Dimensions of sustainability for a health communication intervention in African American churches: a multi-methods study
Dimensions of sustainability for a health communication intervention in African American churches: a multi-methods study
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DOI：
10.1186/s13012-017-0576-x
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发表时间：
2017-03-28
影响因子：
7.2
通讯作者：
Holt, Cheryl L.
中科院分区：
文献类型：
--
作者：
Scheirer, Mary Ann;Santos, Sherie Lou Z.;Holt, Cheryl L.
背景：近年来，循证健康促进干预措施的可持续性受到越来越多的研究关注。本文报告了来自项目治愈（通过早期意识和学习的健康）的可持续性数据，该项目是一项关于早期发现的癌症传播实施试验，以非洲裔美国人教会为基础。在本文中，我们使用了Scheirer和Dearing的框架，（Am J Publ Health 101：2059- 2067，2011）来评估来自项目HEAL的可持续性的多个维度。（a）继续为干预接受者提供福利，（B）继续开展干预活动，（c）维持社区伙伴关系，（d）组织政策或结构的变化，（e）对根本问题的持续关注，（f）扩散到其他地点，或甚至（g）干预措施的意外后果。项目愈合提供了三个研讨会癌症教育系列由训练有素的平信徒社区健康顾问（CHAs）在他们的教堂交付。在12个月和24个月的干预后，反映了几个层次的分析：参与者的调查，与CHAs访谈，从项目的管理数据库记录的可持续性的多个来源收集;和CHAs，工作人员和社区partners.Results的开放式评论：结果不同的可持续性的每个维度。为了继续受益，最初的375名教会成员中分别有39%和37%参加了12个月和24个月的后续讲习班。大多数参与者报告与家人或朋友分享来自项目HEAL的信息（12个月时为92%; 24个月时为87%）。对于继续进行干预活动，一些社区保健协会报告说，教会至少举办了一次额外的癌症教育讲习班（12个月时为33%; 24个月时为24%），但更多的社区保健协会报告说，他们的教会随后开展了健康活动（12个月时为71%; 24个月时为52%）。没有教会复制了最初的三个工作坊系列。更多的数据确认维护社区的伙伴关系，教会的卫生政策的一些变化，并继续关注健康问题的教会和CHAS.Conclusions：可持续发展的多个层面需要不同的数据来源和分析水平，并显示在这个项目中不同的可持续发展成果。研究结果加强了社区环境中循证健康干预措施的动态性。
Background: Sustainability of evidence-based health promotion interventions has received increased research attention in recent years. This paper reports sustainability data from Project HEAL (Health through Early Awareness and Learning) a cancer communication implementation trial about early detection, based in African American churches. In this paper, we used a framework by Scheirer and Dearing (Am J Publ Health 101: 2059- 2067, 2011) to evaluate multiple dimensions of sustainability from Project HEAL.Methods: We examined the following dimensions of sustainability: (a) continued benefits for intervention recipients, (b) continuation of intervention activities,c) maintaining community partnerships, (d) changes in organizational policies or structures, (e) sustained attention to the underlying issues, (f) diffusion to additional sites, or even (g) unplanned consequences of the intervention. Project HEAL provided a three-workshop cancer educational series delivered by trained lay peer community health advisors (CHAs) in their churches. Multiple sources of sustainability were collected at 12 and 24 months after the intervention that reflect several levels of analysis: participant surveys; interviews with CHAs; records from the project's management database; and openended comments from CHAs, staff, and community partners.Results: Outcomes differ for each dimension of sustainability. For continued benefit, 39 and 37% of the initial 375 church members attended the 12- and 24-month follow-up workshops, respectively. Most participants reported sharing the information from Project HEAL with family or friends (92% at 12 months; 87% at 24 months). For continuation of intervention activities, some CHAs reported that the churches held at least one additional cancer educational workshop (33% at 12 months; 24% at 24 months), but many more CHAs reported subsequent health activities in their churches (71% at 12 months; 52% at 24 months). No church replicated the original series of three workshops. Additional data confirm the maintenance of community partnerships, some changes in church health policies, and continued attention to health issues by churches and CHAs.Conclusions: The multiple dimensions of sustainability require different data sources and levels of analysis and show varied sustainability outcomes in this project. The findings reinforce the dynamic nature of evidence-based health interventions in community contexts.