Résumés
Résumé
L’utilisation des Interventions Fondées sur les Preuves (IFP) est de plus en plus encouragée dans le domaine psychosocial, mais leur validation demeure controversée. La recherche sur les IFP est dominée par les études d’efficacité qui visent à tester les effets des interventions dans des conditions optimales. Cependant, les conclusions de ces études peuvent difficilement s’appliquer en pratique. La recherche d’efficacité doit être complétée par la recherche d’effectivité qui vise à tester les effets des interventions dans des conditions de la pratique courante (dans le « vrai monde »). Cet article vise à définir la recherche d’effectivité, à présenter ses principales stratégies de recherche et à dégager ses implications dans la validation des IFP. La recherche d’effectivité représente souvent un premier test de réalité pour une intervention survenant entre la recherche d’efficacité et le transfert éventuel de cette intervention de la recherche vers la pratique. Cette recherche exige un travail d’équilibriste entre des orientations méthodologiques contradictoires : maximiser la validité écologique, la validité externe et l’utilité pratique des résultats et, d’autre part, préserver un bon niveau de validité interne. Réussir cet équilibre permet de produire une preuve pertinente, applicable, généralisable, mais aussi robuste quant aux effets d’une intervention dans un contexte de pratique courante. La recherche d’effectivité est dorénavant incontournable et mérite d’être priorisée au Québec comme ailleurs.
Mots-clés :
- Efficacité,
- effectivité,
- interventions fondées sur les preuves,
- interventions factuelles,
- meilleures pratiques
Abstract
The use of evidence-based interventions is increasingly valued in the psychosocial domain, but their process of validation remains controversial. Research on evidence-based interventions has been dominated by efficacy trials, which aim to test the effects of interventions under optimal conditions. However, conclusions from these studies may be difficult to translate in ordinary clinical practice. It is increasingly recognized that efficacy trials should be complemented by effectiveness trials, which aim to test the effects of interventions under real-world conditions. Effectiveness research now occupies an important place in the international scientific literature, but this type of research still has limited visibility in the francophone literature in Quebec and around the world. The aims of this article are to define effectiveness research, to present its main methods, and to highlight its implications for the validation and definition of evidence-based interventions. Effectiveness research often represents the first ‘reality check’ for an intervention occurring between efficacy research and dissemination or implementation research. This research involves attempting to find a balance between contradictory methodological orientations: to maximize ecological validity, external validity, and practical utility on one side and to preserve internal validity on the other. Through this balance, effectiveness research has the potential to produce evidence that is relevant, applicable, and generalizable, yet also robust. Effectiveness research is increasingly playing a key role in the validation of evidence-based interventions and should become a priority in Quebec.
Keywords:
- Efficacy,
- effectiveness,
- randomized-controlled trials,
- evidence-based interventions,
- evidence-based practice,
- best practices,
- practice guidelines
Parties annexes
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