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二者永不兼容?——实施科学与政策实施研究的比较。

Never the twain shall meet?--a comparison of implementation science and policy implementation research.

机构信息

Division of Healthcare Analysis, Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden.

出版信息

Implement Sci. 2013 Jun 10;8:63. doi: 10.1186/1748-5908-8-63.

Abstract

BACKGROUND

Many of society's health problems require research-based knowledge acted on by healthcare practitioners together with implementation of political measures from governmental agencies. However, there has been limited knowledge exchange between implementation science and policy implementation research, which has been conducted since the early 1970s. Based on a narrative review of selective literature on implementation science and policy implementation research, the aim of this paper is to describe the characteristics of policy implementation research, analyze key similarities and differences between this field and implementation science, and discuss how knowledge assembled in policy implementation research could inform implementation science.

DISCUSSION

Following a brief overview of policy implementation research, several aspects of the two fields were described and compared: the purpose and origins of the research; the characteristics of the research; the development and use of theory; determinants of change (independent variables); and the impact of implementation (dependent variables). The comparative analysis showed that there are many similarities between the two fields, yet there are also profound differences. Still, important learning may be derived from several aspects of policy implementation research, including issues related to the influence of the context of implementation and the values and norms of the implementers (the healthcare practitioners) on implementation processes. Relevant research on various associated policy topics, including The Advocacy Coalition Framework, Governance Theory, and Institutional Theory, may also contribute to improved understanding of the difficulties of implementing evidence in healthcare. Implementation science is at a relatively early stage of development, and advancement of the field would benefit from accounting for knowledge beyond the parameters of the immediate implementation science literature.

SUMMARY

There are many common issues in policy implementation research and implementation science. Research in both fields deals with the challenges of translating intentions into desired changes. Important learning may be derived from several aspects of policy implementation research.

摘要

背景

许多社会健康问题需要医学专业人士基于研究的知识,并采取政府机构的政治措施加以应对。然而,自 20 世纪 70 年代初以来,实施科学与政策实施研究之间的知识交流一直有限。本研究通过对实施科学和政策实施研究的选择性文献进行叙述性回顾,旨在描述政策实施研究的特点,分析该领域与实施科学之间的主要相似点和不同点,并讨论政策实施研究中积累的知识如何为实施科学提供信息。

讨论

在简要概述政策实施研究之后,对两个领域的几个方面进行了描述和比较:研究的目的和起源;研究的特点;理论的发展和应用;变革的决定因素(自变量);以及实施的影响(因变量)。比较分析表明,这两个领域有许多相似之处,但也存在深刻的差异。不过,从政策实施研究的几个方面仍可以得出重要的经验教训,包括与实施背景的影响以及实施者(医疗保健从业者)的价值观和规范对实施过程的影响有关的问题。关于各种相关政策主题的研究,包括倡导联盟框架、治理理论和制度理论,也可能有助于更好地理解在医疗保健中实施证据的困难。实施科学仍处于相对早期的发展阶段,该领域的发展将受益于考虑实施科学文献以外的知识。

总结

政策实施研究和实施科学中有许多共同的问题。两个领域的研究都涉及将意图转化为期望的变化的挑战。可以从政策实施研究的几个方面获得重要的经验教训。

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