Results from checkpoint measurements.

BackgroundTailored health messaging can be used to improve symptom recognition of ischemic heart disease (IHD) and reduce barriers to care. Therefore, we propose that a gender-informed and culturally-sensitive toolkit for health messaging could improve health outcomes by promoting adequate care seeking in the community. Hence, we will develop, implement, and evaluate a toolkit to improve IHD-related symptom recognition and care seeking in an ethnically-diverse population.MethodsWe developed a toolkit in co-creation with patients, citizens, community leaders, and healthcare professionals. Subsequently, we pilot-implemented the toolkit through organizing information sessions in four different community-based settings. Finally, using a mixed-methods design, we evaluated the Reach, Effectiveness, Adoption, Implementation, and Maintenance of the toolkit (RE-AIM), including its effect on knowledge gain on symptom recognition and care seeking,.ResultsApproximately 240 people attended the information sessions, of whom 69% women, and the mean age was 63 (standard deviation 10.7) years old. Our results showed a small increase [varying from 53.4–74.4% pre-test to 67.6–85.4% post-test] in knowledge about IHD symptoms. A great willingness to adoption the intervention was observed among the targeted community leaders, and despite several points of improvement, including fidelity to the implementation, attendees and community leaders reflected positively on the toolkit. The main challenge regarding the maintenance of the toolkit was a lack of experience in organizing community events by potential maintenance organizations.ConclusionWhile the co-created toolkit was well-received, and findings concerning the reach, adoption, and implementation were positive, the (cost)effectiveness should be further evaluated to study the long-term impact of the intervention. Moreover, the need for integration of the intervention in current infrastructure constituted a challenge to the maintenance of the toolkit.背景：定制化健康宣教内容可提升缺血性心脏病（ischemic heart disease, IHD）的症状识别率，并降低就医障碍。据此，我们提出，具备性别适配性与文化敏感性的健康宣教工具包，可通过推动社区群体合理就医，改善健康结局。因此，本研究将开发、实施并评估一款工具包，以提升多族裔人群对IHD相关症状的识别能力与就医意愿。 方法：本研究通过与患者、普通市民、社区领袖及医疗保健专业人员协同共创，开发了该工具包。随后，我们在四类不同的社区场景中举办信息宣讲会，完成该工具包的试点实施。最后，采用混合研究设计，评估该工具包的覆盖范围（Reach）、效果（Effectiveness）、采纳度（Adoption）、实施质量（Implementation）与可持续性（Maintenance）（即RE-AIM框架），并考察其对症状识别与就医相关知识提升的影响。 结果：约240人参与了本次信息宣讲会，其中女性占比69%，平均年龄为63岁（标准差10.7）。研究结果显示，受试者对IHD相关症状的认知水平小幅提升，从前测的53.4%~74.4%提升至后测的67.6%~85.4%。目标群体中的社区领袖展现出较高的工具包采纳意愿；尽管在实施贴合度等方面存在若干改进空间，但参与宣讲会的民众与社区领袖均对该工具包给出了积极评价。工具包可持续运维面临的主要挑战为：潜在的运维组织缺乏社区活动筹办经验。 结论：尽管本次协同共创的工具包获得了良好反响，且覆盖范围、采纳度与实施情况相关结果均呈积极态势，但仍需进一步评估其（成本）效益，以探究该干预措施的长期影响。此外，如何将该干预措施整合至现有公共卫生基础设施中，也成为工具包可持续运维的一大挑战。