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精准公共卫生联盟作为社区参与的一种模式和方法。

Precision public health alliances as a model and method for community engagement.

作者信息

McGladrey Margaret L, Lacy Mary Elizabeth, McQuerry Kristen, Hogg-Graham Rachel, Slavova Svetla, Clear Emily R, Heier Kory, Phan Caitline, Hall Megan, Parker Ryan, Keeton Mindy, Sword Jennifer, Ard Thomas, Salem Charbel

机构信息

College of Public Health, University of Kentucky, Lexington, KY, United States.

King's Daughters Medical Center, University of Kentucky, Ashland, KY, United States.

出版信息

Front Public Health. 2025 Aug 21;13:1617776. doi: 10.3389/fpubh.2025.1617776. eCollection 2025.

Abstract

Using precision analytics approaches with population health data helps identify localized patterns of social determinants and comorbidities, supporting the design of tailored interventions. The University of Kentucky College of Public Health (UKCPH) and UK King's Daughters (UKKD) have partnered to create a Precision Public Health Alliance (PPHA) applying precision analytics to UKKD electronic health records (EHR) as well as secondary datasets to map social, demographic, and clinical comorbidity factors onto colorectal cancer (CRC) screening data in UKKD's rural service area (the northeastern Kentucky counties of Boyd, Carter, Greenup, and Lawrence and southeast Ohio county of Lawrence). In addition to UKKD and UKCPH clinicians and researchers, PPHA includes a community-based Action Team of local social services, behavioral health, and public health agencies and Cooperative Extension agents responsible for translating findings into quality improvement priorities. In Fall 2024, UKKD and UKCPH developed a statistical analysis plan to examine the interplay of social, geographic, and clinical factors associated with CRC screening rates, which is a UKKD quality improvement priority. Findings from this analysis of EHR and secondary county-level data and a summary of UKKD's existing quality improvement efforts related to CRC screening were presented to the Action Team in March 2025. The first meeting of the Action Team demonstrated initial proof-of-concept that PPHA approaches can catalyze community-based practice improvements. Immediately after the meeting with UKCPH support, the local health department and community mental health center pursued adoption of UKKD stool-based screening strategies and UKKD created a simple workflow for receiving referrals from community-based partners. This community case study contributes to community engagement with initial findings and best practices for PPHA of healthcare systems, local public health departments, and social services agencies to analyze population health trends in order to target quality improvement needs and co-design place-based, cross-sector strategies to address them with evidence-based practices. This replicable PPHA pilot in rural Kentucky and Ohio is an innovative method and model for how to engage communities most effectively in identifying and taking action to improve their chief health concerns.

摘要

运用精准分析方法处理人群健康数据,有助于识别社会决定因素和共病的局部模式,为量身定制的干预措施设计提供支持。肯塔基大学公共卫生学院(UKCPH)与肯塔基国王女儿医院(UKKD)合作创建了精准公共卫生联盟(PPHA),将精准分析应用于UKKD的电子健康记录(EHR)以及二级数据集,以便将社会、人口和临床共病因素映射到UKKD农村服务区(肯塔基州东北部的博伊德、卡特、格林普和劳伦斯县以及俄亥俄州东南部的劳伦斯县)的结直肠癌(CRC)筛查数据上。除了UKKD和UKCPH的临床医生和研究人员外,PPHA还包括一个由当地社会服务、行为健康和公共卫生机构以及合作推广人员组成的社区行动小组,负责将研究结果转化为质量改进重点。2024年秋季,UKKD和UKCPH制定了一项统计分析计划,以研究与CRC筛查率相关的社会、地理和临床因素之间的相互作用,这是UKKD的一项质量改进重点。2025年3月,将对EHR和县级二级数据进行分析的结果以及UKKD现有的与CRC筛查相关的质量改进工作总结提交给了行动小组。行动小组的第一次会议展示了初步的概念验证,即PPHA方法可以促进基于社区的实践改进。在UKCPH的支持下,会议结束后,当地卫生部门和社区心理健康中心立即采用了UKKD基于粪便的筛查策略,UKKD还创建了一个简单的工作流程,用于接收来自社区合作伙伴的转诊。这个社区案例研究有助于社区参与初步研究结果以及医疗系统、当地公共卫生部门和社会服务机构PPHA的最佳实践,以分析人群健康趋势,从而确定质量改进需求,并共同设计基于地点的跨部门策略,以基于循证实践来解决这些问题。肯塔基州农村地区和俄亥俄州这个可复制的PPHA试点项目,是一种创新方法和模式,用于说明如何最有效地让社区参与识别并采取行动改善其主要健康问题。

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