Study of the Naturalistic Dissemination Process of an Evidence-based Program

描述（由申请人提供）：公共卫生从业人员对循证体育活动项目的使用很少，尽管人们普遍知道推荐使用这些项目的指南。公共卫生组织只是传播此类循证方案的一个部门；其他领域包括健身中心、工作场所和医疗中心。据我们所知，还没有研究在部门和组织层面对此类方案的传播和实施进行调查。每日积极生活（Active Living Every Day，简称ALED）是一项以证据为基础的体育活动计划，由体育活动领域的领先出版商Human Kinetics （HK）积极推广到四个主要领域。在这一回顾性观察项目中，我们建议研究新技术的传播过程：1)部门和组织对采用新技术决策的影响，以及2)组织对新技术实施和适应的影响。本文将检验基于创新扩散模型的理论预测。我们将在案例对照研究（n=120个案例和480个对照）中评估行业层面的影响（即行业规范，领头羊组织的行动，以及与其他组织的部门内部沟通）和组织影响（即对ALED和其他体育活动项目的了解，组织价值观，决策过程，感知创新特征和采用的潜在障碍）作为als采用的预测因素。我们还将评估与项目实施相关的组织变量（即意见领导、组织决策、背景支持、感知创新、与现有项目的兼容性、其他体育活动项目的采用），并在一项仅测试后的观察性研究中描述对ALED的适应。我们将在仅测试后的研究中分析目前使用ALED的组织和以前实施过该计划但已停止使用的组织（即病例对照研究中的病例；n=120）。数据将从以下方面获取：(a)香港数据库中有关推广工作、促进者培训、购买和使用辅助认证材料和网上资源的数据；(b)对机构主管的调查；以及(c)对采用机构主管的后续访谈。该项目将提高对传播的理论认识，并为改进循证预防项目的传播策略提供经验信息。

DESCRIPTION (provided by applicant): The use of evidence-based physical activity programs by public health practitioners is small, despite widespread knowledge of guidelines recommending their use. Public health organizations represent only one sector where such evidence-based programs may be disseminated; other sectors include fitness centers, worksites, and medical centers. To our knowledge, no study has examined the dissemination and implementation of such programs at the sector and organizational level. Active Living Every Day (ALED) is an evidence-based physical activity program that has been actively disseminated to four major sectors by Human Kinetics (HK), a leading publisher in the physical activity field. In this retrospective observational project, we propose to examine these processes in the dissemination of ALED: 1) sector and organization influences on decisions to adopt ALED and 2) organization influences on implementation and adaptation of ALED. Theoretical predictions about these processes based on the Diffusion of Innovations Model will be tested. We will assess sector-level influences (i.e. sector norms, actions by bellwether organizations, and intra-sector communication with other organizations) and organizational influences (i.e. knowledge of ALED and other physical activity programs, organizational values, decision-making processes, perceived innovation characteristics, and potential barriers to adoption) as predictors of ALED adoption in a case- control study (n=120 cases and 480 controls). We will also evaluate organization variables (i.e. opinion leadership, organizational decision-making, contextual supports, perceived innovation, compatibility with existing programs, adoption of other physical activity programs) associated with program implementation and describe adaptations made to ALED in an observational posttest-only study. We will analyze organizations that currently use ALED and those that have previously implemented the program but have discontinued using it (i.e., the cases in the case-control study; n=120) in the posttest-only study. Data will be obtained from (a) HK databases on promotional efforts, facilitator training, and purchase and use of ALED materials and online resources, (b) a survey of organization directors, and (c) follow-up interviews with directors at adopting organizations. The project will improve theoretical understanding of dissemination and provide empirical information for improving dissemination strategies for evidence-based prevention programs.