An Analysis of National Institutes of Health-Funded Dissemination and Implementation Research in Low- and Middle-Income Countries.

Amina Chtourou, Elise M Garton, Gila Neta
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Abstract

Implementation science can inform healthcare delivery to improve outcomes in resource-constrained settings through tailored strategies. The National Institutes of Health funds implementation science largely through its Dissemination and Implementation Research in Health program. We analyzed the program's grants with collaborators in low- and middle-income countries to understand trends and gaps in National Institutes of Health-funded global implementation science research. Query-View-Report was used to identify grants awarded between fiscal years 2013-2022 with at least one collaborating institution in a low- and middle-income country. Two coders reviewed the abstract and specific aims to determine the intervention being studied, setting, implementer, implementation outcomes, strategies, frameworks, and study design. From fiscal years 2013-2022, 81 grants had collaborating institutions across 25 low- and middle-income countries in five World Bank-defined regions, funded by 11 National Institutes of Health institutes and centers. Most grants focused on cancer (n = 12), other non-communicable diseases (n = 16), and tuberculosis (n = 12). Common implementation outcomes included costs (n = 43), fidelity (n = 38), maintenance (n = 36), and adoption (n = 35). Commonly studied implementation strategies included assess for readiness and identify barriers and facilitators (n = 18), revise professional roles (n = 17), and change service sites (n = 15). Frequently reported frameworks were RE-AIM (n = 30), CFIR (n = 22), and EPIS (n = 8). Most grants tested implementation strategies using experimental study designs (n = 52) in healthcare settings (n = 56). The National Institutes of Health funds a range of implementation science grants with collaborators in low- and middle-income countries. This analysis helps identify commonly utilized implementation outcomes, strategies, and frameworks and enables exploration of gaps and opportunities for further global research.

低收入和中等收入国家国立卫生研究院资助的传播和实施研究分析。
实施科学可以为医疗保健服务提供信息,通过量身定制的战略改善资源受限环境下的结果。美国国立卫生研究院主要通过其卫生项目的传播和实施研究来资助实施科学。我们与低收入和中等收入国家的合作者分析了该计划的拨款情况,以了解美国国立卫生研究院资助的全球实施科学研究的趋势和差距。查询-查看-报告用于确定2013-2022财政年度与中低收入国家至少一个合作机构之间的赠款。两位编码员回顾了抽象和具体的目标,以确定正在研究的干预措施、设置、实施者、实施结果、策略、框架和研究设计。从2013-2022财政年度起,81笔赠款在世界银行确定的五个地区的25个低收入和中等收入国家的合作机构获得,由11个国立卫生研究院和中心提供资金。大多数赠款的重点是癌症(n = 12)、其他非传染性疾病(n = 16)和结核病(n = 12)。常见的实施结果包括成本(n = 43)、保真度(n = 38)、维护(n = 36)和采用(n = 35)。通常研究的实施策略包括评估准备情况、识别障碍和促进因素(n = 18)、修改专业角色(n = 17)和改变服务地点(n = 15)。经常报道的框架有RE-AIM (n = 30)、CFIR (n = 22)和EPIS (n = 8)。大多数赠款在医疗保健机构(n = 56)中使用实验研究设计(n = 52)测试实施策略。美国国立卫生研究院与低收入和中等收入国家的合作者共同资助一系列实施科学赠款。这一分析有助于确定常用的实施成果、战略和框架,并有助于探索进一步开展全球研究的差距和机会。
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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