地区孕产妇健康研究议程:一种参与式方法。

Developing a research agenda for maternal health in the Top End of the Northern Territory of Australia: a participatory approach.

作者信息

Bowden Emily R, Brown Kiarna, Smiler-Cairns Marissa, Murray Jessica, Kennedy Meaghan, McCallum Gabrielle B, Unger Holger W

机构信息

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, NT, 0811, Australia.

Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, Australia.

出版信息

BMC Health Serv Res. 2025 Jul 29;25(1):987. doi: 10.1186/s12913-025-13127-4.

Abstract

BACKGROUND

Evidence supports that engaging consumers in developing and co-designing research priorities and protocols with key stakeholders improves acceptability of and participation in research and leads to better health outcomes. This is particularly relevant when considering research with First Nations, migrant and refugee populations, adolescents, women living with disability and those in the LGBTQIA + community who face systemic disadvantage, shouldering a disproportionate burden of poor outcomes. This study aimed to identify priorities for maternal health research in the Top End of the NT from the perspective of consumers and key stakeholders.

METHODS

Using a participatory approach, focus groups and in-depth discussions with consumers, maternal health care providers and stakeholders were conducted over a three-month period (Part A), followed by a 1-day stakeholder forum in Darwin (Part B). Data was triangulated and a list of research priorities developed.

RESULTS

Five priorities emerged. First, there is a need to develop and test strategies removing barriers for engagement of consumers and clinicians in maternal health research. Second, research into specific clinical concerns raised by consumers, such as prevention of preterm birth, must be complemented by health systems research enabling better patient journeys. Third, there is a need to develop and test innovative tools to enable comprehensive counselling of women from diverse backgrounds regarding aspects of care, based on most recent evidence-based and consumer needs. Further, there is a demand for research into innovative approaches to recruitment and retention of maternity care providers in a sparsely populated region of Australia, with a focus on provider well-being and continuity of integrated care. Finally, a need for research collaboration across similar settings and relevant disciplines to enable enhanced maternal health was identified.

CONCLUSIONS

Emerging research priorities, implementing evidence-based practices, and regularly updating these priorities through ongoing stakeholder engagement, can work towards a future where maternal health services are accessible and responsive to the diverse needs of women and families residing in the Top End of the NT. Whilst consumers and stakeholders raised specific clinical priorities, health system research was identified as a key priority, focussing on patient journeys, co-design, and continuity of care through staff retention.

摘要

背景

有证据表明,让消费者参与制定研究重点和与关键利益相关者共同设计研究方案,可提高研究的可接受性和参与度,并带来更好的健康结果。在考虑对原住民、移民和难民群体、青少年、残疾妇女以及 LGBTQIA + 社区中面临系统性劣势、承受不良后果负担过重的人群进行研究时,这一点尤为重要。本研究旨在从消费者和关键利益相关者的角度确定北领地顶端地区孕产妇健康研究的重点。

方法

采用参与式方法,在三个月内与消费者、孕产妇保健提供者和利益相关者进行了焦点小组讨论和深入讨论(A 部分),随后在达尔文举行为期一天的利益相关者论坛(B 部分)。对数据进行了三角验证,并制定了研究重点清单。

结果

出现了五个重点。第一,需要制定和测试消除消费者和临床医生参与孕产妇健康研究障碍的策略。第二,对消费者提出的特定临床问题(如预防早产)的研究,必须辅以卫生系统研究,以实现更好的患者就医过程。第三,需要开发和测试创新工具,以便根据最新的循证和消费者需求,为不同背景的女性提供关于护理方面的全面咨询。此外,需要对澳大利亚人口稀少地区招聘和留住孕产妇护理提供者的创新方法进行研究,重点关注提供者的福祉和综合护理的连续性。最后,确定需要跨类似环境和相关学科进行研究合作,以改善孕产妇健康。

结论

新出现的研究重点、实施循证实践以及通过持续的利益相关者参与定期更新这些重点,有助于实现这样一个未来:孕产妇保健服务能够满足北领地顶端地区妇女和家庭的多样化需求并做出响应。虽然消费者和利益相关者提出了具体的临床重点,但卫生系统研究被确定为关键重点,侧重于患者就医过程、共同设计以及通过留住员工实现护理的连续性。

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