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采用宏观、中观和微观框架分析研究政策执行情况:以全国范围内和伦敦西北部的应用卫生研究与护理协作领导(CLAHRC)计划为例。

Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care (CLAHRC) programme nationally and in North West London.

机构信息

Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.

出版信息

Health Res Policy Syst. 2012 Oct 15;10:32. doi: 10.1186/1478-4505-10-32.

Abstract

BACKGROUND

The publication of Best research for best health in 2006 and the "ring-fencing" of health research funding in England marked the start of a period of change for health research governance and the structure of research funding in England. One response to bridging the 'second translational gap' between research knowledge and clinical practice was the establishment of nine Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The goal of this paper is to assess how national-level understanding of the aims and objectives of the CLAHRCs translated into local implementation and practice in North West London.

METHODS

This study uses a variation of Goffman's frame analysis to trace the development of the initial national CLAHRC policy to its implementation at three levels. Data collection and analysis were qualitative through interviews, document analysis and embedded research.

RESULTS

Analysis at the macro (national policy), meso (national programme) and micro (North West London) levels shows a significant common understanding of the aims and objectives of the policy and programme. Local level implementation in North West London was also consistent with these.

CONCLUSIONS

The macro-meso-micro frame analysis is a useful way of studying the transition of a policy from high-level idea to programme in action. It could be used to identify differences at a local (micro) level in the implementation of multi-site programmes that would help understand differences in programme effectiveness.

摘要

背景

2006 年《最佳研究,最佳健康》的出版以及英格兰健康研究资金的“隔离”标志着健康研究治理和英格兰研究资金结构变革时期的开始。为了弥合研究知识与临床实践之间的“第二个转化差距”,人们做出了一种回应,即建立了九个应用健康研究与保健合作组织(CLAHRCs)。本文旨在评估国家层面上对 CLAHRC 目标的理解如何转化为西北伦敦的地方实施和实践。

方法

本研究使用了戈夫曼框架分析的变体,从三个层面追溯了最初的全国 CLAHRC 政策的制定过程,以及其在国家、地区和地方三个层面的实施情况。通过访谈、文献分析和嵌入式研究,收集和分析数据均采用定性方法。

结果

在宏观(国家政策)、中观(国家项目)和微观(西北伦敦)层面的分析表明,对政策和项目目标的理解具有显著的一致性。西北伦敦的地方实施情况也与这些目标一致。

结论

宏观-中观-微观框架分析是研究政策从高层理念到实际运作方案转变的一种有用方法。它可以用来识别多地点项目在地方(微观)层面实施方面的差异,从而帮助理解项目效果的差异。

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