Mendel Peter, Meredith Lisa S, Schoenbaum Michael, Sherbourne Cathy D, Wells Kenneth B
RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, USA.
Adm Policy Ment Health. 2008 Mar;35(1-2):21-37. doi: 10.1007/s10488-007-0144-9. Epub 2007 Nov 8.
The effective dissemination and implementation of evidence-based health interventions within community settings is an important cornerstone to expanding the availability of quality health and mental health services. Yet it has proven a challenging task for both research and community stakeholders. This paper presents the current framework developed by the UCLA/RAND NIMH Center to address this research-to-practice gap by: (1) providing a theoretically-grounded understanding of the multi-layered nature of community and healthcare contexts and the mechanisms by which new practices and programs diffuse within these settings; (2) distinguishing among key components of the diffusion process-including contextual factors, adoption, implementation, and sustainment of interventions-showing how evaluation of each is necessary to explain the course of dissemination and outcomes for individual and organizational stakeholders; (3) facilitating the identification of new strategies for adapting, disseminating, and implementing relatively complex, evidence-based healthcare and improvement interventions, particularly using a community-based, participatory approach; and (4) enhancing the ability to meaningfully generalize findings across varied interventions and settings to build an evidence base on successful dissemination and implementation strategies.
在社区环境中有效传播和实施循证健康干预措施是扩大优质健康和心理健康服务可及性的重要基石。然而，事实证明，这对研究人员和社区利益相关者来说都是一项具有挑战性的任务。本文介绍了加州大学洛杉矶分校/兰德国家心理健康研究所中心目前制定的框架，以解决这一研究与实践之间的差距，具体方式如下：（1）对社区和医疗环境的多层性质以及新实践和项目在这些环境中传播的机制提供基于理论的理解；（2）区分传播过程的关键组成部分，包括背景因素、干预措施的采用、实施和维持，展示对每个部分进行评估对于解释个体和组织利益相关者的传播过程和结果的必要性；（3）促进确定新的策略，以适应、传播和实施相对复杂的循证医疗保健和改进干预措施，特别是采用基于社区的参与式方法；（4）提高在各种干预措施和环境中有意义地推广研究结果的能力，以建立关于成功传播和实施策略的证据基础。
