Aschbrenner Kelly A, Rabin Borsika A, Bartels Stephen J, Glasgow Russell E
Department of Psychiatry, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA.
UC San Diego, The Herbert Wertheim School of Public Health and Human Longevity Science, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
Implement Sci. 2025 Jun 23;20(1):30. doi: 10.1186/s13012-025-01441-8.
A major gap in implementation research is guidance for designing studies to assess the impact of adaptations to interventions and implementation strategies. Many researchers regard experimental designs as the gold standard. However, the possible study designs for assessing the impact of adaptation on implementation, service and person-level outcomes is broad in scope, including descriptive and correlational research and variations of randomized controlled trials. This article provides a set of key methodological recommendations for assessing the impact of adaptations to interventions and implementation strategies on implementation outcomes.
We offer four key recommendations for investigating the impact of adaptations on implementation outcomes. First, we recommend defining the construct of adaptations and identifying the type and timing of adaptations. Second, we recommend that study teams identify the expected proximal and distal outcomes of adaptations. Third, we recommend that study teams consider all possible study design options and select the design that is best suited to answer the research question(s), and is feasible given practical and technical constraints, and acceptable to research partners and participants. Fourth, we recommend that study teams consider the type of adaptation and outcome data available, the goals of the adaptation study, and the complexity of the study design when selecting analytic approaches. We provide materials and examples related to the four key recommendations to help study teams plan and conduct adaptation studies.
This article provides methodological recommendations for assessing the impact of adaptations to interventions and implementation strategies on implementation, service, and person-level outcomes that are grounded in the practical realities of implementation research. Increasing the number of studies examining how, which, and under what conditions adaptations are associated with mechanisms and outcomes will advance research on adaptation.
实施研究中的一个主要差距在于缺乏关于设计研究以评估干预措施和实施策略适应性影响的指导。许多研究人员将实验设计视为黄金标准。然而，用于评估适应性对实施、服务和个人层面结果影响的可能研究设计范围很广，包括描述性和相关性研究以及随机对照试验的变体。本文提供了一套关键的方法学建议，用于评估干预措施和实施策略的适应性对实施结果的影响。
我们为调查适应性对实施结果的影响提供四项关键建议。首先，我们建议定义适应性的概念并确定适应性的类型和时机。其次，我们建议研究团队确定适应性预期的近端和远端结果。第三，我们建议研究团队考虑所有可能的研究设计选项，并选择最适合回答研究问题、在实际和技术限制下可行且为研究伙伴和参与者所接受的设计。第四，我们建议研究团队在选择分析方法时考虑适应性的类型和可用的结果数据、适应性研究的目标以及研究设计的复杂性。我们提供了与这四项关键建议相关的材料和示例，以帮助研究团队规划和开展适应性研究。
本文提供了基于实施研究实际情况的方法学建议，用于评估干预措施和实施策略的适应性对实施、服务和个人层面结果的影响。增加研究适应性如何、何种以及在何种条件下与机制和结果相关联的研究数量，将推动适应性研究的发展。
