Strengthening Research on Complex Health Interventions: State-of-the-Art Conference

加强对复杂健康干预措施的研究：最先进的会议

• 批准号: 9924839
• 负责人: BRIAN S MITTMAN
• 金额: $ 4.99万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-01 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9924839
• 关键词: Strengthening; Research; Complex; Health; Interventions

PROJECT SUMMARY/ABSTRACT Complex health interventions (CHIs), including clinical, health service delivery and public health interventions with multiple adaptable components addressing multiple intervention targets are increasingly prevalent within the U.S. health system. CHIs represent promising solutions to complex health problems requiring simultaneous, coordinated efforts targeting root causes at the patient, clinician, health system, community, and/or regional, state and national levels. CHIs pose unique challenges and barriers to research and evaluation, however: prevailing health-related research approaches are optimized for simple, fixed, homogeneous interventions (e.g., pharmaceutical interventions) delivered with high levels of standardization and fidelity, but are poorly equipped to handle complex, multiple-component, heterogeneous and adaptable interventions. Furthermore, the primary goals of research on simple interventions – e average effect size estimates and answers to questions such as “is intervention A effective?” or “is intervention A superior to intervention B?” – are not useful for CHIs, for which the prevailing answer is generally “it depends.” Decision makers require guidance to support multiple decisions for CHIs, including (a) selecting interventions matched to features of their settings, (b) adapting CHIs to meet local circumstances, and (c) managing local conditions to enhance intervention effectiveness through improved intervention-context concordance. Research approaches capable of guiding the complex, multiple decisions and management actions required for CHIs are very different from those optimized to produce estimates of average intervention effect sizes. CHIs require distinctive study designs, intervention delivery and adaptation activities, data collection and analysis methods, and other study features. The expert meeting proposed in this application will convene key policy, practice and research leaders to (1) review the goals and desired outcomes of research evaluating CHIs and available methods standards and guidance for such studies, (2) assess prevailing research practices for CHIs and the relationship between prevailing vs. recommended practices, (3) identify barriers and facilitators to improved research practices, and (4) produce guidance and a set of recommendations for policy, practice and research stakeholder activities that will strengthen research on CHIs. The proposed conference will include pre-meeting preparation, a structured three-day meeting containing panel sessions and intensive small-group working sessions, and post-meeting work to operationalize the recommendations and facilitate their implementation. The initiative will facilitate improvement in the quality and value of research on complex interventions to enhance the contributions of this research to (a) improved evidence, insights and understanding of the operation and effects of CHIs and to (b) improvements in clinicians' and healthcare leaders' success in appropriately selecting, implementing and managing CHIs.

项目概要/摘要 复杂的健康干预措施 (CHIs)，包括临床、卫生服务提供和公共卫生干预措施 具有多个适应性组件来解决多个干预目标的情况在以下领域越来越普遍 美国卫生系统代表了解决复杂健康问题的有希望的解决方案。 针对患者、临床医生、卫生系统、社区、 和/或区域、州和国家层面的CHI给研究和研究带来了独特的挑战和障碍。 然而，评估：流行的健康相关研究方法针对简单、固定、 以高水平标准化提供同质干预措施（例如药物干预措施） 和保真度，但缺乏处理复杂、多组件、异构和适应性的能力 此外，简单干预研究的主要目标——平均效应大小。 对诸如“干预 A 有效吗？”或“干预 A 是否优于干预 A”等问题的估计和答案 干预 B？”——对 CHI 没有用，普遍的答案通常是“视情况而定”。 制定者需要指导来支持 CHI 的多项决策，包括 (a) 选择匹配的干预措施 适应当地环境的特点，(b) 调整 CHI 以满足当地情况，以及 (c) 管理当地条件 通过改善干预与情境的一致性来提高干预效果。 研究方法能够进行复杂的、多重的决策并指导所需的管理行动 CHI 与那些经过优化以产生平均干预效应大小估计值的 CHI 非常不同。 需要独特的研究设计、干预实施和适应活动、数据收集和分析 本申请中提出的专家会议将召开关键政策、 实践和研究领导者 (1) 审查评估 CHI 和的研究的目标和预期结果 此类研究的可用方法标准和指南，(2) 评估 CHI 的现行研究实践 以及流行做法与推荐做法之间的关系，(3) 确定阻碍和促进因素 改进研究实践，(4) 为政策、实践和 拟议的会议将包括加强 CHI 研究的研究利益相关者活动。 会前准备，为期三天的结构化会议，其中包括小组会议和密集小组会议 工作会议和会后工作，以落实建议并促进其落实 该倡议的实施将有助于提高复杂研究的质量和价值。 采取干预措施，以增强本研究对以下方面的贡献：(a) 改进证据、见解和 了解 CHI 的运作和效果以及 (b) 改善人群和医疗保健 领导者在适当选择、实施和管理 CHI 方面的成功。