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Advancing Scientific Methods in Community and Cultural Context to Promote Health Equity: Lessons From Intervention Outcomes Research With American Indian and Alaska Native Communities

机译：在社区和文化背景下推进科学方法以促进健康公平：与美洲印第安人和阿拉斯加土著社区的干预成果研究的经验教训

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摘要

Evidence-based interventions hold promise for reducing gaps in health equity across diverse populations, but evidence about effectiveness within these populations lags behind the mainstream, often leaving opportunities to fulfill this promise unrealized. Mismatch between standard intervention outcomes research methods and the cultural and community contexts of populations at greatest risk presents additional challenges in designing and implementing rigorous studies; these challenges too often impede efforts to generate needed evidence. We draw on experiences with American Indian and Alaska Native (AIAN) communities to illustrate how consideration of culture and context can constructively shape intervention research and improve the quality of evidence produced. Case examples from a partnership with one AI community highlight opportunities for increasing alignment in intervention development, research design, and study implementation to maximize both validity and feasibility. We suggest that responsively tailoring intervention outcome research to cultural and community contexts is fundamental to supporting health equity.
机译：以证据为基础的干预措施有望缩小不同人群之间在卫生公平性方面的差距，但是这些人群中有效性的证据落后于主流，常常使实现这一诺言的机会无法实现。标准干预结果研究方法与风险最大的人群的文化和社区背景不匹配，在设计和实施严格的研究方面面临更多挑战；这些挑战常常阻碍了产生所需证据的努力。我们借鉴美洲印第安人和阿拉斯加原住民（AIAN）社区的经验，以说明对文化和背景的考虑如何能够建设性地影响干预研究并提高所产生证据的质量。来自与一个AI社区的合作伙伴关系的案例示例突出了在干预开发，研究设计和研究实施中增加一致性的机会，以最大程度地提高有效性和可行性。我们建议，针对文化和社区环境做出自适应的干预结果研究，是支持健康公平的基础。

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