scholarly journals Using the Consolidated Framework for Implementation Research to design and implement a perinatal education program in a large maternity hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sheridan Guyatt ◽  
Megan Ferguson ◽  
Michael Beckmann ◽  
Shelley A. Wilkinson
Keyword(s):  
Health Service ◽  
Implementation Research ◽  
Theoretical Approach ◽  
Research Process ◽  
Maternity Hospital ◽  
Local Context ◽  
Local Implementation ◽  
Early Parenting ◽  
Worked Example ◽  
Theoretical Approaches

Abstract Background Implementation science aims to embed evidence-based practice as ‘usual care’ using theoretical underpinnings to guide these processes. Conceptualising the complementary purpose and application of theoretical approaches through all stages of an implementation project is not well understood and is not routinely reported in implementation research, despite call for this. This paper presents the synthesis and a collective approach to application of a co-design model, a model for understanding need, theories of behaviour change with frameworks and tools to guide implementation and evaluation brought together with the Consolidated Framework for Implementation Research (CFIR). Method Using a determinant framework such as the CFIR provides a lens for understanding, influencing, and explaining the complex and multidimensional variables at play within a health service that contribute to planning for and delivering effective patient care. Complementary theories, models, frameworks, and tools support the research process by providing a theoretical and practical structure to understanding the local context and guiding successful local implementation. Results This paper provides a rationale for conceptualising the multidimensional approach for implementation using the worked example of a pregnancy, birth, postnatal and early parenting education intervention for expectant and new parents at a large maternity hospital. Conclusion This multidimensional theoretical approach provides useful, practical guidance to health service researchers and clinicians to develop project specific rationale for their theoretical approach to implementation projects.

scholarly journals A guide to systems-level, participatory, theory-informed implementation research in global health

2021 ◽  
Vol 6 (12) ◽  
pp. e005365
Author(s):  
Nadine Seward ◽  
Charlotte Hanlon ◽  
Saba Hinrichs-Kraples ◽  
Crick Lund ◽  
Jamie Murdoch ◽  
...  
Keyword(s):  
Global Health ◽  
Implementation Research ◽  
Scale Up ◽  
Implementation Strategies ◽  
Local Context ◽  
Theoretical Approaches ◽  
Life Saving ◽  
Health Related ◽  
Controlled Environments ◽  
Healthcare Interventions

Implementation research is a multidisciplinary field that addresses the complex phenomenon of how context influences our ability to deliver evidence-informed healthcare. There is increasing realisation of the importance of applying robust implementation research to scale-up life-saving interventions that meet health-related sustainable development goals. However, the lack of high-quality implementation research is impeding our ability to meet these targets, globally. Within implementation research, theory refers to the proposed hypothesis and/or explanation of how an intervention is expected to interact with the local context and actors to bring about change. Although there is increasing interest in applying theory to understand how and why implementation programmes work in real-world settings, global health actors still tend to favour impact evaluations conducted in controlled environments. This may, in part, be due to the relative novelty as well as methodological complexity of implementation research and the need to draw on divergent disciplines, including epidemiology, implementation science and social sciences. Because of this, implementation research is faced with a particular set of challenges about how to reconcile different ways of thinking and constructing knowledge about healthcare interventions. To help translate some of the ambiguity surrounding how divergent theoretical approaches and methods contribute to implementation research, we draw on our multidisciplinary expertise in the field, particularly in global health. We offer an overview of the different theoretical approaches and describe how they are applied to continuously select, monitor and evaluate implementation strategies throughout the different phases of implementation research. In doing so, we offer a relatively brief, user-focused guide to help global health actors implement and report on evaluation of evidence-based and scalable interventions, programmes and practices.

scholarly journals Empowering students to innovate health services: Teaching transferability of health interventions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Schloemer ◽  
P Schröder-Bäck
Keyword(s):  
Health Services ◽  
Implementation Research ◽  
Research Process ◽  
Practice Change ◽  
Practical Training ◽  
Master Program ◽  
Public Health Professionals ◽  
High Workload ◽  
Healthcare Professions ◽  
Different Populations

