Creating Change: A collaborative action inquiry approach for integrating creativity and community assets into ICS responses to Health Disparities

创造变革：一种协作行动调查方法，用于将创造力和社区资产整合到 ICS 对健康差异的响应中

• 批准号: AH/X006301/1
• 负责人: Barry Percy-Smith
• 金额: $ 25.67万
• 依托单位: University of Huddersfield
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2022
• 资助国家: 英国
• 起止时间: 2022 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=AH%2FX006301%2F1
• 关键词: Creating; Change; collaborative; action; inquiry

In a context where health systems are under increasing strain and the social drivers of health disparities are increasingly being recognised, there is a growing acknowledgement of the value of non-medical responses such as creative, physical and nature-based activities in supporting health and wellbeing. Evidence reveals that one third of GP appointments are for issues that are not medical and many tangible health problems arise as a result of social drivers (for example, loneliness, anxieties around finances or housing, depression about body image or being unemployed). The potential for developing the wider use of creative and community-based approaches to address health disparities is therefore substantial. West Yorkshire is leading the way in developing the use of non-medical interventions to promote health and well-being. For example, the award-winning charity Creative Minds has developed an innovative approach to providing creative and outdoor activities through a network of over 120 community providers; and West Yorkshire is one of the National Centre for Creative Health pilots. However, creative and community providers rely on short term funding and are not fully integrated into the health care system with the result that provision can be ad hoc and unsustainable. This project will build on leading edge developments across West Yorkshire in progressing the creative health agenda by bringing together key stakeholders (health trusts, local authorities, creative/cultural practitioners, community providers and people with lived experience) to innovate thinking in order to better integrate creative and community-based responses into health improvement strategies and systems to address health disparities. The project will encompass a truly coproductive approach centred around the use of collaborative action inquiry as a participatory process of learning for change in four iterative phases. It will build on stories from people with lived experience to provide a deeper understanding of the social drivers and complexities of health problems in communities, as well as learning from the challenges and achievements of partners in practice. These will be complemented by a rapid review of evidence about different collaborative models for community health provision which together will inform coproduction of an initial programme theory in a cross-ICS collaborative action inquiry workshop. The initial programme theory will be used to focus community mapping of creative provision and partnerships and further coproduction in consultation workshops with community groups and people with lived experience in phase 2. This will be followed by a further cycle of collaborative action inquiry with key stakeholders to refine the programme theory about how to integrate community assets into responses to health disparities and work up into a logic model, principles and guidance. These will then be tested in 5 action research case studies which will involve setting up community asset hubs, one in each of the ICS local authority areas to further refine the cross-ICS consortium model for integrating community assets. The final phase will involve a third stakeholder action inquiry workshop to respond to learning from the action research case studies and further refine and finalise the programme theory for the consortium and develop plans for scaling up, embedding and sustaining the integration of community assets into health improvement systems research. The new University of Huddersfield Health Innovation Campus and Wellbeing Academy will provide a context for hosting these developments and undertaking the research and development functions needed to support, sustain and further develop health improvement initiatives. We have support from all the key health and local authority players along with creative community providers and people with lived experience and wider community representatives who will be actively involved throughout the project.

在卫生系统承受的压力越来越大，健康差距的社会驱动因素越来越多地被认识到的背景下，人们越来越认识到非医疗应对措施的价值，如创造性的，身体的和基于自然的活动，以支持健康和福祉。有证据表明，三分之一的全科医生预约是为了非医疗问题，许多有形的健康问题是由于社会驱动因素（例如，孤独，对财务或住房的焦虑，对身体形象的抑郁或失业）而出现的。因此，更广泛地利用创造性和基于社区的办法来解决保健差距问题的潜力很大。西约克郡在发展非医疗干预措施以促进健康和福祉方面处于领先地位。例如，屡获殊荣的慈善机构“创意思维”开发了一种创新方法，通过120多个社区提供者网络提供创意和户外活动;西约克郡是国家创意健康中心试点之一。然而，创造性和社区提供者依赖于短期资金，没有完全融入卫生保健系统，结果是提供服务可能是临时性的和不可持续的。该项目将建立在整个西约克郡的前沿发展，通过汇集关键利益攸关方（健康信托基金，地方当局，创意/文化从业者，社区提供者和有生活经验的人）来推进创意健康议程，以创新思维，以便更好地将创意和基于社区的反应纳入健康改善战略和系统，以解决健康差距。该项目将包括一个真正的协同生产办法，其核心是利用协作行动调查，作为分四个迭接阶段的参与性学习变革进程。它将借鉴有实际经验的人的故事，以更深入地了解社区卫生问题的社会驱动因素和复杂性，并从合作伙伴在实践中面临的挑战和取得的成就中学习。这些将通过对社区卫生服务提供的不同合作模式的证据进行快速审查来补充，这些模式将共同为跨ICS合作行动调查研讨会的初步方案理论提供信息。最初的计划理论将用于集中社区绘制创意提供和伙伴关系，并在第二阶段与社区团体和有生活经验的人举行的协商研讨会上进一步共同制作。随后将与主要利益攸关方进行另一轮协作行动调查，以完善关于如何将社区资产纳入应对健康差距的方案理论，并逐步形成逻辑模型、原则和指导。然后将在5个行动研究案例研究中对这些进行测试，这些案例研究将涉及建立社区资产中心，在ICS地方当局的每个地区建立一个中心，以进一步完善跨ICS联盟整合社区资产的模式。最后阶段将包括第三个利益相关者行动调查研讨会，以回应从行动研究案例研究中学习到的知识，并进一步完善和最终确定联盟的方案理论，并制定计划，以扩大，嵌入和维持社区资产整合到健康改善系统研究中。新的哈德斯菲尔德大学健康创新校园和福利学院将为举办这些发展提供一个环境，并承担支持，维持和进一步发展健康改善举措所需的研发职能。我们得到了所有主要卫生和地方当局参与者的支持，沿着有创造性的社区提供者和有生活经验的人，以及将积极参与整个项目的更广泛的社区代表。