专题笔谈
ENGLISH ABSTRACT
公共卫生干预措施分类探索及对我国的启示
王振中
赵艺皓
张峥岩
宫恩莹
邵瑞太
作者及单位信息
·
DOI: 10.3760/cma.j.cn112150-20230118-00046
Exploration of the classification of public health intervention and its implication for China
Wang Zhenzhong
Zhao Yihao
Zhang Zhengyan
Gong Enying
Shao Ruitai
Authors Info & Affiliations
Wang Zhenzhong
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Zhao Yihao
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Zhang Zhengyan
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Gong Enying
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Shao Ruitai
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
·
DOI: 10.3760/cma.j.cn112150-20230118-00046
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摘要

公共卫生干预措施是一种在特定情况下实施的一系列有组织、具体的手段,以实现改善健康、预防控制疾病等有关目标。而公共卫生干预措施分类是随着对干预措施研究深入,逐步明确干预措施的性质、类别和所针对的干预对象,从而发展的一种类型学研究,可以帮助规范公共卫生干预措施概念、开发、筛选并评估干预措施效果,提高公共卫生行动效果。本文梳理了国际上主要干预措施分类模式,分析归纳了5种公共卫生干预措施分类方法,分别为依据目标、性质、对象、层级、作用方式分类,并介绍相关案例,提出我国应当针对公共卫生干预措施进一步深入系统研究,发展基于循证的干预措施与实践,并推广有效干预措施与成果转化,促进公共卫生事业的发展。

公共卫生;干预措施;分类
ABSTRACT

Public health interventions refer to a series of organized and specific measures implemented in specific situations to achieve goals related to improving health, preventing and controlling diseases, and more. As research on intervention measures has deepened, the classification of public health interventions has gradually developed, clarifying the nature, categories and intervention targets of these measures. This typological study can help standardize the concepts of public health interventions, develop, select, and evaluate the effectiveness of intervention measures, and improve the effectiveness of public health actions. This paper reviews the main international classification models of intervention measures, analyzes and summarizes five classification methods of public health interventions, namely, based on goals, nature, objects, hierarchies, and modes of action, and introduces relevant cases. The paper proposes that China should conduct further in-depth and systematic research on public health interventions, develop evidence-based intervention measures and practices, promote the effective transformation of intervention measures and results, and facilitate the development of public health.

Public health;Intervention;Classification
Shao Ruitai, Email: nc.defsmabaciatiuroahs
引用本文

王振中,赵艺皓,张峥岩,等. 公共卫生干预措施分类探索及对我国的启示[J]. 中华预防医学杂志,2023,57(10):1655-1662.

