PDF(Pubmed)
Abstract：
Lessons from global health have long informed efforts to improve primary health care (PHC) in the United States (US). Despite this history, no generalizable framework exists to guide US stakeholders in the identification and application of ideas from abroad related to the key PHC components of community engagement and service delivery. We sought to develop such a framework.
We reviewed the experience of Global to Local, a community-based organization (CBO) founded with a mission to apply global health strategies to improve the health in vulnerable populations in the US, and examined the experience of care delivery organizations in the US that have successfully implemented global-to-local solutions. Based on that experience, and supported by the advice of an expert panel, we developed a framework for applying global learning to improve US PHC.
The framework includes six change concepts under three broad categories. The first category focuses on the need to actively and intentionally incorporate a global perspective in organizational program design and improvement activities. The second category addresses approaches to identifying global solutions related to community engagement and to health service delivery. The third category focuses on adaptation and implementation of lessons from global health in domestic contexts by applying relevant insights from dissemination and implementation science and diffusion of innovation theory.
In the absence of a robust literature providing implementation guidance to US health systems and CBOs open to adopting or adapting PHC strategies and practices from other countries, the proposed framework synthesizing the experience of organizations that have done so can inform efforts to apply lessons from global health to improve PHC in the US.
We reviewed the experience of Global to Local, a community-based organization (CBO) founded with a mission to apply global health strategies to improve the health in vulnerable populations in the US, and examined the experience of care delivery organizations in the US that have successfully implemented global-to-local solutions. Based on that experience, and supported by the advice of an expert panel, we developed a framework for applying global learning to improve US PHC.
The framework includes six change concepts under three broad categories. The first category focuses on the need to actively and intentionally incorporate a global perspective in organizational program design and improvement activities. The second category addresses approaches to identifying global solutions related to community engagement and to health service delivery. The third category focuses on adaptation and implementation of lessons from global health in domestic contexts by applying relevant insights from dissemination and implementation science and diffusion of innovation theory.
In the absence of a robust literature providing implementation guidance to US health systems and CBOs open to adopting or adapting PHC strategies and practices from other countries, the proposed framework synthesizing the experience of organizations that have done so can inform efforts to apply lessons from global health to improve PHC in the US.
摘要：
UNASSIGNED：长期以来，全球卫生的经验教训为改善美国（US）的初级卫生保健（PHC）提供了信息。尽管有这样的历史,没有可推广的框架来指导美国利益相关者识别和应用与社区参与和服务提供的关键PHC组成部分相关的国外想法。我们寻求建立这样一个框架。
UNASSIGNED：我们回顾了全球到本地的经验，一个以社区为基础的组织（CBO），其使命是应用全球卫生战略来改善美国弱势群体的健康状况，并审查了美国成功实施全球到本地解决方案的护理提供组织的经验。根据这些经验,并在专家小组的建议下，我们开发了一个应用全球学习来提高美国PHC的框架。
UNASSIGNED：该框架包括三个大类别下的六个变更概念。第一类侧重于在组织方案设计和改进活动中积极和有意地纳入全球视角的必要性。第二类涉及确定与社区参与和卫生服务提供有关的全球解决方案的方法。第三类侧重于通过应用传播和实施科学以及创新理论传播的相关见解，在国内环境中适应和实施全球健康的经验教训。
UNASSIGNED：由于缺乏为美国卫生系统和社区组织提供实施指导的有力文献，因此可以采用或适应其他国家的PHC战略和做法，拟议的框架综合了已经这样做的组织的经验，可以为努力应用全球卫生的经验教训，以改善美国的PHC提供信息。
UNASSIGNED：我们回顾了全球到本地的经验，
UNASSIGNED：该框架包括三个大类别下的六个变更概念。
UNASSIGNED：由于缺乏为美国卫生系统和社区组织提供实施指导的有力文献，因此可以采用或适应其他国家的PHC战略和做法，
