Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Atlanta, GA, USA.
Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Transl Behav Med. 2023 May 13;13(5):327-337. doi: 10.1093/tbm/ibac115.
Many studies have explored organizational factors that facilitate implementation. However, there is still a limited understanding of determinants external to the implementing organization and their effects on evidence-based intervention (EBI) adoption, implementation, and outcomes. The purpose of this scoping review was to assess definitions of context and identify salient determinants of outer context found in dissemination and implementation theories, models, and frameworks. We employed a compilation of dissemination and implementation frameworks from two reviews as the data source. We abstracted the following information: type of article, outcomes of the framework, presence of a context definition, presence of any outer setting definition and the definition, number and domains of outer setting mentioned, definitions of outer context constructs, and any quantitative measures of outer setting. We identified 19 definitions of outer context. Forty-seven (49%) frameworks reported one or more specific constructs of the outer setting. While the outer context domains described in the frameworks varied, the most common domains were policy (n = 24), community (n = 20), partnerships (n = 13), and communications (n = 12). Based on our review of the frameworks, more conceptualization and measurement development for outer context domains are needed. Few measures were found and definitions of domains varied across frameworks. Expanding outer context construct definitions would advance measure development for important factors external to the organizations related to EBI implementation.
许多研究都探讨了促进实施的组织因素。然而,对于实施组织外部的决定因素及其对基于证据的干预措施(EBI)的采用、实施和结果的影响,我们的理解仍然有限。本范围综述的目的是评估背景的定义,并确定传播和实施理论、模型和框架中发现的外部环境的显著决定因素。我们将来自两项综述的传播和实施框架汇编作为数据源。我们提取了以下信息:文章类型、框架的结果、是否有背景定义、是否有任何外部环境定义及其定义、外部环境提到的数量和领域、外部环境结构的定义以及任何外部环境的定量措施。我们确定了 19 个外部环境的定义。47(49%)个框架报告了一个或多个外部环境的特定结构。虽然框架中描述的外部环境领域各不相同,但最常见的领域是政策(n=24)、社区(n=20)、伙伴关系(n=13)和沟通(n=12)。基于我们对框架的审查,需要对外部环境领域进行更多的概念化和测量开发。我们发现的措施很少,而且框架之间的领域定义也有所不同。扩展外部环境结构的定义将有助于为与 EBI 实施相关的组织外部重要因素开发措施。