Shea Christopher M
Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Implement Res Pract. 2021 Jan 1;2. doi: 10.1177/2633489521990443. Epub 2021 Mar 23.
The importance of having a champion to promote implementation efforts has been discussed in the literature for more than five decades. However, the empirical literature on champions remains underdeveloped. As a result, health organizations commonly use champions in their implementation efforts without the benefit of evidence to guide decisions about how to identify, prepare, and evaluate their champions. The goal of this article is to present a model of champion impact that draws upon previous literature and is intended to inform future research on champions and serve as a guide for practitioners serving in a champion role.
The proposed model is informed by existing literature, both conceptual and empirical. Prior studies and reviews of the literature have faced challenges in terms of operationalizing and reporting on champion characteristics, activities, and impacts. The proposed model addresses this challenge by delineating these constructs, which allows for consolidation of factors previously discussed about champions as well as new hypothesized relationships between constructs.
The model proposes that a combination of champion commitment and champion experience and self-efficacy influence champion performance, which influences peer engagement with the champion, which ultimately influences the champion's impact. Two additional constructs have indirect effects on champion impact. Champion beliefs about the innovation and organizational support for the champion affect champion commitment.
The proposed model is intended to support prospective studies of champions by hypothesizing relationships between constructs identified in the champion literature, specifically relationships between modifiable factors that influence a champion's potential impact. Over time, the model should be modified, as appropriate, based on new findings from champion-related research.
五十多年来,文献中一直在讨论拥有倡导者来推动实施工作的重要性。然而,关于倡导者的实证文献仍不发达。因此,卫生组织在实施工作中普遍使用倡导者,但却没有证据来指导如何识别、培养和评估他们的倡导者。本文的目的是提出一个倡导者影响模型,该模型借鉴了以往的文献,旨在为未来关于倡导者的研究提供参考,并为担任倡导者角色的从业者提供指导。
所提出的模型以现有文献为依据,包括概念性文献和实证文献。先前的研究和文献综述在对倡导者的特征、活动和影响进行操作化和报告方面面临挑战。所提出的模型通过界定这些构建来应对这一挑战,这使得能够整合先前讨论的关于倡导者的因素以及构建之间新的假设关系。
该模型提出,倡导者的承诺、经验和自我效能的组合会影响倡导者的表现,这会影响同行与倡导者的互动,最终影响倡导者的影响。另外两个构建对倡导者的影响有间接作用。倡导者对创新的信念以及组织对倡导者的支持会影响倡导者的承诺。
所提出的模型旨在通过假设倡导者文献中确定的构建之间的关系,特别是影响倡导者潜在影响的可改变因素之间的关系,来支持对倡导者的前瞻性研究。随着时间的推移,应根据与倡导者相关研究的新发现,酌情对该模型进行修改。