scholarly journals How does embedded implementation research work? Examining core features through qualitative case studies in Latin America and the Caribbean

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii98-ii111 ◽  
Author(s):  
N Ilona Varallyay ◽  
Sara C Bennett ◽  
Caitlin Kennedy ◽  
Abdul Ghaffar ◽  
David H Peters
Keyword(s):  
Decision Maker ◽  
Implementation Research ◽  
Research Work ◽  
Decision Makers ◽  
System Level ◽  
Comparative Case Study ◽  
Structured Interviews ◽  
Embedded Implementation ◽  
Programme Improvement ◽  
Core Features

Abstract Innovative strategies are needed to improve the delivery of evidence-informed health interventions. Embedded implementation research (EIR) seeks to enhance the generation and use of evidence for programme improvement through four core features: (1) central involvement of programme/policy decision-makers in the research cycle; (2) collaborative research partnerships; (3) positioning research within programme processes and (4) research focused on implementation. This paper examines how these features influence evidence-to-action processes and explores how they are operationalized, their effects and supporting conditions needed. We used a qualitative, comparative case study approach, drawing on document analysis and semi-structured interviews across multiple informant groups, to examine three EIR projects in Bolivia, Colombia and the Dominican Republic. Our findings are presented according to the four core EIR features. The central involvement of decision-makers in EIR was enhanced by decision-maker authority over the programme studied, professional networks and critical reflection. Strong research–practice partnerships were facilitated by commitment, a clear and shared purpose and representation of diverse perspectives. Evidence around positioning research within programme processes was less conclusive; however, as all three cases made significant advances in research use and programme improvement, this feature of EIR may be less critical than others, depending on specific circumstances. Finally, a research focus on implementation demanded proactive engagement by decision-makers in conceptualizing the research and identifying opportunities for direct action by decision-makers. As the EIR approach is a novel approach in these low-resource settings, key supports are needed to build capacity of health sector stakeholders and create an enabling environment through system-level strategies. Key implications for such supports include: promoting EIR and creating incentives for decision-makers to engage in it, establishing structures or mechanisms to facilitate decision-maker involvement, allocating funds for EIR, and developing guidance for EIR practitioners.

scholarly journals Embedded implementation research determinants in Latin American health systems

2021 ◽  
Vol 55 ◽  
pp. 16
Author(s):  
Rodrigo García-Cerde ◽  
Victor Becerril-Montekio ◽  
Étienne Langlois ◽  
Ludovic Reveiz ◽  
Jacqueline Alcalde-Rabanal ◽  
...  
Keyword(s):  
Latin American ◽  
Implementation Research ◽  
Decision Makers ◽  
Research Use ◽  
Theory Approach ◽  
Structured Interviews ◽  
Sense Of Ownership ◽  
High Level ◽  
Embedded Implementation ◽  
Grounded Theory Approach

OBJECTIVE: To assess the determinants of embedded implementation research (EIR) conduct in seven Latin American and Caribbean countries. METHODS: This qualitative interpretative study conducted and analyzed 14 semi-structured interviews based on a grounded theory approach using Atlas-ti© 7.5.7. We grouped the conditions appointed by interviewees as determinants of EIR conduct into six domains. RESULTS: The participation of high-level engaged decision makers as research co-producers is an important EIR determinant that fosters research use. Nevertheless, EIR faces challenges such as dealing with key personnel changes and fluctuating political contexts. CONCLUSIONS: Despite its limitations, EIR is effective in creating a sense of ownership of research results among implementers, which helps bridge the gap between research and decision-making in health system

scholarly journals Cross-cutting lessons from the Decision-Maker Led Implementation Research initiative

2021 ◽  
Vol 19 (S2) ◽  
Author(s):  
Arielle Mancuso ◽  
Shahira Ahmed Malm ◽  
Alyssa Sharkey ◽  
A. S. M. Shahabuddin ◽  
Zubin Cyrus Shroff
Keyword(s):  
Decision Making ◽  
Decision Maker ◽  
Implementation Research ◽  
Decision Makers ◽  
Middle Income ◽  
Future Design ◽  
Systems Research ◽  
Effective Interventions ◽  
Decision Making Processes ◽  
The Individual

