Brown C Hendricks, Curran Geoffrey, Palinkas Lawrence A, Aarons Gregory A, Wells Kenneth B, Jones Loretta, Collins Linda M, Duan Naihua, Mittman Brian S, Wallace Andrea, Tabak Rachel G, Ducharme Lori, Chambers David A, Neta Gila, Wiley Tisha, Landsverk John, Cheung Ken, Cruden Gracelyn
Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611; email:
Division of Health Services Research, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205; email:
Annu Rev Public Health. 2017 Mar 20;38:1-22. doi: 10.1146/annurev-publhealth-031816-044215.
The wide variety of dissemination and implementation designs now being used to evaluate and improve health systems and outcomes warrants review of the scope, features, and limitations of these designs. This article is one product of a design workgroup that was formed in 2013 by the National Institutes of Health to address dissemination and implementation research, and whose members represented diverse methodologic backgrounds, content focus areas, and health sectors. These experts integrated their collective knowledge on dissemination and implementation designs with searches of published evaluations strategies. This article emphasizes randomized and nonrandomized designs for the traditional translational research continuum or pipeline, which builds on existing efficacy and effectiveness trials to examine how one or more evidence-based clinical/prevention interventions are adopted, scaled up, and sustained in community or service delivery systems. We also mention other designs, including hybrid designs that combine effectiveness and implementation research, quality improvement designs for local knowledge, and designs that use simulation modeling.
目前用于评估和改善卫生系统及成果的各种传播与实施设计,有必要对这些设计的范围、特点和局限性进行审视。本文是一个设计工作小组的成果之一,该小组由美国国立卫生研究院于2013年成立,旨在开展传播与实施研究,其成员代表了不同的方法学背景、内容重点领域和卫生部门。这些专家将他们关于传播与实施设计的集体知识与已发表的评估策略研究相结合。本文重点介绍传统转化研究连续体或流程中的随机和非随机设计,该连续体或流程建立在现有的疗效和效果试验基础上,以研究一种或多种基于证据的临床/预防干预措施如何在社区或服务提供系统中被采用、扩大规模并持续实施。我们还提及其他设计,包括结合效果研究和实施研究的混合设计、针对本地知识的质量改进设计以及使用模拟建模的设计。