Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health
Multilevel Interventions To Address Health Disparities Show Promise In Improving Population Health
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DOI：
10.1377/hlthaff.2015.1360
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发表时间：
2016-08-01
期刊：
影响因子：
9.7
通讯作者：
Richardson, DeJuran
中科院分区：
文献类型：
--
作者：
Paskett, Electra;Thompson, Beti;Richardson, DeJuran
多层次干预是指至少影响两个层次的影响--例如，患者和卫生保健提供者。它们可以是实验设计，也可以是由政策变化引起的自然实验，例如《平价医疗法案》或地方政策的实施。衡量多层次干预措施的效果具有挑战性，因为它们允许各级之间的互动，而且必须评估每项干预措施的影响并将其转化为实践。我们讨论了美国国立卫生研究院人口健康和健康差距中心的两个项目如何使用多层次的干预措施来减少健康差距。这些干预措施侧重于人类乳头瘤病毒疫苗的接种和社区层面的饮食改变，结果喜忧参半。社区的投入促进了多层次干预措施的设计和实施，需要更先进的方法和措施来评估这些干预措施的各个级别和组成部分的影响。
Multilevel interventions are those that affect at least two levels of influence-for example, the patient and the health care provider. They can be experimental designs or natural experiments caused by changes in policy, such as the implementation of the Affordable Care Act or local policies. Measuring the effects of multilevel interventions is challenging, because they allow for interaction among levels, and the impact of each intervention must be assessed and translated into practice. We discuss how two projects from the National Institutes of Health's Centers for Population Health and Health Disparities used multilevel interventions to reduce health disparities. The interventions, which focused on the uptake of the human papillomavirus vaccine and community-level dietary change, had mixed results. The design and implementation of multilevel interventions are facilitated by input from the community, and more advanced methods and measures are needed to evaluate the impact of the various levels and components of such interventions.