Framework for identification and measurement of spillover effects in policy implementation: intended non-intended targeted non-targeted spillovers (INTENTS).
Framework for identification and measurement of spillover effects in policy implementation: intended non-intended targeted non-targeted spillovers (INTENTS).
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DOI：
10.1186/s43058-022-00280-8
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发表时间：
2022-03-14
影响因子：
--
通讯作者：
Sutton M
中科院分区：
文献类型：
--
作者：
Francetic I;Meacock R;Elliott J;Kristensen SR;Britteon P;Lugo-Palacios DG;Wilson P;Sutton M
研究人员和政策制定者越来越意识到，医疗干预可能会产生超出最初预期的后果。这些意想不到的后果或“溢出效应”是由医疗保健组织和提供的复杂特征造成的，可能会增加或降低整体效果。它们的潜在影响对执行战略的设计和评估以及决策具有重要影响。然而，对溢出效应的考虑仍然是片面的和不系统的。我们制定了一个全面的框架，以确定和衡量医疗保健服务的组织和提供方式的变化所产生的溢出效应。我们进行了范围审查，以绘制现有的关于卫生和保健干预中溢出效应的文献，并利用这一审查的结果来开发一个全面的框架，以确定和衡量溢出效应。范围审查确定了一系列不同的溢出效应，要么是非故意作为干预目标的代理所经历的，要么是对目标代理的非预期影响。我们的范围审查显示，溢出效应往往只在被发现具有统计意义或可能解释意外发现时才在论文中讨论，而不是作为评估研究的预先指定特征。这妨碍了评估特定政策或干预措施的所有潜在影响的能力。我们提出了一种溢出效应的分类，根据结果和经历溢出效应的单位进行分类：单位内溢出效应、单位间溢出效应和对角线溢出效应。然后，我们提出了意图框架：意向的、非有意的、定向的、非定向的溢出。意向框架考虑了干预可能影响的单位和结果，以及产生溢出效应的机制。在考虑实施战略可能产生的潜在影响以及在设计和评价这类干预措施时应采取的步骤时，意向框架为研究人员和政策制定者提供了一个结构化的指南。意向框架的应用将使溢出效应能够在今后的评价和决策中得到适当处理，确保正确地确定干预措施的各种成本和效益。网上版载有补充材料，可在10.1186/s43058022-00280-8查阅。
There is increasing awareness among researchers and policymakers of the potential for healthcare interventions to have consequences beyond those initially intended. These unintended consequences or “spillover effects” result from the complex features of healthcare organisation and delivery and can either increase or decrease overall effectiveness. Their potential influence has important consequences for the design and evaluation of implementation strategies and for decision-making. However, consideration of spillovers remains partial and unsystematic. We develop a comprehensive framework for the identification and measurement of spillover effects resulting from changes to the way in which healthcare services are organised and delivered. We conducted a scoping review to map the existing literature on spillover effects in health and healthcare interventions and used the findings of this review to develop a comprehensive framework to identify and measure spillover effects. The scoping review identified a wide range of different spillover effects, either experienced by agents not intentionally targeted by an intervention or representing unintended effects for targeted agents. Our scoping review revealed that spillover effects tend to be discussed in papers only when they are found to be statistically significant or might account for unexpected findings, rather than as a pre-specified feature of evaluation studies. This hinders the ability to assess all potential implications of a given policy or intervention. We propose a taxonomy of spillover effects, classified based on the outcome and the unit experiencing the effect: within-unit, between-unit, and diagonal spillover effects. We then present the INTENTS framework: Intended Non-intended TargEted Non-Targeted Spillovers. The INTENTS framework considers the units and outcomes which may be affected by an intervention and the mechanisms by which spillover effects are generated. The INTENTS framework provides a structured guide for researchers and policymakers when considering the potential effects that implementation strategies may generate, and the steps to take when designing and evaluating such interventions. Application of the INTENTS framework will enable spillover effects to be addressed appropriately in future evaluations and decision-making, ensuring that the full range of costs and benefits of interventions are correctly identified. The online version contains supplementary material available at 10.1186/s43058-022-00280-8.
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影响因子：
7.7
作者：
Benjamin-Chung J;Abedin J;Berger D;Clark A;Jimenez V;Konagaya E;Tran D;Arnold BF;Hubbard AE;Luby SP;Miguel E;Colford JM Jr
通讯作者：
Colford JM Jr
影响因子：
8.4
作者：
Flodgren, Gerd;Eccles, Martin P.;Shepperd, Sasha;Scott, Anthony;Parmelli, Elena;Beyer, Fiona R.
通讯作者：
Beyer, Fiona R.
DOI：
10.1136/bmj.d3590
发表时间：
2011-06-28
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Doran T;Kontopantelis E;Valderas JM;Campbell S;Roland M;Salisbury C;Reeves D
通讯作者：
Reeves D
影响因子：
0.9
作者：
Birckmayer, JD;Weiss, CH
通讯作者：
Weiss, CH
影响因子：
7.7
作者：
Benjamin-Chung, Jade;Arnold, Benjamin F.;Hubbard, Alan E.
通讯作者：
Hubbard, Alan E.