Fidelity Versus Flexibility Translating Evidence-Based Research into Practice
Fidelity Versus Flexibility Translating Evidence-Based Research into Practice
复制标题
DOI：
10.1016/j.amepre.2008.08.005
复制
发表时间：
2008-11-01
影响因子：
5.5
通讯作者：
Green, Lawrence W.
中科院分区：
文献类型：
--
作者：
Cohen, Deborah J.;Crabtree, Benjamin F.;Green, Lawrence W.
背景：了解研究转化为实践的过程是有限的。本研究旨在探讨如何干预措施的变化在implementation.Methods：数据收集从2005年7月至2007年9月。进行了实时和跨病例比较，检查了十项旨在改善基于实践的研究网络中初级保健实践中的健康促进的干预措施。一个迭代组的过程被用来分析定性数据（调查数据，访谈，实地考察，并由受赠人约每2周的项目日记条目），并确定实施过程中报告的干预adaptations.Results：所有的干预措施都需要改变，因为它们被整合到实践中。修改因项目和实践而异，而且往往是意料之外的。确定了三大类变化，包括为适应实践和患者情况以及人员成本而进行的修改。此外，研究团队发挥了至关重要的作用，通过他们的个人影响力的使用，并通过提供动力，再培训和工具的帮助，以促进干预措施的吸收。这些努力的研究团队，虽然很少被认为是干预的重要组成部分，是成功实施和translation.Conclusions的一个积极因素：变化是常见的，当干预措施实施到实践环境。当研究设计和报告标准被修改以帮助质量改进团队理解时，
Background: Understanding the process by which research is translated into practice is limited. This study sought to examine how interventions change during implementation.Methods: Data were collected from July 2005 to September 2007. A real-time and cross-case comparison was conducted, examining ten interventions designed to improve health promotion in primary care practices in practice-based research networks. An iterative group process was used to analyze qualitative data (survey data, interviews, site visits, and project diary entries made by grantees approximately every 2 weeks) and to identify intervention adaptations reported during implementation.Results: All interventions required changes as they were integrated into practice. Modifications differed by project and by practice, and were often unanticipated. Three broad categories of changes were identified and include modifications undertaken to accommodate practices' and patients' circumstances as well as personnel costs. In addition, research teams played a crucial role in fostering intervention uptake through their use of personal influence and by providing motivation, retraining, and instrumental assistance to practices. These efforts by the research teams, although rarely considered an essential component of the intervention, were an active ingredient in successful implementation and translation.Conclusions: Changes are common when interventions are implemented into practice settings. The translation of evidence into practice will be improved when research design and reporting standards are modified to help quality-improvement teams understand