scholarly journals Blending Participatory Action Synthesis and Meta-ethnography: An Innovative Approach to Evaluating Complex Community Health Transformation

2020 ◽  
Author(s):  
Kristin Reed ◽  
Tara Carr ◽  
Rumana S. Rabbani ◽  
Caroline E. Chandler ◽  
Jonathan Scaccia ◽  
...  
Keyword(s):  
Community Health ◽  
Complex Interventions ◽  
Real Life ◽  
Evaluation Process ◽  
Well Being ◽  
Health Improvement ◽  
Synthesis Methods ◽  
Contextual Knowledge ◽  
Participatory Action ◽  
Community Transformation

Abstract Background: Community health improvement processes are diverse and complex, and evaluation methods to gain generalizable knowledge across community are limited by available data, and the need for deep contextual knowledge. Methods: This article describes an innovative participatory approach to evaluation of a community transformation initiative involving up to eighteen communication nationwide. The approach blends two qualitative research synthesis methods: participatory action synthesis and meta-ethnography and applies them to the pragmatic evaluation of a program in real-life settings. Results: In this article, we present the justification for and details about the evaluation process. Four cycles of synthesis and engagement resulted in development of concepts to describe community actions for transformation.Conclusion: The approach presented here will be useful to both researchers and practitioners interested in evaluating community-based health and well-being initiatives and other complex interventions conducted in complex settings.

The community transformation map: A maturity tool for planning change in community health improvement for equity and well-being.

2021 ◽  
Vol 91 (3) ◽  
pp. 322-331
Author(s):  
Ariel M. Domlyn ◽  
Jonathan Scaccia ◽  
Niñon Lewis ◽  
Shemekka Ebony Coleman ◽  
Gareth Parry ◽  
...  
Keyword(s):  
Community Health ◽  
Well Being ◽  
Health Improvement ◽  
Community Transformation ◽  
Community Health Improvement

scholarly journals Qualitative evidence synthesis for complex interventions and guideline development: clarification of the purpose, designs and relevant methods

2019 ◽  
Vol 4 (Suppl 1) ◽  
pp. e000882 ◽  
Author(s):  
Kate Flemming ◽  
Andrew Booth ◽  
Ruth Garside ◽  
Özge Tunçalp ◽  
Jane Noyes
Keyword(s):  
Qualitative Research ◽  
Systematic Reviews ◽  
Guideline Development ◽  
Evidence Synthesis ◽  
Complex Interventions ◽  
Real Life ◽  
Synthesis Methods ◽  
Qualitative Evidence Synthesis ◽  
Qualitative Evidence ◽  
Broad Term

This paper is one of a series exploring the implications of complexity for systematic reviews and guideline development, commissioned by the WHO. The paper specifically explores the role of qualitative evidence synthesis. Qualitative evidence synthesis is the broad term for the group of methods used to undertake systematic reviews of qualitative research evidence. As an approach, qualitative evidence synthesis is increasingly recognised as having a key role to play in addressing questions relating to intervention or system complexity, and guideline development processes. This is due to the unique role qualitative research can play in establishing the relative importance of outcomes, the acceptability, fidelity and reach of interventions, their feasibility in different settings and potential consequences on equity across populations. This paper outlines the purpose of qualitative evidence synthesis, provides detail of how qualitative evidence syntheses can help establish understanding and explanation of the complexity that can occur in relation to both interventions and systems, and how qualitative evidence syntheses can contribute to evidence to decision frameworks. It provides guidance for the choice of qualitative evidence synthesis methods in the context of guideline development for complex interventions, giving ‘real life’ examples of where this has occurred. Information to support decision-making around choice qualitative evidence synthesis methods in the context of guideline development is provided. Approaches for reporting qualitative evidence syntheses are discussed alongside mechanisms for assessing confidence in the findings of a review.

scholarly journals Implementation of Primary Healthcare Services in Community Health Stations in Highly Urbanized City

2021 ◽  
Vol 4 (3) ◽  
pp. 123-132
Author(s):  
Hanna B. Gella ◽  
Merlita V. Caelian
Keyword(s):  
Community Health ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Well Being ◽  
Healthcare Services ◽  
Health Improvement ◽  
Patient Centeredness ◽  
Sustainable Development Goal ◽  
The Sustainable Development ◽  
Child Healthcare

