Department of Public Health Sciences, University of Rochester, Rochester, NY, USA.
Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
Health Res Policy Syst. 2021 Aug 4;19(1):110. doi: 10.1186/s12961-021-00764-4.
Public health emergencies-such as the 2020 COVID-19 pandemic-accelerate the need for both evidence generation and rapid dissemination and implementation (D&I) of evidence where it is most needed. In this paper, we reflect on how D&I frameworks and methods can be pragmatic (i.e., relevant to real-world context) tools for rapid and iterative planning, implementation, evaluation, and dissemination of evidence to address public health emergencies.
THE PRAGMATIC, RAPID, AND ITERATIVE D&I (PRIDI) CYCLE: The PRIDI cycle is based on a "double-loop" learning process that recognizes the need for responsiveness and iterative adaptation of implementation cycle (inner loop) to the moving landscapes, presented by the outer loops of emerging goals and desired outcomes, emerging interventions and D&I strategies, evolving evidence, and emerging characteristics and needs of individuals and contexts. Stakeholders iteratively evaluate these surrounding landscapes of implementation, and reconsider implementation plans and activities.
Even when the health system priority is provision of the best care to the individuals in need, and scientists are focused on development of effective diagnostic and therapeutic technologies, planning for D&I is critical. Without a flexible and adaptive process of D&I, which is responsive to emerging evidence generation cycles, and closely connected to the needs and priorities of stakeholders and target users through engagement and feedback, the interventions to mitigate public health emergencies (e.g., COVID-19 pandemic), and other emerging issues, will have limited reach and impact on populations that would most benefit. The PRIDI cycle is intended to provide a pragmatic approach to support planning for D&I throughout the evidence generation and usage processes.
公共卫生紧急事件（例如 2020 年的 COVID-19 大流行）加速了在最需要的地方生成证据并快速传播和实施（D&I）证据的需求。在本文中，我们反思了 D&I 框架和方法如何成为实用（即与现实背景相关）的工具，用于快速和迭代地规划、实施、评估和传播证据，以应对公共卫生紧急事件。
实用、快速和迭代的 D&I（PRIDI）周期：PRIDI 周期基于“双环”学习过程，认识到需要对实施周期（内环）进行响应和迭代调整，以适应不断变化的目标和预期结果、新兴干预措施和 D&I 策略、不断发展的证据以及个人和环境的新兴特征和需求的外部循环。利益相关者迭代评估这些实施的外部环境，并重新考虑实施计划和活动。
即使卫生系统的重点是为有需要的个人提供最佳护理，科学家们专注于开发有效的诊断和治疗技术，D&I 的规划也至关重要。如果没有灵活和适应的 D&I 过程，该过程对新兴的证据生成周期做出响应，并通过参与和反馈与利益相关者和目标用户的需求和优先事项紧密相连，那么减轻公共卫生紧急事件（例如 COVID-19 大流行）和其他新兴问题的干预措施将对最受益的人群产生有限的影响。PRIDI 周期旨在提供一种实用的方法，支持整个证据生成和使用过程中的 D&I 规划。
