Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial.
Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial.
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DOI：
10.5888/pcd14.170326
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发表时间：
2017-11-30
影响因子：
5.5
通讯作者：
Yan Y
中科院分区：
文献类型：
--
作者：
Brownson RC;Allen P;Jacob RR;deRuyter A;Lakshman M;Reis RS;Yan Y
尽管州卫生部门的从业人员处于实施循证干预措施的理想位置，但很少有研究探讨如何建立他们这样做的能力。本研究的目的是探讨如何在个人和组织层面增加使用循证决策过程。我们进行了一项2组、分组随机试验，收集了基线数据，并在18至24个月进行了随访。12个州的卫生部门配对，并随机分配到干预或控制条件。2014年3月至2015年3月，在6个干预州开展了为期多日的循证决策培训沿着开展了一系列补充性能力建设活动。个人层面的结果是公共卫生从业人员的循证决策技能;组织层面的结果是获得研究证据和参与性决策。采用混合协方差分析模型评价干预效果，采用整群随机试验设计。分析时间为2017年3月至5月。初次培训后18至24个月的参与率为73.5%。在调整参与者和状态特征的混合模型中，干预组在整体技能差距（P = .01）和6个技能领域中显着改善。在4个组织变量中，只有获得证据和熟练的工作人员表现出干预效果（P = .04）。需要制定有针对性的积极战略，在个人和组织层面建设循证决策的能力。我们的研究提出了几种传播干预措施，供寻求改善公共卫生实践的领导者考虑。
Although practitioners in state health departments are ideally positioned to implement evidence-based interventions, few studies have examined how to build their capacity to do so. The objective of this study was to explore how to increase the use of evidence-based decision-making processes at both the individual and organization levels. We conducted a 2-arm, group-randomized trial with baseline data collection and follow-up at 18 to 24 months. Twelve state health departments were paired and randomly assigned to intervention or control condition. In the 6 intervention states, a multiday training on evidence-based decision making was conducted from March 2014 through March 2015 along with a set of supplemental capacity-building activities. Individual-level outcomes were evidence-based decision making skills of public health practitioners; organization-level outcomes were access to research evidence and participatory decision making. Mixed analysis of covariance models was used to evaluate the intervention effect by accounting for the cluster randomized trial design. Analysis was performed from March through May 2017. Participation 18 to 24 months after initial training was 73.5%. In mixed models adjusted for participant and state characteristics, the intervention group improved significantly in the overall skill gap (P = .01) and in 6 skill areas. Among the 4 organizational variables, only access to evidence and skilled staff showed an intervention effect (P = .04). Tailored and active strategies are needed to build capacity at the individual and organization levels for evidence-based decision making. Our study suggests several dissemination interventions for consideration by leaders seeking to improve public health practice.
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影响因子：
1.6
作者：
Stamatakis, Katherine A.;Hino, Adriano Akira Ferreira;Brownson, Ross C.
通讯作者：
Brownson, Ross C.
影响因子：
2.8
作者：
Yarber L;Brownson CA;Jacob RR;Baker EA;Jones E;Baumann C;Deshpande AD;Gillespie KN;Scharff DP;Brownson RC
通讯作者：
Brownson RC
影响因子：
1.6
作者：
Brownson, Ross C.;Ballew, Paula;Kreuter, Matthew W.
通讯作者：
Kreuter, Matthew W.
影响因子：
5.5
作者：
Brownson, Ross C.;Ballew, Paula;Myers, Bradford A.
通讯作者：
Myers, Bradford A.
DOI：
10.1146/annurev.publhealth.25.050503.153933
发表时间：
2004-01-01
影响因子：
20.8
作者：
Briss, PA;Brownson, RC;Zaza, S
通讯作者：
Zaza, S