Vanderbilt University Medical Center, Nashville, TN, USA.
Virginia Tech, Blacksburg, VA, USA.
Health Educ Behav. 2023 Jun;50(3):416-429. doi: 10.1177/10901981211067170. Epub 2022 Jan 7.
It is well known that perceptions of intervention characteristics (e.g., cost, source, evidence strength and quality) are a critical link from dissemination to implementation. What is less known is the process by which researchers understand the characteristics most valued by key intermediaries (i.e., real-world decision-makers), particularly in the federal system of Cooperative Extension. In Extension, university-based specialists are available to assist county-based agents in program selection, delivery, and evaluation. For this work, a sequential explanatory mixed-methods design was used to conduct surveys and semi-structured interviews, informed by the Diffusion of Innovations theory and Consolidated Framework for Implementation Research. Educators and specialists were recruited across 47 states to identify characteristics of health promotion interventions that facilitate the adoption decision-making process. Analysis of intervention attribute importance survey data was conducted through a one-way ANOVA with Bonferroni post hoc test to determine individual variable differences between responses. Interviews underwent a conventional content analysis. In total, 121 educators and 47 specialists from 33 states completed the survey. Eighteen educators and 10 specialists completed interviews. Educators and specialists valued components such as the community need for the intervention, and potential reach compared with other components including previous delivery settings and external funding of the intervention ( < .05). Qualitative data indicated divergence between educators and specialists; educators valued understanding the intervention cost (time and training) and specialists valued the evidence base and external funding available. Intervention developers should communicate information valued by different stakeholders to improve the adoption of evidence-based interventions.
众所周知，干预措施特征（如成本、来源、证据强度和质量）的认知是从传播到实施的关键环节。人们知之甚少的是，研究人员了解关键中介（即现实世界的决策者）最看重的特征的过程，特别是在联邦合作推广系统中。在推广系统中，基于大学的专家可协助县级代理进行项目选择、交付和评估。为此，采用顺序解释性混合方法设计进行了调查和半结构化访谈，这是基于创新扩散理论和实施研究综合框架的。从 47 个州招募了教育工作者和专家，以确定促进健康干预措施的特征，这些特征有助于促进决策过程。通过单向方差分析（One-way ANOVA）和 Bonferroni 事后检验对干预属性重要性调查数据进行了分析，以确定来自不同州的 121 名教育工作者和 47 名专家对这些特征的不同回答。访谈进行了常规内容分析。共有 121 名教育工作者和来自 33 个州的 47 名专家完成了调查。18 名教育工作者和 10 名专家完成了访谈。教育工作者和专家重视干预措施对社区的需求以及与其他干预措施的潜在影响范围，如先前的实施环境和干预措施的外部资金等（<0.05）。定性数据表明教育工作者和专家之间存在分歧；教育工作者重视了解干预成本（时间和培训），而专家重视证据基础和可用的外部资金。干预措施开发者应向不同利益相关者传达有价值的信息，以提高基于证据的干预措施的采用率。
