Expert-generated standard practice elements for evidence-based home visiting programs using a Delphi process.
Expert-generated standard practice elements for evidence-based home visiting programs using a Delphi process.
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DOI：
10.1371/journal.pone.0275981
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Daro, Deborah
中科院分区：
文献类型：
--
作者：
Haroz, Emily E.;Ingalls, Allison;Decker Sorby, Karla;Dozier, Mary;Kaye, Miranda P.;Sarche, Michelle;Supplee, Lauren H.;Whitaker, Daniel J.;Grubin, Fiona;Daro, Deborah
各州、领地、非营利组织和部落有资格获得联邦资金，以实施联邦政府批准的基于证据的家访计划。这代表着翻译科学的巨大成功，每年为这些实施工作分配4亿美元。这项立法还要求每年将这笔资金的3%分配给在其社区实施家访的部落实体。然而，实施利益相关者面临着选择哪个计划最适合他们所希望的结果和背景的挑战。此外，最近的审查表明，当在实践中实施并规模化提供时，许多基于证据的家访计划无法复制临床试验期间取得的保留率和效果。为了向项目实施者提供信息，并更好地识别家访项目中驱动重大影响的有效成分，我们的目标是开发一种专家派生的共识分类法，对家访实践中使用的对优先结果领域至关重要的要素进行分类。我们召集了一个由16名专家组成的小组，他们代表研究人员、模型代表和使用Delphi方法的计划实施者。我们首先使用开放式调查得出标准实践要素(SPE)，然后将这些要素与行为改变技术(BCT)进行比较，考虑到它们在家访领域的普遍重要性；最后将它们的重要性评级为10个结果领域。我们的过程确定了48个来自该小组的SPE，并根据文献添加了83个额外的BCT。六个SPE，主要与家庭访客的特征和技能有关，在所有结果领域被评为必要的。在83项BCT中，53项在所有结果领域中被评为不必要的。这项工作代表了以共识为基础的家访计划所需技术和策略分类的第一步，并为未来的假设检验和复制研究提供了一个框架。
States, territories, non-profits, and tribes are eligible to obtain federal funding to implement federally endorsed evidence-based home visiting programs. This represents a massive success in translational science, with $400 million a year allocated to these implementation efforts. This legislation also requires that 3% of this annual funding be allocated to tribal entities implementing home visiting in their communities. However, implementing stakeholders face challenges with selecting which program is best for their desired outcomes and context. Moreover, recent reviews have indicated that when implemented in practice and delivered at scale, many evidence-based home visiting programs fail to replicate the retention rates and effects achieved during clinical trials. To inform program implementers and better identify the active ingredients in home visiting programs that drive significant impacts, we aimed to develop an expert derived consensus taxonomy on the elements used in home visiting practice that are essential to priority outcome domains. We convened a panel of 16 experts representing researchers, model representatives, and program implementers using a Delphi approach. We first elicited standard practice elements (SPEs) using open-ended inquiry, then compared these elements to behavior change techniques (BCTs) given their general importance in the field of home visiting; and finally rated their importance to 10 outcome domains. Our process identified 48 SPEs derived from the panel, with 83 additional BCTs added based on the literature. Six SPEs, mostly related to home visitor characteristics and skills, were rated essential across all outcome domains. Fifty-three of the 83 BCTs were rated unnecessary across all outcome domains. This work represents the first step in a consensus-grounded taxonomy of techniques and strategies necessary for home visiting programs and provides a framework for future hypothesis testing and replication studies.
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