Abstract Background Almost 20 million children under one year of age did not receive basic vaccines in 2019, and most of these children lived in low- and middle-income countries. Implementation research has been recognized as an emerging area that is critical to strengthen the implementation of interventions proven to be effective. As a component of strengthening implementation, WHO has called for greater embedding of research within decision-making processes. One strategy to facilitate the embedding of research is to engage decision-makers as Principal Investigators of the research. Since 2015, the Alliance for Health Policy and Systems Research within the WHO and the United Nations Children’s Fund have supported decision-maker led research by partnering with Gavi, the Vaccine Alliance, in an initiative called "Decision-Maker Led Implementation Research". This synthesis paper describes the cross-cutting lessons from the initiative to further understand and develop future use of the decision-maker led strategy. Methods This study used qualitative methods of data collection, including a document review and in-depth interviews with decision-makers and researchers engaged in the initiative. Document extraction and thematic content analysis were applied. The individual project was the unit of analysis and the results were summarized across projects. Results Research teams from 11 of the 14 projects participated in this study, for an overall response rate of 78.6%. Most projects were carried out in countries in Africa and conducted at the sub-state or sub-district level. Seven enablers and five barriers to the process of conducting the studies or bringing about changes were identified. Key enablers were the relevance, acceptability, and integration of the research, while key barriers included unclear results, limited planning and support, and the limited role of a single study in informing changes to strengthen implementation. Conclusions Decision-maker led research is a promising strategy to facilitate the embedding of research into decision-making processes and contribute to greater use of research to strengthen implementation of proven-effective interventions, such as immunization. We identified several lessons for consideration in the future design and use of the decision-maker led strategy.

Analytical Study on Big Data

2018 ◽  
Vol 8 (5) ◽  
pp. 75
Author(s):  
Vivek Raich ◽  
Pankaj Maurya
Keyword(s):  
Information Technology ◽  
Big Data ◽  
Decision Maker ◽  
Analytical Study ◽  
Large Data ◽  
Decision Makers ◽  
Continuous Increase ◽  
Analytic Methods ◽  
Data Store ◽  
Business Engineering

in the time of the Information Technology, the big data store is going on. Due to which, Huge amounts of data are available for decision makers, and this has resulted in the progress of information technology and its wide growth in many areas of business, engineering, medical, and scientific studies. Big data means that the size which is bigger in size, but there are several types, which are not easy to handle, technology is required to handle it. Due to continuous increase in the data in this way, it is important to study and manage these datasets by adjusting the requirements so that the necessary information can be obtained.The aim of this paper is to analyze some of the analytic methods and tools. Which can be applied to large data. In addition, the application of Big Data has been analyzed, using the Decision Maker working on big data and using enlightened information for different applications.

Serving the People in Long Beach, California: Advancing Justice for Southeast Asian Youth through Community University Research Partnerships

2019 ◽  
Vol 16 (1-2) ◽  
pp. 1-34
Author(s):  
R. Varisa Patraporn
Keyword(s):  
Asian American ◽  
Research Work ◽  
Community Based Participatory Research ◽  
Youth Empowerment ◽  
Long Beach ◽  
Structured Interviews ◽  
Research Partnerships ◽  
Community Needs ◽  
The People ◽  
The Impact

Khmer Girl’s in Action is a nonprofit that successfully utilizes community-based participatory research (CBPR) with university partners to create social change for youth in Long Beach, CA. Based on semi-structured interviews and content analysis of news articles, I explore the impact and sustainability of this research work and the research partnerships. Findings highlight impacts such as youth empowerment, heightened awareness around community needs, policy change, and CBPR curriculum improvements in the field as impacts. Sustainability requires integrating research into program funding, utilizing a tailored training curriculum, building on community members prior relationships, and selecting partners that share common goals, levels of commitment, and flexibility. As funders demand more data to justify community needs, understanding more examples of such work in the Asian American community will be useful for informing future partnerships.

scholarly journals Drivers of Broad-Spectrum Antibiotic Overuse across Diverse Hospital Contexts—A Qualitative Study of Prescribers in the UK, Sri Lanka and South Africa

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 94
Author(s):  
Carolyn Tarrant ◽  
Andrew M. Colman ◽  
David R. Jenkins ◽  
Edmund Chattoe-Brown ◽  
Nelun Perera ◽  
...  
Keyword(s):  
South Africa ◽  
Sri Lanka ◽  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Low Income ◽  
System Level ◽  
Comparative Approach ◽  
Structured Interviews ◽  
Public And Private ◽  
The Uk

