A framework for testing and promoting expanded dissemination of promising preventive interventions that are being implemented in community settings.
A framework for testing and promoting expanded dissemination of promising preventive interventions that are being implemented in community settings.
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用于测试和促进扩大传播正在社区环境中实施的有前景的预防性干预措施的框架。
DOI：
10.1007/s11121-013-0409-3
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
Snyder,JamesJ
中科院分区：
文献类型：
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作者：
Mason,WAlex;Fleming,CharlesB;Thompson,RonaldW;Haggerty,KevinP;Snyder,JamesJ
近年来开发了许多基于证据的预防干预措施，但很少得到广泛应用。由于目前的重点是疗效试验，以证据为基础的干预措施的广泛传播和实施往往是事后才想到的。扭转这一趋势的一个潜在策略是找到一个有前途的项目，并通过严格的评估来改进和测试项目的有效性。如果该计划有证据支持，那么传播工具已经到位，并且有可能扩大。这种策略很少被使用，迄今为止取得的成功也有限，部分原因是该领域缺乏指导此类研究的框架。为了解决这一差距，我们概述了一个框架，通过严格的测试过程，并在必要时修改计划，以促进扩大传播，推动目前正在社区环境中实施的有希望的预防性干预措施。该框架以RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) （Glasgow等人，Am J public Health 89:1322-1327, 1999）为指导，重点关注项目测试的外部和内部有效性，并举例说明。讨论了挑战，例如对否定和无效结果的响应，以及框架中固有的机会。
Many evidence-based preventive interventions have been developed in recent years, but few are widely used. With the current focus on efficacy trials, widespread dissemination and implementation of evidence-based interventions are often afterthoughts. One potential strategy for reversing this trend is to find a promising program with a strong delivery vehicle in place and improve and test the program’s efficacy through rigorous evaluation. If the program is supported by evidence, the dissemination vehicle is already in place and potentially can be expanded. This strategy has been used infrequently and has met with limited success to date, in part, because the field lacks a framework for guiding such research. To address this gap, we outline a framework for moving promising preventive interventions that are currently being implemented in community settings through a process of rigorous testing and, if needed, program modification in order to promote expanded dissemination. The framework is guided by RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) (Glasgow et al., Am J Publ Health 89:1322–1327, 1999), which focuses attention on external as well as internal validity in program tests, and is illustrated with examples. Challenges, such as responding to negative and null results, and opportunities inherent in the framework are discussed.