让我们被倾听：对实施科学研究中与应受公平对待人群合作的研究方法进行批判性分析和辩论。

Let us be heard: critical analysis and debate of collaborative research approaches used in implementation science research with equity-deserving populations.

作者信息

Gallant Sarah Madeline, Mann Cynthia, Benoit Britney, Aston Megan, Curran Janet, Cassidy Christine

机构信息

IWK Health and Dalhousie University, Halifax, NS, Canada.

Saint Francis Xavier University, Antigonish, NS, Canada.

出版信息

Implement Sci Commun. 2025 Jan 24;6(1):12. doi: 10.1186/s43058-025-00695-z.

DOI:10.1186/s43058-025-00695-z

PMID:39856795

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11762516/

Abstract

BACKGROUND

Implementation Science research completed with equity-deserving populations is not well understood or explored. The current opioid epidemic challenges healthcare systems to improve existing practices through implementation of evidence-based interventions. Pregnant persons diagnosed with opioid use disorder (OUD) is an equity-deserving population that continues to experience stigmatization within our healthcare system. Efforts are being made to implement novel approaches to care for this population; however, the implementation research continues to leave the voices of pregnant persons unheard, compounding the existing stigma and marginalization experienced.

METHODS

This debate paper highlights a specific case that explores the implementation of the Eat, Sleep, Console (ESC) model of care, a function-based empowerment model used to guide the care for pregnant persons diagnosed with OUD and their infants. We establish our debate within the conceptual discussion of Nguyen and colleagues (2020), and critically analyze the collaborative research approaches, engaged scholarship, Mode 2 research, co-production, participatory research and IKT, within the context of engaging equity-deserving populations in research. We completed a literature search in CINAHL, Google Scholar, PubMed and Embase using keywords including collaborative research, engagement, equity-deserving, marginalized populations, birthparents, substance use and opioid use disorder with Boolean operators, to support our debate.

DISCUSSION

IKT and Community Based Participatory Action Research (CBPR) were deemed the most aligned approaches within the case, and boast many similarities; however, they are fundamentally distinct. Although CBPR's intentional methods to address social injustices are essential to consider in research with pregnant persons diagnosed with OUD, IKT aligned best within the implementation science inquiry due to its neutral philosophical underpinning and congruent aims in exploring complex implementation science inquiries. A fundamental gap was noted in IKT's intentional considerations to empowerment and equitable engagement of equity-deserving populations in research; therefore, we proposed informing an IKT approach with Edelman's Trauma and Resilience Informed Research Principles and Practice (TRIRPP) Framework.

摘要

背景

针对应受公平对待人群开展的实施科学研究尚未得到充分理解或探索。当前的阿片类药物流行给医疗系统带来了挑战，要求通过实施循证干预措施来改进现有做法。被诊断为患有阿片类药物使用障碍（OUD）的孕妇是应受公平对待的人群，她们在我们的医疗系统中仍面临着污名化。目前正在努力为这一人群实施新的护理方法；然而，实施研究仍然没有听取孕妇的声音，加剧了她们现有的污名化和边缘化状况。

方法

这篇辩论文章重点介绍了一个具体案例，该案例探讨了饮食、睡眠、安抚（ESC）护理模式的实施情况，这是一种基于功能的赋权模式，用于指导对被诊断为患有OUD的孕妇及其婴儿的护理。我们在Nguyen及其同事（2020年）的概念性讨论范围内展开辩论，并在让应受公平对待人群参与研究的背景下，批判性地分析协作研究方法、参与式学术研究、模式2研究、共同生产、参与式研究和知识-实践转化（IKT）。我们使用包括协作研究、参与、应受公平对待、边缘化人群、亲生父母、物质使用和阿片类药物使用障碍等关键词，并结合布尔运算符，在CINAHL、谷歌学术、PubMed和Embase中进行了文献检索，以支持我们的辩论。

讨论

IKT和基于社区的参与性行动研究（CBPR）在该案例中被认为是最相符的方法，且有许多相似之处；然而，它们在本质上是不同的。尽管在对被诊断为患有OUD的孕妇进行研究时，CBPR解决社会不公正问题的有意方法至关重要，但由于IKT的中立哲学基础以及在探索复杂的实施科学问题方面目标一致，因此在实施科学探究中IKT最为契合。IKT在赋予应受公平对待人群权力以及让其公平参与研究方面缺乏有意的考量，这是一个根本性的差距；因此，我们建议用埃德尔曼的创伤与恢复力知情研究原则与实践（TRIRPP）框架来完善IKT方法。