Primary healthcare is integral to the Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being.  A descriptive study assessed the implementation of primary healthcare services in community health stations through a researcher-made questionnaire among healthcare providers and beneficiaries of 30 community health stations.  The results revealed that, as a whole, the implementation of primary healthcare services in community health stations is great, with maternal and child healthcare implemented to a very great extent while the treatment of non-communicable diseases to a great extent only.  The major challenges encountered are the lack of medical drugs, supplies and equipment, and medical professionals.  Primary healthcare has made contributions to the community's health improvement; however, challenges imply that the quality and efficiency of the services need improvement. The study contributed to new knowledge on implementing healthcare at the lowest level of government, emphasizing patient-centeredness.

scholarly journals Scoping review study to identify how communities in the USA, Australia, New Zealand and Canada use quality improvement (QI) approaches to address community health and well-being

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e034302
Author(s):  
Tara Carr ◽  
Mallory Wolfe Turner ◽  
Rohit Ramaswamy
Keyword(s):  
Quality Improvement ◽  
New Zealand ◽  
Community Health ◽  
Scoping Review ◽  
Well Being ◽  
Health Improvement ◽  
Clinical Settings ◽  
Support Design ◽  
The Usa ◽  
Health And Well Being

IntroductionBoth US and global communities lag on key health indicators. There has been limited progress in building capacity to improve health beyond the healthcare field. Yet, communities also need to engage in health improvement initiatives. A substantial body of literature describes standards and core components for quality improvement (QI) approaches in clinical settings. This study aims to determine how communities in the USA, Australia, New Zealand and Canada use QI approaches for health and well-being improvement and how such approaches compare to those in clinical settings.Methods and analysisWe developed a study protocol based on scoping review framework by Arksey and O’Malley, methodological advancements for scoping studies (Levac et al) and other published protocols. We developed research questions in an iterative process and used the Population, Intervention, Comparison, Outcomes strategy to determine eligibility criteria. Electronic databases deemed appropriate (Web of Science, Scopus, and Proquest Health Management) will be searched for studies that meet inclusion criteria. References of included studies will be included when relevant. Two reviewers will independently screen all abstracts and full-text studies for inclusion. A third reviewer will adjudicate disagreements that arise. An instrument will be developed to extract data from included studies. Quantitative and qualitative results will be reported.Ethics and disseminationWe developed this protocol to systematically conduct a scoping review of how US communities use QI approaches to address community health and well-being. Results will benefit multiple stakeholders by informing how to better support, design and evaluate community well-being improvement interventions. Results will be distributed through peer-reviewed journals, conferences, presentations and a public health graduate course.

Formative Evaluation and Complex Health Improvement Initiatives: A Learning System to Improve Theory, Implementation, Support, and Evaluation

2019 ◽  
Vol 41 (1) ◽  
pp. 89-106
Author(s):  
V. C. Scott ◽  
K. Alia ◽  
J. Scaccia ◽  
R. Ramaswamy ◽  
S. Saha ◽  
...  
Keyword(s):  
Complex Systems ◽  
Community Health ◽  
Formative Evaluation ◽  
Complex Interventions ◽  
Learning System ◽  
Health Improvement ◽  
Evaluation Team ◽  
Implementation Support ◽  
Evaluation Approach ◽  
Community Health Improvement

Sustainable community health improvement often requires the implementation of complex interventions in complex systems. Drawing from the Four Keys to Success frame (theory, implementation, support, and evaluation), this article describes how we used a formative evaluation approach to foster a learning system capable of monitoring and addressing emerging community needs within the Spreading Community Accelerators Through Learning and Evaluation (SCALE) initiative—a national capacity-building effort to support 24 community coalitions’ progress toward a Culture of Health. The formative evaluation approach resulted in critical advancements to the theory, implementation, and nature of supports provided in SCALE. These improvements enabled the SCALE evaluation team to shift from the initial focus on program implementation issues to a greater emphasis on downstream factors (community-level outcomes). The ability of formative evaluation to grapple with the emerging challenges of implementing complex interventions in complex systems makes it particularly valuable for community health improvement initiatives.

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