Developing and maintaining partnerships as the foundation of implementation and implementation science: reflections over a half century.

摘要

Public health depends on its base of community support, and each public health program depends on this support for its survival. As a broad field public health is dramatically intrusive; it invades the most private lives of citizens, including instructions how to brush your teeth, injections of bacterial vaccines into your body against disease, guidelines on what to eat, prohibitions against smoking, limits on ages of individuals allowed to use of alcohol and prohibitions against use while driving, prohibitions against use of illicit drugs at all. Even sexual practices receive strong instructions such as promoting safe sex behavior such as condom use. Public health law requires vaccinating the community's children before school entry, and even requires chlorine-a poison-in the community's drinking water. In teaching public health I have often cited the first rule: "Don't get kicked out of the community". And that brings us to the issue of partnerships, the foundation on which all public health is built. These reflections are about the required but complex nature of relationships among community organization constituents, service delivery agencies, and research institutions and investigators to carry out programs- from priority setting to their initial testing of efficacy, then effectiveness, and now into implementation and "going-to-scale".