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首页> 外文期刊>Prevention science: the official journal of the Society for Prevention Research >Adaptation and Fidelity: a Recipe Analogy for Achieving Both in Population Scale Implementation
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Adaptation and Fidelity: a Recipe Analogy for Achieving Both in Population Scale Implementation

机译：适应性和保真度：在人口规模实施中实现两者的食谱比喻

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Balancing adherence to fidelity of evidence-based programs and adaptation to local context is one of the key debates in the adoption and implementation of effective programs. Concern about maintaining fidelity to achieve outcomes can result in replication of research-based models that can be a poor fit with the real world. Equally, unplanned adaptation can result in program drift away from the core elements needed to achieve outcomes. To support implementation of the Maternal Early Childhood Sustained Home-visiting (MECSH) program in multiple sites in three countries, an analogy was developed to identify how both fidelity and adaptation can be managed and successfully achieved. This article presents the Commonsense Cookery Book Basic Plain Cake with Variations recipe analogy to articulate the dual requirements of both fidelity and adaptation to achieve quality implementation of the MECSH program. Components classified by the analogy include identification of core ingredients, methods, and equipment that contribute to fundamental outcomes and fidelity to the evidence-based program, and a planned, collaborative approach to identification of needed variations to suit locally sourced capacity, needs, and tastes. Quality is achieved by identifying and measuring the core ingredients and the variations. Sourcing local ingredients and honoring of context support sustainability of quality practice. Using this analogy has assisted adopters of the MECSH program to understand that effective implementation requires uncompromised commitment to expectations of fidelity to the core components and methods; planned, proactive adaptation; systematic monitoring of both core program and agreed variations; and local ownership and sustainability.
机译：在采用和实施有效的方案中，关键的辩论之一是在坚持遵守循证方案的忠诚度和适应当地情况之间取得平衡。对保持忠诚度以实现成果的担忧可能导致复制基于研究的模型，而该模型可能与现实世界不符。同样，计划外的适应可能导致计划偏离实现成果所需的核心要素。为了支持在三个国家/地区的多个地点实施孕产妇持续家庭访问（MECSH）计划，制定了一个比喻来确定如何管理和成功实现忠诚度和适应性。本文介绍了常识性烹饪书《带有变化的基本纯蛋糕》的食谱，以阐明保真度和适应性的双重要求，以实现MECSH计划的高质量实施。通过类比分类的成分包括：识别有助于基本结果和保真度的循证计划的核心成分，方法和设备，以及一种计划的协作方法，以识别所需的变化以适应本地采购的能力，需求和口味。通过识别和测量核心成分及其变化来实现质量。采购当地食材和尊重环境可以支持质量实践的可持续性。使用这种类比帮助MECSH计划的采用者了解有效的实施需要对核心组件和方法的保真度期望做出坚定的承诺;有计划的，主动的适应;对核心计划和商定的变化进行系统的监测;以及地方所有权和可持续性。

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