Article(id=1321169524922101865, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169495406785472, articleNumber=null, orderNo=null, doi=10.11847/zgggws1147908, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1746979200000, receivedDateStr=2025-05-12, revisedDate=1751731200000, revisedDateStr=2025-07-06, acceptedDate=1755014400000, acceptedDateStr=2025-08-13, onlineDate=1792920960883, onlineDateStr=2026-10-25, pubDate=1762704000000, pubDateStr=2025-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792920960883, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792920960883, creator=13701087609, updateTime=1792920960883, updator=13701087609, issue=Issue{id=1321169495406785472, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='11', pageStart='1281', pageEnd='1408', issueExtLink='null', onlineDate='null', pubDate='1762704000000', pubDateStr='2025-11-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792920953847, creator='13701087609', updateTime=1793011176900, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1321547918390178721, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169495406785472, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1321547918390178722, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169495406785472, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1386, endPage=1395, ext={EN=ArticleExt(id=1321169525169565802, articleId=1321169524922101865, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=A comparative analysis of funding structures, research themes, and development trends in implementation science funding projects in the health sector between China and the United States, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

This study aims to systematically review and compare the funding structures, research themes, and developmental trends of health-related implementation science projects funded by the National Natural Science Foundation of China (NSFC) and the United States National Institutes of Health (NIH). The findings will offer valuable insights for optimizing the strategic planning and funding policies of health-related scientific research in China.

Methods

With "implementation science" and "implementation research" as core keywords, relevant data on health-related implementation science funding projects from both NSFC and NIH were retrieved and screened from their official websites and various commercial databases, covering the period from January 1, 2000 to December 1, 2024. CiteSpace 6.1.2 R6 was then employed to conduct visualized analyses of theme clustering and temporal trends, enabling a comparative analysis of the funding structures, research themes, and developmental trends of these projects between China and the United States.

Results

A total of 39 NSFC-funded projects and 487 NIH-funded projects were included in the final analysis. Both China and the United States demonstrated a strong commitment to the strategic value of implementation science in transforming public health policies and healthcare delivery systems, consistently increasing financial investment in this area. However, significant differences were observed in their funding priorities. China primarily focused on mental health and psychological well-being, whereas the United States emphasized addressing major national or international multi-center public health challenges and supporting large-scale collaborative network research. Regarding research collaboration networks, the implementation science projects funded by NSFC were concentrated at Sun Yat-sen University and Peking University, while in the United States, the University of Washington, Johns Hopkins University, and Yale University ranked highest. High-frequency keyword analysis of implementation science funding projects revealed that China′s research themes concentrated on "implementation science," "multiphase optimization strategy," "implementation research," "empirical research," "effect evaluation," "community," "elderly," and "children." The United States focused on "implementation science," "research personnel," "public health," "evidence base," "scale up," "implementation strategy," and "AIDS prevention," with denser distribution of keyword hotspots. Analysis of developmental trends indicated that China′s research hotspots were relatively dispersed across the time dimension, exhibiting short-term and discontinuous characteristics. Conversely, the United States′ research hotspots showed significant centrality, with greater continuity and regularity in their thematic evolution.

Conclusions

Substantial disparities exist between China and the United States concerning the funding priorities, scale, and developmental trajectories of implementation science. China still needs to further strengthen its research mechanisms, inter-institutional collaboration, and methodological innovation in this domain.

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HU Linlin, E-mail:
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目的

系统梳理和比较国家自然科学基金委员会(NSFC)与美国国立卫生研究院(NIH)卫生领域资助项目在资助结构、研究主题和发展趋势上的异同,为未来中国实施卫生领域科学研究的合理布局和资助政策的完善提供借鉴。

方法

以“实施科学”和“实施性研究”为核心关键词,通过NSFC和NIH官方网站结合多元商业数据库检索并筛选2000年1月1日—2024年12月1日NSFC和NIH在卫生领域实施科学资助项目的相关数据;并应用CiteSpace 6.1.2 R6软件对主题聚类和时间轴趋势进行可视化分析,对中国和美国卫生领域资助项目资助结构、研究主题和发展趋势进行比较。

结果

最终纳入NSFC资助项目39项和NIH资助项目487项。研究发现,中国和美国均高度重视实施科学在公共卫生政策和健康服务体系转型中的战略价值并持续加大资金投入,但两国在资助重点上存在显著差异,中国主要聚焦于精神卫生与心理健康领域,而美国则更侧重于应对全国性或国际多中心重大公共卫生挑战或支持大规模协作网络研究;研究合作网络比较显示,中国实施科学领域的资助主要集中于中山大学和北京大学;而美国则以华盛顿大学(University of Washington)、约翰·霍普金斯大学(Johns Hopkins University)和耶鲁大学(Yale University)排名靠前;实施科学资助项目高频关键词分析结果显示,中国在研究主题上关注“实施科学”“多阶段优化策略”“实施性研究”“实证研究”“效果评价”“社区”“老年”和“儿童”等;而美国则聚焦于“implementation science”“research personnel”“public health”“evidence base”“scale up”“implementation strategy”和“AIDS prevention”等,且其关键词热点分布相对密集。发展趋势分析结果显示,中国的研究热点在时间维度上相对分散且呈短期、跳跃式的特征;而美国的研究热点则呈现出显著的中心性且在主题演进上更具连续性和规律性。

