Bragge Peter, Grimshaw Jeremy M, Lokker Cynthia, Colquhoun Heather
BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, VIC, 3800, Australia.
Clinical Epidemiology Program, Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa, School of Epidemiology, Public Health and Preventive Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
BMC Med Res Methodol. 2017 Mar 4;17(1):38. doi: 10.1186/s12874-017-0314-8.
Proliferation of terms describing the science of effectively promoting and supporting the use of research evidence in healthcare policy and practice has hampered understanding and development of the field. To address this, an international Terminology Working Group developed and published a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. This paper presents results of validation work and a second international workgroup meeting, culminating in the updated AIMD framework [Aims, Ingredients, Mechanism, Delivery].
Framework validity was evaluated against terminology schemas (n = 51); primary studies (n = 37); and reporting guidelines (n = 10). Framework components were independently categorized as fully represented, partly represented, or absent by two researchers. Opportunities to refine the framework were systematically recorded. A meeting of the expanded international Terminology Working Group updated the framework by reviewing and deliberating upon validation findings and refinement proposals.
There was variation in representativeness of the components across the three types of literature, in particular for the component 'causal mechanisms'. Analysis of primary studies revealed that representativeness of this concept lowered from 92 to 68% if only explicit, rather than explicit and non-explicit references to causal mechanisms were included. All components were very well represented in reporting guidelines, however the level of description of these was lower than in other types of literature. Twelve opportunities were identified to improve the framework, 9 of which were operationalized at the meeting. The updated AIMD framework comprises four components: (1) Aims: what do you want your intervention to achieve and for whom? (2) Ingredients: what comprises the intervention? (3) Mechanisms: how do you propose the intervention will work? and (4) Delivery: how will you deliver the intervention?
The draft simplified framework was validated with reference to a wide range of relevant literature and improvements have enhanced useability. The AIMD framework could aid in the promotion of evidence into practice, remove barriers to understanding how interventions work, enhance communication of interventions and support knowledge synthesis. Future work needs to focus on developing and testing resources and educational initiatives to optimize use of the AIMD framework in collaboration with relevant end-user groups.
用于描述在医疗保健政策和实践中有效促进和支持研究证据使用的科学的术语不断增加，这阻碍了该领域的理解和发展。为解决这一问题，一个国际术语工作组制定并发布了一个简化的干预框架，以促进证据融入卫生实践、系统和政策。本文介绍了验证工作的结果以及第二次国际工作组会议的情况，最终形成了更新后的AIMD框架[目标、要素、机制、实施]。
根据术语模式（n = 51）、初级研究（n = 37）和报告指南（n = 10）对框架的有效性进行评估。两名研究人员将框架组件独立分类为充分体现、部分体现或未体现。系统记录了完善框架的机会。扩大后的国际术语工作组会议通过审查和审议验证结果及完善建议对框架进行了更新。
三种类型文献中各组件的代表性存在差异，尤其是“因果机制”组件。对初级研究的分析表明，如果仅纳入对因果机制的明确提及，而非明确和非明确提及，则该概念的代表性从92%降至68%。所有组件在报告指南中都有很好的体现，然而这些组件的描述程度低于其他类型的文献。确定了12个改进框架的机会，其中9个在会议上得到了落实。更新后的AIMD框架包括四个组件：（1）目标：你希望你的干预措施实现什么目标，针对谁？（2）要素：干预措施包括什么？（3）机制：你认为干预措施将如何发挥作用？（4）实施：你将如何实施干预措施？
简化框架草案已参照广泛的相关文献进行了验证，改进措施提高了其可用性。AIMD框架有助于促进将证据转化为实践，消除理解干预措施如何发挥作用的障碍，加强干预措施的沟通并支持知识整合。未来的工作需要集中在与相关最终用户群体合作开发和测试资源及教育举措，以优化AIMD框架的使用。
