Developing social capital in implementing a complex intervention: a process evaluation of the early implementation of a suicide prevention intervention in four European countries

BMC Public Health

Ulrich Hegerl^1,11  Peeter Värnik^1,10  Julia Maloney⁷  David McDaid³  Chantal van Audenhove⁵  Nicole Koburger^1,11  Zoltan Cserháti¹  Susana Costa⁴  Claire Coffey²  Ricardo Gusmão⁴  András Székely¹  Ella Arensman²  James Coyne⁸  Rory C O’Connor⁹  Margaret Maxwell⁶  Fiona M Harris⁶ 

[1] Institute of Behavioural Sciences, Semmelweis University Budapest, Nagyvárad tér 4, 1089, Budapest, Hungary;National Suicide Research Foundation, 1 Perrott Avenue, College Road, Cork, Ireland;Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, WC2A 2AE, London, UK;CEDOC, Departamento de Saúde Mental, Faculdade de Ciências Médicas da Universidade Nova de Lisboa, 1169-056, Lisbon, Portugal;LUCAS, Katholieke Universiteit Leuven, Kapucijnenvoer 39 - bus 5310, 3000, Leuven, Belgium;Nursing, Midwifery and Allied Health Professions Research Unit, Iris Murdoch Building, University of Stirling, FK9 4LA, Stirling, UK;Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie der Universität Würzburg, Füchsleinstraße 15, 97080, Würzburg, Germany;Department of Psychiatry, University of Pennsylvania School of Medicine, 3535 Market Street, 6th Floor, 19104, Philadelphia, PA, USA;Suicidal Behaviour Research Laboratory, School of Natural Sciences, University of Stirling, FK9 4LA, Stirling, UK;Estonian-Swedish Mental Health and Suicidology Institute, Õie 39, 11615, Tallinn, Estonia;Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig AöR, Semmelweisstraße 10, 04103, Leipzig, Germany

关键词: Advisory groups;    Social capital;    Realist evaluation;    Suicide prevention;    Process evaluation;    Complex interventions;   

Others  :  1162521
DOI  :  10.1186/1471-2458-13-158

 received in 2012-10-02, accepted in 2013-02-18,  发布年份 2013

【 摘 要 】

Background

Variation in the implementation of complex multilevel interventions can impact on their delivery and outcomes. Few suicide prevention interventions, especially multilevel interventions, have included evaluation of both the process of implementation as well as outcomes. Such evaluation is essential for the replication of interventions, for interpreting and understanding outcomes, and for improving implementation science. This paper reports on a process evaluation of the early implementation stage of an optimised suicide prevention programme (OSPI-Europe) implemented in four European countries.

Methods

The process analysis was conducted within the framework of a realist evaluation methodology, and involved case studies of the process of implementation in four European countries. Datasets include: repeated questionnaires to track progress of implementation including delivery of individual activities and their intensity; serial interviews and focus groups with stakeholder groups; and detailed observations at OSPI implementation team meetings.

Results

Analysis of local contexts in each of the four countries revealed that the advisory group was a key mechanism that had a substantial impact on the ease of implementation of OSPI interventions, particularly on their ability to recruit to training interventions. However, simply recruiting representatives of key organisations into an advisory group is not sufficient to achieve impact on the delivery of interventions. In order to maximise the potential of high level ‘gatekeepers’, it is necessary to first transform them into OSPI stakeholders. Motivations for OSPI participation as a stakeholder included: personal affinity with the shared goals and target groups within OSPI; the complementary and participatory nature of OSPI that adds value to pre-existing suicide prevention initiatives; and reciprocal reward for participants through access to the extended network capacity that organisations could accrue for themselves and their organisations from participation in OSPI.

Conclusions

Exploring the role of advisory groups and the meaning of participation for these participants revealed some key areas for best practice in implementation: careful planning of the composition of the advisory group to access target groups; the importance of establishing common goals; the importance of acknowledging and complementing existing experience and activity; and facilitating an equivalence of benefit from network participation.

【 授权许可】

   
2013 Harris et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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