Files and links (2)
Published (Version of record)CC BY V4.0, Open Access
Published (Version of record)CC BY V4.0, Open
Journal article
The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma
PloS One, Vol.14(4), pp.1-22
08/04/2019
PMCID: PMC6453477
PMID: 30958868
Metrics
2 File views/ downloads
17 Record Views
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
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.
Details
- Title
- The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma
- Creators
- Meena Daivadanam - Uppsala UniversityMaia Ingram - University of ArizonaKristi Sidney Annerstedt - Karolinska InstitutetGary Parker - University College LondonKirsty Bobrow - University of Cape TownLisa Dolovich - McMaster UniversityGillian Gould - University of Newcastle AustraliaMichaela Riddell - Monash UniversityRajesh Vedanthan - New York University School of MedicineJacqui Webster - University of New South WalesPilvikki Absetz - University of Eastern FinlandHelle Mölsted Alvesson - Karolinska InstitutetOdysseas Androutsos - Harokopio University of AthensNiels Chavannes - Leiden University Medical CenterBriana Cortez - Icahn School of Medicine at Mount SinaiPraveen Devarasetty - George Institute for Global HealthEdward Fottrell - University College LondonFrancisco Gonzalez-Salazar - University of MonterreyJane Goudge - University of the WitwatersrandOmarys Herasme - Icahn School of Medicine at Mount SinaiHannah Jennings - University College LondonDeksha Kapoor - All India Institute of Medical SciencesJemima Kamano - Moi UniversityMarise J Kasteleyn - Leiden University Medical CenterChristina Kyriakos - European Network for Smoking and Tobacco PreventionYannis Manios - Harokopio University of AthensKishor Mogulluru - George Institute for Global HealthMayowa Owolabi - University of IbadanMaria Lazo-Porras - Universidad Peruana Cayetano HerediaWnurinham Silva - Imperial College LondonAmanda Thrift - Monash UniversityEzinne Uvere - University College Hospital, IbadanRuth Webster - University of New South WalesRianne van der Kleij - Leiden University Medical CenterJosefien van Olmen - Instituut voor Tropische GeneeskundeConstantine Vardavas - European Network for Smoking and Tobacco PreventionPuhong Zhang - George Institute for Global Health
- Publication Details
- PloS One, Vol.14(4), pp.1-22
- Publisher
- Public Library of Science
- Grant note
- Funding for the studies described and for article submission was provided by the following GACD Hypertension Program, Diabetes Program and Lung disease Program funding agencies: Canadian Institutes of Health Research; Canadian Stroke Network; Grand Challenges Canada; Chinese Academy of Medical Sciences; International Development Research Centre; National Council of Science and Technology, Mexico; European Commission; Fogarty International Center; National Institutes of Health; Indian Council of Medical Research; National Heart, Lung, and Blood Institute; Medical Research Council, United Kingdom; Medical Research Council, South Africa; National Health and Medical Research Council, Australia; National Institute of Neurological Disorders and Stroke, United States. GACD provided support in the form of contributions towards salaries for authors KSA and GP for their overall responsibilities in the working group and the GACD secretariat respectively. The funder, however, did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.
- Identifiers
- 991012958197302368
- Copyright
- © 2019 Daivadanam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Academic Unit
- School of Health and Human Sciences; Faculty of Health
- Language
- English
- Resource Type
- Journal article