Harvey Gill, Kitson Alison
School of Nursing, University of Adelaide, Adelaide, SA, 5005, Australia.
Alliance Manchester Business School, University of Manchester, Manchester, UK.
Implement Sci. 2016 Mar 10;11:33. doi: 10.1186/s13012-016-0398-2.
The Promoting Action on Research Implementation in Health Services, or PARIHS framework, was first published in 1998. Since this time, work has been ongoing to further develop, refine and test it. Widely used as an organising or conceptual framework to help both explain and predict why the implementation of evidence into practice is or is not successful, PARIHS was one of the first frameworks to make explicit the multi-dimensional and complex nature of implementation as well as highlighting the central importance of context. Several critiques of the framework have also pointed out its limitations and suggested areas for improvement.
Building on the published critiques and a number of empirical studies, this paper introduces a revised version of the framework, called the integrated or i-PARIHS framework. The theoretical antecedents of the framework are described as well as outlining the revised and new elements, notably, the revision of how evidence is described; how the individual and teams are incorporated; and how context is further delineated. We describe how the framework can be operationalised and draw on case study data to demonstrate the preliminary testing of the face and content validity of the revised framework. This paper is presented for deliberation and discussion within the implementation science community. Responding to a series of critiques and helpful feedback on the utility of the original PARIHS framework, we seek feedback on the proposed improvements to the framework. We believe that the i-PARIHS framework creates a more integrated approach to understand the theoretical complexity from which implementation science draws its propositions and working hypotheses; that the new framework is more coherent and comprehensive and at the same time maintains it intuitive appeal; and that the models of facilitation described enable its more effective operationalisation.
《卫生服务研究实施促进行动》（PARIHS）框架于1998年首次发布。自那时以来，一直在进行进一步开发、完善和测试工作。PARIHS被广泛用作一个组织或概念框架，以帮助解释和预测循证实践的实施为何成功或失败，它是最早明确指出实施的多维度和复杂性以及强调背景的核心重要性的框架之一。对该框架的一些批评也指出了其局限性并提出了改进领域。
基于已发表的批评意见和一些实证研究，本文介绍了该框架的修订版，即综合或i - PARIHS框架。描述了该框架的理论前身，概述了修订和新的要素，特别是证据描述方式的修订；个人和团队的纳入方式；以及背景的进一步界定。我们描述了该框架如何实施，并利用案例研究数据来展示修订框架的表面效度和内容效度的初步测试。本文旨在供实施科学领域的人士进行审议和讨论。针对对原始PARIHS框架实用性的一系列批评和有益反馈，我们寻求对框架改进建议的反馈。我们认为，i - PARIHS框架创建了一种更综合的方法来理解实施科学从中得出其命题和工作假设的理论复杂性；新框架更连贯、更全面，同时保持其直观吸引力；并且所描述的促进模型使其能够更有效地实施。
