Phases of alcohol problem prevention research
Phases of alcohol problem prevention research
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DOI：
10.1111/j.1530-0277.1999.tb04043.x
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发表时间：
1999-01-01
影响因子：
3.2
通讯作者：
Grossman, M
中科院分区：
文献类型：
--
作者：
Holder, H;Flay, B;Grossman, M
我们建立在其他健康研究的先例，提出了一个阶段模型的研究酒精问题的预防，适应本研究的特殊性。我们提出了一个五层次模型，在这个模型中，研究沿着一系列相关的连续体移动：从基础研究到越来越多的应用研究;从描述性的假设产生的试点研究到成熟的、方法复杂的假设检验研究;从较小的样本到较大的样本进行检验;从较大的实验条件控制到较小的实验条件控制;从比较人为的“实验室”环境到现实世界中按地理位置界定的社区;从测试单一预防战略的效果到对纳入干预系统的多种战略进行比较复杂的研究;从研究驱动的结果研究到“示范”项目，这些项目根据事先评估评估各种类型社区执行预防方案的能力。研究的五个阶段是：（1）基础研究，以界定和确定具体的酒精相关问题的流行程度，确定产生具体问题或增加问题风险的因果因素和过程，并为制定有效的预防干预措施提供基础;（2）发展性（初步有效性）研究，以开发和测试新干预措施的可能有效性，安全性和成本，或评估有效性，安全性，现有干预措施的成本;（3）有效性研究，以确定在最佳实施条件下干预措施的效果，安全性和成本（或可得性或执行）和接受（或社区、组织或团体层面的采用;或个人层面的参与、遵从或遵守）;（4）对预防性干预措施的实际有效性进行的有效性研究，这些干预措施在实施和接受方面存在有目的或自然的差异;以及（5）对广泛传播的干预措施的效果进行的示范研究。本文提出的酒精问题预防研究的拟议阶段模型与其他国立卫生研究院机构建立的模型有很大不同。更加重视自然实验、沿着整个研究连续体的方法开发、在适当的情况下整合或合并研究阶段、认识到行为参数在研究序列早期和后期的至关重要性，以及扩展研究连续体以涵盖扩散和传播（即，技术转让）研究。我们还包括在现有的酒精研究和相关问题的讨论，包括成本，特殊人群，方法和传播的分阶段研究的例子。如果有系统地加以遵循，这一模式有可能有助于更广泛地测试和传播已知有效的预防干预措施。
We build on precedents from other health research to present a phases model of research for alcohol problem prevention that accommodates the special characteristics of this research. We propose a five-level model, in which research moves along a series of relevant continua: from basic to more and more applied research; from descriptive hypothesis-generating pilot studies to full-fledged, methodologically sophisticated, hypothesis-testing studies; from smaller to larger samples for testing; from greater to lesser control of experimental conditions; from more artificial "laboratory" environments to real-world geographically defined communities; from testing the effects of single prevention strategies to more complex studies of multiple strategies integrated into intervention systems; and from research-driven outcome studies to "demonstration" projects that evaluate the capacity of various types of communities to implement prevention programs based on prior evaluations. The five phases of research are: (1) foundational research to define and determine the prevalence of specific alcohol-involved problems, establish causal factors and processes that yield the specific problems or increase the risk of a problem, and provide the foundations for the development of effective prevention interventions; (2) developmental (preliminary effectiveness) studies to develop and test the likely effectiveness, safety, and costs of new interventions or to assess the effectiveness, safety, and costs of an existing intervention; (3) efficacy studies to determine the effects, safety, and costs of an intervention under optimal conditions of implementation (or availability or enforcement) and acceptance (or adoption at the community, organizational, or group level; or participation, compliance, or adherence at the individual level); (4) effectiveness studies of the real-world effectiveness of preventive interventions with purposeful or natural variation in implementation and acceptance; and (5) demonstration studies of the effects of interventions when widely disseminated. The proposed phases model for alcohol problem prevention research presented herein differs in significant ways from the models established by other National Institutes of Health agencies. Greater emphasis is placed on natural experiments, on methods development along the whole research continuum, on collapsing or combining research phases when appropriate, on recognizing the critical importance of behavioral parameters early as well as late in the research sequence, and on extending the research continuum to embrace diffusion and dissemination (i,e., technology transfer) studies. We also include examples of phased research in existing alcohol studies and a discussion of relevant issues, including cost, special populations, methods, and dissemination. If systematically followed, this model has the potential to contribute to wider testing and dissemination of prevention interventions of known effectiveness.