Applying an equity lens to assess context and implementation in public health and health services research and practice using the PRISM framework.
Applying an equity lens to assess context and implementation in public health and health services research and practice using the PRISM framework.
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DOI：
10.3389/frhs.2023.1139788
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Glasgow, Russell E
中科院分区：
文献类型：
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作者：
Fort, Meredith P;Manson, Spero M;Glasgow, Russell E
传播和实施科学旨在加强吸收，成功实施和维持基于证据的计划和政策。虽然在许多旨在增加循证方案和政策的可及性和覆盖面的努力中隐含着对卫生公平的关注，但大多数实施框架和模式并没有明确解决这一问题，事实上，通过强调高强度干预或易于交付而不是满足人口内部的需求，解决根深蒂固的结构性不平等，以及适应当地情况和优先事项，可能会增加差距。PRISM（实用，稳健的实施和可持续性模型），RE-AIM（范围，有效性，采用，实施，维护）框架的背景扩展有几个要素，解决健康公平问题，但这些都没有在一个地方得到解释，整合或说明。我们目前的指导应用PRISM与公平透镜在其四个上下文域（外部环境;多层次的干预观点;实施者和目标受众的特点;和实施和可持续性基础设施，以及五个RE-AIM结果维度。然后，我们提出了一个例子与健康公平的考虑和讨论的代表性和参与，代表性和持续的，迭代的动态背景和结构性的不公平的驱动因素的评估的重要性的问题。我们还阐述了一个持续进程的重要性，这一进程需要处理社区优先事项，并应对能力和基础设施的需求和变化。最后，我们的研究和实践的建议，应用PRISM更加重视公平。
Dissemination and implementation science seeks to enhance the uptake, successful implementation, and sustainment of evidence-based programs and policies. While a focus on health equity is implicit in many efforts to increase access to and coverage of evidence-based programs and policies, most implementation frameworks and models do not explicitly address it. Disparities may in fact be increased by emphasizing high intensity interventions or ease of delivery over meeting need within the population, addressing deep-rooted structural inequities, and adapting to local context and priorities. PRISM (Practical, Robust Implementation and Sustainability Model), the contextual expansion of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework has several elements that address health equity, but these have not been explicated, integrated, or illustrated in one place. We present guidance for applying PRISM with an equity lens across its four context domains (external environment; multi-level perspectives on the intervention; characteristics of implementers and intended audience; and the implementation and sustainability infrastructure—as well as the five RE-AIM outcome dimensions. We then present an example with health equity considerations and discuss issues of representation and participation, representativeness and the importance of ongoing, iterative assessment of dynamic context and structural drivers of inequity. We also elaborate on the importance of a continuous process that requires addressing community priorities and responding to capacity and infrastructure needs and changes. We conclude with research and practice recommendations for applying PRISM with an increased emphasis on equity.
影响因子：
4.5
作者：
通讯作者：
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影响因子：
5.2
作者：
Fort MP;Reid M;Russell J;Santos CJ;Running Bear U;Begay RL;Smith SL;Morrato EH;Manson SM
通讯作者：
Manson SM