Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review.
Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review.
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DOI：
10.3402/gha.v8.29842
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发表时间：
2015
影响因子：
2.6
通讯作者：
Renzaho AM
中科院分区：
文献类型：
--
作者：
Cyril S;Smith BJ;Possamai-Inesedy A;Renzaho AM
虽然社区参与（CE）被广泛用于健康促进，但社区参与模型中与改善健康相关的组成部分却知之甚少。本研究的目的是检验社会教育对弱势群体的健康和健康不平等的影响程度，哪些方法学方法能最大限度地提高社会教育的有效性，以及社会教育的组成部分在弱势群体中使用时是可接受的、可行的和有效的。系统评价遵循系统评价和荟萃分析指南的首选报告项目。我们使用评定量表对纳入的研究进行方法学评估。分析侧重于模型综合，以确定与积极研究结果相关的关键环境绩效成分，并对积极研究结果、过程和环境绩效质量指标进行比较分析。在符合我们纳入标准的24项研究中，21项（87.5%）对健康行为、公共卫生计划、卫生服务获取、卫生素养和一系列健康结果产生了积极影响。超过一半的研究（58%）质量良好，而71%和42%的研究分别显示了良好的社区参与研究，并达到了高水平的CE。影响健康结果的主要卫生保健组成部分包括真正的权力分享、合作伙伴关系、双向学习、将受益社区的声音和代理纳入研究方案，以及使用双文化卫生工作者提供干预措施。研究结果表明，如果设计得当，并通过有效的社区咨询和参与实施，社会责任模式可以改善弱势群体的健康和健康行为。我们还发现目前健康干预研究中对CE的测量存在一些差距，这表明开发创新方法以更严格的方式测量CE对健康结果的影响的重要性。
Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE. Out of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery. The findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way.