作为应用科学的实施研究:弥合研究与实践的差距。

Implementation Research as Applied Science: Bridging the Research to Practice Gap.

作者信息

Livingood William C, Bilello Lori, Lukens-Bull Katryne, Smotherman Carmen, Choe Ulyee

机构信息

University of Florida, Jacksonville, FL, USA.

Florida Department of Health in Pinellas County, St. Petersburg, FL, USA.

出版信息

Health Promot Pract. 2020 Jan;21(1):49-57. doi: 10.1177/1524839919858082. Epub 2019 Jun 28.

Abstract

Implementation research is intended to address challenges posed by the slow adoption of evidence-based science by the medical and health promotion practice community. A case study approach is used to illustrate and discuss the use of Quality improvement and Evaluation as an applied approach to implementation science in contrast of more classic purposes of research. Quality improvement was the implementation model used to facilitate organizational change needed to adopt the use of texting to report sexually transmitted infection test results in over a fifth of Florida's larger county health departments. Both quantitative and qualitative methods were used to evaluate implementation. All seven participating county health departments were successful in enrolling clients in texting with extensive variation (24% to 72%) in texting enrollment at the end of the 10-month study. Statistically significant outcomes for those enrolled in texting were recorded through Florida's online sexually transmitted infection reporting system in the form of increased number of people receiving early (1-4 days) treatment and reductions in delayed (≥8 days) or no treatment. This study illustrates an applied approach to implementation research which may be critical to adapt emerging evidence and technologies to the multiple and complex characteristics of the diverse populations served by health promotion institutions.

摘要

实施研究旨在应对医疗卫生促进实践社区在采用循证科学方面进展缓慢所带来的挑战。本文采用案例研究方法,以说明和讨论质量改进与评估作为实施科学的一种应用方法,这与更为传统的研究目的形成对比。质量改进是一种实施模式,用于推动组织变革,以便在佛罗里达州超过五分之一的较大县卫生部门采用短信报告性传播感染检测结果。研究同时运用了定量和定性方法来评估实施情况。在为期10个月的研究结束时,所有七个参与的县卫生部门都成功地让客户注册了短信服务,短信注册率差异很大(从24%到72%)。通过佛罗里达州的在线性传播感染报告系统记录了注册短信服务者的统计学显著结果,表现为接受早期(1 - 4天)治疗的人数增加,以及延迟(≥8天)或未接受治疗的人数减少。本研究说明了一种实施研究的应用方法,这种方法对于使新出现的证据和技术适应健康促进机构所服务的多样化人群的多重和复杂特征可能至关重要。

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