The role of context in implementation research for non-communicable diseases

Answering the 'how-to' dilemma

Meena Daivadanam, Maia Ingram, Kristi Sidney Annerstedt, Gary Parker, Kirsty Bobrow, Lisa Dolovich, Gillian Gould, Michaela Riddell, Rajesh Vedanthan, Jacqui Webster, Pilvikki Absetz, Helle Mölsted Alvesson, Odysseas Androutsos, Niels Chavannes, Briana Cortez, Praveen Devarasetty, Edward Fottrell, Francisco Gonzalez-Salazar, Jane Goudge, Omarys Herasme & 17 others Hannah Jennings, Deksha Kapoor, Jemima Kamano, Marise J. Kasteleyn, Christina Kyriakos, Yannis Manios, Kishor Mogulluru, Mayowa Owolabi, Maria Lazo-Porras, Wnurinham Silva, Amanda Thrift, Ezinne Uvere, Ruth Webster, Rianne Van Der Kleij, Josefien Van Olmen, Constantine Vardavas, Puhong Zhang

Research output: Contribution to journalArticleResearchpeer-review

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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.

Original languageEnglish
Article numbere0214454
JournalPLoS ONE
Volume14
Issue number4
DOIs
Publication statusPublished - 1 Apr 2019

Cite this

Daivadanam, M., Ingram, M., Annerstedt, K. S., Parker, G., Bobrow, K., Dolovich, L., ... Zhang, P. (2019). The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma. PLoS ONE, 14(4), [e0214454]. https://doi.org/10.1371/journal.pone.0214454
Daivadanam, Meena ; Ingram, Maia ; Annerstedt, Kristi Sidney ; Parker, Gary ; Bobrow, Kirsty ; Dolovich, Lisa ; Gould, Gillian ; Riddell, Michaela ; Vedanthan, Rajesh ; Webster, Jacqui ; Absetz, Pilvikki ; Alvesson, Helle Mölsted ; Androutsos, Odysseas ; Chavannes, Niels ; Cortez, Briana ; Devarasetty, Praveen ; Fottrell, Edward ; Gonzalez-Salazar, Francisco ; Goudge, Jane ; Herasme, Omarys ; Jennings, Hannah ; Kapoor, Deksha ; Kamano, Jemima ; Kasteleyn, Marise J. ; Kyriakos, Christina ; Manios, Yannis ; Mogulluru, Kishor ; Owolabi, Mayowa ; Lazo-Porras, Maria ; Silva, Wnurinham ; Thrift, Amanda ; Uvere, Ezinne ; Webster, Ruth ; Van Der Kleij, Rianne ; Van Olmen, Josefien ; Vardavas, Constantine ; Zhang, Puhong. / The role of context in implementation research for non-communicable diseases : Answering the 'how-to' dilemma. In: PLoS ONE. 2019 ; Vol. 14, No. 4.
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title = "The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma",
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.",
author = "Meena Daivadanam and Maia Ingram and Annerstedt, {Kristi Sidney} and Gary Parker and Kirsty Bobrow and Lisa Dolovich and Gillian Gould and Michaela Riddell and Rajesh Vedanthan and Jacqui Webster and Pilvikki Absetz and Alvesson, {Helle M{\"o}lsted} and Odysseas Androutsos and Niels Chavannes and Briana Cortez and Praveen Devarasetty and Edward Fottrell and Francisco Gonzalez-Salazar and Jane Goudge and Omarys Herasme and Hannah Jennings and Deksha Kapoor and Jemima Kamano and Kasteleyn, {Marise J.} and Christina Kyriakos and Yannis Manios and Kishor Mogulluru and Mayowa Owolabi and Maria Lazo-Porras and Wnurinham Silva and Amanda Thrift and Ezinne Uvere and Ruth Webster and {Van Der Kleij}, Rianne and {Van Olmen}, Josefien and Constantine Vardavas and Puhong Zhang",
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Daivadanam, M, Ingram, M, Annerstedt, KS, Parker, G, Bobrow, K, Dolovich, L, Gould, G, Riddell, M, Vedanthan, R, Webster, J, Absetz, P, Alvesson, HM, 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 2019, 'The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma', PLoS ONE, vol. 14, no. 4, e0214454. https://doi.org/10.1371/journal.pone.0214454

The role of context in implementation research for non-communicable diseases : Answering the 'how-to' dilemma. / Daivadanam, Meena; Ingram, Maia; Annerstedt, Kristi Sidney; Parker, Gary; Bobrow, Kirsty; Dolovich, Lisa; Gould, Gillian; Riddell, Michaela; Vedanthan, Rajesh; Webster, Jacqui; Absetz, Pilvikki; Alvesson, Helle Mölsted; Androutsos, Odysseas; Chavannes, Niels; Cortez, Briana; Devarasetty, Praveen; Fottrell, Edward; Gonzalez-Salazar, Francisco; Goudge, Jane; Herasme, Omarys; Jennings, Hannah; Kapoor, Deksha; Kamano, Jemima; Kasteleyn, Marise J.; Kyriakos, Christina; Manios, Yannis; Mogulluru, Kishor; Owolabi, Mayowa; Lazo-Porras, Maria; Silva, Wnurinham; Thrift, Amanda; Uvere, Ezinne; Webster, Ruth; Van Der Kleij, Rianne; Van Olmen, Josefien; Vardavas, Constantine; Zhang, Puhong.

In: PLoS ONE, Vol. 14, No. 4, e0214454, 01.04.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The role of context in implementation research for non-communicable diseases

T2 - Answering the 'how-to' dilemma

AU - Daivadanam, Meena

AU - Ingram, Maia

AU - Annerstedt, Kristi Sidney

AU - Parker, Gary

AU - Bobrow, Kirsty

AU - Dolovich, Lisa

AU - Gould, Gillian

AU - Riddell, Michaela

AU - Vedanthan, Rajesh

AU - Webster, Jacqui

AU - Absetz, Pilvikki

AU - Alvesson, Helle Mölsted

AU - Androutsos, Odysseas

AU - Chavannes, Niels

AU - Cortez, Briana

AU - Devarasetty, Praveen

AU - Fottrell, Edward

AU - Gonzalez-Salazar, Francisco

AU - Goudge, Jane

AU - Herasme, Omarys

AU - Jennings, Hannah

AU - Kapoor, Deksha

AU - Kamano, Jemima

AU - Kasteleyn, Marise J.

AU - Kyriakos, Christina

AU - Manios, Yannis

AU - Mogulluru, Kishor

AU - Owolabi, Mayowa

AU - Lazo-Porras, Maria

AU - Silva, Wnurinham

AU - Thrift, Amanda

AU - Uvere, Ezinne

AU - Webster, Ruth

AU - Van Der Kleij, Rianne

AU - Van Olmen, Josefien

AU - Vardavas, Constantine

AU - Zhang, Puhong

PY - 2019/4/1

Y1 - 2019/4/1

N2 - 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.

AB - 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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DO - 10.1371/journal.pone.0214454

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Daivadanam M, Ingram M, Annerstedt KS, Parker G, Bobrow K, Dolovich L et al. The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma. PLoS ONE. 2019 Apr 1;14(4). e0214454. https://doi.org/10.1371/journal.pone.0214454