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Facilitating Implementation of Research Evidence (FIRE) : an international cluster randomised controlled trial to evaluate two models of facilitation informed by the Promoting Action in Research Implementation in Health Services (PARIHS) framework
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Seers, Kate, Rycroft-Malone, Jo, Cox, Karen, Crichton, Nicola, Tudor Edwards, Rhiannon, Eldh, Ann Catrine, Estabrooks, Carole A., Harvey, Gill, Hawkes, Claire, Jones, Carys, Kitson, Alison, McCormack, Brendan, McCullan, Christel, Mockford, Carole, Niessen, Theo, Slater, Paul, Titchen, Angie, Zijpp, Teatske van der and Wallin, Lars (2018) Facilitating Implementation of Research Evidence (FIRE) : an international cluster randomised controlled trial to evaluate two models of facilitation informed by the Promoting Action in Research Implementation in Health Services (PARIHS) framework. Implementation Science, 13 . 137. doi:10.1186/s13012-018-0831-9 ISSN 1748-5908.
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Official URL: https://doi.org/10.1186/s13012-018-0831-9
Abstract
Background
Health care practice needs to be underpinned by high quality research evidence, so that the best possible care can be delivered. However, evidence from research is not always utilised in practice. This study used the Promoting Action on Research Implementation in Health Services (PARIHS) framework as its theoretical underpinning to test whether two different approaches to facilitating implementation could affect the use of research evidence in practice.
Methods
A pragmatic clustered randomised controlled trial with embedded process and economic evaluation was used. The study took place in four European countries across 24 long-term nursing care sites, for people aged 60 years or more with documented urinary incontinence. In each country, sites were randomly allocated to standard dissemination, or one of two different types of facilitation. The primary outcome was the documented percentage compliance with the continence recommendations, assessed at baseline, then at 6, 12, 18, and 24 months after the intervention.
Data were analysed using STATA15, multi-level mixed-effects linear regression models were fitted to scores for compliance with the continence recommendations, adjusting for clustering.
Results
Quantitative data were obtained from reviews of 2313 records. There were no significant differences in the primary outcome (documented compliance with continence recommendations) between study arms and all study arms improved over time.
Conclusions
This was the first cross European randomised controlled trial with embedded process evaluation that sought to test different methods of facilitation. There were no statistically significant differences in compliance with continence recommendations between the groups. It was not possible to identify whether different types and “doses” of facilitation were influential within very diverse contextual conditions. The process evaluation (Rycroft-Malone et al., Implementation Science. doi: 10.1186/s13012-018-0811-0) revealed the models of facilitation used were limited in their ability to overcome the influence of contextual factors.
Item Type: | Journal Article | ||||||
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Alternative Title: | |||||||
Subjects: | R Medicine > R Medicine (General) | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing |
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Library of Congress Subject Headings (LCSH): | Clinical trials, Urinary incontinence -- Treatment | ||||||
Journal or Publication Title: | Implementation Science | ||||||
Publisher: | BioMed Central Ltd. | ||||||
ISSN: | 1748-5908 | ||||||
Official Date: | 16 November 2018 | ||||||
Dates: |
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Volume: | 13 | ||||||
Article Number: | 137 | ||||||
DOI: | 10.1186/s13012-018-0831-9 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 23 October 2018 | ||||||
Date of first compliant Open Access: | 23 November 2018 | ||||||
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