While ‘dose’ is broadly understood as the ‘amount’ of an intervention, there is considerable variation in how this concept is defined. How we conceptualise, and subsequently measure, the dose of interventions has important implications for understanding how interventions produce their effects and are subsequently resourced and scaled up. This paper aims to explore the degree to which dose is currently understood as a distinct and well-defined implementation concept outside of clinical settings. We searched four databases (MEDLINE, PsycINFO, EBM Reviews and Global Health) to identify original research articles published between 2000 and 2015 on health promotion interventions that contained the word ‘dose’ or ‘dosage’ in the title, abstract or keywords. We identified 130 articles meeting inclusion criteria and extracted data on how dose/dosage was defined and operationalised, which we then synthesised to reveal key themes in the use of this concept across health promotion interventions. Dose was defined in a variety of ways, including in relation to the amount of intervention delivered and/or received, the level of participation in the intervention and, in some instances, the quality of intervention delivery. We also observed some conflation of concepts that are traditionally kept separate (such as fidelity) either as slippage or as part of composite measures (such as ‘intervention dose’). Dose is not a well-defined or consistently applied concept in evaluations of health promotion interventions. While current approaches to conceptualisation and measurement of dose are suitable for interventions in organisational settings, they are less well suited to policies delivered at a population level. Dose often accompanies a traditional monotonic linear view of causality (e.g. dose response) which may or may not fully represent the intervention’s theory of how change is brought about. Finally, we found dose and dosage to be used interchangeably. We recommend a distinction between these terms, with ‘dosage’ having the advantage of capturing change to amount ‘dispensed’ over time (in response to effects achieved). Dosage therefore acknowledges the inevitable dynamic and complexity of implementation.

中文翻译：

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实施健康促进干预措施中的剂量可操作性变化：范围界定审查中的见解和建议

虽然“剂量”被广泛理解为干预的“量”，但在定义这一概念的方式上却有很大的不同。我们如何概念化并随后衡量干预的剂量，对于理解干预如何产生效果并随后获得资源和扩大规模具有重要意义。本文旨在探讨目前在临床环境之外将剂量理解为独特且定义明确的实施概念的程度。我们搜索了四个数据库（MEDLINE，PsycINFO，EBM评论和全球健康），以识别2000年至2015年之间发表的有关健康促进干预措施的原创研究文章，这些研究文章的标题，摘要或关键字中包含“剂量”或“剂量”一词。我们确定了130篇符合入选标准的文章，并提取了有关剂量/剂量的定义和操作方法的数据，然后将其合成以揭示在整个健康促进干预措施中使用该概念的关键主题。剂量的确定方式多种多样，包括与所提供和/或接受的干预措施的数量，干预措施的参与程度以及在某些情况下干预措施的质量有关。我们还观察到一些概念的混淆，这些概念传统上是分开的（例如保真度），既可以作为滑动也可以作为综合措施的一部分（例如“干预剂量”）。在评估健康促进干预措施时，剂量不是一个定义明确或始终如一的概念。尽管当前的概念化和剂量测量方法适合于组织环境中的干预措施，但它们不太适合于在人群一级实施的政策。剂量通常伴随着因果关系的传统单调线性视图（例如剂量响应），它可能会也可能不会完全代表干预如何产生变化的理论。最后，我们发现剂量和剂量可以互换使用。我们建议在这些术语之间进行区分，“剂量”的优势在于可以随时间（响应所实现的效果）而捕获“已分配”量的变化。因此，剂量确认了实现过程不可避免的动态性和复杂性。剂量通常伴随着因果关系的传统单调线性视图（例如剂量响应），它可能会也可能不会完全代表干预如何产生变化的理论。最后，我们发现剂量和剂量可以互换使用。我们建议在这些术语之间进行区分，“剂量”的优势在于可以随时间（响应所实现的效果）而捕获“已分配”量的变化。因此，剂量确认了实现过程不可避免的动态性和复杂性。剂量通常伴随着因果关系的传统单调线性视图（例如剂量响应），它可能会也可能不会完全代表干预如何产生变化的理论。最后，我们发现剂量和剂量可以互换使用。我们建议在这些术语之间进行区分，“剂量”的优势在于可以随时间（响应所实现的效果）而捕获“已分配”量的变化。因此，剂量确认了实现过程不可避免的动态性和复杂性。“剂量”的优势在于可以捕获随时间变化的“已分配”量的变化（响应所实现的效果）。因此，剂量确认了实现过程不可避免的动态性和复杂性。“剂量”的优势在于可以捕获随时间变化的“已分配”量的变化（响应所实现的效果）。因此，剂量确认了实现过程不可避免的动态性和复杂性。