The Library
A realist process evaluation within the Facilitating Implementation of Research Evidence (FIRE) cluster randomised controlled international trial : an exemplar
Tools
Rycroft-Malone, Jo, Seers, Kate, Eldh, Ann Catrine, Cox, Karen, Crichton, Nicola, Harvey, Gill, Hawkes, Claire, Kitson, Alison, McCormack, Brendan George, McMullan, Christel, Mockford, Carole, Niessen, Theo , Slater, Paul, Titchen, Angie, van der Zijpp, Teatske and Wallin, Lars (2018) A realist process evaluation within the Facilitating Implementation of Research Evidence (FIRE) cluster randomised controlled international trial : an exemplar. Implementation Science, 13 . 138. doi:10.1186/s13012-018-0811-0 ISSN 1748-5908.
|
PDF
WRAP-realist-process-evaluation-cluster-randomised-trial-Seers-2018.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (2179Kb) | Preview |
|
PDF
WRAP-realist-process-evaluation-facilitating-implementation-FIRE-controlled-Seers-2018.pdf - Accepted Version Embargoed item. Restricted access to Repository staff only - Requires a PDF viewer. Download (2516Kb) |
Official URL: https://doi.org/10.1186/s13012-018-0811-0
Abstract
Background
Facilitation is a promising implementation intervention, which requires theory-informed evaluation. This paper presents an exemplar of a multi-country realist process evaluation that was embedded in the first international randomised controlled trial evaluating two types of facilitation for implementing urinary continence care recommendations. We aimed to uncover what worked (and did not work), for whom, how, why and in what circumstances during the process of implementing the facilitation interventions in practice.
Methods
This realist process evaluation included theory formulation, theory testing and refining. Data were collected in 24 care home sites across four European countries. Data were collected over four time points using multiple qualitative methods: observation (372 h), interviews with staff (n = 357), residents (n = 152), next of kin (n = 109) and other stakeholders (n = 128), supplemented by facilitator activity logs. A combined inductive and deductive data analysis process focused on realist theory refinement and testing.
Results
The content and approach of the two facilitation programmes prompted variable opportunities to align and realign support with the needs and expectations of facilitators and homes. This influenced their level of confidence in fulfilling the facilitator role and ability to deliver the intervention as planned. The success of intervention implementation was largely dependent on whether sites prioritised their involvement in both the study and the facilitation programme. In contexts where the study was prioritised (including release of resources) and where managers and staff support was sustained, this prompted collective engagement (as an attitude and action). Internal facilitators’ (IF) personal characteristics and abilities, including personal and formal authority, in combination with a supportive environment prompted by managers triggered the potential for learning over time. Learning over time resulted in a sense of confidence and personal growth, and enactment of the facilitation role, which resulted in practice changes.
Conclusion
The scale and multi-country nature of this study provided a novel context to conduct one of the few trial embedded realist-informed process evaluations. In addition to providing an explanatory account of implementation processes, a conceptual platform for future facilitation research is presented. Finally, a realist-informed process evaluation framework is outlined, which could inform future research of this nature.
Item Type: | Journal Article | ||||||
---|---|---|---|---|---|---|---|
Subjects: | R Medicine > R Medicine (General) | ||||||
Divisions: | 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 |
||||||
Library of Congress Subject Headings (LCSH): | Clinical trials, Nursing homes | ||||||
Journal or Publication Title: | Implementation Science | ||||||
Publisher: | BioMed Central Ltd. | ||||||
ISSN: | 1748-5908 | ||||||
Official Date: | 16 November 2018 | ||||||
Dates: |
|
||||||
Volume: | 13 | ||||||
Article Number: | 138 | ||||||
DOI: | 10.1186/s13012-018-0811-0 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 28 August 2018 | ||||||
Date of first compliant Open Access: | 23 November 2018 | ||||||
RIOXX Funder/Project Grant: |
|
||||||
Related URLs: |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year