Antimicrobial stewardship programs focus on reducing overuse of broad-spectrum antibiotics (BSAs), primarily through interventions to change prescribing behavior. This study aims to identify multi-level influences on BSA overuse across diverse high and low income, and public and private, healthcare contexts. Semi-structured interviews were conducted with 46 prescribers from hospitals in the UK, Sri Lanka, and South Africa, including public and private providers. Interviews explored decision making about prescribing BSAs, drivers of the use of BSAs, and benefits of BSAs to various stakeholders, and were analyzed using a constant comparative approach. Analysis identified drivers of BSA overuse at the individual, social and structural levels. Structural drivers of overuse varied significantly across contexts and included: system-level factors generating tensions with stewardship goals; limited material resources within hospitals; and patient poverty, lack of infrastructure and resources in local communities. Antimicrobial stewardship needs to encompass efforts to reduce the reliance on BSAs as a solution to context-specific structural conditions.

Consumer perspectives of vocational rehabilitation and return to work following acquired brain injury

2021 ◽  
pp. 1-21
Author(s):  
Kerrin Watter ◽  
Areti Kennedy ◽  
Vanette McLennan ◽  
Jessica Vogler ◽  
Sarah Jeffery ◽  
...  
Keyword(s):  
Brain Injury ◽  
Return To Work ◽  
Vocational Rehabilitation ◽  
Acquired Brain Injury ◽  
System Level ◽  
Structured Interviews ◽  
Post Injury ◽  
Vocational Rehabilitation Services ◽  
Workplace Supports ◽  
Vocational Goals

Abstract Introduction: Following acquired brain injury, the goal of return to work is common. While return to work is supported through different rehabilitation models and services, access to vocational rehabilitation varies within and between countries, and global rates of employment post-injury remain low. The literature identifies outcomes from vocational programs and experiences with return to work, yet little is known about individuals’ perceptions and experiences regarding rehabilitation to support their vocational goals and experiences in attempting to return to work. Method: This qualitative study investigated the experiences of community-living adults with acquired brain injury (n = 8; mean age 45 years; mean time post-injury of 5.5 years) regarding their vocational rehabilitation and return to work. Focus groups and semi-structured interviews were conducted, with data analyzed via thematic analysis. Results: Participants identified negative and positive experiences with vocational rehabilitation and return to work. Five overarching themes were identified: addressing vocational rehabilitation in rehabilitation; facilitators of recovery and return to work; the importance and experience of working again; acquired brain injury and identity; and services, systems and policies. Participants also identified five key areas for early vocational rehabilitation services: education; service provision; employer liaison; workplace supports; and peer mentors. Study findings inform current and future practice and service delivery, at a clinical, service and system level.

scholarly journals Adding value to the use of Health Impact Assessment and social return on investment technologies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Green ◽  
K Ashton ◽  
M Dyakova ◽  
L Parry-Williams
Keyword(s):  
Impact Assessment ◽  
Return On Investment ◽  
Health Impact Assessment ◽  
Grey Literature ◽  
Health Impact ◽  
Social Value ◽  
Decision Makers ◽  
Structured Interviews ◽  
Social Return On Investment ◽  
The Impact

Abstract Health Impact Assessment (HIA) and Social Return on Investment (SROI) are beneficial public health methodologies that assess potential effects on health including social, economic and environmental factors and have synergies in their approaches. This paper explores how HIA and SROI can complement each other to capture and account for the impact and social value of an assessed intervention or policy. A scoping review of academic and grey literature was undertaken to identify case studies published between January 1996 and April 2019 where HIA and SROI methods have been used to complement each other. Semi-structured interviews were carried out with nine international experts from a range of regulatory/legislative contexts to gain a better understanding of past experiences and expertise of both HIA and SROI. A thematic analysis was undertaken on the data collected. The review identified two published reports which outline when HIA and SROI have both been used to assess the same intervention. Interview results suggest that both methods have strengths as standalone processes i.e. HIAs are well-structured in their approach, assessing health in its broadest context and SROI can add value by monetizing social value as well as capturing social/environmental impact. Similarities of the two methods were identified i.e. a strong emphasis on stakeholder engagement and common shared principles. When questioned how the two methods could complement each other in practice, the results indicate the benefits of using HIA to explore initial impact, and as a platform on which to build SROI to monetarize social value. HIA and SROI methodologies have cross-over. The research suggests potential benefits when used in tandem or combining the methods to assess impact and account for health and social value. Innovative work is now being carried out in Wales to understand the implications of this in practice and to understand how the results of the two methods could be used by decision-makers. Key messages HIA and SROI methods can be used in tandem to capture both the health impact and social value of policies and proposed interventions. HIA and SROI when used together can provide valuable information to inform decision makers around the health impact and social value of proposed policies and interventions.

