Beyond the project: Building a strategic theory of change to address dementia care, treatment and support gaps across seven middle-income countries
Beyond the project: Building a strategic theory of change to address dementia care, treatment and support gaps across seven middle-income countries
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DOI：
10.1177/14713012211029105
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发表时间：
2021-07-01
影响因子：
2.4
通讯作者：
Schneider, Marguerite
中科院分区：
文献类型：
--
作者：
Breuer, Erica;Comas-Herrera, Adelina;Schneider, Marguerite
来自中等收入国家的证据表明，痴呆症的患病率很高，而且还在不断增加，因此需要服务。然而，对痴呆症患者及其照顾者的护理、治疗或支持方面的投资很少。加强发展中国家对痴呆症的反应(STRIDE)项目旨在在巴西、印度尼西亚、印度、牙买加、肯尼亚、墨西哥和南非建设痴呆症护理和服务的研究能力和证据。本文介绍了改变理论(TOC)的方法，我们用来共同设计我们的研究项目，并与利益相关者一起制定痴呆症护理、治疗和支持的战略方向。TOC明确了一项计划将如何实现其影响的潜在过程。我们与不同级别政府的研究人员、实践者、痴呆症患者、照顾者和政策制定者一起，在每个国家和整个STRIDE项目中开发了ToC。这包括：(1)与所有项目合作伙伴共同举办一次TOC初始讲习班(43人参加)；(2)在每个STARE国家举办TOC讲习班(每个国家22-49人参加)；(3)具体国家TOC与总体项目TOC的比较；(4)根据世卫组织痴呆症指南和行动计划对TOC进行审查；以及(5)最后审查。我们的经验表明，TOC是在不同利益攸关方之间产生痴呆症护理、治疗和支持的共同愿景的有效方式。然而，项目捐款应明确界定，并使用其他战略，以确保痴呆症患者及其照顾者适当参与目标为本课程过程。
Evidence from middle-income countries indicates high and increasing prevalence of dementia and need for services. However, there has been little investment in care, treatment or support for people living with dementia and their carers. The Strengthening Responses to Dementia in Developing Countries (STRiDE) project aims to build both research capacity and evidence on dementia care and services in Brazil, Indonesia, India, Jamaica, Kenya, Mexico and South Africa. This article presents the Theory of Change (ToC) approach we used to co-design our research project and to develop a strategic direction for dementia care, treatment and support, with stakeholders. ToC makes explicit the process underlying how a programme will achieve its impact. We developed ToCs in each country and across the STRiDE project with researchers, practitioners, people living with dementia, carers and policymakers at different levels of government. This involved (1) an initial ToC workshop with all project partners (43 participants); (2) ToC workshops in each STRiDE country (22-49 participants in each); (3) comparison between country-specific and overall project ToCs; (4) review of ToCs in light of WHO dementia guidelines and action plan and (5) a final review. Our experiences suggest ToC is an effective way to generate a shared vision for dementia care, treatment and support among diverse stakeholders. However, the project contribution should be clearly delineated and use additional strategies to ensure appropriate participation from people living with dementia and their carers in the ToC process.