Kellam Sheppard G, Langevin Doris J
Center for Integrating Education and Prevention Research in Schools, American Institutes for Research, Washington, District of Columbia 20007-3835, USA.
Prev Sci. 2003 Sep;4(3):137-53. doi: 10.1023/a:1024693321963.
This report provides a multidimensional framework for understanding the meaning of evidence in prevention science. Six themes comprise the framework, each with impact on the meaning of evidence. (1) There are rigorous prevention scientific strategies now in use; each has shared but also unique requirements for the meaning of evidence. Some are directed at individuals, others at small social contexts, others at larger societal structures. (2) The phases of prevention research have shared but also unique requirements for evidence. These include efficacy, effectiveness, sustainability, going-to-scale, and sustaining programs systemwide. (3) Prevention programs address different segments of the population defined by levels of risk: the total population; a smaller subpopulation at increased risk; or a still smaller subpopulation at very high risk. The levels influence the meaning of evidence. (4) Economic analysis and economic evidence must become a central part of prevention research. These are needed for appropriate policy decision making and for assessing long-term benefits. (5) Collaboration is required for rigor in prevention research: including researchers, but also policy makers, program advocates and leaders, and community and institutional leaders. Broad ownership is critical for implementing rigorous research and for sustaining program fidelity. (6) Acceptance of a multidimensional framework for understanding "evidence" is essential across those agencies and institutions that carry out and/or use prevention science. The more widely the vision of the prevention field is shared, and the more the various qualities and rules of evidence are accepted and implemented, the better the quality will be of prevention research and programs.
本报告提供了一个多维框架，用于理解预防科学中证据的意义。该框架由六个主题组成，每个主题都对证据的意义产生影响。（1）目前正在使用严格的预防科学策略；每种策略对证据的意义都有共同但也独特的要求。有些针对个人，有些针对小型社会环境，有些针对更大的社会结构。（2）预防研究的各个阶段对证据有共同但也独特的要求。这些要求包括有效性、效果、可持续性、扩大规模以及在全系统维持项目。（3）预防项目针对按风险水平界定的不同人群：总人口；风险增加的较小亚人群；或风险极高的更小亚人群。这些风险水平会影响证据的意义。（4）经济分析和经济证据必须成为预防研究的核心部分。这对于做出适当的政策决策和评估长期效益是必要的。（5）预防研究的严谨性需要合作：包括研究人员，也包括政策制定者、项目倡导者和领导者，以及社区和机构领导者。广泛的参与对于开展严谨的研究和维持项目的保真度至关重要。（6）对于开展和/或使用预防科学的那些机构和组织来说，接受一个理解“证据”的多维框架至关重要。预防领域的愿景分享得越广泛，各种证据的质量和规则被接受和实施得越多，预防研究和项目的质量就会越好。