Abstract Background To improve the health of different populations, health systems need healthcare professionals who are able to innovate health services. In order to empower students from various healthcare professions to change health service practice in a sustainable way, a training was developed based on the PIET-T models of transferability (Schloemer & Schröder-Bäck, 2018). It was evaluated at three universities in Germany and the Netherlands. Objective The aims of the training were to enable students to: 1. Critically analyze existing evidence about successful and unsuccessful transfers of evidence-based interventions to specific “real-world” contexts (1 day), 2. Conduct an assessment of transferability with case studies using problem-based learning (1 day), 3. Practice implementation research in a healthcare organization (4 months, 4 hours/week). The training was evaluated through discussions, a written reflection and a questionnaire in order to understand students' learning experiences. Results Two bachelor programs for occupational, physical and speech therapists, and one master program for public health professionals took part from 09/2019 to 03/2020, including 66 students. Students valued the training as important, 73 % found it helpful for professional practice. They reflected various ideas how to use the PIET-T models for practice change. Although the implementation research process was perceived as high workload, students valued the experience of getting to know barriers and solutions in a practical setting. Conclusions The students of all programs value the practical relevance of teaching with profession-related specifications. Practical application of the PIET-T models opens up new approaches in teaching in order to educate knowledge on improvement of health services in different contexts. Key messages Empowering students to improve healthcare requires practical training. Training on transferability helps students develop skills for improvement of health services.

scholarly journals Variety of theoretical approaches to legal interpretation

2021 ◽  
pp. 109-114
Author(s):  
A. Yе. Shevchenko ◽  
S. V. Kudin
Keyword(s):  
Social Relations ◽  
Theoretical Approach ◽  
Special Kind ◽  
Integrative Approach ◽  
Legal Interpretation ◽  
True Nature ◽  
Theoretical Approaches ◽  
The Will ◽  
The Subject ◽  
The Law

The article explores the variety of theoretical approaches to legal interpretation. It has been determined that the variety of approaches to legal interpretation is due to the complexity of the nature of the origin of this phenomenon, the conditions for the development of post-non-classical science, and the recent influence of the paradigm of comparism, which assumes pluralism of opinions and ideas in legal research. It was found that in modern science there are four traditional theoretical approaches to the essence of legal interpretation. It has been determined that the content of the first approach is revealed within the framework of legal hermeneutics through a number of categories. The essence of the second approach (formal dogmatic or static) is expressed in the fact that the subject of interpretation must strictly and rigorously follow the letter of the law, establish only the meaning of the normative legal act, which the lawmaking body enshrined in it at the time of the publication of the act. That is why normative legal acts cannot, through interpretation, adapt to the changing economic, social, political, cultural internal and external conditions of public life. It is proved that the essence of the dynamic theoretical approach lies in the fact that the subject of legal interpretation adapts the normative legal act to the changes that occur in various social relations. It was found that there is a contradiction between the dynamic and static approaches in legal interpretation, which is reflected in the traditionally called objective and subjective theories of interpretation. According to the subjective theory, the purpose of legal interpretation is to establish the «will of the legislator», and according to the objective theory – to establish the «will of the law». It has been substantiated that the essence of the activity approach is that interpretation is considered as a special kind of legal activity aimed at understanding and clarifying the content of legal texts. The authors of this article point out that in order to establish the true nature of legal interpretation, the methodological foundations of the study should be presented much broader and more diverse, and not be limited only to traditional approaches. When studying it, a comprehensive, integrative approach is needed, which, based on the relevance of interdisciplinary relationships, would include logical, language (linguistic), philosophical, sociological, psychological, axiological (value), ethical, legal, historical, economic, political, mathematical and other substantiation of legal interpretation. Keywords: diversity, theoretical approach, legal interpretation, interpretive practice, integrative approach

scholarly journals Community, Forest Carbon & Indigeneity: A Case Study of the Loru Project in Espiritu Santo, Vanuatu

