School of Medicine, University of Colorado, Aurora, CO, United States.
Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.
Front Public Health. 2021 Jul 6;9:680316. doi: 10.3389/fpubh.2021.680316. eCollection 2021.
Implementation science is concerned with the study of adoption, implementation and maintenance of evidence-based interventions and use of implementation strategies to facilitate translation into practice. Ways to conceptualize and overcome challenges to implementing evidence-based practice may enhance the field of implementation science. The concept of mental models may be one way to view such challenges and to guide selection, use, and adaptation of implementation strategies to deliver evidence-based interventions. A mental model is an interrelated set of beliefs that shape how a person forms expectations for the future and understands the way the world works. Mental models can shape how an individual thinks about or understands how something or someone does, can, or should function in the world. Mental models may be sparse or detailed, may be shared among actors in implementation or not, and may be substantially tacit, that is, of limited accessibility to introspection. Actors' mental models can determine what information they are willing to accept and what changes they are willing to consider. We review the concepts of mental models and illustrate how they pertain to implementation of an example intervention, shared decision making. We then describe and illustrate potential methods for eliciting and analyzing mental models. Understanding the mental models of various actors in implementation can provide crucial information for understanding, anticipating, and overcoming implementation challenges. Successful implementation often requires changing actors' mental models or the way in which interventions or implementation strategies are presented or implemented. Accurate elicitation and understanding can guide strategies for doing so.
实施科学关注的是研究采用、实施和维护基于证据的干预措施，并利用实施策略来促进向实践的转化。概念化和克服实施基于证据的实践的挑战的方法可能会增强实施科学领域。心理模型的概念可能是查看此类挑战并指导选择、使用和适应实施策略以提供基于证据的干预措施的一种方式。心理模型是一套相互关联的信念，这些信念塑造了一个人如何形成对未来的期望并理解世界运作方式的方式。心理模型可以塑造个人如何思考或理解某事或某人在世界上的运作方式、能力或应该如何运作。心理模型可以是稀疏的或详细的，可以在实施中的参与者之间共享，也可以是实质性的隐性的，即难以内省。参与者的心理模型可以决定他们愿意接受哪些信息以及他们愿意考虑哪些改变。我们回顾了心理模型的概念，并举例说明了它们如何与共享决策的实施干预措施相关。然后，我们描述并说明了启发和分析心理模型的潜在方法。了解实施中各种参与者的心理模型可以为理解、预测和克服实施挑战提供关键信息。成功的实施通常需要改变参与者的心理模型或干预措施或实施策略的呈现或实施方式。准确的启发和理解可以指导这样做的策略。
