Powell Byron J, Waltz Thomas J, Chinman Matthew J, Damschroder Laura J, Smith Jeffrey L, Matthieu Monica M, Proctor Enola K, Kirchner JoAnn E
Center for Mental Health Policy and Services Research, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA.
Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA.
Implement Sci. 2015 Feb 12;10:21. doi: 10.1186/s13012-015-0209-1.
Identifying, developing, and testing implementation strategies are important goals of implementation science. However, these efforts have been complicated by the use of inconsistent language and inadequate descriptions of implementation strategies in the literature. The Expert Recommendations for Implementing Change (ERIC) study aimed to refine a published compilation of implementation strategy terms and definitions by systematically gathering input from a wide range of stakeholders with expertise in implementation science and clinical practice.
Purposive sampling was used to recruit a panel of experts in implementation and clinical practice who engaged in three rounds of a modified Delphi process to generate consensus on implementation strategies and definitions. The first and second rounds involved Web-based surveys soliciting comments on implementation strategy terms and definitions. After each round, iterative refinements were made based upon participant feedback. The third round involved a live polling and consensus process via a Web-based platform and conference call.
Participants identified substantial concerns with 31% of the terms and/or definitions and suggested five additional strategies. Seventy-five percent of definitions from the originally published compilation of strategies were retained after voting. Ultimately, the expert panel reached consensus on a final compilation of 73 implementation strategies.
This research advances the field by improving the conceptual clarity, relevance, and comprehensiveness of implementation strategies that can be used in isolation or combination in implementation research and practice. Future phases of ERIC will focus on developing conceptually distinct categories of strategies as well as ratings for each strategy's importance and feasibility. Next, the expert panel will recommend multifaceted strategies for hypothetical yet real-world scenarios that vary by sites' endorsement of evidence-based programs and practices and the strength of contextual supports that surround the effort.
识别、开发和测试实施策略是实施科学的重要目标。然而，文献中使用不一致的语言以及对实施策略的描述不充分，使这些工作变得复杂。实施变革专家建议（ERIC）研究旨在通过系统地收集来自实施科学和临床实践领域广泛利益相关者的意见，完善已发表的实施策略术语和定义汇编。
采用目的抽样法招募实施和临床实践方面的专家小组，他们参与三轮经过修改的德尔菲法，就实施策略和定义达成共识。第一轮和第二轮包括基于网络的调查，征求对实施策略术语和定义的意见。每轮之后，根据参与者的反馈进行迭代完善。第三轮包括通过基于网络的平台和电话会议进行现场投票和达成共识的过程。
参与者对31%的术语和/或定义提出了重大关切，并提出了另外五种策略。投票后，最初发表的策略汇编中75%的定义得以保留。最终，专家小组就73种实施策略的最终汇编达成了共识。
本研究通过提高实施策略的概念清晰度、相关性和全面性推动了该领域的发展，这些策略可在实施研究和实践中单独或组合使用。ERIC的未来阶段将专注于开发概念上不同的策略类别以及对每种策略的重要性和可行性进行评级。接下来，专家小组将针对假设但现实的情景推荐多方面策略，这些情景因各场所对循证项目和实践的认可程度以及围绕该工作的背景支持力度而异。
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