Needs and Challenges Related to Multilevel Interventions: Physical Activity Examples
Needs and Challenges Related to Multilevel Interventions: Physical Activity Examples
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DOI：
10.1177/1090198118796458
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发表时间：
2018-10-01
影响因子：
4.2
通讯作者：
Sallis, James F.
中科院分区：
文献类型：
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作者：
Sallis, James F.
这篇评论的主题是讨论多层次健康行为改变干预措施的必要性和挑战，概念化，实施和评估。生态模型、国家和国际权威团体的建议以及越来越多的证据都支持需要采取干预措施，以改变包括个人、社会环境、组织、建筑环境和政策在内的多个层面的影响，从而改善公众健康。虽然多层次的干预措施在实践中越来越普遍，但它们仍然没有得到充分利用，对多层次干预措施的研究相对较少。从身体活动的例子，几种类型的证据进行了总结，以证明多层次的干预是可行的，可以是有效的。实施和评估多层次干预措施的严重挑战包括需要具有不同专业知识的团队，缺乏对干预措施实施的控制，时间表的不可预测性，长时间管理复杂的团队，以及需要应用不熟悉和不太严格的研究设计和方法。建议提供培训，资金的优先事项和学术奖励，可能会导致更多和更好的多层次的干预措施的变化。
The theme of this commentary is to discuss the need for, and challenges of, conceptualizing, implementing, and evaluating multilevel health behavior change interventions. Ecological models, recommendations from national and international authoritative groups, and growing evidence all support the need for interventions designed to change multiple levels of influence, including individuals, social environments, organizations, built environments, and policies, to achieve population improvements in public health. Though multilevel interventions are becoming more common in practice, they are still under-used, and research on multilevel interventions is relatively rare. Drawing on examples from physical activity, several types of evidence are summarized to demonstrate that multilevel interventions are feasible and can be effective. Serious challenges to implementing and evaluating multilevel interventions include the need for teams with diverse expertise, lack of control over intervention implementation, unpredictability of timelines, managing complex teams over extended periods, and need to apply unfamiliar and less-rigorous study designs and methods. Recommendations are offered for changes in training, funding priorities, and academic incentives that could lead to more and better multilevel interventions.