Center for Prevention Implementation Methodology (Ce-PIM) for Drug Abuse and HIV, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Dr., Chicago, IL, USA.
Center for Healthcare Studies, Institute of Public Health and Medicine, Northwestern University Feinberg School of Medicine, 633 N St. Claire St., Chicago, Illinois, USA.
Psychiatry Res. 2020 Jan;283:112521. doi: 10.1016/j.psychres.2019.112521. Epub 2019 Aug 17.
Implementation research necessitates a shift from clinical trial methods in both the conduct of the study and in the way that it is evaluated given the focus on the impact of implementation strategies. That is, the methods or techniques to support the adoption and delivery of a clinical or preventive intervention, program, or policy. As strategies target one or more levels within the service delivery system, evaluating their impact needs to follow suit. This article discusses the methods and practices involved in quantitative evaluations of implementation research studies. We focus on evaluation methods that characterize and quantify the overall impacts of an implementation strategy on various outcomes. This article discusses available measurement methods for common quantitative implementation outcomes involved in such an evaluation-adoption, fidelity, implementation cost, reach, and sustainment-and the sources of such data for these metrics using established taxonomies and frameworks. Last, we present an example of a quantitative evaluation from an ongoing randomized rollout implementation trial of the Collaborative Care Model for depression management in a large primary healthcare system.
实施研究需要从临床研究方法转变,无论是在研究的实施过程中,还是在考虑实施策略的影响时,都需要进行评估。也就是说,这些方法或技术可以支持临床或预防干预、计划或政策的采用和实施。由于策略针对服务提供系统中的一个或多个层次,因此需要相应地评估其影响。本文讨论了定量评估实施研究的方法和实践。我们重点介绍了评估实施策略对各种结果的整体影响的评价方法。本文讨论了这种评估中常见的定量实施结果的可用测量方法——采用、保真度、实施成本、覆盖范围和维持——以及使用既定分类法和框架获取这些指标数据的来源。最后,我们展示了正在进行的一项随机实施试验的一个例子,该试验在一个大型初级保健系统中实施协作护理模式来管理抑郁症。