Rabin Borsika A, Brownson Ross C, Kerner Jon F, Glasgow Russell E
Department of Community Health and Prevention Research Center, School of Public Health, Saint Louis University, St. Louis, Missouri, USA.
Am J Prev Med. 2006 Oct;31(4 Suppl):S24-34. doi: 10.1016/j.amepre.2006.06.009.
During the past decade, numerous intervention studies have been published on the effectiveness of programs to promote active living; however, few studies have addressed the dissemination of effective physical activity interventions. Both community settings and healthcare settings are important locations for dissemination of evidence-based programs and policies. A major gap in the existing literature involves the appropriate methodologic approaches for planning, evaluating, and reporting on dissemination efforts for effective and promising interventions in these locations. To address this gap, two hypothetical dissemination studies are presented: a quasi-experimental study of local health agencies (Scenario 1) and a group-randomized trial of clinical practices (Scenario 2). These studies help to elucidate the barriers and opportunities for implementing evidence-based physical activity interventions across different settings. Based on the scenarios, the existing literature, and the authors' experience, dissemination challenges that researchers and practitioners may experience (i.e., issues of design, measures of outcomes and external validity, the balance between fidelity and adaptation to local settings, and the review and funding of dissemination science) are discussed. Researchers, practitioners, and policymakers are invited to address the issues outlined in this article in order to bridge the gap between the generation of new knowledge on efficacious physical activity interventions and widespread application of these approaches in community and clinical settings.
在过去十年中,已经发表了大量关于促进积极生活方式项目有效性的干预研究;然而,很少有研究涉及有效体育活动干预措施的推广。社区环境和医疗环境都是推广循证项目和政策的重要场所。现有文献中的一个主要差距在于,缺乏适用于规划、评估和报告在这些场所推广有效且有前景干预措施的方法学途径。为了填补这一差距,本文提出了两项假设性的推广研究:一项针对地方卫生机构的准实验研究(方案1)和一项针对临床实践的群组随机试验(方案2)。这些研究有助于阐明在不同环境中实施循证体育活动干预措施的障碍和机遇。基于这些方案、现有文献以及作者的经验,本文讨论了研究人员和从业者可能遇到的推广挑战(即设计问题、结果测量和外部效度问题、保真度与适应当地环境之间的平衡以及推广科学的审查和资金问题)。邀请研究人员、从业者和政策制定者解决本文中概述的问题,以弥合关于有效体育活动干预措施的新知识生成与这些方法在社区和临床环境中的广泛应用之间的差距。