BACKGROUND Clinical practice guideline (CPG) activity has escalated internationally in the last 20 years, leading to increasingly sophisticated methods for CPG developers and implementers. Despite this, there remains a lack of practical support for end-users in terms of effectively and efficiently implementing CPG recommendations into local practice. This paper describes South African experiences in implementing international CPG recommendations for best practice stroke rehabilitation into local contexts, using a purpose-build approach. METHODS Composite recommendations were synthesised from 16 international CPGs to address end-user questions about best practice rehabilitation for South African stroke survivors. End-user representatives on the project team included methodologists, policy-makers, clinicians, managers, educators, researchers and stroke survivors. The Adopt-Contextualise-Adapt model was applied as a decision-guide to streamline discussions on endorsement and development of implementation strategies. Where recommendations required contextualisation to address local barriers before they could be effectively implemented, prompts were provided to identify barriers and possible solutions. Where recommendations could not be implemented without additional local evidence (adaptation), options were identified to establish new evidence. FINDINGS The structured implementation process was efficient in terms of time, effort, resources and problem solving. The process empowered the project team to make practical decisions about local uptake of international recommendations, develop local implementation strategies, and determine who was responsible, for what and when. Different implementation strategies for the same recommendation were identified for different settings, to address different barriers. CONCLUSION The South African evidence translation experience could be useful for evidence implementers in other countries, when translating CPG recommendations developed elsewhere, into local practice.

中文翻译：

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南非在将“采用情境适应框架”应用于中风康复临床实践指南中的经验。

背景技术在过去的20年中，临床实践指南（CPG）活动在国际上不断升级，从而为CPG开发人员和实施者带来了越来越复杂的方法。尽管如此，在有效和高效地将CPG建议落实到本地实践方面，仍然缺乏对最终用户的实际支持。本文介绍了南非在建立国际CPG建议方面的经验，该建议采用目的明确的方法，以在当地情况下将中风康复的最佳实践应用到当地。方法综合了16个国际CPG的综合建议，以解决最终用户有关南非卒中幸存者最佳实践康复的问题。项目团队的最终用户代表包括方法学家，政策制定者，临床医生，经理，教育工作者，研究人员和中风幸存者。采纳情境适应模型被用作决策指南，以简化关于认可和制定实施策略的讨论。如果建议需要根据背景情况进行处理，以解决当地的障碍，然后才能有效实施，则提示提供了确定障碍和可能解决方案的提示。如果没有额外的当地证据（适应）就无法实施建议，则可以找到建立新证据的备选方案。结果在时间，精力，资源和问题解决方面，结构化的实施过程是高效的。该流程使项目团队能够就本地采纳国际建议做出切实可行的决策，制定本地实施策略，并确定谁负责，何时何地负责。针对不同的环境确定了针对同一建议的不同实施策略，以解决不同的障碍。结论当将其他地方制定的CPG建议转化为当地实践时，南非证据翻译经验可能对其他国家的证据实施者有用。