Strengthening methods for tracking adaptations and modifications to implementation strategies.
Strengthening methods for tracking adaptations and modifications to implementation strategies.
复制标题
加强跟踪适应和对实施策略的修改的方法。
DOI：
10.1186/s12874-021-01326-6
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发表时间：
2021-06-26
影响因子：
4
通讯作者：
Gold R
中科院分区：
文献类型：
--
作者：
Haley AD;Powell BJ;Walsh-Bailey C;Krancari M;Gruß I;Shea CM;Bunce A;Marino M;Frerichs L;Lich KH;Gold R
制定有效的执行战略需要充分跟踪和报告这些战略的实施情况。有关于定义和报告执行战略特点的准则，但不是用于描述在实践中如何调整和修改战略的准则。我们建立在现有实施科学方法的基础上，为跟踪战略修改提供新的方法。这些方法是在一项旨在帮助社区诊所采用与健康有关的活动的社会决定因素的实施战略一揽子计划的阶梯式楔形试验中制定的：简而言之，“实施支助小组”通过一个多步骤的过程为诊所提供支持。这些方法包括五个组成部分：1)描述计划的战略；2)跟踪其使用；3)监测障碍；4)描述修改；5)确定/描述新的战略。我们使用实施变更分类的专家建议对战略进行分类，使用Proctor等人的S报告框架来描述它们，使用实施研究综合框架来描述代码障碍/需要修改的上下文因素，以及报告适应和修改框架的要素-增强以描述战略修改。我们提供了三个使用这些方法的例子：1)对以促进为重点的策略进行修改(诊所报告某些会议太频繁，因此在随后的楔形区域中减少了它们的频率)；2)诊所级别的策略添加，涉及将一个寻求社区卫生工作者相关工作流程帮助的研究诊所与另一个已经有这样的工作流程的研究诊所联系起来；3)研究级别的策略添加，涉及在克服以前遇到的(而不是从头开始的)挑战方面提供帮助。这些用于跟踪对实现策略的修改的方法建立在现有的方法、框架和指导方针的基础上；然而，由于这些方法都不是完美的匹配，我们按照指示添加了几个框架，并选择性地使用了某些框架的组件。虽然这些方法是时间密集型的，需要更多的工作来简化它们，但它们是第一批提交给实施科学的此类方法之一。因此，它们可用于评估有效战略修改的研究以及有效战略的复制和推广。我们提出这些方法是为了指导其他寻求记录实施战略和对其研究进行修改的人。ClinicalTrials.gov ID：NCT03607617(2018年7月31日首次发布)。
Developing effective implementation strategies requires adequate tracking and reporting on their application. Guidelines exist for defining and reporting on implementation strategy characteristics, but not for describing how strategies are adapted and modified in practice. We built on existing implementation science methods to provide novel methods for tracking strategy modifications. These methods were developed within a stepped-wedge trial of an implementation strategy package designed to help community clinics adopt social determinants of health-related activities: in brief, an ‘Implementation Support Team’ supports clinics through a multi-step process. These methods involve five components: 1) describe planned strategy; 2) track its use; 3) monitor barriers; 4) describe modifications; and 5) identify / describe new strategies. We used the Expert Recommendations for Implementing Change taxonomy to categorize strategies, Proctor et al.’s reporting framework to describe them, the Consolidated Framework for Implementation Research to code barriers / contextual factors necessitating modifications, and elements of the Framework for Reporting Adaptations and Modifications-Enhanced to describe strategy modifications. We present three examples of the use of these methods: 1) modifications made to a facilitation-focused strategy (clinics reported that certain meetings were too frequent, so their frequency was reduced in subsequent wedges); 2) a clinic-level strategy addition which involved connecting one study clinic seeking help with community health worker-related workflows to another that already had such a workflow in place; 3) a study-level strategy addition which involved providing assistance in overcoming previously encountered (rather than de novo) challenges. These methods for tracking modifications made to implementation strategies build on existing methods, frameworks, and guidelines; however, as none of these were a perfect fit, we made additions to several frameworks as indicated, and used certain frameworks’ components selectively. While these methods are time-intensive, and more work is needed to streamline them, they are among the first such methods presented to implementation science. As such, they may be used in research on assessing effective strategy modifications and for replication and scale-up of effective strategies. We present these methods to guide others seeking to document implementation strategies and modifications to their studies. clinicaltrials.gov ID: NCT03607617 (first posted 31/07/2018).
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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
DOI：
10.1186/s13012-017-0649-x
发表时间：
2017-10-03
期刊：
Implementation science : IS
影响因子：
--
作者：
Powell BJ;Stanick CF;Halko HM;Dorsey CN;Weiner BJ;Barwick MA;Damschroder LJ;Wensing M;Wolfenden L;Lewis CC
通讯作者：
Lewis CC
DOI：
10.1186/s13012-015-0242-0
发表时间：
2015-04-21
期刊：
Implementation science : IS
影响因子：
--
作者：
Nilsen P
通讯作者：
Nilsen P
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
影响因子：
3.7
作者：
Boyd, Meredith R.;Powell, Byron J.;Lewis, Cara C.
通讯作者：
Lewis, Cara C.