PDF(Pubmed)
Abstract：
Proctor and colleagues\' 2011 paper proposed a taxonomy of eight implementation outcomes and challenged the field to address a research agenda focused on conceptualization, measurement, and theory building. Ten years later, this paper maps the field\'s progress in implementation outcomes research. This scoping review describes how each implementation outcome has been studied, research designs and methods used, and the contexts and settings represented in the current literature. We also describe the role of implementation outcomes in relation to implementation strategies and other outcomes.
Arksey and O\'Malley\'s framework for conducting scoping reviews guided our methods. Using forward citation tracing, we identified all literature citing the 2011 paper. We conducted our search in the Web of Science (WOS) database and added citation alerts sent to the first author from the publisher for a 6-month period coinciding with the WOS citation search. This produced 1346 titles and abstracts. Initial abstract screening yielded 480 manuscripts, and full-text review yielded 400 manuscripts that met inclusion criteria (empirical assessment of at least one implementation outcome).
Slightly more than half (52.1%) of included manuscripts examined acceptability. Fidelity (39.3%), feasibility (38.6%), adoption (26.5%), and appropriateness (21.8%) were also commonly examined. Penetration (16.0%), sustainability (15.8%), and cost (7.8%) were less frequently examined. Thirty-two manuscripts examined implementation outcomes not included in the original taxonomy. Most studies took place in healthcare (45.8%) or behavioral health (22.5%) organizations. Two-thirds used observational designs. We found little evidence of progress in testing the relationships between implementation strategies and implementation outcomes, leaving us ill-prepared to know how to achieve implementation success. Moreover, few studies tested the impact of implementation outcomes on other important outcome types, such as service systems and improved individual or population health.
Our review presents a comprehensive snapshot of the research questions being addressed by existing implementation outcomes literature and reveals the need for rigorous, analytic research and tests of strategies for attaining implementation outcomes in the next 10 years of outcomes research.
Arksey and O\'Malley\'s framework for conducting scoping reviews guided our methods. Using forward citation tracing, we identified all literature citing the 2011 paper. We conducted our search in the Web of Science (WOS) database and added citation alerts sent to the first author from the publisher for a 6-month period coinciding with the WOS citation search. This produced 1346 titles and abstracts. Initial abstract screening yielded 480 manuscripts, and full-text review yielded 400 manuscripts that met inclusion criteria (empirical assessment of at least one implementation outcome).
Slightly more than half (52.1%) of included manuscripts examined acceptability. Fidelity (39.3%), feasibility (38.6%), adoption (26.5%), and appropriateness (21.8%) were also commonly examined. Penetration (16.0%), sustainability (15.8%), and cost (7.8%) were less frequently examined. Thirty-two manuscripts examined implementation outcomes not included in the original taxonomy. Most studies took place in healthcare (45.8%) or behavioral health (22.5%) organizations. Two-thirds used observational designs. We found little evidence of progress in testing the relationships between implementation strategies and implementation outcomes, leaving us ill-prepared to know how to achieve implementation success. Moreover, few studies tested the impact of implementation outcomes on other important outcome types, such as service systems and improved individual or population health.
Our review presents a comprehensive snapshot of the research questions being addressed by existing implementation outcomes literature and reveals the need for rigorous, analytic research and tests of strategies for attaining implementation outcomes in the next 10 years of outcomes research.
摘要：
背景：Proctor及其同事在2011年的论文中提出了八个实施成果的分类法，并挑战了该领域，以解决专注于概念化的研究议程，测量,和理论建设。十年后,本文绘制了该领域在实施成果研究方面的进展。这个范围审查描述了每个实施结果是如何被研究的，使用的研究设计和方法，以及当前文献中所代表的背景和设置。我们还描述了实施成果在实施战略和其他成果方面的作用。
方法：Arksey和O\'Malley进行范围审查的框架指导了我们的方法。使用正向引文跟踪，我们确定了所有引用2011年论文的文献。我们在WebofScience（WOS）数据库中进行了搜索，并添加了从出版商发送给第一作者的引文警报，为期6个月，与WOS引文搜索相吻合。这产生了1346个标题和摘要。最初的摘要筛选产生了480份手稿，全文审查产生了400份符合纳入标准的手稿(至少一项实施结果的实证评估).
结果：略多于一半（52.1％）的收录手稿被检查为可接受性。保真度（39.3%），可行性(38.6%)，采用率（26.5%），和适当性(21.8%)也被普遍检查。渗透率（16.0%），可持续性（15.8%），和费用(7.8%)的检查频率较低。32份手稿检查了原始分类法中未包括的实施结果。大多数研究发生在医疗保健（45.8％）或行为健康（22.5％）组织中。三分之二的人使用了观测设计。我们发现在测试实施战略和实施结果之间的关系方面几乎没有进展的证据，让我们没有准备好知道如何实现实施成功。此外，很少有研究测试实施结果对其他重要结果类型的影响，例如服务系统和改善个人或人口健康。
结论：我们的综述提供了现有实施成果文献正在解决的研究问题的全面快照，并揭示了严格的需求，在未来10年的成果研究中，对实现实施成果的战略进行分析研究和测试。
方法：Arksey和O\'Malley进行范围审查的框架指导了我们的方法。使用正向引文跟踪，我们确定了所有引用2011年论文的文献。我们在WebofScience（WOS）数据库中进行了搜索，并添加了从出版商发送给第一作者的引文警报，为期6个月，与WOS引文搜索相吻合。这产生了1346个标题和摘要。最初的摘要筛选产生了480份手稿，全文审查产生了400份符合纳入标准的手稿(至少一项实施结果的实证评估).
结果：略多于一半（52.1％）的收录手稿被检查为可接受性。保真度（39.3%），可行性(38.6%)，采用率（26.5%），和适当性(21.8%)也被普遍检查。渗透率（16.0%），可持续性（15.8%），和费用(7.8%)的检查频率较低。32份手稿检查了原始分类法中未包括的实施结果。大多数研究发生在医疗保健（45.8％）或行为健康（22.5％）组织中。三分之二的人使用了观测设计。我们发现在测试实施战略和实施结果之间的关系方面几乎没有进展的证据，让我们没有准备好知道如何实现实施成功。此外，很少有研究测试实施结果对其他重要结果类型的影响，例如服务系统和改善个人或人口健康。
结论：我们的综述提供了现有实施成果文献正在解决的研究问题的全面快照，并揭示了严格的需求，在未来10年的成果研究中，对实现实施成果的战略进行分析研究和测试。
