Transferability of interventions in health education: a review

BMC Public Health

François Alla¹  Valery Ridde²  Laetitia Minary¹  Linda Cambon³ 

[1] Inserm, CIC-EC, Centre hospitalier universitaire, 54000, Nancy, France;Department of Social and Preventive Medicine, CRCHUM, 3875 Saint-Urbain, Montreal, QC, H2W 1 V1, Canada;Université de Lorraine, Faculté de Médecine, Ecole de Santé Publique, 9 avenue de la Forêt de Haye – BP 184, F-54505, Vandœuvre-lès-Nancy, France

关键词: Complex intervention;    Assessment;    Evaluation;    Evidence-based;    Health promotion;    Health education;    Applicability;    Transferability;   

Others  :  1163478
DOI  :  10.1186/1471-2458-12-497

 received in 2012-02-17, accepted in 2012-07-02,  发布年份 2012

【 摘 要 】

Background

Health education interventions are generally complex. Their outcomes result from both the intervention itself and the context for which they are developed. Thus, when an intervention carried out in one context is reproduced in another, its transferability can be questionable. We performed a literature review to analyze the concept of transferability in the health education field.

Methods

Articles included were published between 2000 and 2010 that addressed the notion of transferability of interventions in health education. Articles were analyzed using a standardized grid based on four items: 1) terminology used; 2) factors that influenced transferability; 3) capacity of the research and evaluation designs to assess transferability; and 4) tools and criteria available to assess transferability.

Results

43 articles met the inclusion criteria. Only 13 of them used the exact term “transferability” and one article gave an explicit definition: the extent to which the measured effectiveness of an applicable intervention could be achieved in another setting. Moreover, this concept was neither clearly used nor distinguished from others, such as applicability. We highlight the levels of influence of transferability and their associated factors, as well as the limitations of research methods in their ability to produce transferable conclusions.

Conclusions

We have tried to clarify the concept by defining it along three lines that may constitute areas for future research: factors influencing transferability, research methods to produce transferable data, and development of criteria to assess transferability. We conclude this review with three propositions: 1) a conceptual clarification of transferability, especially with reference to other terms used; 2) avenues for developing knowledge on this concept and analyzing the transferability of interventions; and 3) in relation to research, avenues for developing better evaluation methods for assessing the transferability of interventions.

