The promise of adaptation and adaptive designs in implementation science has been hindered by the lack of clarity and precision in defining what it means to adapt, especially regarding the distinction between adaptive study designs and adaptive implementation strategies. To ensure a common language for science and practice, authors reviewed the implementation science literature and found that the term adaptive was used to describe interventions, implementation strategies, and trial designs. To provide clarity and offer recommendations for reporting and strengthening study design, we propose a taxonomy that describes fixed versus adaptive implementation strategies and implementation trial designs. To improve impact, ( a) future implementation studies should prespecify implementation strategy core functions that in turn can be taught to and replicated by health system/community partners, ( b) funders should support exploratory studies that refine and specify implementation strategies, and ( c) investigators should systematically address design requirements and ethical considerations (e.g., randomization, blinding/masking) with health system/community partners.Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

中文翻译：

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实施科学与实践中的自适应设计：它们的前景以及加深理解和改进沟通的需要

由于在定义适应的含义方面缺乏清晰度和精确性，特别是在适应性研究设计和适应性实施策略之间的区别方面，适应性和适应性设计在实施科学中的前景受到了阻碍。为了确保科学和实践的共同语言，作者回顾了实施科学文献，发现适应性一词用于描述干预措施、实施策略和试验设计。为了提供清晰度并为报告和加强研究设计提供建议，我们提出了一种分类法，描述固定与适应性实施策略和实施试验设计。为了提高影响力，(a) 未来的实施研究应预先规定实施战略的核心功能，而这些功能又可以向卫生系统/社区合作伙伴传授和复制，(b) 资助者应支持探索性研究，以完善和明确实施战略，以及 (c) ）研究人员应与卫生系统/社区合作伙伴系统地解决设计要求和伦理考虑（例如随机化、盲法/掩蔽）。《公共卫生年度审查》第 45 卷的预计最终在线发布日期为 2024 年 4 月。请参阅 http:// /www.annualreviews.org/page/journal/pubdates 了解修订后的估计。