Rugged landscapes: complexity and implementation science.
Rugged landscapes: complexity and implementation science.
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崎岖的地貌：复杂性与实施科学。
DOI：
10.1186/s13012-020-01028-5
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发表时间：
2020-09-29
期刊：
影响因子：
--
通讯作者：
Brownson RC
中科院分区：
文献类型：
--
作者：
Ornstein JT;Hammond RA;Padek M;Mazzucca S;Brownson RC
Mis-implementation—defined as failure to successfully implement and continue evidence-based programs—is widespread in public health practice. Yet the causes of this phenomenon are poorly understood. We develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, ruggedness, and context-specificity. Agents in the model attempt to solve problems using one of three approaches—Plan-Do-Study-Act (PDSA), evidence-based interventions (EBIs), and evidence-based decision-making (EBDM). The model demonstrates that the most effective approach to implementation and quality improvement depends on the underlying nature of the problem. Rugged problems are best approached with a combination of PDSA and EBI. Context-specific problems are best approached with EBDM. The model’s results emphasize the importance of adapting one’s approach to the characteristics of the problem at hand. Evidence-based decision-making (EBDM), which combines evidence from multiple independent sources with on-the-ground local knowledge, is a particularly potent strategy for implementation and quality improvement.
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影响因子：
5.5
作者：
Gibbert WS;Keating SM;Jacobs JA;Dodson E;Baker E;Diem G;Giles W;Gillespie KN;Grabauskas V;Shatchkute A;Brownson RC
通讯作者：
Brownson RC
DOI：
10.1097/01.phh.0000311891.73078.50
发表时间：
2008-03-01
影响因子：
3.3
作者：
Dreisinger, Mariah;Leet, Terry L.;Brownson, Ross C.
通讯作者：
Brownson, Ross C.
影响因子：
3.3
作者：
Barnhill, Anne;Palmer, Anne;Bennett, Wendy L.
通讯作者：
Bennett, Wendy L.
DOI：
10.1097/phh.0b013e3182a5c2f8
发表时间：
2014-07-01
影响因子：
3.3
作者：
Harris, April L.;Scutchfield, F. Douglas;Ingram, Richard C.
通讯作者：
Ingram, Richard C.
影响因子：
8
作者：
Lannotti, Lora L.;Utter, Chessa K.;Waters, William F.
通讯作者：
Waters, William F.