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首页> 外文期刊>Journal of child psychology and psychiatry >Annual Research Review: The state of implementation science in child psychology and psychiatry: a review and suggestions to advance the field
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Annual Research Review: The state of implementation science in child psychology and psychiatry: a review and suggestions to advance the field

机译：年度研究综述：儿童心理学和精神病学的实施科学状态：提升领域的审查和建议

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Background Scientists have developed evidence‐based interventions that improve the symptoms and functioning of youth with psychiatric disorders; however, these interventions are rarely used in community settings. Eliminating this research‐to‐practice gap is the purview of implementation science, the discipline devoted to the study of methods to promote the use of evidence‐based practices in routine care. Methods We review studies that have tested factors associated with implementation in child psychology and psychiatry, explore applications of social science theories to implementation, and conclude with recommendations to advance implementation science through the development and testing of novel, multilevel, causal theories. Results During its brief history, implementation science in child psychology and psychiatry has documented the implementation gap in routine care, tested training approaches and found them to be insufficient for behavior change, explored the relationships between variables and implementation outcomes, and initiated randomized controlled trials to test implementation strategies. This research has identified targets related to implementation (e.g., clinician motivation, organizational culture) and demonstrated the feasibility of activating these targets through implementation strategies. However, the dominant methodological approach has been atheoretical and predictive, relying heavily on a set of variables from heuristic frameworks. Conclusions Optimizing the implementation of effective treatments in community care for youth with psychiatric disorders is a defining challenge of our time. This review proposes a new direction focused on developing and testing integrated causal theories. We recommend implementation scientists: (a) move from observational studies of implementation barriers and facilitators to trials that include causal theory; (b) identify a core set of implementation determinants; (c) conduct trials of implementation strategies with clear targets, mechanisms, and outcomes; (d) ensure that behaviors that are core to EBP s are clearly defined; and (e) agree upon standard measures. This agenda will help fulfill the promise of evidence‐based practice for improving youth behavioral health.
机译：背景科学家制定了基于证据的干预措施，可改善青年与精神疾病的症状和运作;但是，这些干预措施很少用于社区设置。消除了这种研究 - 实践差距是实施科学的涵义视察，致力于研究方法促进使用循证护理的循证实践的研究。方法审查对儿童心理学和精神病学相关的有关的研究的研究，探讨了社会科学理论对实施的应用，并通过建议通过对新颖，多级，因果理论的开发和测试推进实施科学。结果在历史简史期间，儿童心理学和精神病学的实施科学已经记录了常规护理中的实施差距，测试培训方法，并发现它们不足以进行行为变革，探讨了变量与实施结果之间的关系，并开始了随机对照试验测试实施策略。该研究确定了与实施有关的目标（例如，临床医生动机，组织文化），并通过实施策略展示了激活这些目标的可行性。然而，主导的方法论方法是无所作为和预测的，依赖于启发式框架的一组变量。结论优化对青少年社区护理的有效治疗的实施是我们时间的定义挑战。本综述提出了新的方向，重点是开发和测试综合因果理论。我们建议实施科学家：（a）从实施障碍和促进者的观察研究转变为包括因果理论的试验; （b）确定一套实施决定因素; （c）以明确的目标，机制和结果进行实施策略的试验; （d）确保明确定义了核心核心的行为; （e）就标准措施同意。该议程将有助于履行基于证据的实践，以改善青年行为健康。

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