结论

中国和美国在实施科学资助重点、资助规模及发展路径上存在显著差异,我国在研究机制完善、跨机构协同以及方法创新方面仍需进一步加强。

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吴珍(2001—),硕士在读,研究方向:卫生政策;整合照护;医疗保障

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胡琳琳,E-mail:
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tableContent=null), ArticleFig(id=1321169535764377774, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169524922101865, language=CN, label=图7, caption=美国实施科学资助项目的关键词时间趋势图, figureFileSmall=dC+LlYvAdwm2L+ujs/8ncg==, figureFileBig=BDbHN2pQfBYdOjjx1YoMDA==, tableContent=null), ArticleFig(id=1321169535869235375, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169524922101865, language=EN, label=Tab.1, caption=

Top 10 most influential funding projects in implementation science in China and the United States

, figureFileSmall=null, figureFileBig=null, tableContent=
研究项目中国研究项目美国
机构名称资助金额/人民币机构名称资助金额/美元
基于队列的抑郁症规范化防治及管理的
实施性研究
中山大学5 000 000District of Columbia Center for
AIDS Research
George Washington
University
146 947 644
在资源匮乏地区预防重复自杀的社区干预的实施性
研究:我国宁夏回族自治区和加拿大努纳武特地区
上海市精神
卫生中心
5 000 000NIA AD/ADRD Health Care
Systems Research Collaboratory
Brown University61 051 116
强化基于评估的治疗对抑郁症的疗效(EMBED):
一项中加实施性合作研究
上海市精神
卫生中心
4 980 000A pragmatic trial of two strategies
for implementing an effective eHealth
HIV prevention program
Northwestern University
at Chicago
26 528 109
基于初级卫生保健系统的围生期抑郁的筛查与
管理
安徽医科
大学
4 600 000The DC Cohort: A Longitudinal
Population-Based Cohort Study of
People Living with HIV in
Washington, DC
George Washington
University
25 210 930
基于多阶段优化策略的儿童NAFLD体力活动
干预模式研究
首都医科
大学
570 000Center for Interdisciplinary
Research on AIDS
Yale University22 180 880
基于社会交换理论驱动MSM社群自主扩大HIV
检测覆盖面的实施科学研究
中山大学490 000Optimizing HIV prevention for
highly vulnerable methamphetamine-
using sexual minority men
Graduate School of Public
Health and Health Policy
21 833 058
协同护理模式下居家老年痴呆患者管理的
实施科学研究——基于多重方案随机序贯试验
四川大学480 000The University of Rochester′s
Clinical and Translational
Science Institute
University of Rochester20 173 999
实施科学视角下的儿童肥胖防控政策扩散机制
研究及“干预-实施型”综合行动策略构建
中国医科
大学
480 000The Florida Node Alliance of the
National Drug Abuse Treatment
Clinical Trials Network
University of Miami School
of Medicine
20 020 443
跨省异地就医直接结算政策对降低流动人口
住院经济负担的效果评价-基于中断时间序列研究
中山大学480 000ICAP Clinical Trials UnitColumbia University
Health Sciences
18 236 408
基于社区的糖尿病前期健康管理模式:
筛查工具、成本效果、实施策略
复旦大学450 000RURAL: Risk Underlying Rural
Areas Longitudinal Cohort Study
University of Texas Health
Science Center
14 735 573
), ArticleFig(id=1321169537458876592, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169524922101865, language=CN, label=表1, caption=

中国和美国实施科学领域前10名高影响力资助项目

, figureFileSmall=null, figureFileBig=null, tableContent=
研究项目中国研究项目美国
机构名称资助金额/人民币机构名称资助金额/美元
基于队列的抑郁症规范化防治及管理的
实施性研究
中山大学5 000 000District of Columbia Center for
AIDS Research
George Washington
University
146 947 644
在资源匮乏地区预防重复自杀的社区干预的实施性
研究:我国宁夏回族自治区和加拿大努纳武特地区
上海市精神
卫生中心
5 000 000NIA AD/ADRD Health Care
Systems Research Collaboratory
Brown University61 051 116
强化基于评估的治疗对抑郁症的疗效(EMBED):
一项中加实施性合作研究
上海市精神
卫生中心
4 980 000A pragmatic trial of two strategies
for implementing an effective eHealth
HIV prevention program
Northwestern University
at Chicago
26 528 109
基于初级卫生保健系统的围生期抑郁的筛查与
管理
安徽医科
大学
4 600 000The DC Cohort: A Longitudinal
Population-Based Cohort Study of
People Living with HIV in
Washington, DC
George Washington
University
25 210 930
基于多阶段优化策略的儿童NAFLD体力活动
干预模式研究
首都医科
大学
570 000Center for Interdisciplinary
Research on AIDS
Yale University22 180 880
基于社会交换理论驱动MSM社群自主扩大HIV
检测覆盖面的实施科学研究
中山大学490 000Optimizing HIV prevention for
highly vulnerable methamphetamine-
using sexual minority men
Graduate School of Public
Health and Health Policy
21 833 058
协同护理模式下居家老年痴呆患者管理的
实施科学研究——基于多重方案随机序贯试验
四川大学480 000The University of Rochester′s
Clinical and Translational
Science Institute
University of Rochester20 173 999
实施科学视角下的儿童肥胖防控政策扩散机制
研究及“干预-实施型”综合行动策略构建
中国医科
大学
480 000The Florida Node Alliance of the
National Drug Abuse Treatment
Clinical Trials Network
University of Miami School
of Medicine
20 020 443
跨省异地就医直接结算政策对降低流动人口
住院经济负担的效果评价-基于中断时间序列研究
中山大学480 000ICAP Clinical Trials UnitColumbia University
Health Sciences
18 236 408
基于社区的糖尿病前期健康管理模式:
筛查工具、成本效果、实施策略
复旦大学450 000RURAL: Risk Underlying Rural
Areas Longitudinal Cohort Study
University of Texas Health
Science Center
14 735 573
), ArticleFig(id=1321169537567928497, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169524922101865, language=EN, label=Tab.2, caption=

