Quinn Ashlinn K, Neta Gila, Sturke Rachel, Olopade Christopher O, Pollard Suzanne L, Sherr Kenneth, Rosenthal Joshua P
Fogarty International Center, U.S. National Institutes of Health, Bethesda, MD, United States.
National Cancer Institute, U.S. National Institutes of Health, Bethesda, MD, United States.
Front Public Health. 2019 Dec 20;7:389. doi: 10.3389/fpubh.2019.00389. eCollection 2019.
The use of models and frameworks to design and evaluate strategies to improve delivery of evidence-based interventions is a foundational element of implementation science. To date, however, evaluative implementation science frameworks such as (RE-AIM) have not been widely employed to examine environmental health interventions. We take advantage of a unique opportunity to utilize and iteratively adapt the RE-AIM framework to guide NIH-funded case studies of the implementation of clean cooking fuel programs in eleven low- and middle-income countries. We used existing literature and expert consultation to translate and iteratively adapt the RE-AIM framework across several stages of the NIH Clean Cooking Implementation Science case study project. Checklists and templates to guide investigators were developed at each stage. The RE-AIM framework facilitated identification of important emerging issues across this set of case studies, in particular highlighting the fact that data associated with certain important outcomes related to health and welfare are chronically lacking in clean fuel programs. Monitoring of these outcomes should be prioritized in future implementation efforts. As RE-AIM was not originally designed to evaluate household energy interventions, employing the framework required adaptation. Specific adaptations include the broadening of to encompass indicators of success toward any stated programmatic goal, and expansion of to include household-level uptake of technology. The RE-AIM implementation science framework proved to be a useful organizing schema for 11 case studies of clean fuel cooking programs, in particular highlighting areas requiring emphasis in future research and evaluation efforts. The iterative approach used here to adapt an implementation science framework to a specific programmatic goal may be of value to other multi-country program efforts, such as those led by international development agencies. The checklists and templates developed for this project are publicly available for others to use and/or further modify.
使用模型和框架来设计和评估改善循证干预措施实施的策略是实施科学的一个基本要素。然而，迄今为止，诸如RE-AIM等评估性实施科学框架尚未广泛用于检验环境卫生干预措施。我们利用一个独特的机会，运用并反复调整RE-AIM框架，以指导美国国立卫生研究院资助的关于在11个低收入和中等收入国家实施清洁烹饪燃料项目的案例研究。我们利用现有文献并进行专家咨询，在国立卫生研究院清洁烹饪实施科学案例研究项目的几个阶段对RE-AIM框架进行翻译和反复调整。在每个阶段都制定了指导研究人员的清单和模板。RE-AIM框架有助于识别这组案例研究中出现的重要新问题，尤其突出了一个事实，即清洁燃料项目长期缺乏与某些与健康和福利相关的重要结果相关的数据。在未来的实施工作中，应优先监测这些结果。由于RE-AIM最初并非设计用于评估家庭能源干预措施，因此采用该框架需要进行调整。具体调整包括拓宽范围以涵盖朝着任何既定项目目标取得成功的指标，并扩大范围以纳入家庭层面的技术采用情况。事实证明，RE-AIM实施科学框架对于11个清洁燃料烹饪项目的案例研究是一个有用的组织架构，尤其突出了未来研究和评估工作中需要重点关注的领域。此处采用的将实施科学框架调整以适应特定项目目标的迭代方法，可能对其他多国项目工作有价值，例如由国际发展机构牵头的项目。为该项目开发的清单和模板已公开提供，供其他人使用和/或进一步修改。
