Hongtu Chen, Komatra Chuengsatiansup, Dylan R Wong, Siranee Sihapark, Thawatchai Krisanaprakornkit, Bussabong Wisetpholchai, Sirinart Tongsiri, Ladson Hinton, Dolores Gallagher-Thompson, Abraham Wandersman, Andrea H Marques, Andrea Lamont, Sue E Levkoff
{"title":"评论:加强卫生干预措施的系统准备:中低收入国家实施干预措施和实施支持的经验教训。","authors":"Hongtu Chen, Komatra Chuengsatiansup, Dylan R Wong, Siranee Sihapark, Thawatchai Krisanaprakornkit, Bussabong Wisetpholchai, Sirinart Tongsiri, Ladson Hinton, Dolores Gallagher-Thompson, Abraham Wandersman, Andrea H Marques, Andrea Lamont, Sue E Levkoff","doi":"10.1177/01632787241295322","DOIUrl":null,"url":null,"abstract":"<p><p>In low- and middle-income countries (LMICs), barriers such as low system readiness, contextual mismatches, and resource limitations impede effective implementation of evidence-based interventions. This commentary offers insights into overcoming these challenges with a case study of the PRISM project, designed to reduce behavioral and psychological symptoms of dementia in older adults living in Thailand. The case highlights how combining two evidence-based models - the <i>Reducing Disability in Alzheimer's Disease</i> clinical intervention and the <i>Getting To Outcomes</i> implementation science process enhances program success. Using interviews with stakeholders across various health system levels, we identify factors critical to successful program implementation: (1) integrating interventions into policy frameworks, (2) empowering local implementers, (3) fostering collaborative learning, and (4) adapting interventions to local contexts. The case demonstrates that building system readiness through local engagement and ownership is central to scaling up health programs in LMICs. This commentary's contribution lies in its emphasis on the role of implementation science as a vehicle for translating research into practice. It presents a practical, adaptive model for embedding interventions into routine health systems, thereby offering a pathway for successfully scaling up evidence-based programs in LMICs. 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Commentary: Strengthening System Readiness for Health Interventions: Lessons for Implementing Interventions and Implementation Support in Low-And Middle-Income Countries.
In low- and middle-income countries (LMICs), barriers such as low system readiness, contextual mismatches, and resource limitations impede effective implementation of evidence-based interventions. This commentary offers insights into overcoming these challenges with a case study of the PRISM project, designed to reduce behavioral and psychological symptoms of dementia in older adults living in Thailand. The case highlights how combining two evidence-based models - the Reducing Disability in Alzheimer's Disease clinical intervention and the Getting To Outcomes implementation science process enhances program success. Using interviews with stakeholders across various health system levels, we identify factors critical to successful program implementation: (1) integrating interventions into policy frameworks, (2) empowering local implementers, (3) fostering collaborative learning, and (4) adapting interventions to local contexts. The case demonstrates that building system readiness through local engagement and ownership is central to scaling up health programs in LMICs. This commentary's contribution lies in its emphasis on the role of implementation science as a vehicle for translating research into practice. It presents a practical, adaptive model for embedding interventions into routine health systems, thereby offering a pathway for successfully scaling up evidence-based programs in LMICs. Such findings provide lessons for overcoming barriers to implementation in resource-limited environments.
期刊介绍:
Evaluation & the Health Professions is a peer-reviewed, quarterly journal that provides health-related professionals with state-of-the-art methodological, measurement, and statistical tools for conceptualizing the etiology of health promotion and problems, and developing, implementing, and evaluating health programs, teaching and training services, and products that pertain to a myriad of health dimensions. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 31 days