Abstract:
Since launching health health-promoting settings approach to health by WHO, valuable progress has happened in implementing its holistic concepts in settings such as cities, schools, workplaces, hospitals and healthcare services. However, significant knowledge-intention-success gaps still exist in creating sustainable health-promoting changes in settings. The complexity of the task of bridging this gap has contributed to the call for a complexity-informed paradigm shift to health as well as settings, followed by increasing consultation of relevant complexity theories, frameworks and tools in health research. This paper provides a critical scoping review of the application of complex adaptive system (CAS) theory in settings-based health promotion research. We included 14 papers, mostly qualitative studies, reporting on planning or implementation of change initiatives, less on its evaluation. CAS theory application was often incomplete thereby reducing the potential benefit of using this lens to understand change management. We suggest some recommendations how to comprehensively apply the CAS theory in setting-based health research and to report on all CAS characteristics to enhance the understanding of settings as adaptive health-promoting settings.
摘要:
自世卫组织启动促进健康的健康环境方法以来,在城市、学校,工作场所,医院和医疗服务。然而,在创造可持续的促进健康的环境变化方面,仍然存在显著的知识-意图-成功差距。弥合这一差距的任务的复杂性促使人们呼吁将基于复杂性的范式转变为健康和环境,其次是对相关复杂性理论的咨询增加,健康研究的框架和工具。本文对复杂适应系统(CAS)理论在基于环境的健康促进研究中的应用进行了严格的范围审查。我们收录了14篇论文,主要是定性研究,报告变革举措的规划或实施情况,对其评价较少。CAS理论的应用通常是不完整的,从而降低了使用此镜头来了解变更管理的潜在好处。我们提出了一些建议,建议如何在基于环境的健康研究中全面应用CAS理论,并报告所有CAS特征,以增强对环境作为适应性健康促进环境的理解。