University of Exeter, College of Medicine and Health, South Cloisters, Exeter, EX1 2LU, UK.
PenARC, Exeter, UK.
BMC Health Serv Res. 2022 Jun 10;22(1):764. doi: 10.1186/s12913-022-08110-2.
A UK programme, led by the National Institute for Health Research (NIHR) ( https://www.nihr.ac.uk ) and coordinated by Applied Research Collaborations (ARC), ( https://www.nihr.ac.uk/explore-nihr/support/collaborating-in-applied-health-research.htm ) aimed to identify and select evidence-based, implementation-ready service innovations for evaluation. The programme focused on seven areas of health provision. We report on a prioritisation process designed to identify and assess innovations in one of these areas: child and maternal health (CH&M).
We developed a three-stage, online, stakeholder driven process to 1) identify, 2) assess and prioritise and 3) select evidence-based interventions or service models, using crowdsourcing to identify projects and the APEASE criteria to assess and select projects. A brief evidence review was conducted for all initial suggestions to identify those with the largest evidence-base to take forward for ranking by stakeholders. Stakeholder workshops considered and ranked these suggestions using the APEASE criteria. We then conducted in-depth evidence reviews for the highest ranked suggestions. The Project Management Group and Advisory Board used these reviews and the APEASE criteria to select the final projects.
We received 32 initial suggestions from a range of clinicians, practitioners and researchers. Fourteen of the most evidence-based suggestions were considered and ranked at four themed stakeholder workshops. Nine suggestions were ranked for further in-depth evidence review and a final four projects were selected for implementation evaluation using the APEASE criteria. These were: 1. Maternal Mental Health Services Multidisciplinary Teams 2. Early years tooth brushing programme 3. Trauma-focused CBT for young people in care and 4. Independent Domestic Violence Advisors in maternity settings. Feedback from participants suggested that having public representatives participating in all stakeholder meetings, rather than being consulted separately, focused discussions clearly on patient benefit rather than research aims.
The stakeholder-driven process achieved its aim of identifying, prioritising and assessing and selecting, evidence-based projects for wider implementation and evaluation. The concurrent process could be adapted by other researchers or policy makers.
由英国国家卫生研究院（NIHR）（https://www.nihr.ac.uk）领导并由应用研究合作组织（ARC）协调的英国方案旨在确定和选择基于证据、准备就绪可实施的服务创新以进行评估。该方案侧重于七个卫生服务领域。我们报告了一个优先级确定过程，旨在确定和评估其中一个领域（儿童和孕产妇健康（CH＆M））中的创新。
我们制定了一个三阶段的在线利益相关者驱动的流程，以 1）识别，2）评估和优先排序，以及 3）选择基于证据的干预措施或服务模式，使用众包来识别项目，以及使用 APEASE 标准来评估和选择项目。对所有初步建议进行了简短的证据审查，以确定那些具有最大证据基础的项目，以便由利益相关者进行排名。利益相关者研讨会使用 APEASE 标准考虑和对这些建议进行排名。然后，我们对排名最高的建议进行了深入的证据审查。项目管理小组和咨询委员会使用这些审查和 APEASE 标准来选择最终项目。
我们从各种临床医生、从业者和研究人员那里收到了 32 个初步建议。在四个主题利益相关者研讨会上考虑和排名了 14 个最具证据基础的建议。对 9 个建议进行了进一步的深入证据审查，并使用 APEASE 标准选择了最终的 4 个项目进行实施评估。这些项目是：1. 孕产妇心理健康服务多学科团队；2. 幼儿刷牙计划；3. 照顾中的年轻人创伤聚焦 CBT；4. 产妇环境中的独立家庭暴力顾问。参与者的反馈表明，让公众代表参加所有利益相关者会议，而不是单独进行咨询，将讨论重点明确放在患者受益上，而不是研究目标上。
利益相关者驱动的流程实现了其目标，即确定、优先排序、评估和选择基于证据的项目，以进行更广泛的实施和评估。该并发过程可以由其他研究人员或政策制定者改编。
