Hermes Eric DA, Lyon Aaron R, Schueller Stephen M, Glass Joseph E
Veterans Affairs Connecticut Healthcare System, West Haven, CT, United States.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
J Med Internet Res. 2019 Jan 25;21(1):e11752. doi: 10.2196/11752.
Behavioral intervention technologies (BITs) are websites, software, mobile apps, and sensors designed to help users address or change behaviors, cognitions, and emotional states. BITs have the potential to transform health care delivery, and early research has produced promising findings of efficacy. BITs also favor new models of health care delivery and provide novel data sources for measurement. However, there are few examples of successful BIT implementation and a lack of consensus on as well as inadequate descriptions of BIT implementation measurement. The aim of this viewpoint paper is to provide an overview and characterization of implementation outcomes for the study of BIT use in routine practice settings. Eight outcomes for the evaluation of implementation have been previously described: acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability. In a proposed recharacterization of these outcomes with respect to BIT implementation, definitions are clarified, expansions to the level of analysis are identified, and unique measurement characteristics are discussed. Differences between BIT development and implementation, an increased focus on consumer-level outcomes, the expansion of providers who support BIT use, and the blending of BITs with traditional health care services are specifically discussed. BITs have the potential to transform health care delivery. Realizing this potential, however, will hinge on high-quality research that consistently and accurately measures how well such technologies have been integrated into health services. This overview and characterization of implementation outcomes support BIT research by identifying and proposing solutions for key theoretical and practical measurement challenges.
行为干预技术(BITs)是旨在帮助用户解决或改变行为、认知和情绪状态的网站、软件、移动应用程序及传感器。BITs有潜力改变医疗保健服务的提供方式,早期研究已得出了关于其疗效的有前景的结果。BITs还支持新的医疗保健服务模式,并为测量提供新的数据来源。然而,成功实施BITs的例子很少,对于BITs实施测量缺乏共识且描述不足。本观点论文的目的是概述和描述在常规实践环境中使用BITs的研究的实施结果。先前已描述了评估实施的八个结果:可接受性、采用率、适宜性、可行性、保真度、实施成本、渗透率和可持续性。在针对BITs实施对这些结果进行重新描述的提议中,明确了定义,确定了分析层面的扩展,并讨论了独特的测量特征。特别讨论了BITs开发与实施之间的差异、对消费者层面结果的更多关注、支持BITs使用的提供者范围的扩大以及BITs与传统医疗保健服务的融合。BITs有潜力改变医疗保健服务的提供方式。然而,要实现这一潜力,将取决于高质量的研究,即持续且准确地衡量这些技术在医疗服务中的整合程度。对实施结果的这一概述和描述通过识别关键理论和实际测量挑战并提出解决方案来支持BITs研究。
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