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首页> 外文期刊>Journal of urban health >Long-Term Effects of Integrated Strategies of Community Health Promotion on Diabetes Mellitus Mortality: a Natural Policy Experiment Based on Aggregated Longitudinal Secondary Data
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Long-Term Effects of Integrated Strategies of Community Health Promotion on Diabetes Mellitus Mortality: a Natural Policy Experiment Based on Aggregated Longitudinal Secondary Data

机译：社区健康促进型糖尿病死亡率综合策略的长期影响：基于聚合的纵向二级数据的自然政策实验

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Integrated strategies of community health promotion (ISCHP) are based on intersectoral collaborations using the Health in All Policies approach to address determinants of health. While effects on health determinants have been shown, evidence on the effectiveness of ISCHP on health outcomes is scarce. The aim of this study is to assess the long-term effects of ISCHP on diabetes mellitus mortality (DMM) in German communities. A nonrandomized evaluation based on secondary county-level official data (1998–2016) was performed. In April 2019, 149 communities in Germany with ISCHP out of 401 were identified. Communities with?&?5 measurements of DMM, starting before 1999 or after 2015, were excluded. Analyses included 65 communities with ISCHP (IG) and 124 without ISCHP (CG). ISCHP ran for a mean of 5.6?years. Fixed effects (FE) models were used to estimate effects of ISCHP and duration on DMM taking into account the time-varying average age. The FE estimator for DMM is b ?=????2.48 (95% CI???3.45 to???1.51) for IG vs. CG and b?=????0.30 (95% CI???0.46 to???0.14) for ISCHP duration (0–16?years). In the first year of an ISCHP, a reduction of the annual DMM of 0.3 per 100,000 population (1%), and in the 16th year of 4.8 (14%) was achieved. This study provides preliminary evidence of the effectiveness of ISCHP in Germany. Limitations include inaccuracies to classify IG and CG and possible selection bias. Longitudinal county-level data may be an efficient data source to evaluate complex interventions, thereby contributing to further strengthen evidence-based integrated health promotion. Supplementary Information The online version contains supplementary material available at 10.1007/s11524-021-00590-7.
机译：社区健康促进（ISCHP）的综合策略基于使用所有政策方法的跨部门合作，以解决健康的决定因素。虽然已经显示了对健康决定因素的影响，但有关伊斯基金人对健康结果的有效性的证据是稀缺的。本研究的目的是评估ISCHP对德国社区糖尿病死亡率（DMM）的长期影响。基于次级县级官方数据（1998-2016）的非扫描评估进行了。 2019年4月，确定了401名德国德国社区，其中401岁的伊斯坦普队得到了401号。社区与？＆amp; ？5在1999年之前或2015年以后开始的DMM测量，被排除在外。分析包括ischp（Ig）和124的65个社区，没有ischp（cg）。 ischp持续为5.6？多年。固定效应（FE）模型用于估计ISCHP和持续时间对DMM的影响，考虑到时代的时效。用于DMM的FE估计器是B？= ???? 2.48（95％CI ??? 3.45至-ON-1.51）用于Ig与CG和B？= ???? 0.30（95％CI ??? 0.46到??? 0.14）对于ISCHP持续时间（0-16？年）。在ISCHP的第一年，减少了每10万人口每年0.3的年度DMM（1％），并在4.8（14％）的16年内。本研究提供了德国Ischp的有效性的初步证据。限制包括分类IG和CG的不准确性以及可能的选择偏差。纵向县级数据可能是一个有效的数据源来评估复杂的干预措施，从而有助于进一步加强基于证据的综合健康促进。补充信息在线版本包含10.1007 / S11524-021-00590-7的补充材料。

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