The effectiveness of community engagement in public health interventions for disadvantaged groups: a meta-analysis.
The effectiveness of community engagement in public health interventions for disadvantaged groups: a meta-analysis.
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DOI：
10.1186/s12889-015-1352-y
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发表时间：
2015-02-12
影响因子：
4.5
通讯作者：
Thomas J
中科院分区：
文献类型：
--
作者：
O'Mara-Eves A;Brunton G;Oliver S;Kavanagh J;Jamal F;Thomas J
许多发达国家承认健康方面的不平等，弱势群体的健康状况往往比非弱势群体差，例如预期寿命较短。有人建议，让弱势社区成员参与公共卫生倡议是减少卫生不公平现象的一种方式。本系统性综述旨在评估公共卫生干预措施的有效性，这些干预措施使社区参与各种健康问题的一系列健康结果。我们检索了以下公共卫生干预措施的系统评价来源：科克伦CDSR和CENTRAL、坎贝尔图书馆、DARE、NIHR HTA项目网站、HTA数据库和DoPHER。通过识别的综述，我们整理了一个似乎相关的主要研究数据库，并根据我们的纳入标准筛选了这些主要研究的全文文件。同时，我们检索了NHS EED和TRoPHI数据库，以获得其他初步研究。出于这些分析的目的，研究设计仅限于随机和非随机对照试验。只列入了经合组织国家自1990年以来发表的干预措施。我们对健康行为、健康后果、自我效能和社会支持结果进行了随机效应荟萃分析，并对社区结果进行了叙述性总结。我们测试了一系列的调节变量，特别强调社区参与的模型作为一个潜在的调解人的干预效果。在所扫描的9,467项主要研究中，我们确定了131项纳入荟萃分析。健康行为结局的总体效应量为d = .33（95% CI .26，.40）。干预措施也有效地增加了健康后果（d = 0.16，95% CI 0.06，0.27）;健康行为自我效能（d = 0.41，95% CI 0.16，0.65）和感知的社会支持（d = 0.41，95% CI 0.23，0.65）。虽然社区参与的类型不是影响的重要调节因素，但我们在研究中发现了一些趋势。有确凿的证据表明，社区参与干预措施对各种条件下的一系列健康结果产生了积极影响。没有足够的证据来确定一种特定的社区参与模式是否比其他模式更有效。本文的在线版本（doi：10.1186/s12889-015-1352-y）包含补充材料，可供授权用户使用。
Inequalities in health are acknowledged in many developed countries, whereby disadvantaged groups systematically suffer from worse health outcomes such as lower life expectancy than non-disadvantaged groups. Engaging members of disadvantaged communities in public health initiatives has been suggested as a way to reduce health inequities. This systematic review was conducted to evaluate the effectiveness of public health interventions that engage the community on a range of health outcomes across diverse health issues. We searched the following sources for systematic reviews of public health interventions: Cochrane CDSR and CENTRAL, Campbell Library, DARE, NIHR HTA programme website, HTA database, and DoPHER. Through the identified reviews, we collated a database of primary studies that appeared to be relevant, and screened the full-text documents of those primary studies against our inclusion criteria. In parallel, we searched the NHS EED and TRoPHI databases for additional primary studies. For the purposes of these analyses, study design was limited to randomised and non-randomised controlled trials. Only interventions conducted in OECD countries and published since 1990 were included. We conducted a random effects meta-analysis of health behaviour, health consequences, self-efficacy, and social support outcomes, and a narrative summary of community outcomes. We tested a range of moderator variables, with a particular emphasis on the model of community engagement used as a potential moderator of intervention effectiveness. Of the 9,467 primary studies scanned, we identified 131 for inclusion in the meta-analysis. The overall effect size for health behaviour outcomes is d = .33 (95% CI .26, .40). The interventions were also effective in increasing health consequences (d = .16, 95% CI .06, .27); health behaviour self-efficacy (d = .41, 95% CI .16, .65) and perceived social support (d = .41, 95% CI .23, .65). Although the type of community engagement was not a significant moderator of effect, we identified some trends across studies. There is solid evidence that community engagement interventions have a positive impact on a range of health outcomes across various conditions. There is insufficient evidence to determine whether one particular model of community engagement is more effective than any other. The online version of this article (doi:10.1186/s12889-015-1352-y) contains supplementary material, which is available to authorized users.
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影响因子：
--
作者：
Winkleby, MA;Feighery, E;Killen, JD
通讯作者：
Killen, JD
影响因子：
--
作者：
Brenner, Barbara L.;Manice, Melissa P.
通讯作者：
Manice, Melissa P.
影响因子：
9.8
作者：
O'Mara-Eves, Alison;Brunton, Ginny;Thomas, James
通讯作者：
Thomas, James
影响因子：
2
作者：
Chinn, S
通讯作者：
Chinn, S
DOI：
10.1080/01944366908977225
发表时间：
1969-01-01
期刊：
JOURNAL OF THE AMERICAN INSTITUTE OF PLANNERS
影响因子：
--
作者：
ARNSTEIN, SR
通讯作者：
ARNSTEIN, SR