scholarly journals "Evaluation of Complex Interventions in Hard to Serve Regions - Lessons Learned from a German Innovation Fund Project"

2021 ◽  
Vol 21 (S1) ◽  
pp. 113
Author(s):  
Volker Amelung
Keyword(s):  
Complex Interventions ◽  
Lessons Learned ◽  
Innovation Fund

scholarly journals From summative to developmental

2019 ◽  
Vol 27 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Carolyn Steele Gray ◽  
James Shaw
Keyword(s):  
Integrated Care ◽  
Design Thinking ◽  
Complex Interventions ◽  
Service Design ◽  
Lessons Learned ◽  
Portal System ◽  
Contextual Influences ◽  
Content Type ◽  
Advantages And Disadvantages ◽  
Patient Reported

Purpose Models of integrated care are prime examples of complex interventions, incorporating multiple interacting components that work through varying mechanisms to impact numerous outcomes. The purpose of this paper is to explore summative, process and developmental approaches to evaluating complex interventions to determine how to best test this mess. Design/methodology/approach This viewpoint draws on the evaluation and complex intervention literatures to describe the advantages and disadvantages of different methods. The evaluation of the electronic patient reported outcomes (ePRO) mobile application and portal system is presented as an example of how to evaluate complex interventions with critical lessons learned from this ongoing study. Findings Although favored in the literature, summative and process evaluations rest on two problematic assumptions: it is possible to clearly identify stable mechanisms of action; and intervention fidelity can be maximized in order to control for contextual influences. Complex interventions continually adapt to local contexts, making stability and fidelity unlikely. Developmental evaluation, which is more conceptually aligned with service-design thinking, moves beyond these assumptions, emphasizing supportive adaptation to ensure meaningful adoption. Research limitations/implications Blended approaches that incorporate service-design thinking and rely more heavily on developmental strategies are essential for complex interventions. To maximize the benefit of this approach, three guiding principles are suggested: stress pragmatism over stringency; adopt an implementation lens; and use multi-disciplinary teams to run studies. Originality/value This viewpoint offers novel thinking on the debate around appropriate evaluation methodologies to be applied to complex interventions like models of integrated care.

scholarly journals Developing complex interventions: lessons learned from a pilot study examining strategy training in acute stroke rehabilitation

2013 ◽  
Vol 28 (4) ◽  
pp. 378-387 ◽  
Author(s):  
Elizabeth R Skidmore ◽  
Deirdre R Dawson ◽  
Ellen M Whyte ◽  
Meryl A Butters ◽  
Mary Amanda Dew ◽  
...  
Keyword(s):  
Pilot Study ◽  
Acute Stroke ◽  
Stroke Rehabilitation ◽  
Complex Interventions ◽  
Lessons Learned ◽  
Strategy Training

scholarly journals Developing an Initial Program Theory to Explain How Patient-Reported Outcomes Are Used in Health Care Settings: Methodological Process and Lessons Learned

2020 ◽  
Vol 19 ◽  
pp. 160940692091629
Author(s):  
Rachel Flynn ◽  
Kara Schick-Makaroff ◽  
Adrienne Levay ◽  
Joanne Greenhalgh
Keyword(s):  
Health Care ◽  
Patient Reported Outcomes ◽  
Research Question ◽  
Complex Interventions ◽  
Lessons Learned ◽  
Program Theory ◽  
Health Care Settings ◽  
Central Aspect ◽  
Patient Reported ◽  
Initial Program

A central aspect of any theory-driven realist investigation (synthesis or evaluation) is to develop an initial program theory (IPT). An IPT can be used to frame and understand how, for whom, why, and under what contexts complex interventions work or not. Despite well-established evidence that IPTs are a central aspect to any realist investigation, there is wide variation and a lack of methodological discussion on how to develop an IPT. In this article, we present the approach that we used to develop an IPT of how patient-reported outcomes (PROs) are used in health care settings. Specifically, we completed a systematic review to extract tacit theories reported in the literature. The benefit of this approach was that it provided a rigorous review of the literature in the development of IPTs. The challenges included (1) rediscovering what is already well established in the theoretical literature, (2) generating an overabundance of partial candidate theories, and (3) extensive use of time and resources for what was the first stage to our larger funded research study. Our recommendations to other scholars considering this approach are to ensure that they (1) live within their means and (2) narrow the scope of the research question and/or develop a conceptual framework using middle-range theories. These methodological insights are highly relevant to researchers embarking on a realist investigation, tasked with developing an IPT.

scholarly journals Optimizing the development and evaluation of complex interventions: lessons learned from the BetterBirth Program and associated trial

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Dale A. Barnhart ◽  
Katherine E. A. Semrau ◽  
Corwin M. Zigler ◽  
Rose L. Molina ◽  
Megan Marx Delaney ◽  
...  
Keyword(s):  
Complex Interventions ◽  
Lessons Learned

scholarly journals Fidelity is not easy! Challenges and guidelines for assessing fidelity in complex interventions

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Liane R. Ginsburg ◽  
Matthias Hoben ◽  
Adam Easterbrook ◽  
Ruth A. Anderson ◽  
Carole A. Estabrooks ◽  
...  
Keyword(s):  
Complex Interventions ◽  
Internal Validity ◽  
Lessons Learned ◽  
Nursing Home Care ◽  
Group Level ◽  
Pragmatic Trials ◽  
Fidelity Assessment ◽  
Assessment Approach ◽  
Fidelity Model

Abstract Background Fidelity in complex behavioural interventions is underexplored and few comprehensive or detailed fidelity studies report on specific procedures for monitoring fidelity. Using Bellg’s popular Treatment Fidelity model, this paper aims to increase understanding of how to practically and comprehensively assess fidelity in complex, group-level, interventions. Approach and lessons learned Drawing on our experience using a mixed methods approach to assess fidelity in the INFORM study (Improving Nursing home care through Feedback On perfoRMance data—INFORM), we report on challenges and adaptations experienced with our fidelity assessment approach and lessons learned. Six fidelity assessment challenges were identified: (1) the need to develop succinct tools to measure fidelity given tools tend to be intervention specific, (2) determining which components of fidelity (delivery, receipt, enactment) to emphasize, (3) unit of analysis considerations in group-level interventions, (4) missing data problems, (5) how to respond to and treat fidelity ‘failures’ and ‘deviations’ and lack of an overall fidelity assessment scheme, and (6) ensuring fidelity assessment doesn’t threaten internal validity. Recommendations and conclusions Six guidelines, primarily applicable to group-level studies of complex interventions, are described to help address conceptual, methodological, and practical challenges with fidelity assessment in pragmatic trials. The current study offers guidance to researchers regarding key practical, methodological, and conceptual challenges associated with assessing fidelity in pragmatic trials. Greater attention to fidelity assessment and publication of fidelity results through detailed studies such as this one is critical for improving the quality of fidelity studies and, ultimately, the utility of published trials. Trial registration ClinicalTrials.gov NCT02695836. Registered on February 24, 2016

scholarly journals Innovation in Times of Uncertainty: Clinical Trials in Nursing Homes During SARs-CoV-2

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 103-103
Author(s):  
Joan Carpenter
Keyword(s):  
Clinical Trial ◽  
Nursing Homes ◽  
Research Question ◽  
Complex Interventions ◽  
Lessons Learned ◽  
Video Conference ◽  
Trial Protocols ◽  
Potential Failure ◽  
The Impact ◽  
Existing Data

Abstract In March 2020 the Centers for Medicare & Medicaid Services (CMS) announced restrictions on visitors and nonessential personnel in nursing homes to protect residents and facilities from SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) outbreaks. At the time, these measures were “temporary” but they continued well into 2021 resulting in a prolonged pause on in-person study activities in a palliative care clinical trial in 12 nursing homes. This session will address the impact of this pause and decisions made to overcome the potential failure of the trial. Of utmost importance was respecting nursing homes rapidly changing context, continued communication with the site leadership, transitioning to phone and video-conference study activities, and designing a retrospective study using existing data to answer a different but similar research question. As clinical researchers move forward implementing trials and complex interventions in nursing homes, we must use the lessons learned to design flexible trial protocols.

Lessons Learned From Coaching Postsecondary Students With Traumatic Brain Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy
Keyword(s):  
College Students ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sense Of Self ◽  
Scientific Evidence ◽  
Sudden Onset ◽  
Lessons Learned ◽  
Speech Language Pathologists ◽  
The Brain ◽  
Exhaustive List

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.

Experiences With and Lessons Learned From Developing, Implementing, and Evaluating a Support Program for Older Hearing Aid Users and Their Communication Partners in the Hearing Aid Dispensing Setting

2020 ◽  
Vol 29 (3S) ◽  
pp. 638-647 ◽  
Author(s):  
Janine F. J. Meijerink ◽  
Marieke Pronk ◽  
Sophia E. Kramer
Keyword(s):  
Large Scale ◽  
Hearing Aid ◽  
Critical Discussion ◽  
Lessons Learned ◽  
Research Note ◽  
Support Program ◽  
Large Sample Size ◽  
Long Term Effects ◽  
Communication Program ◽  
Communication Partners

Purpose The SUpport PRogram (SUPR) study was carried out in the context of a private academic partnership and is the first study to evaluate the long-term effects of a communication program (SUPR) for older hearing aid users and their communication partners on a large scale in a hearing aid dispensing setting. The purpose of this research note is to reflect on the lessons that we learned during the different development, implementation, and evaluation phases of the SUPR project. Procedure This research note describes the procedures that were followed during the different phases of the SUPR project and provides a critical discussion to describe the strengths and weaknesses of the approach taken. Conclusion This research note might provide researchers and intervention developers with useful insights as to how aural rehabilitation interventions, such as the SUPR, can be developed by incorporating the needs of the different stakeholders, evaluated by using a robust research design (including a large sample size and a longer term follow-up assessment), and implemented widely by collaborating with a private partner (hearing aid dispensing practice chain).

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