The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma.

Daivadanam, M; Ingram, M; Sidney Annerstedt, K; Parker, G; Bobrow, K; Dolovich, L; Gould, G; Riddell, M; Vedanthan, R; Webster, J; Absetz, P; Mölsted Alvesson, H; Androutsos, O; Chavannes, N; Cortez, B; Devarasetty, P; Fottrell, E; Gonzalez-Salazar, F; Goudge, J; Herasme, O; Jennings, H; Kapoor, D; Kamano, J; Kasteleyn, MJ; Kyriakos, C; Manios, Y; Mogulluru, K; Owolabi, M; Lazo-Porras, M; Silva, W; Thrift, A; Uvere, E; Webster, R; van der Kleij, R; van Olmen, J; Vardavas, C; Zhang, P; GACD Concepts and Contexts working group

The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma.

Daivadanam, M Ingram, M Sidney Annerstedt, K Parker, G Bobrow, K Dolovich, L Gould, G Riddell, M Vedanthan, R Webster, J Absetz, P Mölsted Alvesson, H Androutsos, O Chavannes, N Cortez, B Devarasetty, P Fottrell, E Gonzalez-Salazar, F Goudge, J Herasme, O Jennings, H Kapoor, D Kamano, J Kasteleyn, MJ Kyriakos, C Manios, Y Mogulluru, K Owolabi, M Lazo-Porras, M Silva, W Thrift, A Uvere, E Webster, R

van der Kleij, R van Olmen, J Vardavas, C Zhang, P GACD Concepts and Contexts working group

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Publisher:: PUBLIC LIBRARY SCIENCE
Publication Type:: Journal Article
Citation:: PloS one, 2019, 14, (4), pp. e0214454
Issue Date:: 2019-01

