Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change
Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change
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DOI：
10.1370/afm.1549
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发表时间：
2013-05-01
影响因子：
4.4
通讯作者：
Stange, Kurt C.
中科院分区：
文献类型：
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作者：
Tomoaia-Cotisel, Andrada;Scammon, Debra L.;Stange, Kurt C.
我们的目的是通过分享我们的经验和建议，系统地报告contextual factors.METHODS十四队进行研究的初级保健实践转型回顾性认为上下文因素的重要性，以解释他们的研究结果（内部有效性）和运输或重塑他们的研究结果在其他环境/情况（外部有效性）的内部和外部有效性的研究。每个小组提供了一个重要的上下文因素的表格或列表，并将解释性文本作为附录纳入本补充材料的文章中。团队成员确定了他们研究中最重要的背景因素。我们将调查结果按主题进行分组，并制定了报告context.RESULTS的建议最重要的上下文因素分为5个域：（1）的做法设置，（2）较大的组织，（3）外部环境，（4）实施途径，（5）实施的动机。为了理解背景，研究人员建议（1）参与不同的观点和数据来源，（2）考虑多个层次，（3）评估历史和演变随着时间的推移，（4）看正式和非正式的系统和文化，（5）评估（通常是非线性的）背景因素之间的相互作用和研究的过程和结果。我们包括一个模板，表格和解释性元素，以帮助研究团队从事研究参与者在报告相关context.CONCLUSIONS这些研究结果表明识别和报告上下文因素的可行性和潜在效用。在研究过程的多个阶段，让不同的利益相关者参与评估背景，检查他们与结果的关联，并始终如一地报告关键的背景因素，对于有兴趣提高医疗保健研究的内部和外部有效性和影响力的领域来说，是一个重要的挑战。
PURPOSE We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors.METHODS Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context.RESULTS The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context.CONCLUSIONS These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research.