"It's good to feel like you're doing something": a qualitative study examining state health department employees' views on why ineffective programs continue to be implemented in the USA.
"It's good to feel like you're doing something": a qualitative study examining state health department employees' views on why ineffective programs continue to be implemented in the USA.
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“感觉就像您在做某事是很好的”：一项定性研究，研究了国家卫生部门员工对为什么在美国继续实施无效计划的看法。
DOI：
10.1186/s43058-021-00252-4
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发表时间：
2022-01-15
影响因子：
--
通讯作者：
Brownson RC
中科院分区：
文献类型：
--
作者：
Mazzucca S;Saliba LF;Smith R;Weno ER;Allen P;Padek M;Brownson RC
Mis-implementation, the inappropriate continuation of programs or policies that are not evidence-based or the inappropriate termination of evidence-based programs and policies, can lead to the inefficient use of scarce resources in public health agencies and decrease the ability of these agencies to deliver effective programs and improve population health. Little is known about why mis-implementation occurs, which is needed to understand how to address it. This study sought to understand the state health department practitioners’ perspectives about what makes programs ineffective and the reasons why ineffective programs continue. Eight state health departments (SHDs) were selected to participate in telephone-administered qualitative interviews about decision-making around ending or continuing programs. States were selected based on geographic representation and on their level of mis-implementation (low and high) categorized from our previous national survey. Forty-four SHD chronic disease staff participated in interviews, which were audio-recorded and transcribed verbatim. Transcripts were consensus coded, and themes were identified and summarized. This paper presents two sets of themes, related to (1) what makes a program ineffective and (2) why ineffective programs continue to be implemented according to SHD staff. Participants considered programs ineffective if they were not evidence-based or if they did not fit well within the population; could not be implemented well due to program restraints or a lack of staff time and resources; did not reach those who could most benefit from the program; or did not show the expected program outcomes through evaluation. Practitioners described several reasons why ineffective programs continued to be implemented, including concerns about damaging the relationships with partner organizations, the presence of program champions, agency capacity, and funding restrictions. The continued implementation of ineffective programs occurs due to a number of interrelated organizational, relational, human resources, and economic factors. Efforts should focus on preventing mis-implementation since it limits public health agencies’ ability to conduct evidence-based public health, implement evidence-based programs effectively, and reduce the high burden of chronic diseases. The use of evidence-based decision-making in public health agencies and supporting adaptation of programs to improve their fit may prevent mis-implementation. Future work should identify effective strategies to reduce mis-implementation, which can optimize public health practice and improve population health. The online version contains supplementary material available at 10.1186/s43058-021-00252-4.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
5.5
作者：
Gibbert WS;Keating SM;Jacobs JA;Dodson E;Baker E;Diem G;Giles W;Gillespie KN;Grabauskas V;Shatchkute A;Brownson RC
通讯作者：
Brownson RC
影响因子：
4.5
作者：
Day, Rhiannon Eleanor;Sahota, Pinki;Christian, Meaghan Sarah
通讯作者：
Christian, Meaghan Sarah
DOI：
10.1097/01.phh.0000311891.73078.50
发表时间：
2008-03-01
影响因子：
3.3
作者：
Dreisinger, Mariah;Leet, Terry L.;Brownson, Ross C.
通讯作者：
Brownson, Ross C.
影响因子：
2
作者：
Diem G;Brownson RC;Grabauskas V;Shatchkute A;Stachenko S
通讯作者：
Stachenko S