DOI:10.3760/cma.j.cn112150-20230118-00046

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公共卫生是一门预防疾病、延长寿命、促进健康的科学和艺术,通过疾病监测、调查、沟通、动员社会与社区、实施政策和法律、建设服务系统与机构,以及人力发展等策略实现人群健康的使命 1 , 2。而公共卫生干预策略是应对公共卫生问题、疾病防控、健康促进等实际需要的综合规划、方法、路径,通常包括制定健康目标、确定健康优先事项、调动资源及指导实施计划等活动,通过多种以实施科学证据为基础的具体公共卫生行动(干预措施)组合最终达成目标,如全人群策略、高危人群策略、三级预防等策略,其路径中纳入的干预措施组合都不尽相同 3。就本文而言,在公共卫生干预策略的指引路径下,公共卫生干预措施被定义为在特定情况下实施的一系列有组织、具体的手段,以实现与改善健康、预防控制疾病等有关目标。其显著特征为多样化,可以从单一措施涉及到多方面措施,并与多部门协作,横跨不同领域,包括法律、财政激励、社会营销、教育等,可以通过社会决定性因素间接发挥作用,促进健康相关的长期变化 4。因此,开发公共卫生干预措施并进行实践检验,是解决公共卫生问题的重要目标任务之一。
多年来,国内外科研机构和公共卫生部门深入开展针对疾病病因的研究,开展了大量针对公共卫生问题的干预措施效果、成本-效益研究和实践,获得针对各种疾病及其不同阶段、不同人群健康问题或者环境,直接或间接作用形式等符合成本效益的干预措施,因而产生了具有明显特征和作用的多维度、多方位、多层次的多元化干预措施。随着对于疾病病因的认识不断加深,对公共卫生干预措施研究更为深入,逐步明确干预措施的性质、类别和所针对的干预对象,发展了公共卫生干预措施的类型学,从而有利于选择符合目前人群卫生问题的适当的干预措施并加以实施,有效达到预期健康目标。因此标准化分类是成功实施干预措施的重要因素,也有助于评估干预措施的效果并进一步优化完善。
公共卫生干预措施也是世界卫生组织(World Health Organization,WHO)倡导建立的国际卫生干预措施分类(international classification of health interventions,ICHI)的重要组成部分。在健康领域,干预措施是适用于旨在通过预防疾病、治愈或减少现有疾病的严重程度或持续时间或通过恢复因疾病或伤害而丧失的功能来改善人类健康的任何活动 5。卫生干预措施是有组织地行动或者努力促进行为和习惯改变,以改善特定人群的身体和心理健康 6。将公共卫生干预措施纳入ICHI,为收集和分析有关人群预防和健康促进活动的一致性和可比性的信息提供了基础,为国际层面公共卫生相关知识和交流信息提供了共同语言,并且有助于提高公共卫生在卫生系统内以及更为广泛的公共卫生政策领域内的可见度。
目前,我国针对公共卫生干预措施的定义及其分类的相关研究较少,也未提出干预措施的分类标准,因此本文梳理收集了国际上关于公共卫生干预措施分类的相关模式,进行归纳总结并介绍分类案例,为我国开展公共卫生干预措施分类的研究提供参考。
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参考文献
[1]
Gatseva P D , Argirova M . Public health: the science of promoting health[J]. J Public Health, 2011,19(3):205-206. DOI: 10.1007/s10389-011-0412-8 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Winslow CE . The untilled fields of public health[J]. Science, 1920,51(1306):23-33. DOI: 10.1126/science.51.1306.23 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Rehfuess EA , Akl EA . Current experience with applying the GRADE approach to public health interventions: an empirical study[J]. BMC Public Health, 2013,13:9. DOI: 10.1186/1471-2458-13-9 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Smith PG , Morrow RH , Ross DA . Field trials of health interventions: a toolbox[M]. Oxford (UK):OUP Oxford, 2015. DOI: 10.1093/med/9780198732860.001.0001 .
[6]
World Health Organization. International classification of health interventions (ICHI)[EB/OL]. [ 2023-01-03]. https://www.who.int/standards/classifications/international-classification-of-health-interventions.
返回引文位置Google Scholar
百度学术
万方数据
[7]
World Health Organization. ICHI Beta-3 reference guide international classification of health interventions[EB/OL]. [ 2023-01-03]. https://mitel.dimi.uniud.it/ichi/docs/ICHI%20Beta-3%20Reference%20Guide.pdf.
返回引文位置Google Scholar
百度学术
万方数据
[8]
Zaiss A , Dauben HP . Ichi-international classification of health interventions: a balancing act between the demands of statistics and reimbursement[J]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2018,61(7):778-786. DOI: 10.1007/s00103-018-2747-6 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Wübbeler M , Geis S , Stojanovic J ,et al. Coding public health interventions for health technology assessments: a pilot experience with who′s international classification of health interventions (ICHI)[J]. Front Public Health, 2021,9:620637. DOI: 10.3389/fpubh.2021.620637 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Fortune N , Madden R , Riley T ,et al. The international classification of health interventions: an ′epistemic hub′ for use in public health[J]. Health Promot Int, 2021,36(6):1753-1764. DOI: 10.1093/heapro/daab011 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Fortune EN . Strengths and limitations of the draft classification of public health interventions in the World Health Organization′s international classification of health interventions: a developmental appraisal[D]. Sydney:The University of Sydney. 2018.
返回引文位置Google Scholar
百度学术
万方数据
[12]
World Health Organization. Global status report on noncommunicable diseases 2010[M]. Geneva:World Health Organization, 2011.
[13]
World Health Organization. Global status report on noncommunicable diseases 2014[M]. Geneva:World Health Organization, 2014.
[14]
World Health Organization. Preventing chronic diseases: a vital investment[M]. Geneva:World Health Organization, 2005.
[15]
Minnesota Department of Health. Public health interventions: applications for nursing practice, ed2nd. ("The Wheel Manual")[EB/OL]. [ 2023-01-03]. https://www.health.state.mn.us/communities/practice/research/phncouncil/docs/PHInterventions.pdf.
返回引文位置Google Scholar
百度学术
万方数据
[16]
