From Programs to Systems: Deploying Implementation Science and Practice for Sustained Real World Effectiveness in Services for Children and Families
| Autor: | Deborah Ghate |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Program evaluation
Adult Evidence-based practice Process management Adolescent Process (engineering) Child Health Services Context (language use) computer.software_genre 03 medical and health sciences 0302 clinical medicine Developmental and Educational Psychology Humans 0501 psychology and cognitive sciences 030212 general & internal medicine Set (psychology) Complex adaptive system Child Research 05 social sciences Clinical Psychology Software deployment Evidence-Based Practice Program Design Language Data mining Family Relations Psychology computer Delivery of Health Care 050104 developmental & child psychology Program Evaluation |
| Zdroj: | Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. 45(6) |
| ISSN: | 1537-4424 |
| Popis: | The transfer of knowledge of effective practice, especially into "usual care" settings, remains challenging. This article argues that to close this gap we need to recognize the particular challenges of whole-system improvement. We need to move beyond a limited focus on individual programs and experimental research on their effectiveness. The rapidly developing field of implementation science and practice (ISP) provides a particular lens and a set of important constructs that can helpfully accelerate progress. A review of selected key constructs and distinctive features of ISP, including recognizing invisible system infrastructure, co-construction involving active collaboration between stakeholders, and attention to active implementation, supports for providers beyond education and training. Key aspects of an implementation lens likely to be most helpful in sustaining effectiveness include assisting innovators to identify and accommodate the architecture of existing systems, understand the implementation process as a series of distinct but nonlinear stages, identify implementation outcomes as prerequisites for treatment outcomes, and analyse implementation challenges using frameworks of implementation drivers. In complex adaptive systems, how services are implemented may matter more than their specific content, and how services align and adapt to local context may determine their sustained usefulness. To improve implementation-relevant research, we need better process evaluation and cannot rely on experimental methods that do not capture complex systemic contexts. Deployment of an implementation lens may perhaps help to avoid future "rigor mortis," enabling more productively flexible and integrative approaches to both program design and evaluation. |
| Databáze: | OpenAIRE |
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