Application and implications of implementation science framework in school health
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摘要: 实施性研究作为一门新兴学科,已被广泛应用于多个健康领域,如慢性非传染性疾病的预防与控制、心理健康促进等。然而,中国以学校为基础的实施性研究尚处于起步阶段。通过介绍实施性研究在国外学校卫生领域使用的主要框架,综述其基于学校环境中在营养干预、体力活动和心理健康促进、健康危险行为预防等方面的应用,以期为实施性研究应用于中国学校卫生工作提供理论依据和实践指导。Abstract: As an emerging discipline, implementation research has been widely used in many health fields, such as the prevention and control of chronic noncommunicable diseases and mental health promotion. However, school-based implementation research in China is still in its infancy. The paper introduces the implementation science framework applied in the field of school health in foreign countries, and reviews its application in nutrition intervention, physical activity and mental health promotion, and prevention of health risk behaviors in school settings, in order to provide theoretical basis and practical guidance for the application of implementation research in school health in China.
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Key words:
- Implementation science /
- Evidence-based practice /
- Public health /
- Intervention
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 RE-AIM框架维度、层面和内容
Table 1. Dimensions, levels, and content of the RE-AIM framework
维度 层面 框架内容 可及性 个体层面 愿意参加给定计划或项目的人数比例及代表性,以及有资格但未参与的人的特征 有效性 个体层面 干预项目对主要结局的影响,包括潜在的负面影响等 采纳性 个体、组织层面 愿意启动干预项目的环境和负责人(提供计划的人员)的数量、比例和代表性 实施性 个体、组织层面 干预在多大程度上按计划进行,包括不同环境/项目人员之间干预交付的一致性,以及干预计划的时间和成本 可持续性 个体、组织层面 干预项目在多大程度上能够成为组织实践或政策的一部分 表 2 CFIR框架领域、内容和结构
Table 2. Areas, content, and structures of the CFIR framework
领域 内容 结构 干预方案特征 干预项目的特征及其对于实施的潜在影响 干预来源,证据强度,相对优势,适应性,可适用性,复杂性,设计质量,成本 外部因素 描述干预环境的外部政治、社会背景 患者需求,组织网络,同行或竞争压力,政策、法规和激励 内部因素 描述干预环境的内部结构、政治和文化背景 结构特点,协作与沟通,文化,实施氛围(迫切性,兼容性,相对优先次序,激励与奖励,目标与反馈,学习氛围),实施准备度(领导层参与,可用资源,信息的可及性) 个体特征 描述参与干预项目的人员 关于干预项目的认知,自我效能感,个人变化阶段,对组织的认同感,其他个人特点 实施过程 从规划阶段开始,召集参与人员评估,全面描述干预项目 规划,参与(意见领袖,正式任命的利益相关者,拥护者,外部变革推动者),执行,反思 -
[1] CHEN E, NETA G, ROBERTS M C. Complementary approaches to problem solving in healthcare and public health: implementation science and human-centered design[J]. Transl Behav Med, 2021, 11(5): 1115-1121. doi: 10.1093/tbm/ibaa079 [2] BAUER M S, KIRCHNER J. Implementation science: what is it and why should I care[J]. Psychiatry Res, 2020, 283: 112376. doi: 10.1016/j.psychres.2019.04.025 [3] SOLEIMANPOUR S. School-based health centers: at the intersection of health and education[J]. J Adolesc Health, 2020, 67(3): 317-318. doi: 10.1016/j.jadohealth.2020.05.009 [4] BAUER M S, DAMSCHRODER L, HAGEDORN H, et al. An introduction to implementation science for the non-specialist[J]. BMC Psychol, 2015, 3(1): 32. doi: 10.1186/s40359-015-0089-9 [5] JENICEK M. Epidemiology, evidenced-based medicine, and evidence-based public health[J]. J Epidemiol, 1997, 7(4): 187-197. doi: 10.2188/jea.7.187 [6] 全球慢性病联盟中-加抑郁研究团队. 推进实施性研究在中国公共卫生领域中的应用[J]. 