|Author:||Tang, Mei Yee|
|Title:||Dissemination and transferability of health promotion interventions in Hong Kong|
|Subject:||Health promotion -- Evaluation.|
Health promotion -- China -- Hong Kong.
Public health -- China -- Hong Kong.
Hong Kong Polytechnic University -- Dissertations
|Department:||Faculty of Health and Social Sciences|
|Pages:||x, 283 pages : color illustrations|
|Abstract:||Background: With the emergence of Dissemination and Implementation Science, dissemination and transferability of new knowledge/practice are highlighted as the integral parts of implementing effective interventions in the community. The purpose of this study is to evaluate the impact, including dissemination and transferability, of the Health Care and Promotion Fund (HCPF) with a view to informing policy-makers whether funding was successful or not in achieving the expected benefits. Objectives: The study objectives are to (i) identify a suitable tool to assess the impact of health promotion projects; (ii) examine the extent to which the HCPF projects have been disseminated and transferred; and (iii) examine the factors associated with dissemination and transferability, and identify predicators of public health impact for the HCPF funded projects. Methods: From the literature review, the RE-AIM framework (denoting Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance) was considered the most appropriate tool for this study. Attributes of dissemination and transferability are subsumed under the Reach, Adoption and Implementation dimensions. Grantees of projects completed for 12 months or longer were invited to complete a questionnaire based on this framework. Impact Scores were independently assigned to the five RE-AIM dimensions using a 5-point Likert scale (0-100) according to the criteria set by the fund management denoting the funder's perspective. Factors associated with dissemination, transferability and Impact Scores were examined by univariate analysis and logistic regression.|
Results: A total of 122 funded grants (response rate: 94%) were evaluated. Of which, 64.8% were funded to NGOs, 31.1% to universities and 4.1% to hospitals. A total of 926,189 participants had been reached with high representativeness of the proposed target groups (89% with "No different" or "Somewhat different"). And, 74.6% of project materials were disseminated, 68% were adopted by others, 95.1% had "All met" or "Mostly met" the planned criteria for implementation and 67.2% reported barriers. From the funder's perspective, Impact Scores (SD) related to dissemination and transferability were: Reach = 76 (27.5), Adoption = 43.4 (33.4) and Implementation = 69.5 (27.6). Favourable factors for dissemination and transferability included university-led projects, collaboration in the project teams, grant period longer than 16 months and higher grant amount. Significant factors associated with public health impact are: collaboration in the project teams (OR = 2.783, 95% CI 1.081 - 7.163), grant period between 16 and 24 months (OR = 4.178, 95% CI 1.777 - 9.821) and grant period longer than 24 months (OR = 5.761, 95% CI 1.506 - 22.038). Discussion: The RE-AIM framework is helpful to understand the relative strengths and weaknesses of the HCPF funded grants. To meet the study objectives, the framework was enhanced by adding information on strategies for the uptake of knowledge/skills (i.e. types of dissemination and partnerships) under the Adoption dimension. Impact Scores on Efficacy/Effectiveness (39.3), Adoption (43.4) and Maintenance (30.3) are markedly lower than the scores for other dimensions in this study. Collaboration between universities and community organisations should be further encouraged or become a mandatory funding requirement. Longer grant period (beyond 2 years) with higher grant amount (exceeding $500,000) would be the powerful incentives to foster evidence-based practice in health promotion.
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