A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework in the design and measurement of a large scale collaborative multi-site study.
A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework in the design and measurement of a large scale collaborative multi-site study.
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DOI：
10.1186/s40352-018-0068-3
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发表时间：
2018-04-13
期刊：
影响因子：
3.5
通讯作者：
Aarons, Gregory A
中科院分区：
文献类型：
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作者：
Becan, Jennifer E;Bartkowski, John P;Aarons, Gregory A
背景技术背景：本文介绍了美国国家药物滥用研究所（NIDA）资助的合作，少年司法转化研究干预青少年的法律的系统（JJ-TRIALS），利用一个既定的实施科学框架进行多站点，多研究中心实施干预措施的举措。该倡议旨在加强青少年司法机构的能力，以解决未满足的客户需求有关的物质使用，同时加强青少年司法和当地行为健康合作伙伴之间的组织间关系.（探索、准备、实施、维持）框架被选定并用作从项目开始到项目完成的指导模式;包括实施战略到EPIS阶段的映射，研究问题的阐述，以及测量协议的选择、内容和时间。在其他主要发展中，该项目导致其管理实施科学框架的重新概念化，成为EPIS轮的周期形式。EPIS Wheel更符合快速循环测试原理，并允许研究人员通过EPIS跟踪渐进和递归运动。此外，由于这项随机对照试验是基于捆绑策略方法进行的，因此JJ-TRIALS旨在严格测试EPIS阶段的进展，并通过促进数据驱动的决策原则来推动。该项目通过以下方式扩展了EPIS：（1）阐明递归活动在促进变革中的作用和性质（产生圆形EPIS轮），（2）通过将EPIS框架的适用性扩展到单一循证实践（EBP）之外，以解决不同的流程改进工作（代表不同的EBP），和（3）通过从先验建立的研究时间轴中解开EPIS阶段进展的结果测量。JJ-TRIALS中EPIS的使用为在现实世界环境中实际和应用实施框架提供了一个模型，该框架跨越外部服务系统和内部组织环境，以改善对弱势群体的护理。2016年1月22日登记的追溯。
BACKGROUND: This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners.METHODS: The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the mapping of implementation strategies to EPIS stages, articulation of research questions, and selection, content, and timing of measurement protocols. Among other key developments, the project led to a reconceptualization of its governing implementation science framework into cyclical form as the EPIS Wheel. The EPIS Wheel is more consistent with rapid-cycle testing principles and permits researchers to track both progressive and recursive movement through EPIS. Moreover, because this randomized controlled trial was predicated on a bundled strategy method, JJ-TRIALS was designed to rigorously test progress through the EPIS stages as promoted by facilitation of data-driven decision making principles. The project extended EPIS by (1) elucidating the role and nature of recursive activity in promoting change (yielding the circular EPIS Wheel), (2) by expanding the applicability of the EPIS framework beyond a single evidence-based practice (EBP) to address varying process improvement efforts (representing varying EBPs), and (3) by disentangling outcome measures of progression through EPIS stages from the a priori established study timeline.DISCUSSION: The utilization of EPIS in JJ-TRIALS provides a model for practical and applied use of implementation frameworks in real-world settings that span outer service system and inner organizational contexts in improving care for vulnerable populations.TRIAL REGISTRATION: NCT02672150 . Retrospectively registered on 22 January 2016.