Hirschhorn Lisa R, Ojikutu Bisola, Rodriguez William
Division of AIDS, Harvard Medical School, Boston, Massachusetts, USA.
J Infect Dis. 2007 Dec 1;196 Suppl 3:S516-22. doi: 10.1086/521120.
The expansion of human immunodeficiency virus (HIV) care and treatment in Africa and other resource-limited settings has begun to mitigate the impact of the acquired immunodeficiency syndrome pandemic. As this expansion has occurred, critical research has been conducted that has helped to define best practices and establish guidelines in HIV care. However, despite this research, a tremendous gap exists between the actual delivery of care and those strategies with proven efficacy in the clinical research setting: the program-implementation gap. The field of implementation research has the potential to fill this knowledge gap and to address the barriers to the effective replication of evidence-based interventions in local settings. This article reviews the current understanding of the field of implementation research and discusses its association with other areas of health services research, clinical research, and quality management work. Opportunities for conducting implementation research are proposed, and future steps to develop the field are outlined.
在非洲和其他资源有限地区扩大人类免疫缺陷病毒（HIV）护理与治疗工作，已开始减轻获得性免疫缺陷综合征大流行的影响。随着这项工作的推进，开展了关键研究，有助于界定最佳实践并制定HIV护理指南。然而，尽管有这项研究，但在实际护理服务与临床研究中已证实有效的策略之间仍存在巨大差距：即项目实施差距。实施研究领域有潜力填补这一知识空白，并解决在当地环境中有效推广循证干预措施的障碍。本文回顾了对实施研究领域的当前认识，并讨论了其与卫生服务研究、临床研究及质量管理工作等其他领域的关联。文中提出了开展实施研究的机会，并概述了该领域未来的发展步骤。