2021 ◽  
Author(s):  
◽  
Bridget Payne
Keyword(s):  
Social Constructivism ◽  
Social Impact ◽  
Research Process ◽  
Forest Carbon ◽  
Local Context ◽  
Community Ownership ◽  
Alternative Livelihood ◽  
The Social ◽  
Carbon Project ◽  
Institutional Network

<p>Forest carbon farming offers customary landowners an alternative livelihood to socially and environmentally unsustainable logging, through the sale of carbon offset credits. REDD+, the global forest carbon scheme to address deforestation in developing countries, has attracted scholarly criticism for the risks it poses to communities. Critics warn that REDD+: (1) benefits may be captured by elites, (2) threatens forest-dependent livelihoods, (3) reduces local forest governance, and (4) a results-based payments mechanism can undermine conservation. Community-owned forest carbon farming may mitigate these risks by empowering communities to manage forest resources locally. The Loru project in Vanuatu is the first of its kind, and Indigenous landowners legally own the carbon rights and manage the carbon project. This thesis examines the community ownership and the social impact of the Loru project on its Indigenous project owners, the ni-Vanuatu Ser clan. The thesis uses a ‘semi’-mixed-methods approach, based primarily on interviews conducted in in Espiritu Santo, Vanuatu with Indigenous landowners and supplemented with quantitative data from a monitoring exercise conducted by the author. Grounded in social constructivism, the thesis makes a genuine attempt to decolonize the research process, adopting a self-reflexive approach. The research finds that the project is leading to positive social and economic impacts at the community level. Further, the Loru project is legitimately community-owned and driven, meaning it adapts effectively to the local context. Overall, the findings suggest that implementing REDD+ through a multi-scalar institutional network and building local capacity could mitigate the risks of REDD+ to forest communities.</p>

Rebuilding India’s Public Health

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Imrana Qadeer
Keyword(s):  
Public Health ◽  
Health Service ◽  
Structural Adjustment ◽  
Public Health Service ◽  
Developmental Process ◽  
Health Sector ◽  
Public Hospitals ◽  
International Standards ◽  
Local Context ◽  
Inequality In Health

Assuming impervious boundaries of public health service systems when searching for answers to its problems can be misleading as historically, economic and welfare planning to improve the quality of life of all was considered critical. Despite years of planning, the health sector in India has acquired a tumultuous trajectory with chaos prevailing at different levels – conceptualization, policy, financing, organization and community participation. Using the concept of order in Chaos, this paper attempts to trace four basic underlying elementary patterns in the developmental process rooted in the larger socio-political structures that led to this chaos. Its second section explores the roots from where these patterns explaining the links between health, poverty and inequality in health emanate - the zone of conflict of interests among those who hold power and those whom they represent. It explores how they altered the public health service system and settled in favour of a small but powerful elite (the corporates, the upper-middle class and the professionals) seeking international standards irrespective of the local context. Structural Adjustment and the Health Sector Reforms benefited them by shifting subsidies to the private/corporate sector, transforming services into a costly commodity, fragmented and marginalized primary health care and public hospitals while ushering in hi-tech medicine.

scholarly journals Implementation of a national policy for improving health and social care: a comparative case study using the Consolidated Framework for Implementation Research

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Helena Strehlenert ◽  
Johan Hansson ◽  
Monica Elisabeth Nyström ◽  
Henna Hasson
Keyword(s):  
Implementation Research ◽  
Social Care ◽  
National Policy ◽  
Peer Pressure ◽  
Wicked Problems ◽  
Local Context ◽  
Comparative Case Study ◽  
Health And Social Care ◽  
National Quality

