Rabin Borsika A, Cain Kelli L, Glasgow Russell E
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA; email:
Dissemination and Implementation Science Center, Altman Clinical and Translational Research Institute, University of California San Diego, La Jolla, California, USA.
Annu Rev Public Health. 2025 Apr;46(1):111-131. doi: 10.1146/annurev-publhealth-071321-041652. Epub 2024 Dec 10.
When complex public health and health services interventions are implemented in real-world settings, adaptations should be expected, embraced, and studied rather than suppressed and ignored. A substantial amount of recent research has been conducted on the assessment of some types of adaptations, and interest in guiding adaptations to both interventions and implementation strategies is growing. However, there is still a need to investigate the optimal ways to systematically and pragmatically document, analyze, and iteratively guide adaptations as well as to measure the impact of those adaptations on implementation and effectiveness outcomes. This article reviews key findings from the adaptations assessment literature, frameworks to guide classification of adaptations, and methodologies to study adaptations and their impact. We summarize research from diverse settings and populations from public health and health services research on the use of these methodologies and make recommendations for research and practice.
当在现实环境中实施复杂的公共卫生和卫生服务干预措施时，应预料到、欣然接受并研究适应性调整，而不是压制和忽视它们。最近已经对某些类型的适应性调整评估进行了大量研究，并且对指导干预措施和实施策略的适应性调整的兴趣也在增加。然而，仍然需要研究以系统且务实的方式记录、分析和迭代指导适应性调整的最佳方法，以及衡量这些适应性调整对实施和有效性结果的影响。本文回顾了适应性调整评估文献中的关键发现、指导适应性调整分类的框架以及研究适应性调整及其影响的方法。我们总结了来自公共卫生和卫生服务研究中不同环境和人群关于这些方法使用的研究，并为研究和实践提出建议。