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Field	Value	Language
dc.contributor.author	Daivadanam, M
dc.contributor.author	Ingram, M
dc.contributor.author	Sidney Annerstedt, K
dc.contributor.author	Parker, G
dc.contributor.author	Bobrow, K
dc.contributor.author	Dolovich, L
dc.contributor.author	Gould, G
dc.contributor.author	Riddell, M
dc.contributor.author	Vedanthan, R
dc.contributor.author	Webster, J
dc.contributor.author	Absetz, P
dc.contributor.author	Mölsted Alvesson, H
dc.contributor.author	Androutsos, O
dc.contributor.author	Chavannes, N
dc.contributor.author	Cortez, B
dc.contributor.author	Devarasetty, P
dc.contributor.author	Fottrell, E
dc.contributor.author	Gonzalez-Salazar, F
dc.contributor.author	Goudge, J
dc.contributor.author	Herasme, O
dc.contributor.author	Jennings, H
dc.contributor.author	Kapoor, D
dc.contributor.author	Kamano, J
dc.contributor.author	Kasteleyn, MJ
dc.contributor.author	Kyriakos, C
dc.contributor.author	Manios, Y
dc.contributor.author	Mogulluru, K
dc.contributor.author	Owolabi, M
dc.contributor.author	Lazo-Porras, M
dc.contributor.author	Silva, W
dc.contributor.author	Thrift, A
dc.contributor.author	Uvere, E
dc.contributor.author	Webster, R https://orcid.org/0000-0002-7444-3037
dc.contributor.author	van der Kleij, R
dc.contributor.author	van Olmen, J
dc.contributor.author	Vardavas, C
dc.contributor.author	Zhang, P
dc.contributor.author	GACD Concepts and Contexts working group
dc.date.accessioned	2020-05-04T05:21:25Z
dc.date.available	2019-03-13
dc.date.available	2020-05-04T05:21:25Z
dc.date.issued	2019-01
dc.identifier.citation	PloS one, 2019, 14, (4), pp. e0214454
dc.identifier.issn	1932-6203
dc.identifier.issn	1932-6203
dc.identifier.uri	http://hdl.handle.net/10453/140460
dc.description.abstract	INTRODUCTION:Understanding context and how this can be systematically assessed and incorporated is crucial to successful implementation. We describe how context has been assessed (including exploration or evaluation) in Global Alliance for Chronic Diseases (GACD) implementation research projects focused on improving health in people with or at risk of chronic disease and how contextual lessons were incorporated into the intervention or the implementation process. METHODS:Using a web-based semi-structured questionnaire, we conducted a cross-sectional survey to collect quantitative and qualitative data across GACD projects (n = 20) focusing on hypertension, diabetes and lung diseases. The use of context-specific data from project planning to evaluation was analyzed using mixed methods and a multi-layered context framework across five levels; 1) individual and family, 2) community, 3) healthcare setting, 4) local or district level, and 5) state or national level. RESULTS:Project teams used both qualitative and mixed methods to assess multiple levels of context (avg. = 4). Methodological approaches to assess context were identified as formal and informal assessments, engagement of stakeholders, use of locally adapted resources and materials, and use of diverse data sources. Contextual lessons were incorporated directly into the intervention by informing or adapting the intervention, improving intervention participation or improving communication with participants/stakeholders. Provision of services, equipment or information, continuous engagement with stakeholders, feedback for personnel to address gaps, and promoting institutionalization were themes identified to describe how contextual lessons are incorporated into the implementation process. CONCLUSIONS:Context is regarded as critical and influenced the design and implementation of the GACD funded chronic disease interventions. There are different approaches to assess and incorporate context as demonstrated by this study and further research is required to systematically evaluate contextual approaches in terms of how they contribute to effectiveness or implementation outcomes.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	PUBLIC LIBRARY SCIENCE
dc.relation.ispartof	PloS one
dc.relation.isbasedon	10.1371/journal.pone.0214454
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	General Science & Technology
dc.subject.mesh	Humans
dc.subject.mesh	Lung Diseases
dc.subject.mesh	Hypertension
dc.subject.mesh	Diabetes Mellitus
dc.subject.mesh	Chronic Disease
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Geography
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Research Design
dc.subject.mesh	International Cooperation
dc.subject.mesh	Poverty
dc.subject.mesh	Internet
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Middle Aged
dc.subject.mesh	Health Promotion
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Noncommunicable Diseases
dc.subject.mesh	Stakeholder Participation
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Chronic Disease
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Delivery of Health Care
dc.subject.mesh	Diabetes Mellitus
dc.subject.mesh	Female
dc.subject.mesh	Geography
dc.subject.mesh	Health Promotion
dc.subject.mesh	Humans
dc.subject.mesh	Hypertension
dc.subject.mesh	International Cooperation
dc.subject.mesh	Internet
dc.subject.mesh	Lung Diseases
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Noncommunicable Diseases
dc.subject.mesh	Poverty
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Research Design
dc.subject.mesh	Stakeholder Participation
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Treatment Outcome
dc.title	The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma.
dc.type	Journal Article
utslib.citation.volume	14
utslib.location.activity	United States
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
dc.date.updated	2020-05-04T05:21:17Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	14
utslib.start-page	e0214454
utslib.citation.issue	4

Abstract:

INTRODUCTION:Understanding context and how this can be systematically assessed and incorporated is crucial to successful implementation. We describe how context has been assessed (including exploration or evaluation) in Global Alliance for Chronic Diseases (GACD) implementation research projects focused on improving health in people with or at risk of chronic disease and how contextual lessons were incorporated into the intervention or the implementation process. METHODS:Using a web-based semi-structured questionnaire, we conducted a cross-sectional survey to collect quantitative and qualitative data across GACD projects (n = 20) focusing on hypertension, diabetes and lung diseases. The use of context-specific data from project planning to evaluation was analyzed using mixed methods and a multi-layered context framework across five levels; 1) individual and family, 2) community, 3) healthcare setting, 4) local or district level, and 5) state or national level. RESULTS:Project teams used both qualitative and mixed methods to assess multiple levels of context (avg. = 4). Methodological approaches to assess context were identified as formal and informal assessments, engagement of stakeholders, use of locally adapted resources and materials, and use of diverse data sources. Contextual lessons were incorporated directly into the intervention by informing or adapting the intervention, improving intervention participation or improving communication with participants/stakeholders. Provision of services, equipment or information, continuous engagement with stakeholders, feedback for personnel to address gaps, and promoting institutionalization were themes identified to describe how contextual lessons are incorporated into the implementation process. CONCLUSIONS:Context is regarded as critical and influenced the design and implementation of the GACD funded chronic disease interventions. There are different approaches to assess and incorporate context as demonstrated by this study and further research is required to systematically evaluate contextual approaches in terms of how they contribute to effectiveness or implementation outcomes.

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http://hdl.handle.net/10453/140460