【 授权许可】

   
2012 Cambon et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Organization WH: Ottawa Charter for Health Promotion. In. Edited by Promotion FICoH, Canada; 1986.
• [2]Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M: Medical Research Council Guidance. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008, 337:a1655.
• [3]Wang S, Moss JR, Hiller JE: Applicability and transferability of interventions in evidence-based public health. Heal Promot Int 2006, 21(1):76-83.
• [4]Juneau CE, Jones CM, McQueen DV, Potvin L: Evidence-based health promotion: an emerging field. Glob Heal Promot 2011, 18(1):79-89. 122–133, 157–168
• [5]Morgan G: Evidence-based health policy: A preliminary systematic review. Heal Educ J 2010, 69(1):43-47.
• [6]Brownson RC, Fielding JE, Maylahn CM: Evidence-Based Public Health: A Fundamental Concept for Public Health Practice. Annu Rev Publ Health 2009, 30(1):175-201.
• [7]Alla F: Governance: concept and debates. Sante Publique 2008, 20(2):101.
• [8]Cambon L, Ridde V, Alla F: Reflections and perspectives on evidence-based health promotion in the French environment. Revue d Epidemiol Sante Publique 2010, 58(4):277-283.
• [9]Rothwell PM: External validity of randomised controlled trials: "to whom do the results of this trial apply?". Lancet 2005, 365(9453):82-93.
• [10]Dekkers OM, von Elm E, Algra A, Romijn JA, Vandenbroucke JP: How to assess the external validity of therapeutic trials: a conceptual approach. Int J Epidemiol 2010, 39(1):89-94.
• [11]Burchett H, Umoquit M, Dobrow M: How do we know when research from one setting can be useful in another? A review of external validity, applicability and transferability frameworks. J Health Serv Res Pol 2011, 16(4):238-244.
• [12]Burtis AT, Taylor MK: Mapping the literature of health education: 2006–2008. J Med Libr Assoc 2010, 98(4):293-299.
• [13]In Health Promotion Glossary. Division of Health Promotion EaC, Unit HEaHP, Switzerland; 1998:-.
• [14]: Transparent reporting of systematic reviews and meta-analysis - PRISMA. . http://www.prisma-statement.org/statement.htm webcite
• [15]Zubrick SR, Ward KA, Silburn SR, Lawrence D, Williams AA, Blair E, Robertson D, Sanders MR: Prevention of child behavior problems through universal implementation of a group behavioral family intervention. Prev Sci Offic J Soc Prev Res 2005, 6(4):287-304.
• [16]Belansky ES, Romaniello C, Morin C, Uyeki T, Sawyer RL, Scarbro S, Auld GW, Crane L, Reynolds K, Hamman RF, et al.: Adapting and implementing a long-term nutrition and physical activity curriculum to a rural, low-income, biethnic community. J Nutr Educ Behav 2006, 38(2):106-113.
• [17]Roush S: Randomized controlled trials and the flow of information: Comment on Cartwright. Philos Stud 2009, 143(1):137-145.
• [18]Tsey K, Whiteside M, Daly S, Deemal A, Gibson T, Cadet-James Y, Wilson A, Santhanam R, Haswell-Elkins MR: Adapting the 'family wellbeing' empowerment program to the needs of remote indigenous school children. Aust New Zeal J Publ Health 2005, 29(2):112-116.
• [19]Rychetnik L, Frommer M, Hawe P, Shiell A: Criteria for evaluating evidence on public health interventions. J Epidemiol Commun Health 2002, 56(2):119-127.
• [20]Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet 2001, 358(9280):483-488.
• [21]Elford J, Hart G: If HIV prevention works, why are rates of high-risk sexual behavior increasing among MSM? AIDS Educ Prev Offic Publ Int Soc AIDS Educ 2003, 15(4):294-308.
• [22]Flowers P, Hart GJ, Williamson LM, Frankis JS, Der GJ: Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland? Int J STD AIDS 2002, 13(2):102-108.
• [23]Cattan M, White M, Bond J, Learmouth A: Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing Soc 2005, 25(01):41-67.
• [24]Stevens V, De Bourdeaudhuij I, Van Oost P: Anti-bullying interventions at school: aspects of programme adaptation and critical issues for further programme development. Heal Promot Int 2001, 16(2):155-167.
• [25]Victora CG, Habicht JP, Bryce J: Evidence-based public health: moving beyond randomized trials. Am J Public Health 2004, 94(3):400-405.
• [26]Glasgow RE, Klesges LM, Dzewaltowski DA, Bull SS, Estabrooks P: The future of health behavior change research: what is needed to improve translation of research into health promotion practice? Annals Behav Med Publ Soc Behav Med 2004, 27(1):3-12.
