The contribution of qualitative research to the development of tailor-made community-based interventions in primary care: a review
The contribution of qualitative research to the development of tailor-made community-based interventions in primary care: a review
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DOI：
10.1093/eurpub/ckp085
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发表时间：
2010-04-01
影响因子：
4.4
通讯作者：
de Bont, Antoinette A.
中科院分区：
文献类型：
--
作者：
Jansen, Yvonne J. F. M.;Foets, Marleen M. E.;de Bont, Antoinette A.
背景资料：近年来，在使用量身定制的方法和实用的试验方法来评估有效性的趋势已经在从大规模的国家健康预防运动到社区倡议的方案中可见。定性研究更常用于针对社区和/或当地护理做法的定制干预措施。本文系统地回顾了定性研究的贡献，在制定量身定制的以社区为基础的干预措施，在初级保健评估的实用试验方法。方法：系统检索Pubmed/Medline和Embase共33篇文献。使用文献映射过程，根据MRC框架中确定的发展阶段对文章进行排列，以制定改善健康的复杂干预措施。结果如下：审查表明，定性研究主要用于提供对干预措施的实施，交付和评价的背景情况的洞察力。在较小程度上，定性研究结果用于定制和改进干预措施的设计，以更好地适应日常初级保健实践。此外，大多数定性调查结果用于调整干预措施的背景情况，以便在实践中按计划实施干预措施，而不是根据当地情况进行调整。结论：语用试验似乎是矛盾的。虽然务实的试验方法建立了在自然的，非实验条件下的干预措施的有效性，没有务实的适合是允许的。定性研究对制定量身定制的社区干预措施的贡献在于对务实试验中面临的困境进行持续评估，并允许制定真正的量身定制干预措施。
Background: In recent years, a trend in the use of tailor-made approaches and pragmatic trial methodology for evaluating effectiveness has been visible in programs ranging from large-scale national health prevention campaigns to community-based initiatives. Qualitative research is used more often for tailoring interventions towards communities and/or local care practices. This article systematically reviews the contribution of qualitative research in developing tailor-made community-based interventions in primary care evaluated by means of the pragmatic trial methodology. Methods: A systematic search of Pubmed/Medline and Embase revealed 33 articles. Using a literature mapping process, the articles were arranged according to the development phases identified in the MRC framework for the development of complex interventions to improve health. Results: The review showed qualitative research is mainly used to provide insight into the contextual circumstances of the interventions' implementation, delivery and evaluation. To a lesser extent, qualitative research findings are used for tailoring and improving the design of the interventions for a better fit with daily primary care practice. Moreover, most qualitative findings are used for tailoring the interventions' contextual circumstances so that the interventions are performed in practice as planned, rather than adjusted to local circumstances. Conclusions: Pragmatic trials seem to be oxymoronic. Although the pragmatic trial methodology establishes the effectiveness of interventions under natural, non-experimental conditions, no pragmatic fit is allowed. Qualitative research's contribution to the development of tailor-made community-based interventions lies in providing ongoing evaluations of the dilemmas faced in pragmatic trials and allowing for the development of true tailor-made interventions.