Abstract Background Comprehensive policies are becoming common for addressing wicked problems in health and social care. Success of these policies often varies between target organizations. This variation can often be attributed to contextual factors. However, there is a lack of knowledge about the conditions for successful policy implementation and how context influences this process. The aim of this study was to investigate county-level actors’ perspectives on the implementation of a comprehensive national policy in three Swedish counties. The policy focused on developing quality of care for elderly based on the use of national quality registries (NQRs) and to improve coordination of care. Methods A comparative case study approach was used. Data was collected longitudinally through documents and interviews. The Consolidated Framework for Implementation Research (CFIR) guided the analysis. Results All three counties shared the view that the policy addressed important issues. Still, there was variation regarding how it was perceived and managed. Adaptable features—i.e., NQRs and improvement coaches—were perceived as relevant and useful. However, the counties differed in their perceptions of another policy component—i.e., senior management program—as an opportunity or a disturbance. This program, while tackling complex issues of collaboration, fell short in recognizing the counties’ pre-existing conditions and needs and also offered few opportunities for adaptations. Performance bonuses and peer pressure were strong incentives for all counties to implement the policy, despite the poor fit of policy content and local context. Conclusions Comprehensive health policies aiming to address wicked problems have better chances of succeeding if the implementation includes assessments of the target organizations’ implementation capacity as well as the implicit quid pro quos involved in policy development. Special attention is warranted regarding the use of financial incentives when dealing with wicked problems since the complexity makes it difficult to align incentives with the goals and to assess potential consequences. Other important aspects in the implementation of such policies are the use of collaborative approaches to engage stakeholders with differing perspectives, and the tailoring of policy communication to facilitate shared understanding and commitment.

A “Global Theory of Federalism”: The Nature and Challenges of a Federal State

2005 ◽  
Vol 6 (10) ◽  
pp. 1297-1318 ◽  
Author(s):  
Anna Gamper
Keyword(s):  
Theoretical Approach ◽  
Constitutional Law ◽  
Federal State ◽  
Common Denominator ◽  
Global Theory ◽  
Theoretical Approaches ◽  
Interdisciplinary Character ◽  
Or Economics ◽  
Definition Of ◽  
Concrete Concept

Innumerable attempts have been made to explore the theoretical nature of federalism. Due to the long history, worldwide existence and interdisciplinary character of federalism, a plethora of literature has been written on the topic. Yet, these endeavours have not even resulted in a clear and commonly used definition of the term. Surely, it is one of the great dilemmas of this field of research that despite so much discussion, there is no settled common denominator of ‘federalism'. Whereas practical studies and exchange of experience between the various federal systems offer a more conventional research arena, comparative theoretical approaches are much more seldom. This is not the least because of the tremendous semantic challenges of a comparative theoretical approach. At first glance, it is sometimes difficult to understand the terminology of federalism, the meaning of which differs according to the perspectives of constitutional law, political science or economics. Even more difficulty arises when the substance of federal theories is discussed. Again, differences between theories may be due to different academic approaches, particularly between understanding federalism as an overall principle or as a more concrete concept of a federal state and, in particular, whether the constituent units of a federal state are states, and, if states, whether they are sovereign.

scholarly journals A Universal Early Parenting Education Intervention in Community-Based Primary Care Settings: Development and Installation Challenges

2018 ◽  
Vol 8 (4) ◽  
pp. 178 ◽  
Author(s):  
Grainne Hickey ◽  
Sinead McGilloway ◽  
Yvonne Leckey ◽  
Ann Stokes
Keyword(s):  
Primary Care ◽  
Best Practice ◽  
Service Providers ◽  
Practice Change ◽  
Parenting Education ◽  
Local Context ◽  
Programme Implementation ◽  
Community Based ◽  
Early Parenting ◽  
The Impact

Prevention and early intervention programmes, which aim to educate and support parents and young children in the earliest stages of the family lifecycle, have become an increasingly popular policy strategy for tackling intergenerational disadvantage and developmental inequality. Evidence-based, joined-up services are recommended as best practice for achieving optimal outcomes for parents and their children; however, there are persistent challenges to the development, adoption and installation of these kinds of initiatives in community-based primary health care settings. In this paper, we present a description of the design and installation of a multi-stakeholder early parenting education and intervention service model called the Parent and Infant (PIN) programme. This new programme is delivered collaboratively on a universal, area-wide basis through routine primary care services and combines standardised parent-training with other group-based supports designed to educate parents, strengthen parenting skills and wellbeing and enhance developmental outcomes in children aged 0–2 years. The programme design was informed by local needs analysis and piloting to establish an in-depth understanding of the local context. The findings demonstrate that a hospitable environment is central to establishing interagency parenting education and supports. Partnership, relationship-building and strategic leadership are vital to building commitment and buy-in for this kind of innovation and programme implementation. A graduated approach to implementation which provides training/education and coaching as well as organisational and administrative supports for practice change, are also important in creating an environment conducive to collaboration. Further research into the impact, implementation and cost-effectiveness of the PIN programme will help to build an understanding of what works for parents and infants, as well as identifying lessons for the development and implementation of other similar complex prevention and intervention programmes elsewhere. This kind of research coupled with the establishment of effective partnerships involving service providers, parents, researchers and policy makers, is necessary to meeting the challenge of improving family education and enhancing the capacity of family services to help promote positive outcomes for children.