Distribution of influential research institutions receiving funding for implementation science in China and the United States

, figureFileSmall=null, figureFileBig=null, tableContent=
排名中国排名美国
研究机构受资助数量/项研究机构受资助数量/项
1中山大学5 1University of Washington73
2北京大学4 2Johns Hopkins University46
3四川大学3 3Yale University32
4上海市精神卫生中心2 4Northwestern University at Chicago31
4南方医科大学2 5Emory University30
4广州中医药大学2 6Columbia University Health Sciences25
4复旦大学2 7University of California, San Francisco15
5其他19所研究机构1 8Wake Forest University Health Sciences12
8University of North Carolina at Chapel Hill12
10University of Miami School of Medicine10
), ArticleFig(id=1321169537651814578, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169524922101865, language=CN, label=表2, caption=

中国和美国实施科学资助项目的高影响力研究机构分布

, figureFileSmall=null, figureFileBig=null, tableContent=
排名中国排名美国
研究机构受资助数量/项研究机构受资助数量/项
1中山大学5 1University of Washington73
2北京大学4 2Johns Hopkins University46
3四川大学3 3Yale University32
4上海市精神卫生中心2 4Northwestern University at Chicago31
4南方医科大学2 5Emory University30
4广州中医药大学2 6Columbia University Health Sciences25
4复旦大学2 7University of California, San Francisco15
5其他19所研究机构1 8Wake Forest University Health Sciences12
8University of North Carolina at Chapel Hill12
10University of Miami School of Medicine10
), ArticleFig(id=1321169537748283571, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169524922101865, language=EN, label=Tab.3, caption=

Top 20 most frequent keywords in funding projects of implementation science in China and the United States

, figureFileSmall=null, figureFileBig=null, tableContent=
排名中国排名美国
关键词频率/次关键词频率/次
1实施科学27 1implementation science353
2多阶段优化策略7 2research personnel214
3实施性研究5 3public health209
4实证研究3 4evidence base191
4效果评价3 5scale up117
4社区3 6implementation strategy115
4老年3 7AIDS prevention102
4儿童3 8implementation research99
9健康管理2 9health personnel94
9随机对照试验210evidence based intervention93
9抑郁症210health system93
9筛查212high risk88
9体力活动213united states86
9CFIR框架214pharmaceutical preparation81
9脑卒中患者215mental health79
9干预研究216focus groups77
9策略优化217primary outcome74
9干预模式218cessation of life72
9自杀风险219protocols documentation71
9实施策略219cost effectiveness71
), ArticleFig(id=1321169537844752564, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169524922101865, language=CN, label=表3, caption=

中国和美国实施科学资助项目前20个高频关键词分布

, figureFileSmall=null, figureFileBig=null, tableContent=
排名中国排名美国
关键词频率/次关键词频率/次
1实施科学27 1implementation science353
2多阶段优化策略7 2research personnel214
3实施性研究5 3public health209
4实证研究3 4evidence base191
4效果评价3 5scale up117
4社区3 6implementation strategy115
4老年3 7AIDS prevention102
4儿童3 8implementation research99
9健康管理2 9health personnel94
9随机对照试验210evidence based intervention93
9抑郁症210health system93
9筛查212high risk88
9体力活动213united states86
9CFIR框架214pharmaceutical preparation81
9脑卒中患者215mental health79
9干预研究216focus groups77
9策略优化217primary outcome74
9干预模式218cessation of life72
9自杀风险219protocols documentation71
9实施策略219cost effectiveness71
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中美卫生领域实施科学资助项目资助结构、研究主题和发展趋势比较
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吴珍 1 , 陈星宇 1, 2 , 胡琳琳 1, *, *
中国公共卫生 | 调查报告与分析 2025,41(11): 1386-1395
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中国公共卫生 |调查报告与分析 2025 , 41 (11) : 1386 -1395
中美卫生领域实施科学资助项目资助结构、研究主题和发展趋势比较
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吴珍1, 陈星宇1, 2, 胡琳琳1, *, *
作者信息
  • 1中国医学科学院 北京协和医学院卫生健康管理政策学院,北京 100730
  • 2中国人民大学人口与健康学院,北京 100872
通讯作者:
胡琳琳,E-mail:
作者简介:

吴珍(2001—),硕士在读,研究方向:卫生政策;整合照护;医疗保障

A comparative analysis of funding structures, research themes, and development trends in implementation science funding projects in the health sector between China and the United States
Zhen WU1, Xingyu CHEN1, 2, Linlin HU1
Affiliations
  • 1School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • 2School of Population and Heealth, Renmin University of China, Beijing 100872, China
  • Corresponding Author:
    HU Linlin, E-mail:
出版时间: 2025-11-10 doi: 10.11847/zgggws1147908
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目的

系统梳理和比较国家自然科学基金委员会(NSFC)与美国国立卫生研究院(NIH)卫生领域资助项目在资助结构、研究主题和发展趋势上的异同,为未来中国实施卫生领域科学研究的合理布局和资助政策的完善提供借鉴。

方法

以“实施科学”和“实施性研究”为核心关键词,通过NSFC和NIH官方网站结合多元商业数据库检索并筛选2000年1月1日—2024年12月1日NSFC和NIH在卫生领域实施科学资助项目的相关数据;并应用CiteSpace 6.1.2 R6软件对主题聚类和时间轴趋势进行可视化分析,对中国和美国卫生领域资助项目资助结构、研究主题和发展趋势进行比较。

结果

最终纳入NSFC资助项目39项和NIH资助项目487项。研究发现,中国和美国均高度重视实施科学在公共卫生政策和健康服务体系转型中的战略价值并持续加大资金投入,但两国在资助重点上存在显著差异,中国主要聚焦于精神卫生与心理健康领域,而美国则更侧重于应对全国性或国际多中心重大公共卫生挑战或支持大规模协作网络研究;研究合作网络比较显示,中国实施科学领域的资助主要集中于中山大学和北京大学;而美国则以华盛顿大学(University of Washington)、约翰·霍普金斯大学(Johns Hopkins University)和耶鲁大学(Yale University)排名靠前;实施科学资助项目高频关键词分析结果显示,中国在研究主题上关注“实施科学”“多阶段优化策略”“实施性研究”“实证研究”“效果评价”“社区”“老年”和“儿童”等;而美国则聚焦于“implementation science”“research personnel”“public health”“evidence base”“scale up”“implementation strategy”和“AIDS prevention”等,且其关键词热点分布相对密集。发展趋势分析结果显示,中国的研究热点在时间维度上相对分散且呈短期、跳跃式的特征;而美国的研究热点则呈现出显著的中心性且在主题演进上更具连续性和规律性。

结论

中国和美国在实施科学资助重点、资助规模及发展路径上存在显著差异,我国在研究机制完善、跨机构协同以及方法创新方面仍需进一步加强。

实施科学  /  资助项目  /  资助结构  /  研究主题  /  发展趋势  /  卫生领域  /  中国  /  美国
Objective

This study aims to systematically review and compare the funding structures, research themes, and developmental trends of health-related implementation science projects funded by the National Natural Science Foundation of China (NSFC) and the United States National Institutes of Health (NIH). The findings will offer valuable insights for optimizing the strategic planning and funding policies of health-related scientific research in China.

Methods

With "implementation science" and "implementation research" as core keywords, relevant data on health-related implementation science funding projects from both NSFC and NIH were retrieved and screened from their official websites and various commercial databases, covering the period from January 1, 2000 to December 1, 2024. CiteSpace 6.1.2 R6 was then employed to conduct visualized analyses of theme clustering and temporal trends, enabling a comparative analysis of the funding structures, research themes, and developmental trends of these projects between China and the United States.

Results

A total of 39 NSFC-funded projects and 487 NIH-funded projects were included in the final analysis. Both China and the United States demonstrated a strong commitment to the strategic value of implementation science in transforming public health policies and healthcare delivery systems, consistently increasing financial investment in this area. However, significant differences were observed in their funding priorities. China primarily focused on mental health and psychological well-being, whereas the United States emphasized addressing major national or international multi-center public health challenges and supporting large-scale collaborative network research. Regarding research collaboration networks, the implementation science projects funded by NSFC were concentrated at Sun Yat-sen University and Peking University, while in the United States, the University of Washington, Johns Hopkins University, and Yale University ranked highest. High-frequency keyword analysis of implementation science funding projects revealed that China′s research themes concentrated on "implementation science," "multiphase optimization strategy," "implementation research," "empirical research," "effect evaluation," "community," "elderly," and "children." The United States focused on "implementation science," "research personnel," "public health," "evidence base," "scale up," "implementation strategy," and "AIDS prevention," with denser distribution of keyword hotspots. Analysis of developmental trends indicated that China′s research hotspots were relatively dispersed across the time dimension, exhibiting short-term and discontinuous characteristics. Conversely, the United States′ research hotspots showed significant centrality, with greater continuity and regularity in their thematic evolution.

