VERDICT, a VA HSR&D REAP at the South Texas Veterans Health Care System, San Antonio, Texas, USA.
Implement Sci. 2009 Oct 23;4:69. doi: 10.1186/1748-5908-4-69.
A gap continues to exist between what is known to be effective and what is actually delivered in the usual course of medical care. The goal of implementation research is to reduce this gap. However, a tension exists between the need to obtain generalizeable knowledge through implementation trials, and the inherent differences between healthcare organizations that make standard interventional approaches less likely to succeed. The purpose of this paper is to explore the integration of participatory action research and randomized controlled trial (RCT) study designs to suggest a new approach for studying interventions in healthcare settings.
We summarize key elements of participatory action research, with particular attention to its collaborative, reflective approach. Elements of participatory action research and RCT study designs are discussed and contrasted, with a complex adaptive systems approach used to frame their integration.
The integration of participatory action research and RCT design results in a new approach that reflects not only the complex nature of healthcare organizations, but also the need to obtain generalizeable knowledge regarding the implementation process.
在医疗保健的常规过程中，实际提供的服务与已知有效的服务之间仍然存在差距。实施研究的目标是缩小这一差距。然而，在通过实施试验获得可推广知识的需求与使标准干预措施不太可能成功的医疗机构之间的固有差异之间存在紧张关系。本文旨在探讨参与式行动研究和随机对照试验（RCT）研究设计的整合，以提出一种研究医疗保健环境中干预措施的新方法。
我们总结了参与式行动研究的关键要素，特别关注其协作性、反思性方法。讨论并对比了参与式行动研究和 RCT 研究设计的要素，并使用复杂适应系统方法来构建它们的整合。
参与式行动研究和 RCT 设计的整合产生了一种新方法，不仅反映了医疗保健组织的复杂性，还反映了获得有关实施过程的可推广知识的需求。
