Davis Molly, Beidas Rinad S
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA.
Implement Res Pract. 2021 Mar 17;2:2633489521994941. doi: 10.1177/2633489521994941. eCollection 2021 Jan-Dec.
While contextual inquiry, or in-depth mixed-methods work to study the implementation context, is critical for understanding the setting in which a behavioral health evidence-based practice (EBP) will be implemented, current methods to determine potential barriers and facilitators to implementation are often conducted in a single setting and/or for a single EBP per study, often taking 1-2 years to complete. To maximize generalizability and reduce the research-to-practice gap efficiently, it is important to move toward cross-sector and/or cross-EBP contextual inquiry.
In this viewpoint, we argue for (a) collaborative research studies that seek to identify determinants of implementation that are similar and unique across different settings and EBPs, using rapid approaches when possible; (b) enhanced synthesis of existing research on implementation determinants to minimize duplication of contextual inquiry efforts; and (c) clear rationale for why additional in-depth or rapid contextual inquiry is needed before it is conducted. Throughout this viewpoint, the need to balance scientific rigor and speed are considered.
Overall, this viewpoint seeks to encourage researchers to consolidate and share knowledge on barriers and facilitators to implementation to prepare for the scaling out of much needed implementation strategies and interventions for improving health.
Significant time and resources are often devoted to understanding what makes it easier or harder to use best practices for behavioral health concerns in health care settings. The goal of the current viewpoint is to offer ways to streamline this process so that high-quality behavioral health services can reach the patients that need them more quickly. In particular, we advocate for ways to share knowledge among researchers and learn from prior findings to more efficiently identify what makes it easier or harder to use best practices for addressing behavioral health problems in a given setting (e.g., primary care, schools, specialty mental health).
虽然情境调查，即用于研究实施背景的深入混合方法研究，对于理解将实施循证行为健康实践（EBP）的环境至关重要，但目前确定实施潜在障碍和促进因素的方法通常是在单一环境中进行，和/或每项研究针对单一的循证实践，通常需要1至2年才能完成。为了最大限度地提高普遍性并有效缩小研究与实践之间的差距，朝着跨部门和/或跨循证实践的情境调查发展很重要。
在本观点中，我们主张：（a）开展合作研究，尽可能采用快速方法，以确定不同环境和循证实践中相似和独特的实施决定因素；（b）加强对现有实施决定因素研究的综合，以尽量减少情境调查工作的重复；（c）在进行额外的深入或快速情境调查之前，明确说明为何需要这样做。在整个观点阐述过程中，都考虑了平衡科学严谨性和速度的必要性。
总体而言，本观点旨在鼓励研究人员整合和分享关于实施障碍和促进因素的知识，为扩大急需的改善健康的实施策略和干预措施做准备。
通常会投入大量时间和资源来了解在医疗环境中使用行为健康问题最佳实践的难易程度。当前观点的目标是提供简化这一过程的方法，以便高质量的行为健康服务能够更快地惠及有需要的患者。特别是，我们倡导研究人员之间分享知识并借鉴先前的研究结果，以便更有效地确定在特定环境（如初级保健、学校、专科心理健康）中使用最佳实践来解决行为健康问题的难易程度。
