Specifying and Reporting Implementation Strategies Used in a School-Based Prevention Efficacy Trial.
Specifying and Reporting Implementation Strategies Used in a School-Based Prevention Efficacy Trial.
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DOI：
10.1177/26334895211047841
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发表时间：
2021-01
影响因子：
--
通讯作者：
Mendelson T
中科院分区：
文献类型：
--
作者：
Moore SA;Arnold KT;Beidas RS;Mendelson T
在疗效和效果研究中，用于加强干预措施实施的执行策略鲜少被报道。在这些阶段追踪并报告执行策略，有望改进未来的研究以及实际应用。我们通过详细说明并报告一项基于学校的疗效试验——“力量项目”（Project POWER）中所采用的执行策略，给出一个此类操作的范例。该试验对一项由大学研究团队、社区成员以及学校工作人员引导者在29所学校开展的创伤知情预防项目进行了测试。
在这项为期4年的试验结束后，“力量项目”核心研究团队成员依据一套既定的校本执行策略分类法，确定了在试验期间助力干预措施实施的执行策略。他们运用已有的执行策略报告指南，对执行者、行动、行动目标、时间安排、实施强度以及执行结果进行了详细说明。
研究团队确定了“力量项目”试验期间采用的37种执行策略。大多数策略归属于“培训并教育利益相关者”“运用评估与迭代策略”以及“发展利益相关者相互关系”这几类。执行者包括研究团队成员和合作学校人员。在准备和实施阶段，这些策略被多次运用。行动目标大多是个人特征、实施过程以及内部环境特征。这些策略主要针对的执行结果是保真度、可接受性、可行性和采用情况。
本研究提供的证据表明，执行策略在疗效研究中得到了应用，并且可以通过回顾性方法识别出来。确定并详细说明转化研究初期阶段所采用的执行策略，能够为未来试验和常规实践中应推进、调整或摒弃哪些执行策略提供参考，以提升实施效果。
干预措施的开发与测试往往与实施规划分开进行。然而，在评估一项干预措施时，若不考虑其日后在现实环境中的应用方式，这便是导致研究与实践脱节的一个主要因素。在对干预措施进行严格测试期间，研究团队投入大量精力和资源，以确保项目按计划实施，从而能够评估其有益效果。然而，用于支持实施的方法或技巧（即执行策略）往往未得到衡量，也未明确说明在后续研究中使用和评估，或者未纳入分发给利益相关者的干预材料中，这是一个被错失的机会。本研究确定并描述了一项由大学研究团队、社区成员和学校工作人员开展的大型基于学校的通用创伤知情预防项目研究试验中所采用的执行策略。通过与该试验的研究团队合作，我们确定了试验期间使用的37种执行策略，并明确了每种策略的使用方式，包括：行动（即所做之事）、执行策略的人员、行动目标、在实施过程中何时以及多久使用一次该策略，以及该策略预期会影响哪些执行结果。在学校干预研究的早期阶段详细阐述执行策略，能够为未来研究和常规实践中应推进、调整或摒弃哪些实施支持提供参考。
The implementation strategies used to enhance the implementation of interventions during efficacy and effectiveness studies are rarely reported. Tracking and reporting implementation strategies during these phases has the potential to improve future research studies and real-world implementation. We present an exemplar of how this might be executed by specifying and reporting the implementation strategies that were used during a school-based efficacy trial, Project POWER, which tested a trauma-informed prevention program delivered by a university research team, community members, and school staff facilitators in 29 schools. Following the conclusion of the 4-year trial, core Project POWER research team members identified the implementation strategies that supported intervention delivery during the trial using an established taxonomy of school-based implementation strategies. The actors, actions, action targets, temporality, dose, and implementation outcomes were specified using established implementation strategies reporting guidelines. The research team identified 37 implementation strategies that were used during the Project POWER trial. Most strategies fell within the categories of Train and Educate Stakeholders, Use Evaluative and Iterative Strategies, and Develop Stakeholder Interrelationships. Actors included members of the research team and partner schools. Strategies were used multiple times during the preparation and implementation phases. Action targets were most often characteristics of individuals, implementation process, and characteristics of the inner setting. Strategies predominantly targeted the implementation outcomes of fidelity, acceptability, feasibility, and adoption. This study provided evidence that implementation strategies are used and can be identified in efficacy research using a retrospective approach. Identifying and specifying implementation strategies used during the initial phases of the translational research pipeline can inform the implementation strategies that are carried forward, adapted, or discontinued in future trials and routine practice to improve implementation and effectiveness outcomes. Intervention development and testing often occurs separately from implementation planning. However, evaluating an intervention without considering how it will be subsequently used in real-world settings is a major factor contributing to the research-to-practice gap. During the rigorous testing of interventions, research teams invest significant effort and resources to ensure their program is delivered as intended and so that beneficial outcomes can be assessed. However, the methods or techniques used to support implementation (i.e., implementation strategies) are often not measured or specified to be used and evaluated during later research or included with intervention materials that are distributed to stakeholders; this is a missed opportunity. This study identifies and describes the implementation strategies used during a large school-based research trial of a universal trauma-informed prevention program delivered by a university research team, community members, and school staff. In collaboration with the trial’s research team, we identified 37 implementation strategies that were used during the trial and defined how each strategy was used, including: the actions (i.e., things done), people who carried out the strategies, the targets of the actions, when and how often during the implementation process the strategies were used, and which implementation outcome(s) the strategy was expected to impact. Explicating implementation strategies during early phases of intervention research in schools can inform which implementation supports to carry forward, adapt, or discontinue in future studies and routine practice.
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DOI：
10.1080/1754730x.2015.1037848
发表时间：
2015
期刊：
Advances in school mental health promotion
影响因子：
--
作者：
Eiraldi R;Wolk CB;Locke J;Beidas R
通讯作者：
Beidas R
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：
3.3
作者：
Franklin, Cynthia G. S.;Kim, Johnny S.;Montgomery, Katherine L.
通讯作者：
Montgomery, Katherine L.
影响因子：
2.6
作者：
Arnold KT;Porter KMP;Frattaroli S;Durham RE;Clary LK;Mendelson T
通讯作者：
Mendelson T
影响因子：
4
作者：
Bunger AC;Powell BJ;Robertson HA;MacDowell H;Birken SA;Shea C
通讯作者：
Shea C