Multiple intervention research programs in community health.
The authors describe an organizing framework for multiple interventions in community health. The framework provides a foundation for programmatic research on multiple interventions and poses critical questions that need to be addressed in the next generation of research in this field. Multiple intervention programs are characterized by the use of multiple strategies targeted at multiple levels of the socio-ecological system and delivered to multiple target audiences. Consequently, they complement the growing literature on the broad determinants of health and health promotion. The authors describe a 4-stage framework and identify gaps and challenges in this field of research. There are 5 key research areas requiring concerted action; researchers must: examine nested determinants, develop integrated conceptual frameworks, examine ways to optimize synergies among interventions, describe spin-offs from multiple intervention programs, and monitor the sustainability of their impact.
Edwards
Nancy
N
School of Nursing, University of Ottawa, 451 Smyth Road, Room 1118, Ottawa, Ontario K1H 8M5, Canada.
Mill
Judy
J
Kothari
Anita R
AR
D002170:Canada; D003152:Community Health Nursing / Q000592:standards*; D003153:Community Health Services / Q000592:standards*; D006293:Health Promotion / Q000458:organization & administration; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D016294:Models, Nursing; D020380:Needs Assessment; D015399:Nursing Research / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation / Q000379:methods*; D012107:Research Design