Conclusions

Substantial disparities exist between China and the United States concerning the funding priorities, scale, and developmental trajectories of implementation science. China still needs to further strengthen its research mechanisms, inter-institutional collaboration, and methodological innovation in this domain.

implementation science  /  funding projects  /  funding structure  /  research themes  /  developmental trends  /  health sector  /  China  /  the United States
吴珍, 陈星宇, 胡琳琳. 中美卫生领域实施科学资助项目资助结构、研究主题和发展趋势比较. 中国公共卫生, 2025 , 41 (11) : 1386 -1395 . DOI: 10.11847/zgggws1147908
Zhen WU, Xingyu CHEN, Linlin HU. A comparative analysis of funding structures, research themes, and development trends in implementation science funding projects in the health sector between China and the United States[J]. Chinese Journal of Public Health, 2025 , 41 (11) : 1386 -1395 . DOI: 10.11847/zgggws1147908
当前,循证实践(evidence-based practice, EBP)正面临着如何将高质量科学证据有效转化为实际应用的严峻挑战。研究表明,EBP成果从研发到临床应用的平均转化周期长达17~20年[1],其中创新型成果的实际转化率甚至不足50%[2];全球范围内约80%的医学研究投资未能带来显著的健康收益[3]。为有效应对这一困境,实施科学应运而生。作为一个新兴的跨学科领域,其致力于识别并克服证据转化中的障碍,从而提升干预措施在真实世界实践中的应用价值和系统性成效[4]。近年来,中国和美国在推动实施科学发展方面均投入了大量关注,但其发展路径和侧重点存在明显差异。美国已逐步迈入系统集成与复杂适应性策略的研究阶段,尤其强调机制创新与跨系统转化[5];而中国则正处于创新方法引进、本土经验总结与实践路径探索的快速发展时期。在此背景下,国家层面的科研资助成为构建和完善实施科学体系的关键驱动力。美国国立卫生研究院(National Institutes of Health, NIH)自2000年起设立了专门的实施科学相关资助计划,旨在加速研究成果的转化落地[6]。中国国家自然科学基金委员会(National Natural Science Foundation of China, NSFC)也于2017年起设立专项支持,以期推动中国实施科学领域的系统性发展[7]。为系统梳理和比较NSFC与NIH卫生领域资助项目在资助结构、研究主题和发展趋势上的异同,为未来中国实施卫生领域科学研究的合理布局和资助政策的完善提供借鉴,本研究以“实施科学”和“实施性研究”为核心关键词,通过NSFC和NIH官方网站并结合多元商业数据库检索筛选2000年1月1日—2024年12月1日NSFC和NIH在卫生领域实施科学资助项目的相关数据。应用CiteSpace 6.1.2 R6软件对主题聚类和时间轴趋势进行可视化分析;对中国和美国卫生领域资助项目资助结构、研究主题和发展趋势进行比较。结果报告如下。
通过NSFC官方网站(https://isisn.nsfc.gov.cn)和NIH官方网站(https://reporter.nih.gov)检索2000年1月1日—2024年12月1日中国和美国卫生领域实施科学资助项目的管理科学和公共卫生与预防医学领域相关数据,同时结合商业数据库(青塔自科云、Medpeer、Citexs、梅斯医学、Letpub)进行补充检索,末次检索日期为2024年12月1日。NSFC和NIH的检索中文关键词为“实施科学”或“实施性研究”,英文关键词为“implementation science”或“implementation research”。
本研究采用Python 3.12编写的爬虫程序对通过公开网页检索获得的相关数据进行自动化抓取和格式转换。研究团队对初步检索结果进行逐一核对并进行交叉复核,最终整理汇总项目标题、申报人、基金类别、关键词和摘要等关键信息。纳入标准为:(1)与实施科学相关的研究项目;(2)研究领域明确归属于管理科学或公共卫生与预防医学。排除标准为:(1)重复项目;(2)与研究主题不相关的项目;(3)项目信息不完整的数据;(4)纯基础医学研究(如遗传学、分子生物学等)。
应用CiteSpace 6.1.2 R6软件作为核心数据分析与可视化工具对中国和美国实施科学资助基金项目进行系统性的可视化分析。生成基金项目分布、合作网络及研究热点图谱以深入揭示中美两国间在实施科学领域研究的异同。采用CiteSpace 6.1.2 R6软件中“剪切”(pruning)选项中的“寻径”(pathfinder)和“裁剪切片网络”(pruning sliced networks)功能优化网络图。研究结果的可靠性评估遵循以下标准:当模块度Q值(modularity Q)≥0.3时且聚类质量S值(silhouette S)≥0.5时,聚类的网络模块结构具有显著性和合理性[8]。
