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Abstract：
Audit and feedback (A&F) is a widely used implementation strategy to influence health professionals\' behavior that is often tested in implementation trials. This study examines how A&F trials describe sustainability, spread, and scale.
This is a theory-informed, descriptive, secondary analysis of an update of the Cochrane systematic review of A&F trials, including all trials published since 2011. Keyword searches related to sustainability, spread, and scale were conducted. Trials with at least one keyword, and those identified from a forward citation search, were extracted to examine how they described sustainability, spread, and scale. Results were qualitatively analyzed using the Integrated Sustainability Framework (ISF) and the Framework for Going to Full Scale (FGFS).
From the larger review, n = 161 studies met eligibility criteria. Seventy-eight percent (n = 126) of trials included at least one keyword on sustainability, and 49% (n = 62) of those studies (39% overall) frequently mentioned sustainability based on inclusion of relevant text in multiple sections of the paper. For spread/scale, 62% (n = 100) of trials included at least one relevant keyword and 51% (n = 51) of those studies (31% overall) frequently mentioned spread/scale. A total of n = 38 studies from the forward citation search were included in the qualitative analysis. Although many studies mentioned the need to consider sustainability, there was limited detail on how this was planned, implemented, or assessed. The most frequent sustainability period duration was 12 months. Qualitative results mapped to the ISF, but not all determinants were represented. Strong alignment was found with the FGFS for phases of scale-up and support systems (infrastructure), but not for adoption mechanisms. New spread/scale themes included (1) aligning affordability and scalability; (2) balancing fidelity and scalability; and (3) balancing effect size and scalability.
A&F trials should plan for sustainability, spread, and scale so that if the trial is effective, the benefits can continue. A deeper empirical understanding of the factors impacting A&F sustainability is needed. Scalability planning should go beyond cost and infrastructure to consider other adoption mechanisms, such as leadership, policy, and communication, that may support further scalability.
Registered with Prospero in May 2022. CRD42022332606.
This is a theory-informed, descriptive, secondary analysis of an update of the Cochrane systematic review of A&F trials, including all trials published since 2011. Keyword searches related to sustainability, spread, and scale were conducted. Trials with at least one keyword, and those identified from a forward citation search, were extracted to examine how they described sustainability, spread, and scale. Results were qualitatively analyzed using the Integrated Sustainability Framework (ISF) and the Framework for Going to Full Scale (FGFS).
From the larger review, n = 161 studies met eligibility criteria. Seventy-eight percent (n = 126) of trials included at least one keyword on sustainability, and 49% (n = 62) of those studies (39% overall) frequently mentioned sustainability based on inclusion of relevant text in multiple sections of the paper. For spread/scale, 62% (n = 100) of trials included at least one relevant keyword and 51% (n = 51) of those studies (31% overall) frequently mentioned spread/scale. A total of n = 38 studies from the forward citation search were included in the qualitative analysis. Although many studies mentioned the need to consider sustainability, there was limited detail on how this was planned, implemented, or assessed. The most frequent sustainability period duration was 12 months. Qualitative results mapped to the ISF, but not all determinants were represented. Strong alignment was found with the FGFS for phases of scale-up and support systems (infrastructure), but not for adoption mechanisms. New spread/scale themes included (1) aligning affordability and scalability; (2) balancing fidelity and scalability; and (3) balancing effect size and scalability.
A&F trials should plan for sustainability, spread, and scale so that if the trial is effective, the benefits can continue. A deeper empirical understanding of the factors impacting A&F sustainability is needed. Scalability planning should go beyond cost and infrastructure to consider other adoption mechanisms, such as leadership, policy, and communication, that may support further scalability.
Registered with Prospero in May 2022. CRD42022332606.
摘要：
背景：审核和反馈（A＆F）是一种广泛使用的实施策略，用于影响卫生专业人员的行为，通常在实施试验中进行测试。这项研究考察了A&F试验如何描述可持续性，传播，和规模。
方法：这是一个理论通知，描述性,描述性对CochraneA&F试验系统综述更新的二次分析，包括2011年以来发表的所有试验.与可持续性相关的关键字搜索，传播，并进行了规模。至少有一个关键字的试验，以及从正向引文搜索中识别出的那些，被提取来检查他们如何描述可持续性，传播，和规模。使用综合可持续性框架（ISF）和全面发展框架（FGFS）对结果进行定性分析。
结果：从更大的评论来看，n=161项研究符合资格标准。78%(n=126)的试验包括至少一个关于可持续性的关键词，这些研究中有49%(n=62)(总体39%)经常提到基于论文多个部分中包含相关文本的可持续性。对于传播/规模，62%(n=100)的试验包括至少一个相关关键词，51%(n=51)的这些研究(总体31%)经常提到传播/量表。来自正向引文搜索的总共n=38项研究被纳入定性分析。尽管许多研究提到需要考虑可持续性，关于这是如何计划的细节有限，已实施，或评估。最常见的持续期持续时间为12个月。定性结果映射到ISF，但并非所有决定因素都被代表。在扩大和支持系统（基础设施）的阶段，与FGFS取得了强有力的一致性，但不是收养机制。新的传播/缩放主题包括(1)调整可负担性和可扩展性;(2)平衡保真度和可扩展性;以及(3)平衡效果大小和可扩展性。
结论：A&F试验应计划可持续性，传播，和规模，以便如果试验有效，好处可以继续。需要对影响A&F可持续性的因素有更深入的经验理解。可扩展性规划应超越成本和基础设施，考虑其他采用机制，比如领导力，政策,和沟通,可以支持进一步的可扩展性。
背景：于2022年5月在Prospero注册。CRD4202232606。
方法：这是一个理论通知，描述性,描述性对CochraneA&F试验系统综述更新的二次分析，包括2011年以来发表的所有试验.与可持续性相关的关键字搜索，传播，并进行了规模。至少有一个关键字的试验，以及从正向引文搜索中识别出的那些，被提取来检查他们如何描述可持续性，传播，和规模。使用综合可持续性框架（ISF）和全面发展框架（FGFS）对结果进行定性分析。
结果：从更大的评论来看，n=161项研究符合资格标准。78%(n=126)的试验包括至少一个关于可持续性的关键词，这些研究中有49%(n=62)(总体39%)经常提到基于论文多个部分中包含相关文本的可持续性。对于传播/规模，62%(n=100)的试验包括至少一个相关关键词，51%(n=51)的这些研究(总体31%)经常提到传播/量表。来自正向引文搜索的总共n=38项研究被纳入定性分析。尽管许多研究提到需要考虑可持续性，关于这是如何计划的细节有限，已实施，或评估。最常见的持续期持续时间为12个月。定性结果映射到ISF，但并非所有决定因素都被代表。在扩大和支持系统（基础设施）的阶段，与FGFS取得了强有力的一致性，但不是收养机制。新的传播/缩放主题包括(1)调整可负担性和可扩展性;(2)平衡保真度和可扩展性;以及(3)平衡效果大小和可扩展性。
结论：A&F试验应计划可持续性，传播，和规模，以便如果试验有效，好处可以继续。需要对影响A&F可持续性的因素有更深入的经验理解。可扩展性规划应超越成本和基础设施，考虑其他采用机制，比如领导力，政策,和沟通,可以支持进一步的可扩展性。
背景：于2022年5月在Prospero注册。CRD4202232606。
