Behavior change intervention research in community settings: how generalizable are the results?
Behavior change intervention research in community settings: how generalizable are the results?
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DOI：
10.1093/heapro/dah211
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发表时间：
2004-06-01
影响因子：
2.7
通讯作者：
Glasgow, RE
中科院分区：
文献类型：
--
作者：
Dzewaltowski, DA;Estabrooks, PA;Glasgow, RE
这篇综述考察了最近在社区环境中进行的行为干预研究在多大程度上报告了内部和外部效度的要素，重点是是否在具有代表性的环境中进行了具有代表性的人群的研究。对促进良好营养、体育活动或戒烟/预防的社区干预研究进行了有针对性的审查，并在1996年至2000年期间发表在11种主要健康行为杂志上。RE-AIM框架(REACH、效力、采用、执行和维护)用于评估每份文件报告REACH要素、效力/效力、采用、执行和维护的程度。共审查了27种出版物。虽然大多数研究(88%)报告了符合条件的目标受众成员的参与率(REACH)，但只有11%的研究报告了符合条件的社区组织或环境的参与率(‘收养’)。很少有研究报告参与的个人或背景是否代表了更广泛的人群中发现的那些。尽管大多数研究(59%)报告了是否实施了干预，但很少有人报告个人是否保持行为改变(30%)，或者组织是否维持干预或制度化干预(0%)。为了增加将社区研究成果转化为实践的可能性，研究应更加重视获取和报告外部有效性信息，如代表性。外部效度信息的缺乏限制了研究者和实践者判断效果的概括性和干预措施的相对效用的能力。改进报告将有助于在社区实施行之有效和广泛适用的干预战略。为了取得重大进展，所有各方，包括研究人员、审查员、编辑和资助者，都需要承担责任，更加重视外部有效性信息，并询问他们可以发挥什么作用来最好地促进这一进程。
This review examines the extent to which recent behavioral intervention studies conducted in community settings reported on elements of internal and external validity, with an emphasis on whether research has been conducted in representative settings with representative populations. A targeted review was conducted on community-based intervention studies that promoted good nutrition, physical activity or smoking cessation/prevention, and were published in 11 leading health behavior journals between 1996 and 2000. The RE-AIM framework (reach, efficacy, adoption, implementation and maintenance) was used to evaluate the extent to which each paper reported on elements of reach, efficacy/effectiveness, adoption, implementation and maintenance. A total of 27 publications were reviewed. Although most studies (88%) reported participation rates among eligible members of the target audience ('reach'), only 11% of studies reported the participation rate ('adoption') among eligible community-based organizations or settings. Few studies reported if participating individuals or settings were representative of those found in the broader population. Although a majority of studies (59%) reported whether the intervention was delivered ('implementation'), few reported whether individuals maintained behavior change (30%) or whether organizations maintained or institutionalized interventions (0%). To increase the potential to translate community research findings to practice, studies should place a greater emphasis on obtaining and reporting external validity information, such as representativeness. The lack of external validity information limits researchers' and practitioners' ability to judge the generalizability of effects and the comparative utility of interventions. Improved reporting will facilitate implementation of proven and broadly applicable intervention strategies in communities. To make significant progress, all parties, including researchers, reviewers, editors and funders, need to take responsibility for increased emphasis on external validity information and ask what role they can best play to facilitate this process.