2000年1月1日—2024年12月1日NSFC和NIH分别资助76项和1 435项实施科学相关项目。去除重复项目后NSFC和NIH资助项目分别为43项和498项。排除与主题无关和信息不完整基金项目后,本研究最终纳入NSFC资助项目39项和NIH资助项目487项。
中国和美国在实施科学领域高影响力资助项目的研究主题和资助规模上存在显著差异。中国的高影响力项目主要聚焦于精神卫生与心理健康领域,针对特定人群或区域开展干预效果评估与策略优化,如中山大学承担的“基于队列的抑郁症规范化防治及管理的实施性研究”项目和上海市精神卫生中心主持的“在资源匮乏地区预防重复自杀的社区干预的实施性研究。我国宁夏回族自治区和加拿大努纳武特地区”项目均获批5 000 000元的资助。其余项目集中于抑郁筛查、儿童运动干预以及老年痴呆协同护理模式等研究。单项资助金额为450 000~4 980 000元;美国的高影响力资助项目更侧重于应对全国性或国际多中心重大公共卫生挑战或支持大规模协作网络。由乔治·华盛顿大学(George Washington University)牵头的“District of Columbia Center for AIDS Research”项目获批了最高146 947 644美元的资助;布朗大学(Brown University)主持的“NIA AD/ADRD Health Care Systems Research Collaboratory”项目获得了61 051 116美元的资助;其高影响力项目涵盖艾滋防控、癌症转化研究和药物滥用治疗网络研究等,单项资助均>14 000 000美元。
中国实施科学领域的资助项目主要集中于中山大学和北京大学,而美国则以华盛顿大学(University of Washington)、约翰·霍普金斯大学(Johns Hopkins University)和耶鲁大学(Yale University)排名靠前。中国学者的整体受资数量相对较少,多数仅获1项资助,其中谢润生和侯丰苏分别获批2项;而美国学者的受资更为集中,Trace S Kershaw主持8项,Donna L Spiegelman主持6项,其余前列学者亦获批4~5项资助。受资学者词云图见图1。
实施科学资助项目高频关键词分析结果显示,中国在研究主题上关注“实施科学”“多阶段优化策略”“实施性研究”“实证研究”“效果评价”“社区”“老年”和“儿童”等;而美国则聚焦于“实施科学(implementation science)”“研究人员(research personnel)”“公共卫生(public health)”“ 循证转化(evidence base)”“规模化(scale up)”“实施策略(implementation strategy)”和“艾滋病防控(AIDS prevention)”等,且其关键词热点分布相对密集(见表3和图2~3)。关键词共现网络分析结果显示,中国和美国在实施科学领域均关注改善健康服务的可及性和有效性,但其研究主题的侧重点存在明显差异。中国研究更偏重公共卫生干预和健康管理,主要聚类包括实施科学、健康管理、序列多次分组、健康教育、老年、急性缺血性脑卒中、医疗保险、影响机制、资源匮乏地区、干预效果、自我管理机制和远程医疗;而美国则关注实施障碍(implementation barriers)、人类免疫缺陷病毒(human immunodeficiency virus, HIV)诊断(HIV diagnosis)、健康政策(health policy)、初级卫生保健(primary care)、家庭(housing)、数据收集(data collection)、行为疗法(behavior therapy)、癌症健康差异(cancer health disparity)、家庭环境(home environment)、影响评估(impact evaluation)、体质量指数(body mass index)和种族与族群(racial and ethnic)。
发展趋势分析结果显示,中国的研究热点在时间维度上相对分散,呈短期、跳跃式的特征;而美国的研究热点则呈现出显著的中心性,且在主题演进上更具连续性和规律性。在中国实施科学项目资助的早期阶段,研究热点较为分散,主要集中于老年、效果评价、抑郁症、健康管理等议题。自2018年起,研究范围逐步拓宽,涵盖至农村老年居民、儿童和流动人口等特定研究群体,并引入随机对照试验、多阶段优化策略和干预研究等方法学;与此同时,研究逐步深入艾滋病、心脑血管疾病、老年痴呆、银屑病和慢性肾脏病等细分疾病领域。值得注意的是,自2023年以来,实施性综合研究框架(Consolidated Framework for Implementation Research, CFIR)和RE-AIM框架等实施科学的理论、框架及模式逐步得到广泛应用,在此期间,精神卫生、健康管理和认知障碍等主题仍是中国实施科学研究的核心方向。而美国实施科学资助项目自2000年启动以来,持续关注“实施障碍(implementation barriers)”这一核心主题;在资助早期,研究多聚焦于HIV诊断(HIV diagnosis)、行为疗法(behavior therapy)和种群与族群(racial and ethnic);2010—2020年研究主题则进一步扩展至健康政策(health policy)和癌症健康差异(cancer health disparity)等细分领域,整体呈较强的连续性和系统性;自2020年以来,美国实施科学研究已发展至相对成熟阶段,其热点爆发强度相对减弱。
