How to increase public participation in advance care planning: findings from a World Cafe to elicit community group perspectives
How to increase public participation in advance care planning: findings from a World Cafe to elicit community group perspectives
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DOI：
10.1186/s12889-019-7034-4
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发表时间：
2019-06-03
影响因子：
4.5
通讯作者：
Simon, Jessica E.
中科院分区：
文献类型：
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作者：
Biondo, Patricia D.;King, Seema;Simon, Jessica E.
背景2014年，加拿大阿尔伯塔省制定了第一个省级医疗保健政策和预先护理计划程序（ACP），这是沟通和记录个人未来医疗保健偏好的过程，开创了新的领域。然而，迄今为止，公众对非加太计划的参与和认识仍然有限。这项倡议的目的是征求社区团体对如何帮助人们了解和参与非加太项目的看法。方法向艾伯塔省300多个社区团体（如卫生/疾病、老年人/退休、社会/服务、法律、信仰、葬礼规划、财务等）发送了有针对性的邀请。来自47个社区团体的67名参与者参加了世界咖啡馆。参与者每隔一段固定的时间在桌子之间移动，并以小组为单位讨论三个与非加太有关的问题。与会者和主持人收集了书面意见。每个评论都根据Michie等人的理论领域框架进行编码，并映射到能力，机会和动机行为改变系统（COM-B），以确定候选干预策略。结果在800个书面评论中，76%映射到行为的机会：物理COM-B组件，反映了访问ACP资源的需求。确定的最常见的干预功能涉及教育、环境重组、培训和实施。我们将干预功能和定性评论综合为八项建议，以使人们参与ACP。这些涉及获取信息资源、团体教育和促进、卫生系统进程、故事的使用、营销、融入生活事件、纳入商业伙伴以及术语的统一。结论社会团体在促进ACP方面的作用得到广泛支持。我们提出了八项让公众参与非加太项目的建议，并与持份者分享。
BackgroundIn 2014, Alberta, Canada broke new ground in having the first provincial healthcare policy and procedure for advance care planning (ACP), the process of communicating and documenting a person's future healthcare preferences. However, to date public participation and awareness of ACP remains limited. The aim of this initiative was to elicit community group perspectives on how to help people learn about and participate in ACP.MethodsTargeted invitations were sent to over 300 community groups in Alberta (e.g. health/disease, seniors/retirement, social/service, legal, faith-based, funeral planning, financial, and others). Sixty-seven participants from 47 community groups attended a World Cafe. Participants moved between tables at fixed time intervals, and in small groups discussed three separate ACP-related questions. Written comments were captured by participants and facilitators. Each comment was coded according to Michie et al.'s Theoretical Domains Framework, and mapped to the Capability, Opportunity and Motivation behavior change system (COM-B) in order to identify candidate intervention strategies.ResultsOf 800 written comments, 76% mapped to the Opportunity: Physical COM-B component of behavior, reflecting a need for access to ACP resources. The most common intervention functions identified pertained to Education, Environmental Restructuring, Training, and Enablement. We synthesized the intervention functions and qualitative comments into eight recommendations for engaging people in ACP. These pertain to access to informational resources, group education and facilitation, health system processes, use of stories, marketing, integration into life events, inclusion of business partners, and harmonization of terminology.ConclusionsThere was broad support for the role of community groups in promoting ACP. Eight recommendations for engaging the public in ACP were generated and have been shared with stakeholders.