Abstract:
BACKGROUND:Improved quality of care is a policy objective of health care systems around the world. Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice, and hence to reduce inappropriate care. It includes the study of influences on healthcare professionals' behaviour and methods to enable them to use research findings more effectively. Cluster randomized trials represent the optimal design for evaluating the effectiveness of implementation strategies. Various codes of medical ethics, such as the Nuremberg Code and the Declaration of Helsinki inform medical research, but their relevance to cluster randomised trials in implementation research is unclear. This paper discusses the applicability of various ethical codes to obtaining consent in cluster trials in implementation research. DISCUSSION:The appropriate application of biomedical codes to implementation research is not obvious. Discussion of the nature and practice of informed consent in implementation research cluster trials must consider the levels at which consent can be sought, and for what purpose it can be sought. The level at which an intervention is delivered can render the idea of patient level consent meaningless. Careful consideration of the ownership of information, and rights of access to and exploitation of data is required. For health care professionals and organizations, there is a balance between clinical freedom and responsibility to participate in research. SUMMARY:While ethical justification for clinical trials relies heavily on individual consent, for implementation research aspects of distributive justice, economics, and political philosophy underlie the debate. Societies may need to trade off decisions on the choice between individualized consent and valid implementation research. We suggest that social sciences codes could usefully inform the consideration of implementation research by members of Research Ethics Committees.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Hutton JL,Eccles MP,Grimshaw JMdoi
10.1186/1748-5908-3-52subject
Has Abstractpub_date
2008-12-17 00:00:00pages
52issn
1748-5908pii
1748-5908-3-52journal_volume
3pub_type
杂志文章abstract:BACKGROUND:Priority setting for artemisinin-based antimalarial drugs has become an integral part of malaria treatment policy change in malaria-endemic countries. Although these drugs are more efficacious, they are also more costly than the failing drugs. When Tanzania changed its National Malaria Treatment Policy in 20...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-18
更新日期:2012-03-18 00:00:00
abstract:BACKGROUND:To improve hypertension care for ethnic minority patients of African descent in the Netherlands, we developed a provider intervention to facilitate the delivery of culturally appropriate hypertension education. This pilot study evaluates how the intervention affected the attitudes and perceived competence of...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-35
更新日期:2010-05-14 00:00:00
abstract:BACKGROUND:A large and compelling clinical evidence base has shown that integrated TB and HIV services leads to reduction in human immunodeficiency virus (HIV)- and tuberculosis (TB)-associated mortality and morbidity. Despite official policies and guidelines recommending TB and HIV care integration, its poor implement...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-017-0661-1
更新日期:2017-11-13 00:00:00
abstract:BACKGROUND:Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-101
更新日期:2011-09-03 00:00:00
abstract:BACKGROUND:In Belgium, the construction of the national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, healthcare providers, Evidence-Based Medicine (EBM) partners, and vend...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-8-83
更新日期:2013-08-05 00:00:00
abstract:BACKGROUND:CAREX Canada has identified solar ultraviolet radiation (UV) as the second most prominent carcinogenic exposure in Canada, and over 75 % of Canadian outdoor workers fall within the highest exposure category. Heat stress also presents an important public health issue, particularly for outdoor workers. The mos...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0277-2
更新日期:2015-07-10 00:00:00
abstract:BACKGROUND:In addition to their more traditional clinical role, midwives are expected to perform various health promotion practice behaviours (HePPBes) such as informing pregnant women about the benefits of physical activity during pregnancy and asking women about their alcohol consumption. There is evidence to suggest...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-019-0913-3
更新日期:2019-06-18 00:00:00
abstract:: Delirium occurs in up to 65% of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive interventions can lower delirium rates. The objective of this study was to implement and evaluate the effectiveness of ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-81
更新日期:2010-10-22 00:00:00
abstract:BACKGROUND:Use of direct oral anticoagulants (DOAC) is rapidly growing for treatment of atrial fibrillation and venous thromboembolism. However, incorrect dosing of these medications is common and puts patients at risk of adverse drug events. One way to improve safe prescribing is the use of population health tools, in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01044-5
更新日期:2020-09-21 00:00:00
abstract:BACKGROUND:Services to treat tobacco dependence are not readily available to smokers in low-middle income countries (LMICs) where smoking prevalence remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of two strategies for implementing tobacco use treatment guidelines in 26...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0558-z
更新日期:2017-02-28 00:00:00
abstract:BACKGROUND:Healthcare systems are not well designed to help people maintain or improve their health. They are generally not person-focused or well-coordinated. The objective of this study is to evaluate the effectiveness of the Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) approach ...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-016-0407-5
更新日期:2016-04-05 00:00:00
abstract:BACKGROUND:With the current funding climate and need for advancements in implementation science, there is a growing demand for grantsmanship workshops to increase the quality and rigor of proposals. A group-based implementation science-focused grantsmanship workshop, the Implementation Development Workshop (IDW), is on...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-016-0429-z
更新日期:2016-05-06 00:00:00
abstract:BACKGROUND:Like in many settings, implementation of evidence-based practices often fall short in pediatric intensive care units (PICU). Very few prior studies have applied implementation science frameworks to understand how best to improve practices in this unique environment. We used the relatively new integrated Prom...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-021-01080-9
更新日期:2021-01-28 00:00:00
abstract:OBJECTIVE:To quantify the extent to which clinicians use clinically-efficacious decision aids as intended during implementation in practice and how fidelity to usage instructions correlates with shared decision making (SDM) outcomes. METHODS:Participant-level meta-analysis including six practice-based randomized contr...