本研究结果显示,NSFC和NIH在实施科学资助结构上呈现显著差异。其中,NSFC在资助早期阶段将精神卫生作为重点领域,资助的4个国际合作重点支持项目均围绕抑郁症展开,体现了我国对精神健康议题的政策重视和优先部署。这一趋势与我国发布《健康中国行动(2019—2030 年)》高度契合,该行动明确将心理健康促进行动列为15项专项行动之一[9]。2025年发布的《关于开展“儿科和精神卫生服务年”行动(2025—2027年)》[10]亦提示需将加强精神卫生服务体系建设作为重点任务。相较而言,NIH则侧重针对重大公共卫生威胁(如艾滋病)等传染病的实施科学项目,这与Goodenow M M等[11]研究结果一致。NIH资助的实施科学项目强调跨领域干预措施的整合与规模化推广,为美国“终止艾滋病病毒流行”的国家战略目标提供关键路径和方法论支持[12]。此外,尽管中国和美国在资助领域上存在差异,但均关注老年健康管理和认知衰退等议题,这与Yao X Y等[13]的研究结果一致。在合作网络结构方面,NSFC支持下的实施科学研究目前仍处于起步阶段,表现出研究力量相对分散、跨学科协同机制不健全等特点,这可能与中国自2015年起在国家级资助项目开始出现运用实施科学理论与方法的项目有关[14]。因此,目前在该领域仍处于初步探索阶段,稳定的研究者群体与高效的科研合作网络尚在逐步构建中[15]。相比之下,美国NIH自2006年设立临床与转化科学奖(Clinical Translational Science Awards, CTSA)以来,通过推动国家心理健康研究所和国家癌症研究所等多部门联动[16],逐步形成稳定且制度化的实施科学研究体系,提高了实施科学研究网络的可持续发展能力[17]。然而,当前中国实施科学领域正处于快速发展的优势阶段,应在现有政策基础上,结合本国卫生体系需求与研究能力布局,进一步明晰适应国情的发展路径。例如,我国可建立实施科学的长期稳定资助机制,将其纳入国家中长期科技发展战略,并设立专项资金以保障在关键领域的持续研究,从而减少因议题更替频繁或周期性断档而对领域发展进程造成的干扰。此外,还可推动构建高效协同的研究网络,借鉴国际合作机制经验,积极促进政府、高校与科研机构间的深度协作,鼓励建设跨学科、跨区域的研究平台,从而提升研究整合能力和实践导向能力,为应对日益复杂的健康挑战与重大公共卫生威胁提供更具系统性的实施科学理论与实践支撑。
在资助项目的研究主题选择中,NSFC资助项目强调实践导向和策略优化,其高频关键词包括“多阶段优化策略”(频率7)、“实施性研究”(频率5)、“实证研究”(频率3)、“效果评价”(频率3)、“社区”(频率3)、“老年人”(频率3)和“儿童”(频率3),老年人和儿童是重点研究对象,与李文星等[18]和姚刚等[19]研究结果一致。而NIH资助项目更关注“研究人员(research personnel)”(频率214)、“公共卫生(public health)”(频率209)、“循证转化(evidence base)”(频率191)、“规模化(scale up)”(频率117)、“实施策略(implementation strategy)”(频率115)等,涵盖主题更为广泛,强调证据转换的有效性,与Johnson A M等[20]和Roberts M C等[21]研究结果一致。聚类分析结果显示,NSFC资助主要集中在健康管理、老年、急性缺血性脑卒中等领域,这与我国人口老龄化的现实需求密切相关[22]。提示实施科学在优化服务提供和疾病管理上具有关键作用。此外,远程医疗和资源匮乏地区健康服务优化也是重要关注点,其中远程医疗能够提升偏远或资源匮乏地区的医疗可及性,但基础设施不足和用户接受程度低仍是其推广的限制因素[23–24],而实施科学则能为克服此障碍提供有效路径。NIH聚类分析集中于实施障碍(implementation barriers)、HIV诊断(HIV diagnosis)和健康政策(health policy)等主题,强调研究成果的实际转化[25]。其中“健康政策(health policy)”聚类反映了科学证据与政策制定和实施之间存在的“鸿沟”。多项研究表明,实施科学可有效弥合这一差距[26–27],推动研究成果向政策和实践的转化[28]。如美国癌症研究中心曾基于实施科学总结电子健康推广的关键议题,以期推动研究、政策与实践的深度融合[29]。总体而言,中国和美国在实施科学资助主题上呈现出不同的政策重点和战略取向。NSFC聚焦于我国重大健康需求和重点关注人群,强调实践导向、干预优化与本土化路径构建;NIH则更注重重大公共卫生挑战,突出多系统协同、健康公平与政策转化。因此,未来我国在推进实施科学发展过程中应立足于人口老龄化、城乡差距和基层服务能力不足等现实问题,持续拓展战略性研究议题,加强实施科学研究与国家战略政策的协同,强化实施科学在人群健康管理中的战略引导作用。具体可参照《全国精神卫生工作规划(2015—2020年)》[30]、《慢性病综合防控示范区建设管理办法》[31]和《“健康中国2030”规划纲要》[32]等政策文件,围绕老年健康、儿童发展、精神卫生、慢性病防治等领域设立重点支持方向;同时,还应积极推动边缘与新兴议题的研究突破,将远程医疗、数字健康、认知障碍照护和心理社会干预等纳入资助范围,并特别关注资源匮乏地区和弱势人群(如残障者、农村老年人、留守儿童等)的实施路径研究,以全面提高我国健康服务的公平性与可及性。