• [27]Glasgow RE, Boles SM, McKay HG, Feil EG, Barrera M: The D-Net diabetes self-management program: long-term implementation, outcomes, and generalization results. Prev Med 2003, 36(4):410-419.
• [28]Estabrooks PA, Gyurcsik NC: Evaluating the impact of behavioral interventions that target physical activity: issues of generalizability and public health. Psychol Sport Exerc 2003, 4(1):41-55.
• [29]Cohen DJ, Crabtree BF, Etz RS, Balasubramanian BA, Donahue KE, Leviton LC, Clark EC, Isaacson NF, Stange KC, Green LW: Fidelity versus flexibility: translating evidence-based research into practice. Am J Prev Med 2008, 35(5 Suppl):S381-S389.
• [30]Chen HT: The bottom-up approach to integrative validity: a new perspective for program evaluation. Eval Program Plann 2010, 33(3):205-214.
• [31]Baranowski T, Stables G: Process evaluations of the 5-a-day projects. Health Educ Behav Offic Publ Soc Publ Health Educ 2000, 27(2):157-166.
• [32]Buijs R, Ross-Kerr J, Cousins SO, Wilson D: Promoting participation: evaluation of a health promotion program for low income seniors. J Commun Health Nurs 2003, 20(2):93-107.
• [33]Glasgow RE, Lichtenstein E, Marcus AC: Why don't we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health 2003, 93(8):1261-1267.
• [34]Spoth R: Translating Family-Focused Prevention Science Into Effective Practice: Toward a Translational Impact Paradigm. Curr Dir Psychol Sci 2008, 17(6):415-421.
• [35]Klesges LM, Dzewaltowski DA, Glasgow RE: Review of external validity reporting in childhood obesity prevention research. Am J Prev Med 2008, 34(3):216-223.
• [36]Kwak L, Kremers SP, van Baak MA, Brug J: Participation rates in worksite-based intervention studies: health promotion context as a crucial quality criterion. Heal Promot Int 2006, 21(1):66-69.
• [37]Feldstein AC, Glasgow RE: A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Joint Commission J Qual Patient Saf Joint Commission Resour 2008, 34(4):228-243.
• [38]Bull SS, Gillette C, Glasgow RE, Estabrooks P: Work site health promotion research: to what extent can we generalize the results and what is needed to translate research to practice? Health Educ Behav Offic Publ Soc Publ Health Educ 2003, 30(5):537-549.
• [39]Eakin EG, Bull SS, Glasgow RE, Mason M: Reaching those most in need: a review of diabetes self-management interventions in disadvantaged populations. Diabetes Metabol Res Rev 2002, 18(1):26-35.
• [40]Reinschmidt KM, Teufel-Shone NI, Bradford G, Drummond RL, Torres E, Redondo F, Elenes JJ, Sanders A, Gastelum S, Moore-Monroy M, et al.: Taking a broad approach to public health program adaptation: adapting a family-based diabetes education program. J Prim Prev 2010, 31(1–2):69-83.
• [41]Zechmeister I, Kilian R, McDaid D: Is it worth investing in mental health promotion and prevention of mental illness? Syst Rev Evid Econ Eval BMC Publ health 2008, 8:20.
• [42]Rimer BK, Glanz K, Rasband G: Searching for evidence about health education and health behavior interventions. Health Educ Behav Offic Publ Soc Publ Health Educ 2001, 28(2):231-248.
• [43]Dzewaltowski DA, Glasgow RE, Klesges LM, Estabrooks PA, Brock E: RE-AIM: evidence-based standards and a Web resource to improve translation of research into practice. Ann Behav Med Publ Soc Behav Med 2004, 28(2):75-80.
• [44]Mukoma W, Flisher AJ, Ahmed N, Jansen S, Mathews C, Klepp KI, Schaalma H: Process evaluation of a school-based HIV/AIDS intervention in South Africa. Scand J Publ Health 2009, 37(Suppl 2):37-47.
• [45]Perrin KM, Burke SG, O'Connor D, Walby G, Shippey C, Pitt S, McDermott RJ, Forthofer MS: Factors contributing to intervention fidelity in a multi-site chronic disease self-management program. Implement Sci IS 2006, 1:26. BioMed Central Full Text
• [46]Card JJ, Solomon J, Cunningham SD: How to adapt effective programs for use in new contexts. Heal Promot Pract 2011, 12(1):25-35.
• [47]Cuijpers P, de Graaf I, Bohlmeijer E: Adapting and disseminating effective public health interventions in another country: towards a systematic approach. Eur J Publ Health 2005, 15(2):166-169.
• [48]Frijling B, Hulscher ME, van Leest LA, Braspenning JC, Van den Hoogen H, Drenthen AJ, Grol RP: Multifaceted support to improve preventive cardiovascular care: a nationwide, controlled trial in general practice. Br J Gen Pract J R Coll Gen Pract 2003, 53(497):934-941.
