运用现实主义方法评估针对孕妇和年轻人的戒烟干预措施。
Using a realist approach to evaluate smoking cessation interventions targeting pregnant women and young people.
机构信息
Section of Population Health, School of Medicine and Dentistry, University of Aberdeen, Foresterhill, Aberdeen, UK.
出版信息
BMC Health Serv Res. 2010 Feb 23;10:49. doi: 10.1186/1472-6963-10-49.
BACKGROUND
This paper describes a study protocol designed to evaluate a programme of smoking cessation interventions targeting pregnant women and young people living in urban and rural locations in Northeast Scotland. The study design was developed on so-called 'realist' evaluation principles, which are concerned with the implementation of interventions as well as their outcomes.
METHODS/DESIGN: A two-phased study was designed based on the Theory of Change (TOC) using mixed methods to assess both process and outcome factors. The study was designed with input from the relevant stakeholders. The mixed-methods approach consists of semi-structured interviews with planners, service providers, service users and non-users. These qualitative interviews will be analysed using a thematic framework approach. The quantitative element of the study will include the analysis of routinely collected data and specific project monitoring data, such as data on service engagement, service use, quit rates and changes in smoking status.
DISCUSSION
The process of involving key stakeholders was conducted using logic modelling and TOC tools. Engaging stakeholders, including those responsible for funding, developing and delivering, and those intended to benefit from interventions aimed at them, in their evaluation design, are considered by many to increase the validity and rigour of the subsequent evidence generated. This study is intended to determine not only the components and processes, but also the possible effectiveness of this set of health interventions, and contribute to the evidence base about smoking cessation interventions aimed at priority groups in Scotland. It is also anticipated that this study will contribute to the ongoing debate about the role and challenges of 'realist' evaluation approaches in general, and the utility of logic modelling and TOC approaches in particular, for evaluation of complex health interventions.
背景
本研究旨在评估一项针对苏格兰东北部城乡地区孕妇和年轻人的戒烟干预计划，描述了其研究方案。该研究设计基于所谓的“现实主义”评估原则，不仅关注干预措施的实施情况，还关注其结果。
方法/设计：本研究采用混合方法，基于变革理论（TOC）设计了两阶段研究，以评估过程和结果因素。该研究设计是在相关利益相关者的参与下进行的。混合方法包括对规划者、服务提供者、服务使用者和非使用者进行半结构化访谈。这些定性访谈将使用主题框架方法进行分析。研究的定量部分将包括对常规收集数据和特定项目监测数据的分析，例如关于服务参与度、服务使用、戒烟率和吸烟状况变化的数据。
讨论
利益相关者的参与过程采用逻辑建模和 TOC 工具进行。许多人认为，让包括负责资助、开发和提供干预措施以及预期从干预措施中受益的人员在内的利益相关者参与其评估设计，可以提高后续产生的证据的有效性和严谨性。本研究旨在确定这组健康干预措施的组成部分和流程，以及可能的有效性，并为苏格兰针对优先群体的戒烟干预措施的证据基础做出贡献。此外，预计本研究还将有助于就“现实主义”评估方法的作用和挑战进行持续辩论，并特别就逻辑建模和 TOC 方法在评估复杂健康干预措施方面的实用性进行辩论。
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