Barriers, frameworks, and mitigating strategies influencing the dissemination and implementation of health promotion interventions in indigenous communities: a scoping review

Implementation Science

Cornelia Jessen¹  Belinda Hernandez²  Christine Markham³  Melissa Peskin³  Ross Shegog³  Lea Sacca³  Travis Lane⁴  Stephanie Craig Rushing⁵ 

[1] Alaska Native Tribal Health Consortium, 4000 Ambassador Drive, 99508, Anchorage, AK, USA;Center for Health Promotion and Disease Prevention, University of Texas Health Science Center School of Public Health in San Antonio, 7411 John Smith Drive, Suite 1100, 78229, San Antonio, TX, USA;Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, 77030, Houston, TX, USA;Inter Tribal Council of Arizona, Inc., 2214 North Central Avenue, 85004, Phoenix, AZ, USA;Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, 97201, Portland, OR, USA;

关键词: Dissemination frameworks;    Implementation barriers;    Indigenous communities;    SISTER strategies;    Cultural context;   

DOI  :  10.1186/s13012-022-01190-y

来源: Springer

【 摘 要 】

BackgroundMany Indigenous communities across the USA and Canada experience a disproportionate burden of health disparities. Effective programs and interventions are essential to build protective skills for different age groups to improve health outcomes. Understanding the relevant barriers and facilitators to the successful dissemination, implementation, and retention of evidence-based interventions and/or evidence-informed programs in Indigenous communities can help guide their dissemination.PurposeTo identify common barriers to dissemination and implementation (D&I) and effective mitigating frameworks and strategies used to successfully disseminate and implement evidence-based interventions and/or evidence-informed programs in American Indian/Alaska Native (AI/AN), Native Hawaiian/Pacific Islander (NH/PI), and Canadian Indigenous communities.MethodsA scoping review, informed by the York methodology, comprised five steps: (1) identification of the research questions; (2) searching for relevant studies; (3) selection of studies relevant to the research questions; (4) data charting; and (5) collation, summarization, and reporting of results. The established D&I SISTER strategy taxonomy provided criteria for categorizing reported strategies.ResultsCandidate studies that met inclusion/exclusion criteria were extracted from PubMed (n = 19), Embase (n = 18), and Scopus (n = 1). Seventeen studies were excluded following full review resulting in 21 included studies. The most frequently cited category of barriers was “Social Determinants of Health in Communities.” Forty-three percent of barriers were categorized in this community/society-policy level of the SEM and most studies (n = 12, 57%) cited this category. Sixteen studies (76%) used a D&I framework or model (mainly CBPR) to disseminate and implement health promotion evidence-based programs in Indigenous communities. Most highly ranked strategies (80%) corresponded with those previously identified as “important” and “feasible” for D&I The most commonly reported SISTER strategy was “Build partnerships (i.e., coalitions) to support implementation” (86%).ConclusionD&I frameworks and strategies are increasingly cited as informing the adoption, implementation, and sustainability of evidence-based programs within Indigenous communities. This study contributes towards identifying barriers and effective D&I frameworks and strategies critical to improving reach and sustainability of evidence-based programs in Indigenous communities.Registration numberN/A (scoping review)

【 授权许可】

CC BY