外部执行支助的变革机制:指导研究和实践的概念模型和案例。

Implementation research and practice Pub Date : 2023-06-21 eCollection Date: 2023-01-01 DOI:10.1177/26334895231179761
William A Aldridge, Rebecca H Roppolo, Jacquie Brown, Brian K Bumbarger, Renée I Boothroyd
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摘要

背景:外部实施支持是实施科学和实践的一个公认特征,通常以技术援助和实施便利等相关术语命名。现有的EIS模型在解决个人和组织层面的实践结果、将实践活动与预期结果联系起来或以公认的行为和组织变革理论为基础方面存在差距。此外,也有人呼吁澄清EIS影响相关结果的变化机制。方法:在这篇文章中,我们对EIS中的变化机制进行了理论化。我们的理论化过程与Kislov等人倡导的方法一致。我们的目标是巩固先前的EIS文献,结合先前经验和概念工作的相关结构,同时借鉴我们丰富的EIS经验,开发一种更高阶、中等阶的变化理论。结果:我们的变革理论在经验和实践上都是有根据的,在概念上处于一个既定的变革大理论中,并以八项实践原则和社会认知理论为指导。变革理论提出了10个核心实践组成部分作为EIS中的变革机制。当根据基本理论和原则使用时,它们被认为有助于在个人、团队、组织和系统层面取得有利的实践结果。该模型通过认识到对顺序支持过程的需求以及以动态和响应方式进行实践的需求,提供了灵活性。举例说明了该模式的主要主题和模式。结论:所提出的模型旨在通过概念化与近端和远端实践结果具有假设关系的可辨别实践成分来支持前瞻性EIS研究。该模型可以在行为上进行操作,以补充和扩展基于能力的实施支持从业者(ISP)培训和指导方法。随着时间的推移,该模型应根据新的经验发现和该领域互联网服务提供商的贡献进行改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Mechanisms of change in external implementation support: A conceptual model and case examples to guide research and practice.

Background: External implementation support (EIS) is a well-recognized feature of implementation science and practice, often under related terms such as technical assistance and implementation facilitation. Existing models of EIS have gaps related to addressing practice outcomes at both individual and organizational levels, connecting practice activities to intended outcomes, or grounding in well-established theories of behavior and organization change. Moreover, there have been calls to clarify the mechanisms of change through which EIS influences related outcomes.

Method: In this article, we theorize about mechanisms of change within EIS. Our theorizing process aligns with the approach advocated by Kislov et al. We aim to consolidate prior EIS literature, combining related constructs from previous empirical and conceptual work while drawing on our extensive EIS experience to develop a higher-order, midrange theory of change.

Results: Our theory of change is empirically and practically informed, conceptually situated within an established grand theory of change, and guided by eight practice principles and social cognitive theory. The theory of change proposes 10 core practice components as mechanisms of change within EIS. When used according to underlying theory and principles, they are believed to contribute to favorable practice outcomes at individual, team, organizational, and system levels. The model offers flexibility by recognizing the need for sequential support processes and the demand to practice in dynamic and responsive ways. Case examples are presented to illustrate major themes and patterns of the model in action.

Conclusions: The proposed model is intended to support prospective EIS studies by conceptualizing discernable practice components with hypothesized relationships to proximal and distal practice outcomes. The model can be behaviorally operationalized to compliment and extend competency-based approaches to implementation support practitioner (ISP) training and coaching. Over time, the model should be refined based on new empirical findings and contributions from ISPs across the field.

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