PDF(Pubmed)
Abstract：
Veterans receiving care within the Veterans Health Administration (VA) are a unique population with distinctive cultural traits and healthcare needs compared to the civilian population. Modifications to evidence-based interventions (EBIs) developed outside of the VA may be useful to adapt care to the VA healthcare system context or to specific cultural norms among veterans. We sought to understand how EBIs have been modified for veterans and whether adaptations were feasible and acceptable to veteran populations.
We conducted a scoping review of EBI adaptations occurring within the VA at any time prior to June 2021. Eligible articles were those where study populations included veterans in VA care, EBIs were clearly defined, and there was a comprehensive description of the EBI adaptation from its original context. Data was summarized by the components of the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME).
We retrieved 922 abstracts based on our search terms. Following review of titles and abstracts, 49 articles remained for full-text review; eleven of these articles (22%) met all inclusion criteria. EBIs were adapted for mental health (n = 4), access to care and/or care delivery (n = 3), diabetes prevention (n = 2), substance use (n = 2), weight management (n = 1), care specific to cancer survivors (n = 1), and/or to reduce criminal recidivism among veterans (n = 1). All articles used qualitative feedback (e.g., interviews or focus groups) with participants to inform adaptations. The majority of studies (55%) were modified in the pre-implementation, planning, or pilot phases, and all were planned proactive adaptations to EBIs.
The reviewed articles used a variety of methods and frameworks to guide EBI adaptations for veterans receiving VA care. There is an opportunity to continue to expand the use of EBI adaptations to meet the specific needs of veteran populations.
We conducted a scoping review of EBI adaptations occurring within the VA at any time prior to June 2021. Eligible articles were those where study populations included veterans in VA care, EBIs were clearly defined, and there was a comprehensive description of the EBI adaptation from its original context. Data was summarized by the components of the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME).
We retrieved 922 abstracts based on our search terms. Following review of titles and abstracts, 49 articles remained for full-text review; eleven of these articles (22%) met all inclusion criteria. EBIs were adapted for mental health (n = 4), access to care and/or care delivery (n = 3), diabetes prevention (n = 2), substance use (n = 2), weight management (n = 1), care specific to cancer survivors (n = 1), and/or to reduce criminal recidivism among veterans (n = 1). All articles used qualitative feedback (e.g., interviews or focus groups) with participants to inform adaptations. The majority of studies (55%) were modified in the pre-implementation, planning, or pilot phases, and all were planned proactive adaptations to EBIs.
The reviewed articles used a variety of methods and frameworks to guide EBI adaptations for veterans receiving VA care. There is an opportunity to continue to expand the use of EBI adaptations to meet the specific needs of veteran populations.
摘要：
背景：与平民相比，在退伍军人健康管理局（VA）内接受护理的退伍军人是具有独特文化特征和医疗保健需求的独特人群。对VA以外开发的基于证据的干预措施（EBIs）的修改可能有助于使护理适应VA医疗保健系统环境或退伍军人中的特定文化规范。我们试图了解如何为退伍军人修改EBIs，以及适应是否可行和被退伍军人接受。
方法：我们在2021年6月之前的任何时间对VA内发生的EBI适应进行了范围审查。符合条件的文章是那些研究人群包括退伍军人护理的文章，EBIs被明确定义，并从原始上下文对EBI改编进行了全面描述。数据是通过报告对循证干预措施的适应和修改框架（FRAME）的组成部分进行总结的。
结果：我们根据搜索词检索了922篇摘要。在审查标题和摘要之后，仍有49篇文章需要全文审查；其中11篇文章(22%)符合所有纳入标准。EBI适用于心理健康(n=4)，获得护理和/或护理交付(n=3)，糖尿病预防（n=2），物质使用(n=2)，体重管理(n=1)，癌症幸存者特有的护理（n=1），和/或减少退伍军人中的犯罪累犯(n=1)。所有文章都使用了定性反馈(例如，访谈或焦点小组)与参与者进行调整。大多数研究(55%)在实施前进行了修改，规划,或试点阶段，和所有计划积极适应EBIs。
■所审查的文章使用了多种方法和框架来指导接受VA护理的退伍军人的EBI适应。有机会继续扩大EBI适应的使用，以满足退伍军人的特定需求。
方法：我们在2021年6月之前的任何时间对VA内发生的EBI适应进行了范围审查。符合条件的文章是那些研究人群包括退伍军人护理的文章，EBIs被明确定义，并从原始上下文对EBI改编进行了全面描述。数据是通过报告对循证干预措施的适应和修改框架（FRAME）的组成部分进行总结的。
结果：我们根据搜索词检索了922篇摘要。在审查标题和摘要之后，仍有49篇文章需要全文审查；其中11篇文章(22%)符合所有纳入标准。EBI适用于心理健康(n=4)，获得护理和/或护理交付(n=3)，糖尿病预防（n=2），物质使用(n=2)，体重管理(n=1)，癌症幸存者特有的护理（n=1），和/或减少退伍军人中的犯罪累犯(n=1)。所有文章都使用了定性反馈(例如，访谈或焦点小组)与参与者进行调整。大多数研究(55%)在实施前进行了修改，规划,或试点阶段，和所有计划积极适应EBIs。
■所审查的文章使用了多种方法和框架来指导接受VA护理的退伍军人的EBI适应。有机会继续扩大EBI适应的使用，以满足退伍军人的特定需求。
