Smith Justin D, Polaha Jodi
Center for Prevention Implementation Methodology, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine.
Division of Primary Care Research, Department of Family Medicine, East Tennessee State University.
Fam Syst Health. 2017 Jun;35(2):125-135. doi: 10.1037/fsh0000252.
This article is a demonstration of how an implementation-science (IS) framework can be coupled with the measurement of implementation outcomes to effectively integrate evidence-based family interventions in primary care. The primary care environment presents a number of challenges for successfully integrating such interventions. However, IS methods can improve the prospect of successfully implementing a new intervention while simultaneously and rigorously evaluating the impact on salient outcomes. We used our experiences across 2 pilot trials in which the family check-up (Smith, Montaño, Mauricio, Berkel, & Dishion, 2016), an evidence-based family intervention, was integrated into primary care. In these pilot trials, the exploration, preparation, implementation, and sustainment (EPIS) framework and the Proctor et al. taxonomy of implementation outcomes were used to guide the implementation and evaluate its success. Grounding our presentation in our pilot work offers an illustration of applying the EPIS framework and outcomes measurement to real-world problems and contexts. When embarking on new efforts to integrate behavioral interventions into health-care settings, the application of IS frameworks and measurement strategies can create generalizable knowledge that substantively contributes to a sparse literature. Today, those "in the trenches" who are translating evidence-based interventions to their setting can contribute to the corpus of research in integrated care by using IS methods to plan a new program and evaluate its feasibility, adoption, and reach. (PsycINFO Database Record
本文展示了实施科学（IS）框架如何与实施结果的测量相结合，以有效地将循证家庭干预措施整合到初级保健中。初级保健环境在成功整合此类干预措施方面存在诸多挑战。然而，IS方法可以提高成功实施新干预措施的可能性，同时严格评估对显著结果的影响。我们利用了在两项试点试验中的经验，在这些试验中，基于证据的家庭干预措施——家庭体检（史密斯、蒙塔尼奥、毛里西奥、伯克和迪希昂，2016年）被整合到初级保健中。在这些试点试验中，探索、准备、实施和维持（EPIS）框架以及普罗克特等人的实施结果分类法被用于指导实施并评估其成功与否。以我们的试点工作为基础进行阐述，说明了如何将EPIS框架和结果测量应用于现实世界的问题和背景中。当着手将行为干预措施整合到医疗保健环境的新工作时，IS框架和测量策略的应用可以创造可推广的知识，为稀少的文献做出实质性贡献。如今，那些正在将循证干预措施转化到其所在环境中的“一线人员”，可以通过使用IS方法来规划新计划并评估其可行性、采用情况和覆盖范围，为综合护理研究的知识库做出贡献。（PsycINFO数据库记录）
