Domlyn Ariel M, Hooks Gwendolyn, Freitag Michelle, Evans Lacey, Stewart Madison, Damschroder Laura, Sussman Jeremy B
Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States.
Division of General Medicine, University of Michigan, Ann Arbor, MI, United States.
Front Health Serv. 2025 Jun 3;5:1521504. doi: 10.3389/frhs.2025.1521504. eCollection 2025.
Academic Detailing (AD) is an educational outreach strategy that has shown positive effects on clinical practice, but its implementation varies widely across programs, necessitating consistent definitions of its essential components. The lack of standardized guidance for tailoring AD and other multi-component implementation strategies presents challenges in program development and effectiveness evaluation. To address this, we applied FRAME-IS (Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies) to specify AD's core components and demonstrate a repeatable program development process. By showcasing a multi-project, multi-site AD program, we aim to provide guidance for others in developing and tailoring AD programs, ultimately enabling more rigorous evaluations of AD's effectiveness.
Literature and training materials were reviewed to develop a list of common AD components, then organized according to a FRAME-IS template. Coders applied directed content analysis to materials from the MIDAS AD program, a multi-site implementation center using AD in four projects across the Veterans Health Administration. Tailoring and development of the AD program was coded according to FRAME-IS modules and ERIC strategy taxonomy.
18 common AD components were identified. These components were retained but six were tailored and an additional seven were added across the MIDAS projects. The rationale for tailoring and additions was mostly to increase appropriateness, acceptability, adoption, and reach of AD. To assist in future tailoring of AD programs, we developed a list of generalizable guiding questions and an AD program documentation and tailoring template.
AD is a robust strategy, but empirical study of the core and modifiable components is constrained by variable definitions of the components. This is the first attempt at developing documentation and tailoring guidelines for AD programs using the nomenclature of implementation science. We further suggest which components may be core and which may be modifiable. Our effort to specify AD components using the FRAME-IS method provides an example for other AD programs, contributing to the future use and study of AD as an implementation strategy and paving the way for more rigorous analysis of which modifications affect outcomes. : ClinicalTrials.gov: NCT05065502.
学术推广（AD）是一种教育外展策略，已显示出对临床实践有积极影响，但其在各项目中的实施差异很大，因此需要对其基本组成部分进行一致的定义。缺乏针对定制AD和其他多组件实施策略的标准化指导，给项目开发和效果评估带来了挑战。为解决这一问题，我们应用了FRAME-IS（基于证据的实施策略的报告改编和修改框架）来明确AD的核心组成部分，并展示一个可重复的项目开发过程。通过展示一个多项目、多地点的AD项目，我们旨在为其他人开发和定制AD项目提供指导，最终实现对AD效果更严格的评估。
回顾文献和培训材料以制定常见AD组件列表，然后根据FRAME-IS模板进行组织。编码人员对来自MIDAS AD项目的材料应用定向内容分析，该项目是一个多地点实施中心，在退伍军人健康管理局的四个项目中使用AD。根据FRAME-IS模块和ERIC策略分类法对AD项目的定制和开发进行编码。
确定了18个常见AD组件。这些组件被保留，但在MIDAS项目中有6个被定制，另外还增加了7个。定制和添加的理由主要是为了提高AD的适用性、可接受性、采用率和覆盖面。为帮助未来定制AD项目，我们制定了一份可推广的指导问题列表以及一个AD项目文档和定制模板。
AD是一种强有力的策略，但对核心和可修改组件的实证研究受到组件定义多变的限制。这是首次尝试使用实施科学的术语为AD项目制定文档和定制指南。我们进一步指出哪些组件可能是核心组件，哪些可能是可修改组件。我们使用FRAME-IS方法明确AD组件的努力为其他AD项目提供了一个范例，有助于未来将AD作为一种实施策略进行使用和研究，并为更严格地分析哪些修改会影响结果铺平道路。：ClinicalTrials.gov：NCT05065502。