scholarly journals Designing the next generation of implementation research training for learners in low- and middle-income countries

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Michael J. Penkunas ◽  
Shiau Yun Chong ◽  
Emma L. M. Rhule ◽  
Evangelia Berdou ◽  
Pascale Allotey
Keyword(s):  
Implementation Research ◽  
Research Training ◽  
Training Model ◽  
Learning By Doing ◽  
Health Interventions ◽  
System Level ◽  
High Quality Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

AbstractEfficacious health interventions tested through controlled trials often fail to show desired impacts when implemented at scale. These challenges can be particularly pervasive in low- and middle-income settings where health systems often lack the capacity and mechanisms required for high-quality research and evidence translation. Implementation research is a powerful tool for identifying and addressing the bottlenecks impeding the success of proven health interventions. Implementation research training initiatives, although growing in number, remain out of reach for many investigators in low- and middle-income settings, who possess the knowledge required to contextualize challenges and potential solutions in light of interacting community- and system-level features. We propose a realigned implementation research training model that centers on team-based learning, tailored didactic opportunities, learning-by-doing, and mentorship.

Women's Role Involvement in Family Businesses, Business Tensions, and Business Success

2003 ◽  
Vol 16 (1) ◽  
pp. 53-68 ◽  
Author(s):  
Sharon M. Danes ◽  
Patricia D. Olson
Keyword(s):  
Decision Maker ◽  
Family Business ◽  
Decision Makers ◽  
Business Success ◽  
Business Owner ◽  
Role Involvement ◽  
Work Involvement ◽  
Women's Role ◽  
The Impact ◽  
Major Decision

This paper is based on a study of 391 family-business-owning couples where the husband is the business owner. The purpose of the study was to examine the work involvement of the wife in the business, the business tensions, and the impact of those tensions on family business success. Fifty-seven percent of wives worked in the business, 47% of whom were paid. Forty-two percent of wives were considered major decision makers. Having more than one decision maker in the business impacted certain types of inclusion tension. Business and family success outcomes varied by level of tensions. There was initial evidence of a threshold where business tensions begin to affect business success negatively.

Barriers for Entering the Digital World: Exploring Customer Value Co-destruction in Self-Service Technologies

2021 ◽  
pp. 231971452110220
Author(s):  
Badra Sandamali Galdolage
Keyword(s):  
Customer Value ◽  
Research Work ◽  
Qualitative Inquiry ◽  
Service Encounters ◽  
Structured Interviews ◽  
Creation Process ◽  
Digital World ◽  
Provision Of Services ◽  
Traditional Service ◽  
Self Service

The value co-creation scholarly work has been criticized for neglecting the possible failures in the collaborative value creation process, which is termed as ‘value co-destruction’. Additionally, both the value co-creation and available limited research work in value co-destruction have overly attended on actor-to-actor interactions taking place in traditional service encounters, disregarding the practical movement towards the provision of services via technological platforms. Though there are ample studies that recognize factors influencing customer acceptance or rejections of technologies, a very limited number of studies have focused on exploring how and why customer collaboration with self-service technologies (SSTs) goes wrong due to the failures in the co-creation process. Therefore, this study attempts to understand how ‘value co-destruction’ takes place in the SSTs. Following a qualitative inquiry, using semi-structured interviews with 25 individuals, 15 reasons for co-destruction that vary among different customer demographics were found and classified into four integrative themes as ‘inabilities in co-learning’, ‘poor co-operation’, ‘problems with connecting’ and ‘poor corrective actions’. The findings fill the gap in the literature by addressing value co-destruction in technological interfaces, particularly in the SST context. Further, it will help practitioners to design and deliver value-enhancing self-service technological interfaces, resulting in none or minimum difficulties for customers.

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