journal_title:Implementation science : IS
pub_type: 杂志文章,meta分析
doi:10.1186/1748-5908-9-26
更新日期:2014-02-22 00:00:00
abstract:BACKGROUND:Implementation researchers have typically studied organizational culture and climate by testing whether individual dimensions are linked to the implementation of evidence-based practices (EBPs) rather than examining how the overarching social context influences implementation. This approach may limit impleme...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/s13012-019-0863-9
更新日期:2019-02-12 00:00:00
abstract:BACKGROUND:There is little information about the functions and behavior change techniques (BCTs) needed to implement shared decision making (SDM) in clinical practice. To guide future implementation initiatives, we sought to develop a BCT taxonomy for SDM implementation interventions. METHODS:This study is a secondary...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01015-w
更新日期:2020-08-20 00:00:00
abstract:BACKGROUND:An important gap exists between research production and its utilization. Few studies have examined the factors affecting knowledge utilization in the field of child and family social services. METHODS:The objectives of the study are to describe knowledge utilization by child protection administrators and pr...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-5-41
更新日期:2010-06-03 00:00:00
abstract:BACKGROUND:The ethical argument that shared decision-making is "the right" thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, ...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0480-9
更新日期:2016-08-08 00:00:00
abstract:BACKGROUND:The last year of life is one of the most resource-intensive periods for people with cancer. Very little population-based research has been conducted on end-of-life cancer care in the Australian health care setting. The objective of this program is to undertake a series of observational studies examining reso...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0148-2
更新日期:2015-02-26 00:00:00
abstract:BACKGROUND:The Department of Veterans Affairs (VA) has led the industry in measuring facility performance as a critical element in improving quality of care, investing substantial resources to develop and maintain valid and cost-effective measures. The External Peer Review Program (EPRP) of the VA is the official data ...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/1748-5908-7-45
更新日期:2012-05-18 00:00:00
abstract:BACKGROUND:Implementation of multifaceted interventions typically involves many diverse elements working together in interrelated ways, including intervention components, implementation strategies, and features of local context. Given this real-world complexity, implementation researchers may be interested in a new mat...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01070-3
更新日期:2020-12-11 00:00:00
abstract:BACKGROUND:The need to better understand processes of removing, reducing, or replacing healthcare services that are no longer deemed essential or effective is common across publicly funded healthcare systems. This paper explores expert international opinion regarding, first, the factors and processes that shape the suc...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0123-y
更新日期:2014-09-10 00:00:00
abstract:BACKGROUND:Counselling on health-related lifestyles is key to the prevention and management of chronic diseases. After comprehensive study of determinants of its delivery in general practice and strategies to improve, we composed a tailored improvement program, which included communication skills training, online patie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-016-0460-0
更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-19
更新日期:2008-04-09 00:00:00
abstract:BACKGROUND:Implementation of clinical research results is challenging, yet the responsibility for implementation is seldom addressed. The process from research to the use of clinical research results in health care can be facilitated by research funders. In this paper, we report the roles of ten Swedish research funder...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-015-0290-5
更新日期:2015-07-17 00:00:00
abstract:OBJECTIVE:Formative evaluation of the implementation process for a digitally supported intervention in polypharmacy in Germany. Qualitative research was conducted within a cluster randomized controlled trial (C-RCT). It focused on understanding how the intervention influences behavior-related outcomes in the prescripti...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01043-6
更新日期:2020-09-21 00:00:00
abstract::In 2004 a UK charity, The Health Foundation, established the 'Engaging with Quality Initiative' to explore and evaluate the benefits of engaging clinicians in quality improvement in healthcare. Eight projects run by professional bodies or specialist societies were commissioned in various areas of acute care. A develop...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-46
更新日期:2008-10-30 00:00:00
abstract::In October 2006, the Chief Medical Officer (CMO) of England asked Professor Sir John Tooke to chair a High Level Group on Clinical Effectiveness in response to the chapter 'Waste not, want not' in the CMOs 2005 annual report 'On the State of the Public Health'. The high level group made recommendations to the CMO to a...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/1748-5908-4-18
更新日期:2009-04-07 00:00:00
abstract:BACKGROUND:This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Pe...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-017-0553-4
更新日期:2017-02-23 00:00:00
abstract:BACKGROUND:Facilitation has been identified in the literature as a potentially key component of successful implementation. It has not, however, either been well-defined or well-studied. Significant questions remain about the operational definition of facilitation and about the relationship of facilitation to other inte...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-1-23
更新日期:2006-10-18 00:00:00