How can we adapt complex population health interventions for new contexts? Progressing debates and research priorities.
How can we adapt complex population health interventions for new contexts? Progressing debates and research priorities.
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DOI：
10.1136/jech-2020-214468
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发表时间：
2021-01
影响因子：
6.3
通讯作者：
ADAPT Panel comprises of Laura Arnold
中科院分区：
文献类型：
--
作者：
Evans RE;Moore G;Movsisyan A;Rehfuess E;ADAPT Panel;ADAPT Panel comprises of Laura Arnold
英国医学研究理事会和国家健康研究所资助了ADAPT研究（2018-2020），为适应新环境的复杂人群健康干预措施制定方法指南。虽然在框架方面取得了进展，但仍有关键的理论和方法论辩论需要取得进展。适应技术研究召集了一次小组会议，以确定和丰富这些辩论。本文介绍了小组的讨论，并提出了未来的研究方向。十六名研究人员和一名政策制定者于2019年7月召开了为期一天的会议。其目的是反思新的研究结果（适应指导意见的系统审查;案例的范围审查;与资助者、期刊编辑、研究人员和政策制定者的定性访谈），推进理论和方法论辩论，并考虑在哪些方面可能需要创新以弥补研究差距。尽管适应框架激增，但在基本概念（如适应）的定义上仍然存在问题。适应的基本原理，往往侧重于不同的情况下，可能会导致适应过度活跃。相似之处应同样重视。关于干预修改的决策目前特权的概念，“核心组件”，工作是需要进步的使用和操作的“功能灵活性”。必须改进语言和方法，以确保不同利害关系方有意义地参与适应进程。需要提供进一步指导，以评估在新的背景下需要进行的重新评价的程度。更好地理解不同的理论观点，特别是复杂系统思维、执行科学和现实主义评估，可能有助于加强适应问题的研究。
The UK Medical Research Council and National Institute for Health Research have funded the ADAPT study (2018–2020), to develop methodological guidance for the adaptation of complex population health interventions for new contexts. While there have been advances in frameworks, there are key theoretical and methodological debates to progress. The ADAPT study convened a panel meeting to identify and enrich these debates. This paper presents the panel’s discussions and suggests directions for future research. Sixteen researchers and one policymaker convened for a 1-day meeting in July 2019. The aim was to reflect on emerging study findings (systematic review of adaptation guidance; scoping review of case examples; and qualitative interviews with funders, journal editors, researchers and policymakers), progress theoretical and methodological debates, and consider where innovation may be required to address research gaps. Despite the proliferation of adaptation frameworks, questions remain over the definition of basic concepts (eg, adaptation). The rationale for adaptation, which often focuses on differences between contexts, may lead to adaptation hyperactivity. Equal emphasis should be placed on similarities. Decision-making about intervention modification currently privileges the concept of ‘core components’, and work is needed to progress the use and operationalisation of ‘functional fidelity’. Language and methods must advance to ensure meaningful engagement with diverse stakeholders in adaptation processes. Further guidance is required to assess the extent of re-evaluation required in the new context. A better understanding of different theoretical perspectives, notably complex systems thinking, implementation science and realist evaluation may help in enhancing research on adaptation.
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