Systematic review of the role of service users as researchers in mental health studies

2005 ◽  
Vol 14 (4) ◽  
pp. 217-226 ◽  
Author(s):  
Giovanni Salvi ◽  
Julia Jones ◽  
Mirella Ruggeri
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Service ◽  
Health Service ◽  
User Involvement ◽  
Active Role ◽  
Research Process ◽  
Service Development ◽  
Service Users ◽  
Stage Of Development

SUMMARYAims – Service user involvement in mental health service development and research is becoming more common in countries like the UK. USA and Canada. This systematic review of the international scientific literature has been carried out to assess the stage of development of mental health service users involvement in research. Method – Systematic review of any research project actively involving service users in any part of the research process. Results – Thirty-five studies met the inclusion and exclusion criteria and were included in the systematic review. Nine studies used quantitative techniques, 24 used qualitative techniques and two studies used both quantitative and qualitative techniques. While three studies were user-led, in three other studies the users were simply consulted but did not have any active role in the research. The remaining 29 studies were based on a collaboration between service users and professional researchers. Conclusions – The involvement of mental health service users in the research process is feasible both in quantitative and qualitative research studies. The involvement of service users in research has a number of benefits; such research requires more accurate planning and more time than the traditional research.Declaration of Interest: none.

scholarly journals Formation of ecological consciousness of applicants for higher education in today's realities: a theoretical aspect

2020 ◽  
pp. 67-81
Author(s):  
Tamara Andreieva ◽  
Olena Dziubenko
Keyword(s):  
Higher Education ◽  
Common Property ◽  
Process Analysis ◽  
Research Process ◽  
Ecological Crisis ◽  
Corrective Justice ◽  
Nature Management ◽  
Consumer Attitude ◽  
Ecological Consciousness ◽  
Theoretical Approaches

The article considers theoretical approaches to the ecological consciousness formation in the Ukrainian realities of today. The purpose of the article is to investigate the peculiarities of the formation of ecological consciousness of applicants for higher education in today's realities. The following methods were used in the research process: analysis, comparison, generalization and systematization. The historical facts of the consequences of consumer attitude to natural resources are given. It has been found that the current ecological crisis in the world is deteriorating, and this is especially noticeable in Ukraine, as evidenced by specific facts. It was found that one of the important tasks for overcoming the ecological crisis is the formation of ecological consciousness. To do this, it is necessary to radically change the worldview paradigm from anthropocentric to nature-centric, to turn to the centuries-old experience of harmonious nature management of the Ukrainian people. The theory of fairness of exchange is considered, which is interpreted as the possibility of each generation to be included in a positive diachronic exchange: the help that the younger generation receives after birth (because the child is born completely powerless and highly helpless) and in adulthood, later it "returns" through helping the elderly, which have entered the third generation phase. Also an important concept in shaping the attitude to the natural environment is the idea of corrective justice, which aims to perceive nature as a common property of mankind, belonging to each generation, and within the generation to each individual equally. It was found that if the collective ecological consciousness of most members of Ukrainian society is at a sufficient level, the individual still needs significant changes, so the formation of ecological consciousness is the most important task of natural education and environmental education, which should begin in the first years of life. It is proved that the role of teachers is extremely important for the formation of ecological consciousness of future generations, starting from educators of preschool education institutions and ending with teachers of higher education institutions, especially pedagogical ones.

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