利用社区研究合作方法解决健康不平等问题的成功与挑战:焦点小组证据的混合方法分析。

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
L J M Thomson, H Waterson, H J Chatterjee
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引用次数: 0

摘要

背景:合作方法的概念是让社区居民参与共同决策过程,以维持或改善他们的物质和社会条件。在 COVID-19 期间,公共服务部门看到了与社区积极合作并让居民参与决策过程的益处。由于社区拥有资源和资产,他们完全有能力为制定当地的健康和福利倡议做出贡献。一项由国家资助、分三个阶段进行的跨学科研究计划 "调动社区资产解决健康不平等问题 "已经建立,其目标是利用地方、文化和自然资产支持健康和幸福。目前的研究旨在综合获得该计划第一阶段资助的研究团队收集的证据,这些团队由学术和非学术、医疗和社会护理、志愿和社区合作伙伴组成:方法:与来自英国各地的研究团队进行了十次在线焦点小组讨论,探讨了利用基于社区的研究合作方法解决健康不平等问题的成功经验和挑战。焦点小组的八个问题分别涉及合作与健康不平等问题:结果:主题和内容分析产生了 185 个子主题,从中确定了 12 个主题。研究证据、资金、与合作伙伴的关系、健康不平等和贫困、社区参与、医疗服务和综合护理系统等主题的编码数量高于平均水平。次要主题是联系工作者和社会处方;培训和支持;基于地方的因素;计划的长期性;建立和扩大计划;以及心理健康:成功之处包括:采用了基于实践和艺术的方法、让那些通常不参与研究的人参与到研究项目中来、以民主的方式分享资金、在已建立的关系基础上发展,以及地方资产在社区参与中发挥的重要作用。面临的挑战包括:缺乏可持续的资金支持、资金的短期性、在帮助最贫困人口方面的不一致性、获得正确的研究证据、取得足够的研究进展、与已经不堪重负的医疗保健人员建立关系,以及重新调整权力平衡,使之有利于社区。尽管存在这些挑战,但与会者主要持乐观态度,认为集体方法和有意义的共同生产将为未来与社区建立研究伙伴关系创造机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successes and challenges of partnership working to tackle health inequalities using collaborative approaches to community-based research: mixed methods analysis of focus group evidence.

Background: The concept of collaborative approaches involves community residents in joint decision-making processes to maintain or enhance their material and social conditions. During COVID-19, public services saw the benefits of actively collaborating with communities and involving residents in decision-making processes. As communities have resources and assets, they are well-placed to contribute to developing local health and wellbeing initiatives. An interdisciplinary and nationally funded three-phase research programme, "Mobilising community assets to tackle health inequalities", was established with the objective of utilising local, cultural, and natural assets to support health and wellbeing. The current study aimed to synthesise evidence collected by research teams awarded funding in phase one of the programme, comprising academic and non-academic, health and social care, voluntary and community partners.

Methods: Ten online focus groups were conducted with research teams from across the UK exploring the successes and challenges of partnership working to tackle health inequalities using collaborative approaches to community-based research. Eight focus group questions were split between partnership working and health inequalities.

Results: Thematic and content analysis produced 185 subthemes from which 12 themes were identified. Major themes representing an above average number of coded responses were research evidence; funding; relationships with partners; health inequalities and deprivation; community involvement; and health service and integrated care systems. Minor themes were link workers and social prescribing; training and support; place-based factors; longevity of programmes; setting up and scaling up programmes; and mental health.

Conclusions: Successes included employing practice-based and arts-based methods, being part of a research project for those not normally involved in research, sharing funding democratically, building on established relationships, and the vital role that local assets play in involving communities. Challenges involved a lack of sustainable financial support, the short-term nature of funding, inconsistencies in reaching the poorest people, obtaining the right sort of research evidence, making sufficient research progress, building relationships with already over-burdened health care staff, and redressing the balance of power in favour of communities. Despite the challenges, participants were mainly optimistic that collective approaches and meaningful co-production would create opportunities for future research partnerships with communities.

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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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