Management Practices to Build Evidence-Based Decision-Making Capacity for Chronic Disease Prevention in Georgia: A Case Study.
Management Practices to Build Evidence-Based Decision-Making Capacity for Chronic Disease Prevention in Georgia: A Case Study.
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DOI：
10.5888/pcd15.170482
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发表时间：
2018-07-12
影响因子：
5.5
通讯作者：
Brownson RC
中科院分区：
文献类型：
--
作者：
Allen P;O'Connor JC;Best LA;Lakshman M;Jacob RR;Brownson RC
研究表明，培训可以提高循证决策所需的技能，但对建立组织支持以建立循证慢性病预防能力知之甚少。本案例研究的目的是评估促进者和挑战，应用管理实践，以支持循证决策的慢性病预防计划在格鲁吉亚的公共卫生系统通过关键的线人访谈和定量测试的变化，通过前后调查的管理实践和技能。慢性病预防科的领导人主持了一次为期多日的培训，提供了定期补充培训，重组了该科和工作人员会议，领导和监督了与合作伙伴的技术援助，建立了透明的基于绩效的合同，并进行了其他改革。一项65项在线调查测量了技能的重要性以及熟练员工的可用性，组织支持以及基线（2014年）和2016年（培训后）的研究证据的使用。结构化访谈指南询问了管理实践、背景、内部和外部促进者和障碍以及建议。74名工作人员和合作伙伴完成了这两项调查（70.5%的答复）。11名参与者还完成了一个小时的电话采访。访谈参与者认为，领导层的支持和多种并行管理做法的实施是提高能力的关键促进因素。主要挑战包括相互竞争的优先事项、缺乏政治意愿以及收到的请求与循证办法背道而驰。在后测中，卫生部门工作人员显著减少了整体技能（10项之和）和10项个人技能中的4项的差距，并增加了研究证据的使用，以证明干预措施的合理性。合作伙伴更多地利用研究证据进行评价，而不是技能。有权力的领导人承诺建立多种管理做法，帮助工作人员学习和应用循证决策过程，这是增加使用循证慢性病预防来改善人口健康的关键。
Research shows that training can improve skills needed for evidence-based decision making, but less is known about instituting organizational supports to build capacity for evidence-based chronic disease prevention. The objectives of this case study were to assess facilitators and challenges of applying management practices to support evidence-based decision making in chronic disease prevention programs in the public health system in Georgia through key informant interviews and quantitatively test for changes in perceived management practices and skills through a pre–post survey. Leadership of the chronic disease prevention section hosted a multiday training, provided regular supplemental training, restructured the section and staff meetings, led and oversaw technical assistance with partners, instituted transparent performance-based contracting, and made other changes. A 65-item online survey measured perceived importance of skills and the availability of skilled staff, organizational supports, and use of research evidence at baseline (2014) and in 2016 (after training). A structured interview guide asked about management practices, context, internal and external facilitators and barriers, and recommendations. Seventy-four staff members and partners completed both surveys (70.5% response). Eleven participants also completed a 1-hour telephone interview. Interview participants deemed leadership support and implementation of multiple concurrent management practices key facilitators to increase capacity. Main challenges included competing priorities, lack of political will, and receipt of requests counter to evidence-based approaches. At posttest, health department staff had significantly reduced gaps in skills overall (10-item sum) and in 4 of 10 individual skills, and increased use of research evidence to justify interventions. Use of research evidence for evaluation, but not skills, increased among partners. The commitment of leaders with authority to establish multiple management practices to help staff members learn and apply evidence-based decision-making processes is key to increased use of evidence-based chronic disease prevention to improve population health.
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影响因子：
5.5
作者：
Winterbauer, Nancy L.;Bridger, Colleen M.;Luo, Huabin
通讯作者：
Luo, Huabin
影响因子：
2.1
作者：
Zardo, Pauline;Collie, Alex;Livingstone, Charles
通讯作者：
Livingstone, Charles
DOI：
10.1186/1748-5908-8-141
发表时间：
2013-12-13
期刊：
Implementation science : IS
影响因子：
--
作者：
Allen P;Sequeira S;Jacob RR;Hino AA;Stamatakis KA;Harris JK;Elliott L;Kerner JF;Jones E;Dobbins M;Baker EA;Brownson RC
通讯作者：
Brownson RC
影响因子：
12.7
作者：
Alongi, Jeanne
通讯作者：
Alongi, Jeanne
影响因子：
3.8
作者：
Roche, Ann M.;Pidd, Ken;Freeman, Toby
通讯作者：
Freeman, Toby