Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK
Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, UK.
BMJ Open. 2022 Oct 26;12(10):e066451. doi: 10.1136/bmjopen-2022-066451.
OBJECTIVES: Research on the adaptation of population health interventions for implementation in new contexts is rapidly expanding. This has been accompanied by a recent increase in the number of frameworks and guidance to support adaptation processes. Nevertheless, there remains limited exploration of the real-world experiences of undertaking intervention adaptation, notably the challenges encountered by different groups of stakeholders, and how these are managed. Understanding experiences is imperative in ensuring that guidance to support adaptation has practical utility. This qualitative study examines researcher and stakeholder experiences of funding, conducting and reporting adaptation research. SETTING: Adaptation studies. PARTICIPANTS: Participants/cases were purposefully sampled to represent a range of adapted interventions, types of evaluations, expertise and countries. Semistructured interviews were conducted with a sample of researchers (n=23), representatives from research funding panels (n=6), journal editors (n=5) and practitioners (n=3). MEASURES: A case study research design was used. Data were analysed using the framework approach. Overarching themes were discussed within the study team, with further iterative refinement of subthemes. RESULTS: The results generated four central themes. The first three relate to the experience of intervention adaptation (1) involving stakeholders throughout the adaptation process and how to integrate the evidence base with experience; (2) selecting the intervention and negotiating the mismatch between the original and the new context; and (3) the complexity and uncertainty when deciding the re-evaluation process. The final theme (4) reflects on participants' experiences of using adaptation frameworks in practice, considering recommendations for future guidance development and refinement. CONCLUSION: This study highlights the range of complexities and challenges experienced in funding, conducting and reporting research on intervention adaptation. Moving forward, guidance can be helpful in systematising processes, provided that it remains responsive to local contexts and encourage innovative practice.
目的:人群健康干预措施适应新环境的实施研究正在迅速扩展。这伴随着支持适应过程的框架和指南数量的最近增加。然而,对于进行干预适应的实际经验,特别是不同利益相关者群体遇到的挑战以及如何管理这些挑战,仍然缺乏有限的探索。了解经验对于确保支持适应的指导具有实际效用至关重要。这项定性研究考察了研究人员和利益相关者在资助、进行和报告适应研究方面的经验。
设置:适应研究。
参与者:参与者/案例是有目的地抽样的,以代表一系列经过调整的干预措施、评估类型、专业知识和国家。对研究人员(n=23)、研究资助小组代表(n=6)、期刊编辑(n=5)和从业人员(n=3)进行了半结构化访谈。
措施:使用案例研究设计。使用框架方法分析数据。在研究小组内讨论了总体主题,并进一步迭代细化了子主题。
结果:结果产生了四个中心主题。前三个主题涉及干预适应的经验(1)在适应过程中涉及利益相关者,以及如何将证据基础与经验相结合;(2)选择干预措施并协商原始干预措施与新环境之间的不匹配;以及(3)在决定重新评估过程时的复杂性和不确定性。最后一个主题(4)反映了参与者在实践中使用适应框架的经验,考虑了对未来指导开发和完善的建议。
结论:这项研究强调了在资助、进行和报告干预适应研究方面经验的范围和复杂性。向前推进,指导在系统处理过程方面是有帮助的,前提是它仍然对当地环境做出反应,并鼓励创新实践。
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