Implementation effectiveness of health interventions for indigenous communities: a systematic review
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Notice bibliographique
Résumé
BACKGROUND: Translating research into practice is an important issue for implementing health interventions effectively for Indigenous communities. He Pikinga Waiora (HPW) is a recent implementation framework that provides a strong foundation for designing and implementing health interventions in Indigenous communities for non-communicable diseases around community engagement, culture-centred approach, systems thinking and integrated knowledge translation. This study addresses the following research question: How are the elements of the HPW Implementation Framework reflected in studies involving the implementation of a non-communicable disease health intervention in an Indigenous community? METHODS: A systematic review was conducted using multiple databases. Studies were included if they involved the implementation or evaluation of a health intervention targeting non-communicable diseases for Indigenous communities in Australia, Canada, New Zealand or the United States of America. Published quantitative and qualitative literature from 2008 to 2018 were included. Methodological appraisal of the included articles was completed using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. Data on the population, topic, methods, and outcomes were detailed for each individual study. Key data extracted included the HPW elements along with study characteristics, who delivered the intervention and health outcomes. Data analysis involved a qualitative synthesis of findings as guided by a coding scheme of the HPW elements. RESULTS: Twenty-one studies were included. Health topics included diabetes, nutrition, weight loss, cancer and general health. The key themes were as follows: (a) two thirds of studies demonstrated high levels of community engagement; (b) from the culture-centred approach, two-thirds of studies reflected moderate to high levels of community voice/agency although only a third of the studies included structural changes and researcher reflexivity; (c) about a quarter of studies included multi-level outcomes and activities consistent with systems thinking, 40% had individual-level outcomes with some systems thinking, and 33% included individual-level outcomes and limited systems thinking; and (d) almost 40% of studies included high levels of end user (e.g., policy makers and tribal leaders) engagement reflective of integrated knowledge translation, but nearly half had limited end-user engagement. CONCLUSIONS: The HPW Implementation Framework is a comprehensive model for potentially understanding implementation effectiveness in Indigenous communities. The review suggests that the studies are reflective of high levels of community engagement and culture-centredness. The long-term sustainability and translation of evidence to practice may be inhibited because of lower levels of systems thinking and integrated knowledge translation. REGISTRATION: Not registered.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,027 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,006 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle