Training and HIV-Treatment Scale-Up: Establishing an Implementation Research Agenda

Purpose This paper aims to conduct an extensive review and advances a framework for the literature of high-growth firms (HGFs) and scale-ups. Design/methodology/approach This paper takes the form of a literature review. Findings The author makes three specific contributions. First, he presents a broad review of high growth in firms, shedding light on the different levels of analysis. Second, he advances a characterization of scale-up companies to enable a better basis for discussion. Finally, he identifies gaps in the existing literature and suggest paths for future research. Originality/value The interest in HGFs and those referred to as scale-ups has increased considerably in recent years. Despite this trend, existing studies still have conceptual divergences and a gap separating theoretical inputs from the actual experiences of entrepreneurs.

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HIV Treatment Scale-up in Africa: The Impact of Drug Resistance

HIV/AIDS Treatment in Resource Poor Countries ◽

10.1007/978-1-4614-4520-3_5 ◽

2012 ◽

pp. 45-56

Author(s):

Nzovu Ulenga ◽

Phyllis J. Kanki

Keyword(s):

Drug Resistance ◽

Scale Up ◽

Hiv Treatment ◽

The Impact

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Evaluation of the Implementation Process of the Mobile Health Platform ‘WelTel’ in Six Sites in East Africa and Canada Using the Modified Consolidated Framework for Implementation Research (mCFIR)

10.21203/rs.3.rs-127906/v1 ◽

2020 ◽

Author(s):

Samia El Joueidi ◽

Kevin Bardosh ◽

Richard Musoke ◽

Binyam Tilahun ◽

Maryam Abo Moslim ◽

...

Keyword(s):

Implementation Research ◽

Digital Health ◽

Descriptive Analysis ◽

Scale Up ◽

Implementation Process ◽

Evidence Based ◽

Structured Interviews ◽

User Friendliness ◽

Domain 3 ◽

And Performance

Abstract Background: Health systems globally are investing in integrating secure messaging platforms for virtual care in clinical practice. Implementation science is essential for adoption, scale-up, spread and maintenance of complex evidence-based solutions in clinics with evolving priorities. In response, the mHealth Research Group modified the existing Consolidated Framework for Implementation Research (mCFIR) to evaluate implementation of virtual health tools in clinical settings. WelTel® is an evidence-based digital health platform widely deployed in various geographical and health contexts. Objectives: To identify the facilitators and barriers for implementing WelTel and to assess the application of the mCFIR tool in facilitating focus groups in different geographical and health settings. Methodology: Both qualitative and semi-quantitative approaches were employed. Six mCFIR sessions were held in three countries with 51 key stakeholders surveyed. The mCFIR tool consists of 5 Domains and 25 Constructs and was built and distributed through Qualtrics XM. “Performance ” and “Importance” scores were valued on a scale of 0 to 10 (Mean + SD). Descriptive analysis was conducted using R computing software. NVivo 12 Pro software was used to analyze mCFIR responses and to generate themes from the participants’ input. Semi-structured interviews were conducted with the focus group facilitators to understand their experience using the mCFIR tool. Results: We observed a parallel trend in the scores for Importance and Performance. Of the five Domains, Domain 4 (End-user Characteristics) and Domain 3 (Inner Settings) scored highest in Importance (8.9 + 0.5 and 8.6 + 0.6, respectively) and Performance (7.6 + 0.7 and 7.2 + 1.3, respectively) for all sites. Domain 2 (Outer Setting) scored the lowest in both Importance and Performance for all sites (7.6 + 0.4 and 5.6 + 1.8). Areas of strengths included timely diagnosis, immediate response, cost-effectiveness, user-friendliness, and simplicity. Areas for improvement included training, phone accessibility, health authority’s engagement, and literacy. Conclusion: The mCFIR tool allowed for a comprehensive understanding of the barriers and facilitators to the implementation, reach, and scale-up of digital health tools. Participants emphasized the importance of creating partnerships with external organizations and health authorities in order to achieve sustainability and scalability.Trial Registration: NCT02603536 – November 11, 2015NCT01549457 – March 9, 2012

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Implementation Research Training Framework 2.0: Making the whole greater than the parts

10.37941/rr/2021/2 ◽

2021 ◽

Author(s):

Keyword(s):

Implementation Research ◽

Research Training ◽

Scale Up ◽

Health Impact ◽

Routine Practice ◽

Tropical Diseases ◽

Middle Income ◽

Middle Income Countries ◽

And Training ◽

New Framework

Clinical innovations alone do not generate public health impact. Implementation research (IR) is a powerful tool for identifying the bottlenecks impeding scale up efforts and helping to turn scientifically tested solutions into routine practice. To enhance the ability of investigators in low- and middle-income countries (LMICs) to design, conduct and interpret IR, several actors, such as the Special Programme for Research and Training in Tropical Diseases (TDR), have sought to strengthen researchers' capacity to design and undertake IR. This report outlines the development of a new framework for IR training in LMICs to inspire thinking and discussion on how training approaches can best serve learners' needs.

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Predictive Analytics: Helping Guide the Implementation Research Agenda at the National Heart, Lung, and Blood Institute

Global Heart ◽

10.1016/j.gheart.2019.02.003 ◽

2019 ◽

Vol 14 (1) ◽

pp. 75 ◽

Cited By ~ 3

Author(s):

Michael M. Engelgau ◽

Muin J. Khoury ◽

Rebecca A. Roper ◽

Jennifer S. Curry ◽

George A. Mensah

Keyword(s):

Implementation Research ◽

Research Agenda ◽

Predictive Analytics ◽

Blood Institute ◽

National Heart ◽

National Heart Lung

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Barriers and facilitators of implementation of a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda using the Consolidated Framework for Implementation Research

Implementation Science ◽

10.1186/s13012-020-01065-0 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Rawlance Ndejjo ◽

Rhoda K. Wanyenze ◽

Fred Nuwaha ◽

Hilde Bastiaens ◽

Geofrey Musinguzi

Keyword(s):

Cardiovascular Disease ◽

Low Income ◽

Implementation Research ◽

Health Workers ◽

Scale Up ◽

Barriers And Facilitators ◽

Prevention Programme ◽

Intervention Implementation ◽

Design Quality ◽

Middle Income

Abstract Background In low- and middle-income countries, there is an increasing attention towards community approaches to deal with the growing burden of cardiovascular disease (CVD). However, few studies have explored the implementation processes of such interventions to inform their scale up and sustainability. Using the consolidated framework for implementation research (CFIR), we examined the barriers and facilitators influencing the implementation of a community CVD programme led by community health workers (CHWs) in Mukono and Buikwe districts in Uganda. Methods This qualitative study is a process evaluation of an ongoing type II hybrid stepped wedge cluster trial guided by the CFIR. Data for this analysis were collected through regular meetings and focus group discussions (FGDs) conducted during the first cycle (6 months) of intervention implementation. A total of 20 CHWs participated in the implementation programme in 20 villages during the first cycle. Meeting reports and FGD transcripts were analysed following inductive thematic analysis with the aid of Nvivo 12.6 to generate emerging themes and sub-themes and thereafter deductive analysis was used to map themes and sub-themes onto the CFIR domains and constructs. Results The barriers to intervention implementation were the complexity of the intervention (complexity), compatibility with community culture (culture), the lack of an enabling environment for behaviour change (patient needs and resources) and mistrust of CHWs by community members (relative priority). In addition, the low community awareness of CVD (tension for change), competing demands (other personal attributes) and unfavourable policies (external policy and incentives) impeded intervention implementation. On the other hand, facilitators of intervention implementation were availability of inputs and protective equipment (design quality and packaging), training of CHWs (Available resources), working with community structures including leaders and groups (process—opinion leaders), frequent support supervision and engagements (process—formally appointed internal implementation leaders) and access to quality health services (process—champions). Conclusion Using the CFIR, we identified drivers of implementation success or failure for a community CVD prevention programme in a low-income context. These findings are key to inform the design of impactful, scalable and sustainable CHW programmes for non-communicable diseases prevention and control.

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