Schaffer MA , Strohschein S , Glavin K . Twenty years with the public health intervention wheel: evidence for practice[J]. Public Health Nurs, 2022,39(1):195-201. DOI: 10.1111/phn.12941 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Keller LO , Strohschein S , Lia-Hoagberg B ,et al. Population-based public health interventions: practice-based and evidence-supported. part I[J]. Public Health Nurs, 2004,21(5):453-468. DOI: 10.1111/j.0737-1209.2004.21509.x .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Keller LO , Strohschein S , Schaffer MA ,et al. Population-based public health interventions: innovations in practice, teaching, and management. PartⅡ[J]. Public Health Nurs, 2004,21(5):469-487. DOI: 10.1111/j.0737-1209.2004.21510.x .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Minnesota Department of Health. Public health interventions applications for public health nursing practice[EB/OL]. [ 2023-01-03]. https://mis.kp.ac.rw/admin/admin_panel/kp_lms/files/digital/Core%20Books/Nursing/Public%20health%20interventions.pdf.
返回引文位置Google Scholar
百度学术
万方数据
[20]
Litvak E , Dufour R , Leblanc É ,et al. Making sense of what exactly public health does: a typology of public health interventions[J]. Can J Public Health, 2020,111(1):65-71. DOI: 10.17269/s41997-019-00268-3 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
World Health Organization. Public health interventions in ICHI[EB/OL]. [ 2023-01-03]. https://www.whofic.nl/sites/default/files/2018-05/newsletter%202012-1.p df .
返回引文位置Google Scholar
百度学术
万方数据
[22]
World Health Organization. ICHI Beta-3[EB/OL]. [ 2023-01-03]. https://mitel.dimi.uniud.it/ichi/#http://id.who.int/ichi/entity/1625302257.
返回引文位置Google Scholar
百度学术
万方数据
[23]
Fortune N , Madden R , Riley T ,et al. The international classification of health interventions: an ′epistemic hub′ for use in public health[J]. Health Promot Int, 2021,36(6):1753-1764. DOI: 10.1093/heapro/daab011 .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Wübbeler M , Geis S , Stojanovic J ,et al. Coding public health interventions for health technology assessments: a pilot experience with who′s international classifica tion of health interventions (ICHI) [J]. Front Public Health, 2021,9:620637. DOI: 10.3389/fpubh.2021.620637 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Jewell NP . Natural history of diseases: statistical designs and issues[J]. Clin Pharmacol Ther, 2016,100(4):353-361. DOI: 10.1002/cpt.423 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Rose G . Sick individuals and sick populations[J]. Int J Epidemiol, 1985,14(1):32-38. DOI: 10.1093/ije/14.1.32 .
返回引文位置Google Scholar
百度学术
万方数据
[27]
McLaren L . In defense of a population-level approach to prevention: why public health matters today[J]. Can J Public Health, 2019,110(3):279-284. DOI: 10.17269/s41997-019-00198-0 .
返回引文位置Google Scholar
百度学术
万方数据
[28]
National Institutes of Health. Theory at a glance a guide for health promotion practice (second edition)[EB/OL]. [ 2023-01-03]. http://www.sbccimplementationkits.org/demandrmnch/wp-content/uploads/2014/02/Theory-at-a-Glance-A-Guide-For-Health-Promotion-Practice.pdf.
返回引文位置Google Scholar
百度学术
万方数据
[29]
Minnesota Department of Health. Public health wheel: intervention update[EB/OL]. [ 2023-01-03]. https://www.health.state.mn.us/communities/practice/resources/training/2011-wheeloverview.html.
返回引文位置Google Scholar
百度学术
万方数据
[30]
de santé publiquede Montréal . Plan d′action régional intégré de santé publique de Montréal 2016-2021[EB/OL]. [ 2023-01-03]. https://numerique.banq.qc.ca/patrimoine/details/52327/2785711.
返回引文位置Google Scholar
百度学术
万方数据
[31]
UK Health Security Agency. Nursing and midwifery contribution to public health improving health and wellbeing[EB/OL]. [ 2023-01-03]. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/210100/NMR_final.pdf.
返回引文位置Google Scholar
百度学术
万方数据
[32]
Fortune N , Madden R , Almborg AH . Use of a new international classification of health interventions for capturing information on health interventions relevant to people with disabilities[J]. Int J Environ Res Public Health, 2018,15(1):145. DOI: 10.3390/ijerph15010145 .
返回引文位置Google Scholar
百度学术
万方数据
[33]
Boeda M . The how and why of statistical classifications[J]. Courrier des statistiques, English series, 2009,15:3-9.
返回引文位置Google Scholar
百度学术
万方数据
[34]
World Health Organization. Classification of digital health interventions v1.0: a shared language to describe the uses of digital technology for health[M]. Geneva:World Health Organization, 2018.
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
邵瑞太,Email: nc.defsmabaciatiuroahs
B
王振中, 赵艺皓, 张峥岩, 等. 公共卫生干预措施分类探索及对我国的启示[J]. 中华预防医学杂志, 2023, 57(10): 1655-1662. DOI: 10.3760/cma.j.cn112150-20230118-00046.
C
所有作者声明无利益冲突
D
中国医学科学院中央级公益性科研院所基本科研业务费 (2021-RC330-004)
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