• [49]Blackstock F, Webster K: Disease-specific health education for COPD: a systematic review of changes in health outcomes. Heal Educ Res 2007, 22(5):703-717.
• [50]Gray D, Saggers S, Sputore B, Bourbon D: What works? A review of evaluated alcohol misuse interventions among aboriginal Australians. Addiction 2000, 95(1):11-22. Abingdon, England
• [51]Nielsen A, Korzen S, Holm L: Inverting the food pyramid? Social and cultural acceptability of Walter Willett's dietary recommendations among people with weight concerns. Appetite 2008, 51(1):178-186.
• [52]Hautmann C, Hanisch C, Mayer I, Pluck J, Dopfner M: Effectiveness of the prevention program for externalizing problem behaviour (PEP) in children with symptoms of attention-deficit/hyperactivity disorder and oppositional defiant disorder--generalization to the real world. J Neural Trans 2008, 115(2):363-370. Vienna, Austria : 1996
• [53]Lorig KR, Hurwicz ML, Sobel D, Hobbs M, Ritter PL: A national dissemination of an evidence-based self-management program: a process evaluation study. Patient Educ Counsel 2005, 59(1):69-79.
• [54]Dzewaltowski DA, Estabrooks PA, Glasgow RE: The future of physical activity behavior change research: what is needed to improve translation of research into health promotion practice? Exerc Sport Sci Rev 2004, 32(2):57-63.
• [55]Glasgow RE, Klesges LM, Dzewaltowski DA, Estabrooks PA, Vogt TM: Evaluating the impact of health promotion programs: using the RE-AIM framework to form summary measures for decision making involving complex issues. Heal Educ Res 2006, 21(5):688-694.
• [56]Heller RF, Verma A, Gemmell I, Harrison R, Hart J, Edwards R: Critical appraisal for public health: a new checklist. Publ Health 2008, 122(1):92-98.
• [57]Festinger L, Riecken HW, Schachter S: L'échec d'une prophétie: psychologie sociale d'un groupe de fidèles qui prédisaient la fin du monde. Presses Universitaires de France, France; 1993.
• [58]Prochaska JO, DiClemente CC: Stages of change in the modification of problem behaviors. Prog Behav Modif 1992, 28:183-218.
• [59]Thorogood ME, Coombes Y: Evaluating health promotion : practice and methods, vol. 3rd edition. Oxford University Press, Oxford; 2010.
• [60]Green LW, Glasgow RE, Atkins D, Stange K: Making evidence from research more relevant, useful, and actionable in policy, program planning, and practice slips "twixt cup and lip". Am J Prev Med 2009, 37(6 Suppl 1):S187-S191.
• [61]: Generalizability and Transferability. . http://writing.colostate.edu/guides/research/gentrans/ webcite
• [62]Walker DG, Teerawattananon Y, Anderson R, Richardson G: Generalisability, Transferability, Complexity and Relevance. In Evidence-Based Decisions and Economics. Wiley-Blackwell, ; 2010:56-66.
• [63]Pawson R, Tilley N: Realistic Evaluation. Sage Publications Ltd, ; 1997.
• [64]Glenton C, Lewin S, Scheel IB: Still too little qualitative research to shed light on results from reviews of effectiveness trials: A case study of a Cochrane review on the use of lay health workers. Implement Sci IS 2011, 6:53. BioMed Central Full Text
• [65]Guevel MR, Pommier J: Mixed methods research in public health: issues and illustration. Santé Publique 2012, 24(1):23-28.
• [66]Walach H, Falkenberg T, Fonnebo V, Lewith G, Jonas W: Circular instead of hierarchical: methodological principles for the evaluation of complex interventions. BMC Med Res Method 2006, 6(1):29. BioMed Central Full Text
• [67]Oakley A, Strange V, Bonell C, Allen E, Stephenson J: Process evaluation in randomised controlled trials of complex interventions. BMJ Clin Res ed 2006, 332(7538):413-416.
• [68]Green LW, Kreuter MW: Health Promotion Planning: An Educational and Environmental Approach. 2nd edition. Mayfield Publishing Compagny, London; 1991.
• [69]Ferguson L: External validity, generalizability, and knowledge utilization. J Nurs Scholarship Offic Publ Sigma Theta Tau Int Honor Soc Nurs Sigma Theta Tau 2004, 36(1):16-22.
• [70]Campbell NC, Murray E, Darbyshire J, Emery J, Farmer A, Griffiths F, Guthrie B, Lester H, Wilson P, Kinmonth AL: Designing and evaluating complex interventions to improve health care. BMJ Clin Res ed 2007, 334(7591):455-459.