背景:复杂的健康干预措施(CHIs)越来越多地用于公共卫生,临床研究和教育,以减轻全球疾病负担。众多的理论,已经开发了模型和框架(TMF)来支持CHI的实施。本系统综述旨在确定和批评与实施的三个特征有关的理论框架;适应性,可扩展性和可持续性(ASaS)。通过拆除组成理论,分析他们的组成部分概念,然后探索影响每个理论的因素,审查小组希望在实施CHIs时提供对注意事项的增强理解。
方法:这篇评论搜索了PubMedMEDLINE,CINAHL,WebofScience,和谷歌学者研究复杂健康干预措施的TMF。叙事综合被用来检查可能影响适应性的因素,复杂健康干预措施的可扩展性和可持续性。
结果:从五个数据库中检索到总共9763项研究(PubMed,MEDLINE,CINAHL,WebofScience,和谷歌学者)。删除重复项并应用资格标准后,35篇论文有资格入选。影响因素可以在外部环境(社会政治环境;领导资金,组织间网络),内部环境;(客户倡导;组织特征),干预特征(监督,监测和评估),和桥接因素(个人采用者或提供者特征)。
结论:这项审查证实,已确定的TMFS通常不包括适应性的三个组成部分,可扩展性,和可持续性。目前的方法侧重于高收入国家或通用的“全世界”方法,很少有针对低收入和中等收入国家的框架。该评论为进一步探索适应性提供了起点,可扩展性和可持续性,在中低收入背景下。
背景:未注册。
BACKGROUND: Complex health interventions (CHIs) are increasingly used in public health, clinical research and education to reduce the burden of disease worldwide. Numerous theories, models and frameworks (TMFs) have been developed to support implementation of CHIs. This systematic review aims to identify and critique theoretical frameworks concerned with three features of implementation;
adaptability, scalability and sustainability (ASaS). By dismantling the constituent theories, analysing their component concepts and then exploring factors that influence each theory the review team hopes to offer an enhanced understanding of considerations when implementing CHIs.
METHODS: This review searched PubMed MEDLINE, CINAHL, Web of Science, and Google Scholar for research investigating the TMFs of complex health interventions. Narrative synthesis was employed to examine factors that may influence the
adaptability, scalability and sustainability of complex health interventions.
RESULTS: A total of 9763 studies were retrieved from the five databases (PubMed, MEDLINE, CINAHL, Web of Science, and Google Scholar). Following removal of duplicates and application of the eligibility criteria, 35 papers were eligible for inclusion. Influencing factors can be grouped within outer context (socio-political context; leadership funding, inter-organisational networks), inner context; (client advocacy; organisational characteristics), intervention characteristics (supervision, monitoring and evaluation), and bridging factors (individual adopter or provider characteristics).
CONCLUSIONS: This review confirms that identified TMFS do not typically include the three components of
adaptability, scalability, and sustainability. Current approaches focus on high income countries or generic \"whole world\" approaches with few frameworks specific to low- and middle-income countries. The review offers a starting point for further exploration of
adaptability, scalability and sustainability, within a low- and middle-income context.
BACKGROUND: Not registered.