政府资助的实施策略的明确性和一致性与更大的基于证据的实践覆盖率有关:混合方法比较案例研究
Matthew Lee1, Sarah B Hunter2, Baji Tumendemberel2
1Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA.
Implementation science : IS
|December 21, 2025
概括
为实施基于证据的实践 (EBP) 提供国家资金至关重要. 青少年社区强化方法 (A-CRA) 的高影响力州使用了特定的要求,并主动解决了障碍.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 政策分析 政策分析
背景情况:
- 关于实施基于证据的实践 (EBP) 的政策融资策略的经验研究有限.
- 国家政府的资金,比如来自SAMHSA的资金,越来越多地用于支持EBP对青少年物质使用的实施.
- 青少年社区强化方法 (A-CRA) 是一个在19个州实施的模范EBP.
研究的目的:
- 使用EPIS框架来解释A-CRA覆盖范围的州级变化.
- 确定改善EBP融资策略的政策影响.
- 了解国家资金如何影响EBP的扩大规模.
主要方法:
- 采用了一种解释性的顺序混合方法比较案例研究设计.
- 根据认证数据,各州根据A-CRA覆盖范围 (高,中,低) 进行分类.
- 来自采访和行政记录的定性数据被合成,以确定影响因素.
主要成果:
- 远程国家 (n=7) 与中等 (n=5) 和远程国家 (n=7) 相比,对A-CRA有更具体的实施要求.
- 积极解决实施障碍,例如提供商流动和领导力支持,与更大的A-CRA覆盖率相关联.
- 观察到一些异常情况,一些州尽管赠款活动的数量/质量较低,但仍取得了很高的覆盖率.
结论:
- 大规模的融资举措可以为EBP融资策略带来普遍化的教训.
- 通过检查现实世界的融资机制,以政策为重点的实施研究得到了推进.
- 调查结果为优化未来资金提供意义,以最大限度地提高EBP的覆盖范围和交付.
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