Jalali Mohammad S, Rahmandad Hazhir, Bullock Sally Lawrence, Ammerman Alice
Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA 02142, USA.
Department of Nutrition, Gillings School of Global Public Health, UNC Center for Health Promotion and Disease Prevention (a CDC Prevention Research Center), University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Int J Environ Res Public Health. 2017 Aug 15;14(8):917. doi: 10.3390/ijerph14080917.
In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.
在本研究中，我们展示了案例研究，以探讨健康干预措施的实施和维持动态。我们分析了具体干预措施是如何构建和消退的，构建和消退机制是如何相互关联的，以及为什么在其他方面相似的组织中我们会看到显著不同的消退率。我们使用多个比较性肥胖预防案例研究来提供关于感兴趣机制的实证信息，并使用定性系统建模将我们不断发展的理解整合到一个内部一致且透明的现象理论中。我们的初步结果确定了强化反馈机制，包括组织流程设计、利益相关者的动机以及利益相关者之间的沟通，这些机制会影响干预措施组成部分的实施和维持。随着时间的推移，这些反馈机制可能会在其他方面相似的组织之间产生分歧，导致实施和维持过程的不同配置。
