社区医疗成果干预评估的项目扩展:研究方法范围综述。

IF 1.6 4区 教育学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Journal of Continuing Education in the Health Professions Pub Date : 2024-08-14 DOI:10.1097/CEH.0000000000000572
Jennifer Maizel, Stephanie L Filipp, Gaia Zori, Sandhya Yadav, Kishan Avaiya, Lauren Figg, Melanie Hechavarria, Xanadu Roque, Claudia Anez-Zabala, Rayhan Lal, Ananta Addala, Michael J Haller, David M Maahs, Ashby F Walker
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引用次数: 0

摘要

导言:自 2003 年启动以来,"社区医疗保健成果推广项目"(ECHO)远程教育模式已通过在超过 180 个国家开展干预活动,为患者、医疗服务提供者和医疗中心提供并改善了医疗成果。最近,由于 COVID-19 的流行以及对远程教育的更高需求,这一模式的使用率有所上升。然而,用于评估 ECHO 项目干预措施的方法的研究却很有限:我们进行了一次范围审查,以确定用于评估 "人道项目 "干预措施的成果和实施成功与否的研究方法的范围和类型,并找出差距和未来调查的机会。利用 Arksey 和 O'Malley 的范围界定综述框架和 PRISMA-ScR 核对表,我们对 121 篇评估 "人道项目 "干预措施的文章中的研究设计、时间性、分析方法、数据来源以及数据水平和类型进行了综述:大多数干预措施涉及药物使用障碍(24.8%,n = 30)、传染病(24%,n = 29)、精神和行为健康状况(21.5%,n = 26)以及慢性病(19%,n = 23)。最常报告的评估方法包括队列研究(86.8%,n = 105)、纵向设计(74.4%,n = 90)、混合方法分析(52.1%,n = 63)、调查(61.2%,n = 74)、过程评估措施(98.3%,n = 119)和提供者层面的结果测量(84.3%,n = 102)。使用实验设计(1.7%,n = 2)、随机化(5.8%,n = 7)或对比组(14%,n = 17)的评价很少,表明其严谨性有限:本范围界定综述表明,有必要采用更严格的评估方法来检验 "人道项目 "模式在改善结果方面的有效性,并制定标准化报告指南,以加强 "人道项目 "未来干预措施评估数据的传播。
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Project Extension for Community Healthcare Outcomes Intervention Evaluations: A Scoping Review of Research Methods.

Introduction: Since its inception in 2003, the Project Extension for Community Healthcare Outcomes (ECHO) tele-education model has reached and improved outcomes for patients, providers, and health centers through interventions in >180 countries. Utilization of this model has recently increased due to the COVID-19 pandemic and a higher demand for remote education. However, limited research has examined the methodologies used to evaluate Project ECHO interventions.

Methods: We conducted a scoping review to determine the extent and types of research methods used to evaluate outcomes and implementation success of Project ECHO interventions and to identify gaps and opportunities for future investigation. Using Arksey and O'Malley's scoping review framework and the PRISMA-ScR checklist, we reviewed study designs, temporality, analysis methods, data sources, and levels and types of data in 121 articles evaluating Project ECHO interventions.

Results: Most interventions addressed substance use disorders (24.8%, n = 30), infectious diseases (24%, n = 29), psychiatric and behavioral health conditions (21.5%, n = 26), and chronic diseases (19%, n = 23). The most frequently reported evaluation methods included cohort studies (86.8%, n = 105), longitudinal designs (74.4%, n = 90), mixed methods analysis (52.1%, n = 63), surveys (61.2%, n = 74), process evaluation measures (98.3%, n = 119), and provider-level outcome measures (84.3%, n = 102). Few evaluations used experimental designs (1.7%, n = 2), randomization (5.8%, n = 7), or comparison groups (14%, n = 17), indicating limited rigor.

Discussion: This scoping review demonstrates the need for more rigorous evaluation methods to test the effectiveness of the Project ECHO model at improving outcomes and standardized reporting guidelines to enhance the dissemination of evaluation data from future Project ECHO interventions.

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来源期刊
CiteScore
3.00
自引率
16.70%
发文量
85
审稿时长
>12 weeks
期刊介绍: The Journal of Continuing Education is a quarterly journal publishing articles relevant to theory, practice, and policy development for continuing education in the health sciences. The journal presents original research and essays on subjects involving the lifelong learning of professionals, with a focus on continuous quality improvement, competency assessment, and knowledge translation. It provides thoughtful advice to those who develop, conduct, and evaluate continuing education programs.
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