MECHANISMS: The MECHANics of Implementation Strategies and MeasureS

项目总结 在理解战略实施的因果机制方面存在根本性的差距 以证据为基础的做法解决了有效、适当提供服务的当地障碍。继续存在 这一差距代表着一个重要的问题，因为在这个问题得到解决之前，科学知识和实践 关于在哪些情况下使用哪些实施战略的指导仍然难以捉摸。长期的 目标是通过机制发展执行科学的证据基础和实际效用-- 有重点的实施研究。此应用程序的目标是克服阻塞的关键问题 通过确定看似合理的战略-机制联系，在执行科学和实践方面取得进展， 开发用于机制评估的因果模型，产生评估此类机制所需的措施 建立联系，并在一个方便用户的网站上提供这些模型、方法和措施。其基本原理是 一旦确定了战略-机制的联系，实施科学家就可以开发出量身定做的 实施策略，并生成更可靠的证据，说明哪些策略在哪些策略中最有效 上下文。此外，实践者将能够更好地选择实施战略来解决其具体问题 执行方面的问题。具体目标是：(1)建立战略-机制联系数据库和 相关的因果路径图；(2)开发心理测量学上强有力的、实用的测量方法 机制；和(3)开发和传播执行机制知识网站，供 不同的利益相关者，通过应用迭代的以用户为中心的设计和社交营销原则。 对于第一个目标，定性研究、团体名义技术、德尔菲法和因果图将 用来确定和确认看似合理的战略-机制联系和明确的主持人， 前提条件，以及与这些联系相关的近端和远端结果。对于第二个目标，快速- 将采用循环测量开发和测试方法，以创建可靠、有效、务实的 没有高质量措施的六个机制的措施。对于第三个目标，我们将制定一种 用户友好的网站和可搜索的数据库，通过以用户为中心的设计，并使用社交媒体传播 营销原则。这个项目具有创新性，因为它改变了当前的范式，从评估 执行战略--承诺加速的机制知情办法的总体有效性 科学进步。拟议的研究具有重大意义，因为它具有垂直推进实施的潜力。 通过发展用于机制识别和评估的微观理论、方法和措施的科学。 预计在实施战略制定、优化、评估和部署方面将出现新的局面 其结果是能够实现，这将导致加强实施循证干预 癌症控制，并最终改善患者的预后。

PROJECT SUMMARY There is a fundamental gap in understanding the causal mechanisms by which strategies for implementing evidence-based practices address local barriers to effective, appropriate service delivery. Continued existence of this gap represents an important problem because, until it is addressed, scientific knowledge and practical guidance about which implementation strategies to use in which contexts will remain elusive. The long-term goal is to develop the evidence base and practical utility of implementation science through mechanisms- focused implementation research. The objective of this application is to overcome critical problems blocking progress in implementation science and practice by identifying plausible strategy-mechanism linkages, developing causal models for mechanism evaluation, producing the measures needed to evaluate such linkages, and making these models, methods, and measures available in a user-friendly website. The rationale is that, once strategy-mechanism linkages are identified, implementation scientists can develop tailored implementation strategies and generate more robust evidence about which strategies work best in which contexts. Moreover, practitioners will be better able to select implementation strategies to address their specific implementation problems. The specific aims are: (1) build a database of strategy-mechanism linkages and associated causal pathway diagrams; (2) develop psychometrically strong, pragmatic measures of mechanisms; and (3) develop and disseminate a website of implementation mechanisms knowledge for use by diverse stakeholders, through the application of iterative user-centered design and social marketing principles. For the first aim, qualitative inquiry, Group Nominal Technique, Delphi methods, and causal diagramming will be used to identify and confirm plausible strategy-mechanism linkages and articulate moderators, preconditions, and proximal and distal outcomes associated with those linkages. For the second aim, rapid- cycle measure development and testing methods will be employed to create reliable, valid, pragmatic measures of six mechanisms for which no high-quality measures exist. For the third aim, we will develop a user-friendly website and searchable database via user-centered design and disseminate those using social marketing principles. This project is innovative because it shifts the current paradigm from evaluating implementation strategy general effectiveness to a mechanisms-informed approach that promises accelerated scientific progress. The proposed research is significant for its potential to vertically advance implementation science by developing micro-theories, methods, and measures for mechanism identification and evaluation. New horizons in implementation strategy development, optimization, evaluation, and deployment are expected to be attainable as a result, which will lead to enhanced implementation of evidence-based interventions for cancer control, and ultimately improvements in patient outcomes.