A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations.

A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations.
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DOI:
10.1186/1748-5908-5-14
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发表时间:
2010-02-09
期刊:
Implementation science : IS
影响因子:
--
通讯作者:
Grimshaw JM
Grimshaw JM
中科院分区:
其他
文献类型:
--
作者:
Davies P;Walker AE;Grimshaw JM

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在实施研究中使用认知,行为和组织理论的兴趣越来越大。然而,理论在实施研究中的使用程度是不确定的。我们对1966年至1998年期间发表的235项指南传播和实施研究的严格评价中的理论使用进行了系统回顾。根据使用类型(明确基于理论,一些概念基础和使用的理论构建)和使用阶段(干预的选择/设计,过程/中介者/主持人和事后/解释)对理论的使用进行分类。235项研究中有53项(22.5%)被认为使用了理论,其中包括14项明确使用理论的研究。大多数研究(n = 42)只使用一种理论;任何研究使用的理论最多为3种。共使用了25种不同的理论。少数理论占理论使用的大部分,包括PRECEDE(教育诊断和评估中的诱发,强化和启用结构),创新的传播,信息过载和社会营销(学术细节)。至少在1998年之前,在已确定的研究中,干预措施的选择和理论在实施研究中的应用的合理性都很差。未来的研究应明确确定干预的理由。需要更多地使用外显理论来理解障碍,设计干预措施,并探索中介途径和主持人,以推进实施研究的科学。
There is growing interest in the use of cognitive, behavioural, and organisational theories in implementation research. However, the extent of use of theory in implementation research is uncertain. We conducted a systematic review of use of theory in 235 rigorous evaluations of guideline dissemination and implementation studies published between 1966 and 1998. Use of theory was classified according to type of use (explicitly theory based, some conceptual basis, and theoretical construct used) and stage of use (choice/design of intervention, process/mediators/moderators, and post hoc/explanation). Fifty-three of 235 studies (22.5%) were judged to have employed theories, including 14 studies that explicitly used theory. The majority of studies (n = 42) used only one theory; the maximum number of theories employed by any study was three. Twenty-five different theories were used. A small number of theories accounted for the majority of theory use including PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation), diffusion of innovations, information overload and social marketing (academic detailing). There was poor justification of choice of intervention and use of theory in implementation research in the identified studies until at least 1998. Future research should explicitly identify the justification for the interventions. Greater use of explicit theory to understand barriers, design interventions, and explore mediating pathways and moderators is needed to advance the science of implementation research.
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