Narratives of community engagement: a systematic review-derived conceptual framework for public health interventions.
Narratives of community engagement: a systematic review-derived conceptual framework for public health interventions.
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DOI：
10.1186/s12889-017-4958-4
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发表时间：
2017-12-11
影响因子：
4.5
通讯作者：
Kavanagh J
中科院分区：
文献类型：
--
作者：
Brunton G;Thomas J;O'Mara-Eves A;Jamal F;Oliver S;Kavanagh J
政府政策越来越多地支持社区参与促进健康。关键是要考虑这些战略是否有效，对谁有效，在什么情况下有效。然而，“社区参与”的定义多种多样，使用的原因也各不相同。考虑到理论和背景，我们开发了一个概念框架，该框架有助于理解是什么使社区参与干预有效（或无效）。我们对社区参与公共卫生干预措施进行了系统的回顾：利益相关者参与;研究文献的搜索，筛选，评估和编码;迭代主题综合和荟萃分析。在社区参与的概念框架与每个审查阶段相互作用之后，对该框架进行了完善。从335份纳入的报告中，出现了三个产品：（1）两个强有力的理论“元叙述”：一个是关于赋权/参与的理论和实践作为一个独立的目标;一个是更功利的观点，最佳地配置卫生服务，以实现既定的成果。这些信息（2）在随后的荟萃分析中可操作的模型。两者都完善了（3）最终的概念框架。这确定了社区参与干预措施可能不同的多个方面。注意到干预目的、理论和实施的各种组合，包括：界定社区和卫生需求的方式;社区参与的最初动机;参与的类型;参与的必要条件和行动;影响的潜在问题。一些方面始终同时发生，导致三个总体模式的有效参与，其中之一：利用同行领导的交付;采用不同程度的社区和卫生服务之间的合作;或建立在赋权哲学。我们的概念框架和模型是考虑社区参与的适当和有效方法的有用工具。应测试和调整这些措施，以便利干预措施的设计和评价。使用这一框架可以理清不同社区参与模式的相对有效性，促进有效、可持续和适当的举措。
Government policy increasingly supports engaging communities to promote health. It is critical to consider whether such strategies are effective, for whom, and under what circumstances. However, ‘community engagement’ is defined in diverse ways and employed for different reasons. Considering the theory and context we developed a conceptual framework which informs understanding about what makes an effective (or ineffective) community engagement intervention. We conducted a systematic review of community engagement in public health interventions using: stakeholder involvement; searching, screening, appraisal and coding of research literature; and iterative thematic syntheses and meta-analysis. A conceptual framework of community engagement was refined, following interactions between the framework and each review stage. From 335 included reports, three products emerged: (1) two strong theoretical ‘meta-narratives’: one, concerning the theory and practice of empowerment/engagement as an independent objective; and a more utilitarian perspective optimally configuring health services to achieve defined outcomes. These informed (2) models that were operationalized in subsequent meta-analysis. Both refined (3) the final conceptual framework. This identified multiple dimensions by which community engagement interventions may differ. Diverse combinations of intervention purpose, theory and implementation were noted, including: ways of defining communities and health needs; initial motivations for community engagement; types of participation; conditions and actions necessary for engagement; and potential issues influencing impact. Some dimensions consistently co-occurred, leading to three overarching models of effective engagement which either: utilised peer-led delivery; employed varying degrees of collaboration between communities and health services; or built on empowerment philosophies. Our conceptual framework and models are useful tools for considering appropriate and effective approaches to community engagement. These should be tested and adapted to facilitate intervention design and evaluation. Using this framework may disentangle the relative effectiveness of different models of community engagement, promoting effective, sustainable and appropriate initiatives.
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影响因子：
12.7
作者：
DAVIDSON, LL;DURKIN, MS;HEAGARTY, MC
通讯作者：
HEAGARTY, MC
影响因子：
3.5
作者：
Barnes, M;Newman, J;Sullivan, H
通讯作者：
Sullivan, H
影响因子：
5.4
作者：
Draper, Alizon Katharine;Hewitt, Gillian;Rifkin, Susan
通讯作者：
Rifkin, Susan
影响因子：
5.1
作者：
Davis, SM;Clay, T;Stone, EJ
通讯作者：
Stone, EJ
影响因子：
3.2
作者：
Bolam, B;McLean, C;Gillies, P
通讯作者：
Gillies, P