Implementation fidelity, attitudes, and influence: a novel approach to classifying implementer behavior.
Implementation fidelity, attitudes, and influence: a novel approach to classifying implementer behavior.
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实现保真度、态度和影响：一种分类实现者行为的新方法。
DOI：
10.1186/s43058-022-00307-0
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发表时间：
2022-06-06
影响因子：
--
通讯作者：
中科院分区：
文献类型：
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本研究试图（1）描述一种新的实施者行为类型的分类方法和（2）探索实施者行为的变化，以应对基于分类的定制实施促进。在38个早期护理和教育教室中进行了一项小规模的群集随机混合III型实施试验，这些教室是“一起，我们一起选择智能饮食”（WISE）计划的一部分。WISE侧重于4个循证实践（EBP），由教师实施，以促进营养。外部促进者（N = 3）使用改良的快速评估程序知情临床人种学（RAPICE）完成沉浸（即，观察）和访谈的主题内容分析，以确定教师在不同水平的实施忠诚的行为特征。本研究以教师对创新的态度、忠诚度/适应性、影响力三个关键因素来区分教师的实施行为。这一过程产生了一种新的分类方法。为了评估应用分类方法的可靠性，我们评估了主持人之间的一致性百分比。根据教师的分类，研究小组开发了一个量身定制的促进反应。为了探索与量身定制的促进相关的行为变化，评估了整个学年的忠诚度和分类的变化。这些分类包括（1）热情采用者（积极态度，满足忠诚目标，积极影响），（2）过度适应采用者（积极态度，不满足忠诚目标，积极影响），（3）被动非采用者（消极态度，不满足忠诚目标，被动影响），以及（4）主动非采用者（消极态度，不满足忠诚目标，积极影响）。三位主持人分类的平均一致率为75%。定性数据支持不同类别的看法模式。在中点和最终分类之间，观察到67%的病例分类发生了正向变化。最后，我们生成了一个扩展的分类方法，以考虑本研究中观察到的三个因素之外的其他组合。从这项研究的数据支持的能力，适用于中等到高的可靠性的分类方法，并使用该方法来调整促进改善实施。研究结果表明，我们的方法更广泛的应用和潜力，以改善实施战略，如便利化的定制的潜力。
The current study sought to (1) describe a new classification approach for types of implementer behavior and (2) explore the implementer behavior change in response to tailored implementation facilitation based on the classifications. A small-scale, cluster-randomized hybrid type III implementation trial was conducted in 38 early care and education classrooms that were part of the Together, We Inspire Smart Eating (WISE) program. WISE focuses on 4 evidence-based practices (EBPs), which are implemented by teachers to promote nutrition. External facilitators (N = 3) used a modified Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) to complete immersion (i.e., observations) and thematic content analyses of interviews to identify the characteristics of teachers’ behavior at varying levels of implementation fidelity. Three key factors—attitudes toward the innovation, fidelity/adaptations, and influence—were identified that the research team used to classify teachers’ implementation behavior. This process resulted in a novel classification approach. To assess the reliability of applying the classification approach, we assessed the percent agreement between the facilitators. Based on the teachers’ classification, the research team developed a tailored facilitation response. To explore behavior change related to the tailored facilitation, change in fidelity and classification across the school year were evaluated. The classifications include (1) enthusiastic adopters (positive attitude, meeting fidelity targets, active influence), (2) over-adapting adopters (positive attitude, not meeting fidelity targets, active influence), (3) passive non-adopters (negative attitude, not meeting fidelity targets, passive influence), and (4) active non-adopters (negative attitudes, not meeting fidelity targets, active influence). The average percent agreement among the three facilitators for classification was 75%. Qualitative data support distinct patterns of perceptions across the classifications. A positive shift in classification was observed for 67% of cases between the mid-point and final classification. Finally, we generated an expanded classification approach to consider additional combinations of the three factors beyond those observed in this study. Data from this study support the ability to apply the classification approach with moderate to high reliability and to use the approach to tailor facilitation toward improved implementation. Findings suggest the potential of our approach for wider application and potential to improve tailoring of implementation strategies such as facilitation.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1186/s13012-017-0611-y
发表时间：
2017-06-26
期刊：
Implementation science : IS
影响因子：
--
作者：
Odeny TA;Petersen M;Muga CT;Lewis-Kulzer J;Bukusi EA;Geng EH
通讯作者：
Geng EH
影响因子：
2.6
作者：
Locke, Jill;Lee, Kristine;Lyon, Aaron R.
通讯作者：
Lyon, Aaron R.
影响因子：
7.2
作者：
Mohr, David C.;Lukas, Carol VanDeusen;Meterko, Mark
通讯作者：
Meterko, Mark
影响因子：
2.5
作者：
James, Karen;Quirk, Alan;Stewart, Duncan
通讯作者：
Stewart, Duncan