Gesundheitswesen 2016; 78(03): 139-145
DOI: 10.1055/s-0035-1548883
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Nachhaltige Implementierung evidenzbasierter Programme in der Gesundheitsförderung: Theoretischer Bezugsrahmen und ein Konzept zum interaktiven Wissenstransfer

Sustainable Implementation of Evidence-Based Programmes in Health Promotion: A Theoretical Framework and Concept of Interactive Knowledge to Action
A. Rütten
1   Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg
,
A. Wolff
1   Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg
,
A. Streber
1   Institut für Sportwissenschaft und Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg
› Author Affiliations
Further Information

Publication History

Publication Date:
18 May 2015 (online)

Zusammenfassung

Ziele: Der Beitrag diskutiert 2 aktuelle Probleme im Bereich der Public Health-Forschung: 1) Übertragung wissenschaftlicher Erkenntnisse in die Praxis und 2) Nachhaltige Implementierung von Modellprojekten. Der Beitrag zielt auf die Integration von wissenschaftlicher und praktischer Evidenzproduktion im Implementierungskontext und auf die Überwindung deduktiver Modelle des Wissenstransfers.

Methodik: Vor dem Hintergrund bestehender theoretischer Ansätze, Pilotstudien sowie eigener konzeptioneller Überlegungen werden anhand einer modellhaften Darstellung des Zusammenspiels von Wissenschaft, Politik und Präventionspraxis Überlegungen zur nachhaltigen Implementierung von Gesundheitsförderungsprogrammen aufgezeigt. Das Konzept beschreibt 4 zentrale Prozesse des Zusammenspiels: Interaktiver Wissenstransfer, Kapazitätsentwicklung, Adaptierung des Programms und Veränderungen im Implementationskontext.

Ergebnisse: Die Sicherung der Nachhaltigkeit von Gesundheitsförderungsprogrammen erfordert eine Integration von wissenschaftlicher und praktischer Evidenzproduktion im Implementierungskontext. Für den Prozess der Integration werden interaktive Ansätze der Wissensproduktion und Umsetzung in Handeln (interactive knowledge to action) diskutiert. Hier sind insbesondere Ansätze der Befähigung und Kapazitätsentwicklung über Beteiligung und systematische Zusammenarbeit relevanter Stakeholder erfolgsversprechend. Durch diese Zusammenarbeit werden Prozesse der dynamischen Interaktion zwischen dem jeweiligen Gesundheitsförderungsprogramm, den Zielgruppen, beteiligten Organisationen sowie dem sozialen, kulturellen und politischen Kontext ausgelöst. Die wechselseitige Adaptation von Programm und Schlüsselkomponenten des Implementierungskontextes fördert dabei gleichzeitig die Wirksamkeit des Programms und die Nachhaltigkeitsentwicklung.

Schlussfolgerung: Die nachhaltige Implementierung evidenzbasierter Gesundheitsförderungsprogramme erfordert Alternativen zu den vorherrschenden deduktiven Modellen des Wissenstransfers. Interaktive Ansätze erweisen sich als erfolgsversprechende Alternativen. Sie verändern aber gleichzeitig die Zuständigkeiten von Wissenschaft, Politik und Public-Health-Praxis. Traditionelle Abgrenzungen zwischen Disziplinen und Sektoren werden z. B. durch die Konstituierung transdisziplinärer Teams sowie gemeinsamer Agenden und Vorgehensweisen überwunden. Diese Ansätze erfordern u. a. auch Anpassungen der Rahmenbedingungen von Forschungsprojekten, wie z. B. längere Förderzeiträume.

Abstract

Objectives: This article discusses 2 current issues in the field of public health research: (i) transfer of scientific knowledge into practice and (ii) sustainable implementation of good practice projects. It also supports integration of scientific and practice-based evidence production. Furthermore, it supports utilisation of interactive models that transcend deductive approaches to the process of knowledge transfer.

Methods: Existing theoretical approaches, pilot studies and thoughtful conceptual considerations are incorporated into a framework showing the interplay of science, politics and prevention practice, which fosters a more sustainable implementation of health promotion programmes. The framework depicts 4 key processes of interaction between science and prevention practice: interactive knowledge to action, capacity building, programme adaptation and adaptation of the implementation context.

Results: Ensuring sustainability of health promotion programmes requires a concentrated process of integrating scientific and practice-based evidence production in the context of implementation. Central to the integration process is the approach of interactive knowledge to action, which especially benefits from capacity building processes that facilitate participation and systematic interaction between relevant stakeholders. Intense cooperation also induces a dynamic interaction between multiple actors and components such as health promotion programmes, target groups, relevant organisations and social, cultural and political contexts. The reciprocal adaptation of programmes and key components of the implementation context can foster effectiveness and sustainability of programmes.

Conclusion: Sustainable implementation of evidence-based health promotion programmes requires alternatives to recent deductive models of knowledge transfer. Interactive approaches prove to be promising alternatives. Simultaneously, they change the responsibilities of science, policy and public health practice. Existing boundaries within disciplines and sectors are overcome by arranging transdisciplinary teams as well as by developing common agendas and procedures. Such approaches also require adaptations of the structure of research projects such as extending the length of funding.

 
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