中华预防医学杂志, 2020, 54(1): 8-12.Global Alliance for Chronic Diseases Canada-China Depression Research Teams. Promoting the application of implementation research in the field of public health in China[J]. Chin J Prev Med, 2020, 54(1): 8-12. (in Chinese) [7] WHO PETERS D H, TRAN N T, ADAM T. Implementation research in health: a practical guide[M]. Geneva: WHO, 2013. [8] DAMSCHRODER L J, ARON D C, KEITH R E, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science[J]. Impl Sci, 2009, 4(1): 1-15. doi: 10.1186/1748-5908-4-1 [9] BIRKEN S A, POWELL B J, SHEA C M, et al. Criteria for selecting implementation science theories and frameworks: results from an international survey[J]. Impl Sci, 2017, 12(1): 124. doi: 10.1186/s13012-017-0656-y [10] GLASGOW R E, VOGT T M, BOLES S M. Evaluating the public health impact of health promotion interventions: the RE-AIM framework[J]. Am J Public Health, 1999, 89(9): 1322-1327. doi: 10.2105/AJPH.89.9.1322 [11] GRAHAM I D, LOGAN J, HARRISON M B, et al. Lost in knowledge translation: time for a map[J]. J Contin Educ Health Prof, 2006, 26(1): 13-24. doi: 10.1002/chp.47 [12] KITSON A, HARVEY G, MCCORMACK B. Enabling the implementation of evidence based practice: a conceptual framework[J]. Q Health Care, 1998, 7(3): 149-158. doi: 10.1136/qshc.7.3.149 [13] SHUE S A, MCGUIRE A B, MATTHIAS M S. Facilitators and barriers to implementation of a peer support intervention for patients with chronic pain: a qualitative study[J]. Pain Med, 2019, 20(7): 1311-1320. doi: 10.1093/pm/pny229 [14] WILLIAMS N J, BEIDAS R S. Annual research review: the state of implementation science in child psychology and psychiatry: a review and suggestions to advance the field[J]. J Child Psychol Psychiatry, 2019, 60(4): 430-450. doi: 10.1111/jcpp.12960 [15] BROWNSON R C, COLDITZ G A, PROCTOR E K, et al. Dissemination and implementation research in health: translating science to practice[M]. New York: Oxford University Press, 2017. [16] HOLTROP J S, ESTABROOKS P A, GAGLIO B, et al. Understanding and applying the RE-AIM framework: clarifications and resources[J]. J Clin Transl Sci, 2021, 5(1): e126. doi: 10.1017/cts.2021.789 [17] LEUNG E, WANNER K J, SENTER L, et al. What will it take?Using an implementation research framework to identify facilitators and barriers in implementing a school-based referral system for sexual health services[J]. BMC Health Serv Res, 2020, 20(1): 292. doi: 10.1186/s12913-020-05147-z [18] KING D K, SHOUP J A, RAEBEL M A, et al. Planning for implementation success using RE-AIM and CFIR frameworks: a qualitative study[J]. Front Public Health, 2020, 8: 59. doi: 10.3389/fpubh.2020.00059 [19] HUANG K Y, CHENG S, THEISE R. School contexts as social determinants of child health: current practices and implications for future public health practice[J]. Public Health Rep, 2013, 128(Suppl 3): 21-28. [20] HERRENKOHL T. Cross-system collaboration and engagement of the public health model to promote the well-being of children and families[J]. J Soc Soc Work Res, 2019, 10(3): 319-332. doi: 10.1086/704958 [21] U.S. Department of Education, Office of Planning, Evaluation and Policy Development, Policy and Program Studies Service. Prevalence and implementation fidelity of research-based prevention programs in public schools: final report[R]. Washington: U.S. Department of Education, 2011. [22] TURUNEN H, SORMUNEN M, JOURDAN D, et al. Health promoting schools: a complex approach and a major means to health improvement[J]. Health Promot Int, 2017, 32(2): 177-184. doi: 10.1093/heapro/dax001 [23] WERNER-SEIDLER A, PERRY Y, CALEAR A L, et al. School-based depression and anxiety prevention programs for young people: a systematic review and Meta-analysis[J]. Clin Psychol Rev, 2017, 51: 30-47. doi: 10.1016/j.cpr.2016.10.005 [24] WILLEBOORDSE M, BARTELINK N H M, VAN ASSEMA P, et al. Battling the obesity epidemic with a