MECHANISMS: The MECHANics of Implementation Strategies and MeasureS

机制：实施策略和措施的机制

• 批准号: 10274716
• 负责人: Cara Charissa Lewis
• 金额: $ 69.88万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-17 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10274716
• 关键词: Address; Affect; Attention; Behavior Therapy; Cancer Control; Consensus; Coupled; Databases; Development; Distal; Effectiveness; Ensure; Evaluation; Evidence based intervention; Evidence based practice; Funding; Goals; Grant; Health; Individual; Interview; Journals; Knowledge; Malignant Neoplasms; Measures; Mechanics; Methods; Mission; Modeling; Outcome; Pathway interactions; Patient-Focused Outcomes; Procedures; Process; Psychometrics; Public Health; Recommendation; Research; Research Personnel; Science; Scientist; Social Marketing; Specific qualifier value; Techniques; Testing; To specify; United States Department of Veterans Affairs; Work; cancer care; care delivery; causal model; evidence base; experience; implementation facilitation; implementation measures; implementation outcomes; implementation research; implementation science; implementation strategy; innovation; model development; population health; programs; repository; research in practice; searchable database; service delivery; theories; therapy development; user centered design; user-friendly; web site

PROJECT SUMMARY There is a fundamental gap in understanding the causal mechanisms by which strategies for implementing evidence-based practices address local barriers to effective, appropriate service delivery. Continued existence of this gap represents an important problem because, until it is addressed, scientific knowledge and practical guidance about which implementation strategies to use in which contexts will remain elusive. The long-term goal is to develop the evidence base and practical utility of implementation science through mechanisms- focused implementation research. The objective of this application is to overcome critical problems blocking progress in implementation science and practice by identifying plausible strategy-mechanism linkages, developing causal models for mechanism evaluation, producing the measures needed to evaluate such linkages, and making these models, methods, and measures available in a user-friendly website. The rationale is that, once strategy-mechanism linkages are identified, implementation scientists can develop tailored implementation strategies and generate more robust evidence about which strategies work best in which contexts. Moreover, practitioners will be better able to select implementation strategies to address their specific implementation problems. The specific aims are: (1) build a database of strategy-mechanism linkages and associated causal pathway diagrams; (2) develop psychometrically strong, pragmatic measures of mechanisms; and (3) develop and disseminate a website of implementation mechanisms knowledge for use by diverse stakeholders, through the application of iterative user-centered design and social marketing principles. For the first aim, qualitative inquiry, Group Nominal Technique, Delphi methods, and causal diagramming will be used to identify and confirm plausible strategy-mechanism linkages and articulate moderators, preconditions, and proximal and distal outcomes associated with those linkages. For the second aim, rapid- cycle measure development and testing methods will be employed to create reliable, valid, pragmatic measures of six mechanisms for which no high-quality measures exist. For the third aim, we will develop a user-friendly website and searchable database via user-centered design and disseminate those using social marketing principles. This project is innovative because it shifts the current paradigm from evaluating implementation strategy general effectiveness to a mechanisms-informed approach that promises accelerated scientific progress. The proposed research is significant for its potential to vertically advance implementation science by developing micro-theories, methods, and measures for mechanism identification and evaluation. New horizons in implementation strategy development, optimization, evaluation, and deployment are expected to be attainable as a result, which will lead to enhanced implementation of evidence-based interventions for cancer control, and ultimately improvements in patient outcomes.

项目概要 在理解实施战略的因果机制方面存在根本差距 基于证据的做法解决了当地提供有效、适当服务的障碍。继续存在 这一差距是一个重要问题，因为在解决这个问题之前，科学知识和实践 关于在哪些情况下使用哪些实施战略的指导仍然难以捉摸。长期来看 目标是通过以下机制开发实施科学的证据基础和实际效用： 重点实施研究。该应用程序的目标是克服阻碍的关键问题 通过确定合理的战略与机制之间的联系，在实施科学和实践方面取得进展， 开发机制评估的因果模型，制定评估此类机制所需的措施 链接，并在用户友好的网站上提供这些模型、方法和措施。理由 是，一旦确定了战略与机制的联系，实施科学家就可以开发定制的 实施策略，并生成更强有力的证据，说明哪些策略在哪些领域最有效 上下文。此外，从业者将能够更好地选择实施策略来解决他们的具体问题 实施问题。具体目标是：（1）建立战略机制联系数据库 相关因果路径图； (2) 制定强有力的、务实的心理测量措施 机制； (3) 开发和传播执行机制知识网站，供 通过应用以用户为中心的迭代设计和社会营销原则，吸引不同的利益相关者。 对于第一个目标，定性探究、群名义技术、德尔菲法和因果图将 用于识别和确认合理的战略机制联系并阐明调节因素， 前提条件以及与这些联系相关的近端和远端结果。对于第二个目标，快速—— 将采用循环测量开发和测试方法来创建可靠、有效、务实的 不存在高质量措施的六种机制的措施。对于第三个目标，我们将开发一个 通过以用户为中心的设计提供用户友好的网站和可搜索的数据库，并使用社交媒体进行传播 营销原则。该项目具有创新性，因为它改变了当前的评估范式 实施战略对基于机制的方法的总体有效性，承诺加速 科学进步。拟议的研究因其垂直推进实施的潜力而具有重要意义 通过发展机制识别和评估的微观理论、方法和措施来发展科学。 实施战略制定、优化、评估和部署有望实现新视野 结果是可以实现的，这将导致加强实施基于证据的干预措施 癌症控制，并最终改善患者的治疗结果。