本研究结果显示,NSFC资助项目关键词在时间维度上表现为热点分散且跳跃式的发展趋势。自2018年以来,随机对照试验[33]和多阶段优化策略[34]等实施科学研究设计逐步受到关注,这反映出我国的实施科学研究方法与设计的日益成熟[35]。相关研究表明,随着新方法学的不断涌现,随机对照试验的设计也变得越来越多样化[36],如效果–实施混合设计、多阶段优化策略和阶梯设计集群随机试验等。与此同时,疾病研究主题逐渐细化,这与国家自然科学基金“十四五”发展规划中提出的“聚焦多种重大疾病类型及其发病机制”的战略导向高度契合[37]。在研究内容方面,精神卫生、健康管理和老年痴呆等持续作为重点领域,充分体现我国在老龄化背景下对慢性病管理与心理健康问题的持续关注与积极回应。在方法论层面,RE-AIM和CFIR等典型实施科学框架的应用日益普及,标志着我国实施科学研究正逐步走向理论化和规范化[5]。相比之下,NIH资助项目在时间维度上则表现出较高的主题集中度和持续性。其中,“实施障碍(implementation barriers)”长期作为核心关键词出现,反映出NIH对干预措施在采纳、适应、整合、规模化和可持续中所面临挑战的关注[38]。21世纪初期,NIH重点关注传染病干预,特别是HIV诊断,强调干预措施的有效实施和规模化推广。研究表明,实施科学方法显著提升了干预措施的成效,并有效促进了整合与推广应用[39]。2000—2010年,围绕“种族与族群(racial and ethnic)”的实施研究兴起,旨在改善少数族裔等弱势群体的健康结局以应对美国日益加剧的健康不平等问题[40–42]。2010—2020年,美国实施科学研究进入快速增长阶段,癌症健康差异(cancer health disparity)成为研究的核心领域,这与“抗癌登月计划”目标高度契合。同时,美国建立了癌症控制实施科学中心网络,利用实施科学的方法推动癌症防治策略的有效转化与实施[43]。总体而言,实施科学研究必须紧密结合人群健康及政策系统所面临的核心挑战,以实现研究成果向实践的有效转化。为推动中国实施科学研究的高质量发展,未来应当关注以下主题:一是聚焦脆弱群体,促进健康公平。实施科学研究应优先关注脆弱人群的健康需求,通过提高服务可及性来有效减轻疾病负担,特别是在健康行为干预、心理健康服务和长期照护模式等方面应加强实证研究,以实现更广泛的健康公平。二是深化重大疾病干预的精细化研究,围绕我国现行疾病谱,应聚焦传染病(如艾滋病)、精神障碍(如抑郁症)、认知退行性疾病(如阿尔茨海默病)等具体疾病领域,探索更具可行性与可持续性的干预路径;并贯穿预防、筛查、诊断、治疗、管理与康复的全流程,以期实现全链条的健康干预优化。三是强化实施科学框架的系统应用和本土化适应,鼓励研究者结合具体研究目标合理选取实施科学框架[44],从而提升研究设计的系统性与干预评估能力[45]。同时,应充分结合中国社会文化与制度特点,调整与优化现有框架,开发更适用于发展中国家语境的本土化工具与策略[15],以增强研究的普适性和转化效能。
综上所述,本研究通过比较中国和美国实施科学资助体系,发现二者均高度重视实施科学在公共卫生政策与健康服务体系转型中的战略价值,并持续加大经费投入。但由于国家发展阶段、卫生体系架构及科研体制成熟度的差异,两国在资助重点、研究主题和发展路径上呈现出显著差异。虽然我国实施科学领域已在精神卫生、老年健康和慢性病管理等方向建立了初步研究基础,但在研究机制完善、跨机构协同和方法创新方面仍有待加强。为推动我国实施科学的高质量发展,提出以下建议:第一,强化资金投入与定向资助机制,推动循证干预研究与实施性研究融合;第二,构建多层次合作网络,推动跨学科、跨机构、跨国界的多元合作;第三,提升实施科学与国家战略对接能力,提高政策转化效能;第四,聚焦重大疾病领域与脆弱人群,提升健康公平导向的实施路径研究;第五,推动实施科学框架的本土化适配,构建中国特色的研究范式。
本研究通过系统梳理和比较中国与美国在实施科学资助体系方面的异同,提炼出对中国具有实践指导意义的国际经验,为进一步优化我国资助政策、提升研究成果转化效率提供有益参考。但仍存在一定的局限性:首先,NIH资助数据依赖于RePORTER数据库,可能受记录滞后和信息不全的影响导致部分项目未能被完全捕捉;其次,国家自然科学基金官网目前仅公开已结题项目的摘要信息,部分在研项目尚无详细数据披露。因此,今后有必要对更多实施科学项目的研究内容和实施过程开展系统化的追踪分析,以便及时把握研究进展、评估干预效果及机制演变,为完善资助策略和政策决策提供更为充分的实证依据。

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2025年第41卷第11期
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doi: 10.11847/zgggws1147908
  • 接收时间:2025-05-12
  • 首发时间:2026-10-25
  • 出版时间:2025-11-10
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  • 收稿日期:2025-05-12
  • 修回日期:2025-07-06
  • 录用日期:2025-08-13
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    1中国医学科学院 北京协和医学院卫生健康管理政策学院,北京 100730
    2中国人民大学人口与健康学院,北京 100872

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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