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翻译中的迷失:在赞比亚开展传播与实施科学的关键经验教训

Lost in translation: key lessons from conducting dissemination and implementation science in Zambia.

作者信息

Maritim Patricia, Munakampe Margarate Nzala, Nglazi Mweete, Mweemba Chris, Sikombe Kombatende, Mbewe Wilson, Silumbwe Adam, Jacobs Choolwe, Zulu Joseph Mumba, Herce Michael, Mutale Wilbroad, Halwindi Hikabasa

机构信息

Implementation Science Centre for Advancing Practice and Training (IMPACT), University of Zambia, Lusaka, Zambia.

Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia.

出版信息

Implement Sci Commun. 2024 Oct 29;5(1):121. doi: 10.1186/s43058-024-00663-z.


DOI:10.1186/s43058-024-00663-z
PMID:39473012
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11520656/
Abstract

BACKGROUND: As the field of implementation science continues to grow, its key concepts are being transferred into new contexts globally, such as Low and Middle Income Countries (LMICs), and its use is constantly being reexamined and expanded. Theoretical and methodological positions commonly used in implementation research and practice have great utility in our work but in many cases are at odds with LMIC contexts. As a team of implementation scientists based in Zambia, we offer this commentary as a critical self-reflection on what has worked and what could limit us from fully utilizing the field's promise for addressing health problems with contextual understanding. MAIN BODY: We used a 'premortem,' an approach used to generate potential alternatives from failed assumptions about a particular phenomenon, as a way to reflect on our experiences conducting implementation research and practice. By utilizing prospectively imagined hindsights, we were able to reflect on the past, present and possible future of the field in Zambia. Six key challenges identified were: (i) epistemic injustices; (ii) simplified conceptualizations of evidence-informed interventions; (iii) limited theorization of the complexity of low-resource contexts and it impacts on implementation; (iv) persistent lags in transforming research into practice; (v) limited focus on strategic dissemination of implementation science knowledge and (vi) existing training and capacity building initiatives' failure to engage a broad range of actors including practitioners through diverse learning models. CONCLUSION: Implementation science offers great promise in addressing many health problems in Zambia. Through this commentary, we hope to spur discussions on how implementation scientists can reimagine the future of the field by contemplating on lessons from our experiences in LMIC settings.

摘要

背景:随着实施科学领域不断发展,其关键概念正在全球范围内被应用于新的情境中,如低收入和中等收入国家(LMICs),并且其应用也在不断地被重新审视和扩展。实施研究与实践中常用的理论和方法立场在我们的工作中具有很大的实用性,但在许多情况下与低收入和中等收入国家的情境不一致。作为一支来自赞比亚的实施科学家团队,我们提供这篇评论,作为对哪些方法有效以及哪些因素可能限制我们在结合情境理解的情况下充分利用该领域解决健康问题的潜力进行的批判性自我反思。 正文:我们采用了“事前剖析”方法,即一种用于从对特定现象的错误假设中生成潜在替代方案的方法,以此来反思我们开展实施研究与实践的经验。通过前瞻性地设想事后认识,我们得以反思赞比亚该领域的过去、现在和可能的未来。确定的六个关键挑战是:(i)认知不公正;(ii)对循证干预措施的概念化过于简化;(iii)对资源匮乏环境的复杂性及其对实施的影响的理论化有限;(iv)研究转化为实践的持续滞后;(v)对实施科学知识的战略传播关注有限;(vi)现有的培训和能力建设举措未能通过多样化的学习模式让包括从业者在内的广泛行为者参与进来。 结论:实施科学在解决赞比亚的许多健康问题方面前景广阔。通过这篇评论,我们希望引发关于实施科学家如何通过思考我们在低收入和中等收入国家环境中的经验教训来重新构想该领域未来的讨论。

相似文献

[1]
Lost in translation: key lessons from conducting dissemination and implementation science in Zambia.

Implement Sci Commun. 2024-10-29

[2]
The Role of Implementation Science in Advancing Resource Generation for Health Interventions in Low- and Middle-Income Countries.

Health Serv Insights. 2021-3-15

[3]
The RELATE model: strategies to effectively engage healthcare organisations to create amenable contexts for implementation.

J Health Organ Manag. 2021-6-24

[4]
Learning needs assessment for multi-stakeholder implementation science training in LMIC settings: findings and recommendations.

Implement Sci Commun. 2021-12-4

[5]
Metaverse-powered basic sciences medical education: bridging the gaps for lower middle-income countries.

Ann Med. 2024-12

[6]
Considering culture, context and community in mhGAP implementation and training: challenges and recommendations from the field.

Int J Ment Health Syst. 2019-8-24

[7]
Capacity building for implementation research: a methodology for advancing health research and practice.

Health Res Policy Syst. 2020-6-1

[8]
Implementation science in resource-poor countries and communities.

Implement Sci. 2018-12-27

[9]
Navigating the field of implementation science towards maturity: challenges and opportunities.

Implement Sci. 2024-3-13

[10]
Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries.

BMC Public Health. 2019-7-16

本文引用的文献

[1]
Understanding inequalities in the coverage of adolescent sexual and reproductive health services: a qualitative case study of the selected regions of Zambia.

Front Reprod Health. 2024-8-6

[2]
Multimethods study to develop tools for competency-based assessments of implementation research training programmes in low and middle-income countries.

BMJ Open. 2024-7-16

[3]
Programme science methodologies and practices that address "FURRIE" challenges: examples from the field.

J Int AIDS Soc. 2024-7

[4]
Programme science in action: lessons from an observational study of HIV prevention programming for key populations in Lusaka, Zambia.

J Int AIDS Soc. 2024-7

[5]
Evaluating a multifaceted implementation strategy and package of evidence-based interventions based on WHO PEN for people living with HIV and cardiometabolic conditions in Lusaka, Zambia: protocol for the TASKPEN hybrid effectiveness-implementation stepped wedge cluster randomized trial.

Implement Sci Commun. 2024-6-6

[6]
Unfair knowledge practices in global health: a realist synthesis.

Health Policy Plan. 2024-6-3

[7]
Pragmatism and crisis: A response to three commentaries.

Soc Sci Med. 2024-5

[8]
Specifying cross-system collaboration strategies for implementation: a multi-site qualitative study with child welfare and behavioral health organizations.

Implement Sci. 2024-2-12

[9]
Implicit and explicit: a scoping review exploring the contribution of anthropological practice in implementation science.

Implement Sci. 2024-2-12

[10]
Adapting an equity-focused implementation process framework with a focus on ethnic health inequities in the Aotearoa New Zealand context.

Int J Equity Health. 2024-1-27

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