Strengthening Research on Complex Health Interventions: State-of-the-Art Conference

加强对复杂健康干预措施的研究：最先进的会议

• 批准号: 9924839
• 负责人: BRIAN S MITTMAN
• 金额: $ 4.99万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-01 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9924839
• 关键词: Strengthening; Research; Complex; Health; Interventions

PROJECT SUMMARY/ABSTRACT Complex health interventions (CHIs), including clinical, health service delivery and public health interventions with multiple adaptable components addressing multiple intervention targets are increasingly prevalent within the U.S. health system. CHIs represent promising solutions to complex health problems requiring simultaneous, coordinated efforts targeting root causes at the patient, clinician, health system, community, and/or regional, state and national levels. CHIs pose unique challenges and barriers to research and evaluation, however: prevailing health-related research approaches are optimized for simple, fixed, homogeneous interventions (e.g., pharmaceutical interventions) delivered with high levels of standardization and fidelity, but are poorly equipped to handle complex, multiple-component, heterogeneous and adaptable interventions. Furthermore, the primary goals of research on simple interventions – e average effect size estimates and answers to questions such as “is intervention A effective?” or “is intervention A superior to intervention B?” – are not useful for CHIs, for which the prevailing answer is generally “it depends.” Decision makers require guidance to support multiple decisions for CHIs, including (a) selecting interventions matched to features of their settings, (b) adapting CHIs to meet local circumstances, and (c) managing local conditions to enhance intervention effectiveness through improved intervention-context concordance. Research approaches capable of guiding the complex, multiple decisions and management actions required for CHIs are very different from those optimized to produce estimates of average intervention effect sizes. CHIs require distinctive study designs, intervention delivery and adaptation activities, data collection and analysis methods, and other study features. The expert meeting proposed in this application will convene key policy, practice and research leaders to (1) review the goals and desired outcomes of research evaluating CHIs and available methods standards and guidance for such studies, (2) assess prevailing research practices for CHIs and the relationship between prevailing vs. recommended practices, (3) identify barriers and facilitators to improved research practices, and (4) produce guidance and a set of recommendations for policy, practice and research stakeholder activities that will strengthen research on CHIs. The proposed conference will include pre-meeting preparation, a structured three-day meeting containing panel sessions and intensive small-group working sessions, and post-meeting work to operationalize the recommendations and facilitate their implementation. The initiative will facilitate improvement in the quality and value of research on complex interventions to enhance the contributions of this research to (a) improved evidence, insights and understanding of the operation and effects of CHIs and to (b) improvements in clinicians' and healthcare leaders' success in appropriately selecting, implementing and managing CHIs.

项目总结/摘要 复杂的卫生干预措施，包括临床、卫生服务提供和公共卫生干预措施 随着多个适应性组件解决多个干预目标越来越普遍， 美国卫生系统。CHIs代表了解决复杂健康问题的有希望的解决方案， 针对患者、临床医生、卫生系统、社区的根本原因， 和/或区域、州和国家各级。CHIs对研究和开发构成了独特的挑战和障碍， 评价，然而：流行的健康相关的研究方法是优化的简单，固定， 同质干预（例如，药物干预），并以高水平的标准化提供 但在处理复杂的、多成分的、异构的和适应性强的问题时， 干预措施。此外，简单干预研究的主要目标-平均效应量 评估和回答诸如“干预措施A是否有效？”或“干预A上级于 干预措施B？”- 对CHI没有用，对于CHI，普遍的答案通常是“这取决于”。决定 决策者需要指导来支持CHIs的多个决策，包括（a）选择与之匹配的干预措施 （B）使CHI适应当地情况，（c）管理当地条件 通过改善干预与环境的一致性来提高干预的有效性。 能够指导所需的复杂、多项决策和管理行动的研究方法 对于CHIs，与那些优化以产生平均干预效应大小估计值的CHIs非常不同。Chis 需要独特的研究设计、干预措施的实施和适应活动、数据收集和分析 方法和其他研究特点。本申请中提议的专家会议将召开关键政策， 实践和研究领导者（1）审查评估CHIs的研究目标和预期成果， 现有的方法标准和指导，这样的研究，（2）评估流行的研究实践，为CHIs 以及现行做法与推荐做法之间的关系，（3）确定障碍和促进因素， 改进研究实践;（4）为政策、实践和 研究利益相关者的活动，将加强对CHIs的研究。会议将包括 会前准备，包括小组讨论会和密集的小组讨论会在内的三天结构性会议 工作会议和会后工作，以落实各项建议， 实施.这一举措将有助于提高关于复杂生物多样性的研究的质量和价值。 干预措施，以加强这项研究的贡献，（a）改善证据，见解和 理解CHIs的操作和效果，以及（B）改善临床医生和医疗保健 领导者在适当选择、实施和管理CHI方面的成功。