Comparing variations in implementation processes and influences across multiple sites: What works, for whom, and how?

PSYCHIATRY RESEARCH

卷:283

Review

Kim, Bo^1,2  Sullivan, Jennifer L.^1,3  Ritchie, Mona J.^4,5  Connolly, Samantha L.^1,2  Drummond, Karen L.^4,5  Miller, Christopher J.^1,2  Greenan, M. Alexis¹  Bauer, Mark S.^1,2 

[1] VA Boston Healthcare Syst, Ctr Healthcare Org & Implementat Res, 150 South Huntington Ave, Boston, MA 02130 USA

[2] Harvard Med Sch, Dept Psychiat, Boston, MA 02115 USA

[3] Boston Univ, Sch Publ Hlth, Dept Hlth Law Policy & Management, Boston, MA USA

[4] Cent Arkansas Vet Healthcare Syst, North Little Rock, AR USA

[5] Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA

关键词: Research methodology;    Data collection methods;    Empirical research;    Outcome and process assessment;    Health plan implementation;    Randomized controlled trial;   

DOI  :  10.1016/j.psychres.2019.112520

来源: Elsevier

【 摘 要 】

Traditional analyses and interpretation of controlled trials rely on measures of central tendency (e.g., mean findings for treatment versus control) to detect treatment effects. These trial designs therefore emphasize homogeneity of results, with variations within the experimental or control groups treated as error to be controlled for or ignored. For implementation trials, however, heterogeneity of results is an expected result to be explored rather than an imperfection to be minimized. Thus, many implementation trials seek to understand not only Does it work? but also What works, for whom, and how? Hence, mixed quantitative-qualitative methods that can capitalize on heterogeneity are needed to (i) comprehensively identify factors that influence the implementation process and (ii) understand their impact on implementation outcomes. This paper outlines the matrixed multiple case study approach, which allows for understanding how these processes and influences similarly or differently interact with outcomes across multiple implementation sites. We provide an example of this approach using data from a multi-site trial that tested the implementation of the evidence-based Collaborative Chronic Care Model at nine US Department of Veterans Affairs medical centers.

【 授权许可】

Free