Castro Felipe Gonzalez, Yasui Miwa
College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
University of Chicago, Chicago, IL, USA.
Prev Sci. 2017 Aug;18(6):623-629. doi: 10.1007/s11121-017-0809-x.
This introduction examines major issues and challenges as presented in this special issue of Prevention Science, "Challenges to the Dissemination and Implementation of Evidence Based Prevention Interventions for Diverse Populations." We describe the Fidelity-Adaptation Dilemma that became the origin of dynamic tensions in prevention science. It generated controversies and debates and new perspectives on the dissemination and implementation of evidence-based interventions (EBIs) within diverse populations. The five articles in this special issue address many of these challenges. These dynamic tensions have culminated in a reframing of this dilemma that now argues that fidelity and adaptation are both equally important imperatives. These five articles also examine the abiding challenges of engagement and sustainability. Also, two commentaries from expert research investigators reflect on these five articles and their contributions to prevention science. The current introduction describes this "second generation" of EBIs as they may contribute towards a reduction of the health disparities and inequities that disproportionately affect sectors of the major ethnocultural populations in the USA. We also present a systems analysis of approaches and challenges in the dissemination and implementation of EBIs within the contemporary integrative care environment. Finally, we mention an initiative for, "building a science of intervention adaptation," that proposes systematic research and the creation of an archive of scientific data on the benefits and problems of intervention adaptation. Collectively, these new directions can integrate scientific rigor and sensitivity to cultural factors, for enhancing the effectiveness and reach of this second generation of evidence-based interventions with diverse ethnocultural populations.
本引言探讨了发表于《预防科学》本期特刊“针对不同人群的循证预防干预措施的传播与实施挑战”中的主要问题和挑战。我们描述了保真度 - 适应性困境，它成为了预防科学中动态张力的根源。这一困境引发了争议和辩论，以及关于在不同人群中传播和实施循证干预措施（EBIs）的新观点。本期特刊中的五篇文章探讨了其中的许多挑战。这些动态张力最终促成了对这一困境的重新审视，现在认为保真度和适应性同样重要。这五篇文章还研究了参与度和可持续性方面持续存在的挑战。此外，两位专家研究人员的评论反思了这五篇文章及其对预防科学的贡献。本引言将当前的这种“第二代”循证干预措施描述为可能有助于减少对美国主要种族文化人群各部门产生不成比例影响的健康差距和不平等现象。我们还对当代综合护理环境中循证干预措施的传播和实施方法及挑战进行了系统分析。最后，我们提到了一项“构建干预适应性科学”的倡议，该倡议提议进行系统研究，并创建一个关于干预适应性的益处和问题的科学数据存档。总体而言，这些新方向可以将科学严谨性与对文化因素的敏感性相结合，以提高第二代循证干预措施对不同种族文化人群的有效性和覆盖面。
