Adaptation of evidence-informed complex population health interventions for implementation and/or re-evaluation in new contexts: New guidance

在一种情况下有效的复杂的人口健康干预措施在另一种情况下可能无效，甚至可能有害。这在很大程度上是因为干预的组成部分在不同的背景下发挥不同的作用。因此，干预措施可能需要调整，以确保其适合新的环境。可能需要进一步评估，以确定干预效果是否可以复制。到目前为止，还没有指导，以支持研究人员在新的情况下调整和评估干预措施。没有标准支持研究资助者或同行评审者决定拟议或报告的改编或评价是否适当。此外，政策制定者和从业人员在决定循证干预措施是否适合其环境，或是否需要调整和进一步评估方面的指导有限。这项研究将为这些社区提供指导，以支持在新的背景下适应，实施和/或重新评估复杂的人口健康干预措施。必须提供指导，以确保采用最适当的方法调整和评价干预措施。这将最大限度地减少用于干预措施的公共支出，这些干预措施由于适应不当而在新的环境中不太可能有效。它还将减少对新情况下干预措施的大规模评价的供资，在这种情况下，对干预措施是否有效的不确定性不足以证明有必要支付费用。我们将审查现有的指导和例子，复杂的人口健康干预措施已适应新的情况。这将有助于我们了解当前的做法，并探讨如何进行调整和合理化。它还将增进对如何使用指导以及如何根据其与新环境的适应性解释干预的成功或失败的理解。我们还将与研究人员，国际研究资助者，同行评审员，政策制定者和从业者的代表进行访谈。将根据审查期间检索到的指南和研究确定参与者。我们还将让研究小组确定的联系人参与进来。选定的参与者将具有委托、提供或评价在新的背景下调整或实施的循证人口健康干预措施的经验。与研究人员，政策制定者和从业人员的访谈将探讨如何围绕干预适应，遵循的程序和指导的使用做出决策和合理性。与研究资助者和同行评审者的访谈将侧重于拟议和报告的改编和评估的适当性。我们随后将完成一个基于网络的德尔菲进程和协商一致会议，以制定适应指南。这将涉及与专家进行三轮调查，以决定哪些建议应纳入指南，以及由于共识不足，可能需要进一步研究的地方。在调查之后，我们将起草指导意见。然后将与专家举行会议，就指导意见达成一致意见并定稿。一旦完成，该指南将分发给研究人员、研究资助者、同行评审者、政策制定者和从业人员，以最大限度地影响干预措施调整的供资、实施和报告方式。

Complex population-health interventions that are effective in one context may not be effective in a different context, and may even be harmful. This is largely because intervention components work differently across different contexts. As such, an intervention may require adaptation to ensure it fits with a new setting. Further evaluation may be necessary to establish if intervention effects can be replicated. To date there is no guidance to support researchers to adapt and evaluate interventions in new contexts. There is no criteria to support research funders or peer reviewers in deciding upon the appropriateness of proposed or reported adaptations or evaluation. Further, there is limited instruction for policy-makers and practitioners to decide if evidence-informed interventions are appropriate to their context, or if adaptation and further evaluation is needed. This study will provide guidance to these communities to support the adaptation, implementation and/or re-evaluation of complex population health interventions in new contexts. It is important to provide guidance to ensure that interventions are adapted and evaluated using the most appropriate methods. This would minimise public spending on interventions that are not likely to be effective in new contexts due to unsuitable adaptations. It will also reduce the funding of large scale evaluations of interventions in new contexts, where uncertainty about their likelihood of working is insufficient to warrant their expense. We will review existing guidance and examples where complex population-health interventions have been adapted to new contexts. This will help us to understand current practice and to explore how adaptations are made and justified. It will also improve understanding of how guidance is used and how intervention successes or failures are explained in relation to its fit with the new context. We will also conduct interviews with researchers, representatives of international level research funders, peer reviewers, policy makers and practitioners. Participants will be identified from guidance and studies retrieved during the reviews. We will also involve contacts identified by the study's research team. Selected participants will have experience of commissioning, delivering or evaluating evidence-informed population health interventions that have been adapted or implemented in a new context. Interviews with researchers, policy-makers and practitioners will explore how decisions are made and justified around intervention adaptation, the procedures followed, and the use of guidance. Interviews with research funders and peer reviewers will focus on the appropriateness of proposed and reported adaptations and evaluation. We will subsequently complete a web-based Delphi process and consensus meeting to develop adaptation guidance. This will involve three rounds of surveys with experts to decide which recommendations should be included in the guidance and where further research may be required as there is insufficient consensus. Following the surveys we will draft the guidance. A meeting will then be held with experts to reach agreement on, and finalise, the guidance. Once completed, the guidance will be disseminated to researchers, research funders, peer reviewers, policy-makers and practitioners to maximise impact on the way in which intervention adaptations are funded, undertaken and reported.