Kalver Emily H, McInnes D Keith, Yakovchenko Vera, Hyde Justeen, Petrakis Beth Ann, Kim Bo
Department of Psychology, Montclair State University, Montclair, NJ, United States.
Center for Healthcare Organization and Implementation Research, Veterans Health Administration, Bedford, MA, United States.
Front Health Serv. 2021 Nov 16;1:752177. doi: 10.3389/frhs.2021.752177. eCollection 2021.
Identifying an intervention's core components is indispensable to gauging whether an intervention is implemented with fidelity and/or is modified; it is often a multi-stage process, starting with the first stage of identifying an initial set of core components that are gradually refined. This first stage of identifying initial core components has not been thoroughly examined. Without a clear set of steps to follow, interventions may vary in the rigor and thought applied to identifying their initial core components. We devised the CORE (Consensus on Relevant Elements) approach to synthesize opinions of intervention developers/implementers to identify an intervention's initial core components, particularly applicable to innovative interventions. We applied CORE to a peer-based intervention that aids military veterans with post-incarceration community reintegration. Our CORE application involved four intervention developers/implementers and two moderators to facilitate the seven CORE steps. Our CORE application had two iterations, moving through Steps 1 (individual core component suggestions) through 7 (group discussion for consensus), then repeating Steps 4 (consolidation of component definitions) through 7. This resulted in 18 consensus-reached initial core components of the peer-based intervention, down from the 60 that the developers/implementers individually suggested at Step 1. Removed components were deemed to not threaten the intervention's effectiveness even if absent. CORE contributes to filling a critical gap regarding identifying an intervention's initial core components (so that the identified components can be subsequently refined), by providing concrete steps for synthesizing the knowledge of an intervention's developers/implementers. Future research should examine CORE's utility across various interventions and implementation settings.
识别一项干预措施的核心组成部分对于判断该干预措施是否忠实实施和/或是否被修改至关重要；这通常是一个多阶段的过程，首先是识别一组初始核心组成部分，然后逐步完善。识别初始核心组成部分的第一阶段尚未得到充分研究。由于缺乏明确的步骤可循，不同干预措施在识别其初始核心组成部分时所采用的严谨性和思路可能会有所不同。我们设计了CORE（相关要素共识）方法，以综合干预措施开发者/实施者的意见，来识别一项干预措施的初始核心组成部分，尤其适用于创新性干预措施。我们将CORE方法应用于一项基于同伴的干预措施，该措施旨在帮助退伍军人在出狱后重新融入社区。我们应用CORE方法时涉及四名干预措施开发者/实施者和两名主持人，以推动CORE方法的七个步骤。我们对CORE方法进行了两轮应用，从步骤1（个人提出核心组成部分建议）到步骤7（小组讨论以达成共识），然后重复步骤4（合并组成部分定义）到步骤7。这导致基于同伴的干预措施达成了18个初始核心组成部分的共识，而在步骤1中开发者/实施者各自提出的有60个。被移除的组成部分即使不存在也被认为不会威胁到干预措施的有效性。CORE方法通过提供具体步骤来综合干预措施开发者/实施者的知识，有助于填补在识别干预措施初始核心组成部分方面的关键空白（以便随后对识别出的组成部分进行完善）。未来的研究应考察CORE方法在各种干预措施和实施环境中的效用。
