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Determinantes clave en los procesos de implementación: una revisión sistemática utilizando el Marco consolidado para
Marin Schmitt1, Maren Hawkins2, Paul Florsheim3
1Zilber College of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St., Milwaukee, WI, USA. marins@uwm.edu.
Implementation science communications
|August 22, 2025
Resumen
Esta revisión identificó ocho determinantes clave que influyen en la implementación del programa de salud. La comprensión de estos factores, como el compromiso del liderazgo y los recursos disponibles, puede mejorar las estrategias de implementación y los resultados.
Área de la Ciencia:
- Ciencias de la aplicación
- Investigación en servicios de salud
- Salud pública
Sus antecedentes:
- Los factores contextuales tienen un impacto significativo en la implementación de los programas de salud.
- Aunque se conocen muchos factores determinantes, su influencia relativa requiere un examen más detallado.
- El Marco Consolidado para la Investigación de Implementación (CFIR, por sus siglas en inglés) proporciona construcciones para evaluar los factores de implementación.
Objetivo del estudio:
- Revisar sistemáticamente los estudios que utilizaron el sistema de calificación de Damschroder y Lowery (2013).
- Identificar los determinantes clave de la aplicación en función de su impacto.
- Orientar el desarrollo de estrategias efectivas de implementación de programas de salud.
Principales métodos:
- La búsqueda de citas hacia adelante de artículos que citan a Damschroder & Lowery (2013) en PubMed, Web of Science y Google Scholar.
- Se incluyen artículos que examinan la magnitud y la valencia de los factores de aplicación.
- Evaluación de la calidad mediante la herramienta de evaluación de métodos mixtos (MMAT).
Principales resultados:
- Cuarenta y ocho artículos fueron incluidos en la revisión final.
- Se identificaron ocho determinantes clave: el compromiso del liderazgo, los líderes de implementación internos designados formalmente, la compatibilidad, los recursos disponibles, los agentes de cambio externos, los campeones, la ventaja relativa y las partes interesadas clave.
Conclusiones:
- La identificación de los determinantes clave puede mejorar el enfoque sistemático de la aplicación.
- Este conocimiento ayuda a los investigadores y profesionales a facilitar los esfuerzos de implementación exitosos.
- La cuantificación del impacto determinante, a pesar de la pérdida de matices, ofrece orientación práctica para mejorar los resultados de la aplicación.
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