Department of Behavioral and Social Sciences, Brown University School of Public Health.
Psychol Addict Behav. 2022 Sep;36(6):724-735. doi: 10.1037/adb0000731. Epub 2021 May 3.
Risky drinking remains high among young adults and is associated with negative health-related consequences. Brief interventions (BIs) are an evidence-based practice for risky drinking that are particularly well suited for young adults. However, the widespread implementation of BIs remains challenging. This article highlights guiding principles for researchers and clinicians seeking to implement BI for young adults. Five guiding principles for the implementation of BIs for young adults with risky drinking are introduced as follows: (a) selecting an implementation model; (b) considering contextual factors; (c) specifying an implementation strategy; (d) assessing implementation outcomes; and (e) embracing hybrid effectiveness-implementation designs. Advancing health equity is considered a key crosscutting theme. Multiple implementation models are discussed including process models, determinant frameworks, classic theories, implementation theories, and evaluation frameworks. Contextual factors impacting BI implementation are then considered across multiple levels within an organization. Next, we present methods for selecting implementation strategies and discuss implementation outcomes that can be measured during preimplementation, implementation, and sustainability phases. Finally, we encourage employing hybrid effectiveness-implementation designs to reduce the BI science-practice gap. Guiding principles are illustrated with examples from two National Institute on Alcohol Abuse and Alcoholism-funded studies exploring BI implementation domestically and internationally. This article introduces foundational principles and emerging strategies to nonspecialist researchers, clinicians, and policymakers seeking to enhance the dissemination and implementation of BIs. Advancing the dissemination and implementation of BIs is essential to ensure that investments in BI research are fully realized to equitably improve public health. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
风险饮酒在年轻人中仍然很高,并且与负面的健康相关后果有关。简短干预 (BI) 是一种针对风险饮酒的循证实践,特别适合年轻人。然而,广泛实施 BI 仍然具有挑战性。本文强调了研究人员和临床医生在为年轻人实施 BI 时需要遵循的指导原则。
为有风险饮酒行为的年轻人实施 BI 的五个指导原则如下:(a) 选择实施模型;(b) 考虑环境因素;(c) 明确实施策略;(d) 评估实施结果;(e) 采用混合有效性-实施设计。推进健康公平被认为是一个关键的交叉主题。讨论了多种实施模型,包括过程模型、决定因素框架、经典理论、实施理论和评估框架。然后考虑了在组织内多个层面上影响 BI 实施的环境因素。接下来,我们介绍了选择实施策略的方法,并讨论了在预实施、实施和可持续性阶段可以测量的实施结果。最后,我们鼓励采用混合有效性-实施设计来缩小 BI 科学-实践差距。通过两项由美国国家酒精滥用和酗酒研究所资助的、在国内和国际上探索 BI 实施的研究示例来说明指导原则。
本文为希望加强 BI 传播和实施的非专业研究人员、临床医生和政策制定者介绍了基本原理和新兴策略。推进 BI 的传播和实施对于确保对 BI 研究的投资得到充分实现以公平地改善公共卫生至关重要。(APA,2022)