school-based intervention: long-term effects of a quasi-experimental study[J]. PLoS One, 2022, 17(9): e0272291. doi: 10.1371/journal.pone.0272291 [25] DUNTON G F, LAGLOIRE R, ROBERTSON T. Using the RE-AIM framework to evaluate the statewide dissemination of a school-based physical activity and nutrition curriculum: "Exercise Your Options"[J]. Am J Health Promot, 2009, 23(4): 229-232. doi: 10.4278/ajhp.071211129 [26] NIGG C, GELLER K, ADAMS P, et al. Successful dissemination of Fun 5: a physical activity and nutrition program for children[J]. Transl Behav Med, 2012, 2(3): 276-285. doi: 10.1007/s13142-012-0120-0 [27] ELINDER L S, WIKLUND C A, NORMAN A, et al. Implementation and evaluation of the school-based family support program a healthy school start to promote child health and prevent overweight and obesity(IMPROVE): study protocol for a cluster-randomized trial[J]. BMC Public Health, 2021, 21(1): 1630. doi: 10.1186/s12889-021-11663-2 [28] MESHKOVSKA B, SCHELLER D A, WENDT J, et al. Barriers and facilitators to implementation of direct fruit and vegetables provision interventions in kindergartens and schools: a qualitative systematic review applying the consolidated framework for implementation research(CFIR)[J]. Int J Behav Nutr Phys Act, 2022, 19(1): 1-19. doi: 10.1186/s12966-021-01238-0 [29] KENNEDY S G, SMITH J J, ESTABROOKS P A, et al. Evaluating the reach, effectiveness, adoption, implementation and maintenance of the resistance training for teens program[J]. Int J Behav Nutr Phys Act, 2021, 18(1): 122. doi: 10.1186/s12966-021-01195-8 [30] DE MEIJ J S, CHINAPAW M J, KREMERS S P, et al. Promoting physical activity in children: the stepwise development of the primary school-based JUMP-in intervention applying the RE-AIM evaluation framework[J]. Br J Sports Med, 2010, 44(12): 879-887. doi: 10.1136/bjsm.2008.053827 [31] SMEDEGAARD S, BRONDEEL R, CHRISTIANSEN L B, et al. What happened in the 'Move for Well-being in School': a process evaluation of a cluster randomized physical activity intervention using the RE-AIM framework[J]. Int J Behav Nutr Phys Act, 2017, 14(1): 159. doi: 10.1186/s12966-017-0614-8 [32] HUDSON K G, LAWTON R, HUGH-JONES S. Factors affecting the implementation of a whole school mindfulness program: a qualitative study using the consolidated framework for implementation research[J]. BMC Health Serv Res, 2020, 20(1): 133. doi: 10.1186/s12913-020-4942-z [33] HUANG K Y, NAKIGUDDE J, RHULE D, et al. Transportability of an evidence-based early childhood intervention in a low-income African country: results of a cluster randomized controlled study[J]. Prev Sci, 2017, 18(8): 964-975. doi: 10.1007/s11121-017-0822-0 [34] OKAMOTO S K, HELM S, CHIN S K, et al. The implementation of a culturally grounded, school-based, drug prevention curriculum in rural Hawai'i[J]. J Commun Psychol, 2020, 48(4): 1085-1099. doi: 10.1002/jcop.22222 [35] EISMAN A B, KIPERMAN S, RUPP L A, et al. Understanding key implementation determinants for a school-based universal prevention intervention: a qualitative study[J]. Transl Behav Med, 2022, 12(3): 411-422. doi: 10.1093/tbm/ibab162 [36] MA W, LIU B, NAN L, et al. Clan-involved approaches to increasing antenatal care use in a rural minority area of China: implementation research[J]. Acta Paediatr, 2018, 107(Suppl 471): 7-16. doi: 10.1111/apa.14357
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