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基于公平性的实施科学:三项研究的比较案例分析

Equity-grounded implementation science: Comparative case analysis of three studies.

作者信息

Nagy Gabriela A, Rivera-Segarra Eliut, Cabassa Leopoldo J

机构信息

Department of Psychology, University of Wisconsin-Milwaukee.

School of Behavioral and Brain Sciences, Ponce Health Sciences University.

出版信息

Psychol Serv. 2025 Aug;22(3):531-545. doi: 10.1037/ser0000931. Epub 2025 Feb 27.

Abstract

Despite research and treatment advances in health care, the implementation of research evidence into practice remains a challenge, especially for historically marginalized populations. There have been numerous calls to action to integrate health equity into implementation science frameworks, models, and theories. Yet, progress toward better integration of these approaches has been hampered by the theoretical and aspirational nature of calls to action up to the present time, which poses a challenge as it remains unclear how to specifically move from rhetoric to action. We present three case examples from our work to illustrate how to synergize health equity research and implementation science into our approach to "equity-grounded implementation science" focused on processes and practices located at the intersection of these fields. These three distinct studies focused on reducing mental health inequities in historically marginalized communities, namely, Latino and Black individuals in mainland United States and Puerto Rico. For each study, we describe the study aim, methodology, setting in which activities were carried out, the health equity elements, and the implementation science aspects. We articulate how each study bridged implementation science and health equity research by (a) situating the study activities in community settings; (b) codesigning interventions to ensure their cultural, linguistic, and contextual relevance; and (c) weaving mixed methods and community-engaged approaches to draw community insights. Finally, we illustrate how to address key implementation outcomes in these health equity studies, representing a significant step toward turning rhetoric into actionable solutions for reducing mental health inequities in marginalized communities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

尽管医疗保健领域在研究和治疗方面取得了进展,但将研究证据应用于实践仍然是一项挑战,尤其是对于历史上被边缘化的人群。已经有许多行动呼吁将健康公平纳入实施科学框架、模型和理论之中。然而,到目前为止,由于行动呼吁的理论性和理想性,这些方法在更好整合方面的进展受到了阻碍,这构成了一个挑战,因为目前尚不清楚如何具体地从言辞转向行动。我们展示了三项来自我们工作的案例,以说明如何将健康公平研究与实施科学协同整合到我们的“基于公平的实施科学”方法中,该方法聚焦于位于这些领域交叉点的过程和实践。这三项不同的研究聚焦于减少历史上被边缘化社区的心理健康不平等现象,即美国大陆以及波多黎各的拉丁裔和黑人个体。对于每项研究,我们描述了研究目的、方法、开展活动的背景、健康公平要素以及实施科学方面。我们阐述了每项研究如何通过以下方式将实施科学与健康公平研究联系起来:(a) 将研究活动置于社区环境中;(b) 共同设计干预措施以确保其文化、语言和背景相关性;(c) 运用混合方法和社区参与方法以获取社区见解。最后,我们说明了如何在这些健康公平研究中解决关键的实施成果问题,这代表着朝着将言辞转化为减少边缘化社区心理健康不平等的可行解决方案迈出了重要一步。(《心理学文摘数据库记录》(c) 2025 美国心理学会,保留所有权利)

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