EFFICACY AND EFFECTIVENESS TRIALS (AND OTHER PHASES OF RESEARCH) IN THE DEVELOPMENT OF HEALTH PROMOTION PROGRAMS
EFFICACY AND EFFECTIVENESS TRIALS (AND OTHER PHASES OF RESEARCH) IN THE DEVELOPMENT OF HEALTH PROMOTION PROGRAMS
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DOI：
10.1016/0091-7435(86)90024-1
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发表时间：
1986-09-01
影响因子：
5.1
通讯作者：
FLAY, BR
中科院分区：
文献类型：
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作者：
FLAY, BR
有效性和有效性的概念是从卫生保健研究和社会项目评估的传统和哲学的观点来检验的。考虑到正在评估的方案的状况、其对目标受众的可获得性和目标受众的接受度，得出了四个级别的健康促进方案测试：(A)在方案实施和接受者参与的最佳条件下的疗效试验；(B)治疗效果试验，目标受众接受度的预期变化；(C)实施效果试验，在不同的实施条件下；以及(D)对以前未测试的方案的方案评估。这四个水平的测试，加上在一个健康促进研究领域(吸烟预防)的经验，为健康促进计划的发展提出了八个阶段的研究：(I)基础研究，(Ii)假设开发，(Iii)试点应用研究，(Iv)原型评估研究，(V)疗效试验，(Vi)治疗有效性试验，(Vii)实施效果试验，和(Viii)示范评估。设计问题，随机分配的使用，盲法程序的使用，以及过程评估在这些不同的研究水平中的作用，特别是有效性和有效性试验，根据卫生保健和社会项目评估研究的术语和方法进行考虑。提出了改进健康促进研究的建议。
The concepts of efficacy and effectiveness are examined from the viewpoints of the traditions and philosophies of health-care research and social program evaluation. Consideration of the status of the program being assessed, its availability to, and its acceptance by the target audience leads to the derivation of four levels of health promotion program testing: (a) efficacy trials, under optimum conditions of program implementation and recipient participation; (b) treatment effectiveness trials, with expected variation in target audience acceptance; (c) implementation effectiveness trials, under varying conditions of implementation; and (d) program evaluation of previously untested programs. These four levels of testing, together with experience in one area of health promotion research (smoking prevention), suggest eight phases of research for the development of health promotion programs: (I) basic research, (II) hypothesis development, (III) pilot applied research, (IV) prototype evaluation studies, (V) efficacy trials, (VI) treatment effectiveness trials, (VII) implementation effectiveness trials, and (VIII) demonstration evaluations. Issues of design, the use of random assignment, the use of blinding procedures, and of the role of process evaluation in these different research levels, particularly efficacy and effectiveness trials, are considered in light of the terminologies and methods of health-care and social program evaluation research. Suggestions are made for improved health promotion research.