Glasgow Russell E, Marcus Alfred C, Bull Sheana S, Wilson Katherine M
Clinical Research Unit, Kaiser Permanente Colorado, Denver, Colorado 80237-8066, USA.
Cancer. 2004 Sep 1;101(5 Suppl):1239-50. doi: 10.1002/cncr.20509.
A large gap exists between the results of research concerning efficacious cancer screening programs and the programs delivered in practice. In this article, the authors discuss issues in, barriers to, and lessons learned regarding the dissemination of interventions. They summarize previous reviews, exemplary studies, and theories regarding the diffusion and dissemination of cancer screening interventions. Six lessons learned address the involvement of key stakeholders, factors influencing diffusion, the need for different types of efficacy and effectiveness studies with greater attention to external validity, replication, the use of theoretical and evaluation models, and the importance of policy infrastructure. In this article, the authors make recommendations for future research and practice, including improving the understanding of the intervention process and changing the types of grants funded and review criteria used. Also needed are an enhanced infrastructure, including policies to support dissemination, and the involvement of researchers, health care administrators, clinicians, and funding organizations in dissemination if the gap between research and practice in cancer screening is to be reduced.
关于有效的癌症筛查项目的研究结果与实际实施的项目之间存在很大差距。在本文中,作者讨论了干预措施传播中的问题、障碍以及经验教训。他们总结了先前关于癌症筛查干预措施传播与扩散的综述、范例研究和理论。总结出的六点经验教训涉及关键利益相关者的参与、影响扩散的因素、开展不同类型的疗效和有效性研究(需更关注外部效度)、复制、理论和评估模型的应用以及政策基础设施的重要性。在本文中,作者对未来的研究和实践提出了建议,包括增进对干预过程的理解、改变资助的拨款类型和使用的评审标准。还需要加强基础设施建设,包括支持传播的政策,并且如果要缩小癌症筛查研究与实践之间的差距,研究人员、医疗保健管理人员、临床医生和资助组织都需要参与到传播工作中来。