Despite enduring and unacceptable disparities in health outcomes for Aboriginal and Torres Strait Islander Australians as well as people living in rural and remote locations, evidence indicates that health services are not routinely evaluated. This article describes an exploration of a context where evaluators and community partners have achieved considerable success in implementing and sustaining ongoing monitoring and evaluation for enhanced service effectiveness in rural and underserved communities of New Hampshire. The purpose of this project was to establish the principles supporting this success and to set the stage for future research investigating the applicability of these principles to the remote Australian context. Semistructured interviews were conducted with 15 people from different organizations and in different positions within those organizations. The results invite a reconsideration of the way in which evidence-based practice is conceptualized as well as the role of external evaluators. The study has important implications and recommendations for both policy and practice.

中文翻译：

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重新思考改善健康结果的评估：对偏远澳大利亚的影响

尽管澳大利亚原住民和托雷斯海峡岛民以及生活在农村和偏远地区的人们的健康结果存在持久且不可接受的差异，但有证据表明，并未对医疗服务进行常规评估。本文描述了评估人员和社区合作伙伴在实施和维持持续监测和评估以提高新罕布什尔州农村和服务不足社区的服务效率方面取得了相当大的成功的背景。该项目的目的是建立支持这一成功的原则，并为未来研究这些原则在澳大利亚偏远地区的适用性的研究奠定基础。对来自不同组织和这些组织内不同职位的 15 人进行了半结构化访谈。结果要求重新考虑循证实践的概念化方式以及外部评估者的作用。该研究对政策和实践都具有重要意义和建议。