Implementation Science | |
The transfer and implementation of an Aboriginal Australian wellbeing program: a grounded theory study | |
Janya R McCalman1  | |
[1] The Cairns Institute, James Cook University, PO Box 6811, Cairns 4870, Australia | |
关键词: Grounded theory; Implementation; Spread; Transfer; Program; Aboriginal; Indigenous; | |
Others : 810882 DOI : 10.1186/1748-5908-8-129 |
|
received in 2013-06-13, accepted in 2013-10-16, 发布年份 2013 | |
【 摘 要 】
Background
The concepts and standard practices of implementation, largely originating in developed countries, cannot necessarily be simply transferred into diverse cultural contexts. There has been relative inattention in the implementation science literature paid to the implementation of interventions targeting minority Indigenous populations within developed countries. This suggests that the implementation literature may be bypassing population groups within developed countries who suffer some of the greatest disadvantage. Within the context of Aboriginal Australian health improvement, this study considers the impact of political and cultural issues by examining the transfer and implementation of the Family Wellbeing program across 56 places over a 20-year period.
Methods
A theoretical model of program transfer was developed using constructivist-grounded theory methods. Data were generated by conducting in-depth interviews with 18 Aboriginal and non-Aboriginal research respondents who had been active in transferring the program. Data were categorised into higher order abstract concepts and the core impetus for and process of program transfer were identified.
Results
Organizations transferred the program by using it as a vehicle for supporting inside-out empowerment. The impetus to support inside-out empowerment referred to support for Aboriginal people's participation, responsibility for and control of their own affairs, and the associated ripple effects to family members, organizations, communities, and ultimately reconciliation with Australian society at large. Program transfer occurred through a multi-levelled process of embracing relatedness which included relatedness with self, others, and structural conditions; all three were necessary at both individual and organizational levels.
Conclusions
Similar to international implementation models, the model of supporting inside-out empowerment by embracing relatedness involved individuals, organizations, and interpersonal and inter-organizational networks. However, the model suggests that for minority Indigenous populations within developed countries, implementation approaches may require greater attention to the empowering nature of the intervention and its implementation, and multiple levels of relatedness by individuals and organizations with self, others, and the structural conditions. Key elements of the theoretical model provide a useful blueprint to inform the transfer of other empowerment programs to minority Indigenous and other disadvantaged populations on a case-by-case basis.
【 授权许可】
2013 McCalman; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20140709053632490.pdf | 509KB | download | |
Figure 2. | 40KB | Image | download |
Figure 1. | 70KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
【 参考文献 】
- [1]Nilsen P, et al.: Never the twain shall meet? - a comparison of implementation science and policy implementation research. Implementation Science 2013., 8(63) doi:10.1186/1748-5908-8-63 [online].
- [2]Kitson A, et al.: Evaluating the successful implementation of evidence into practice using the PARIHS framework: theoretical and practical challenges. Implementation Science 2008., 3(1) doi:10.1186/1748-5908-3-1 [online]
- [3]Damschroder L, et al.: Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science 2009., 4(50) doi:10.1186/1748-5908-4-50 [online]
- [4]Greenhalgh T, et al.: Diffusion of innovations in health service organisations. A systematic literature review. Malden, Mass: BMJ Books, Blackwell Publishing; 2005.
- [5]Ring I, Brown N: Indigenous health: chronically inadequate responses to damning statistics. Med J Aust 2002, 177(11–12):629-31.
- [6]Paul C, et al.: Being sorry is not enough. The sorry state of the evidence base for improving the health of Indigenous populations. Am J Prev Med 2010, 38(5):566-68.
- [7]Brands J: Implementation of innovations in Aboriginal and Torres Strait Islander health care. A review of the literature: Interim report. Brisbane: Lowitja Institute; 2012:49.
- [8]McCalman J, et al.: Applying what works: A systematic search of the transfer and implementation of promising Indigenous Australian health services and programs. BMC Public Health 2012., 12(600) doi:10.1186/1471-2458-12-600 [online]
- [9]Gardner K, et al.: Understanding uptake of continuous quality improvement in indigenous primary healthcare: lessons from a multi-site case study of the audit and best practice for chronic disease project. Implementation Science 2010, 5(21):14.
- [10]Kho M, et al.: Riding the knowledge translation roundabout: lessons learned from the Canadian institutes of health research summer institute in knowledge translation. Implementation Science 2009, 4(1):33. BioMed Central Full Text
- [11]Laws R, et al.: An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study. Implementation Science 2009, 4(1):66. BioMed Central Full Text
- [12]MacLean L, et al.: Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective. Implementation Science 2010, 5(1):36. BioMed Central Full Text
- [13]Novins D, et al.: Use of the evidence base in substance abuse treatment programs for American Indians and Alaska natives: pursuing quality in the crucible of practice and policy. Implementation Science 2011, 6(1):63. BioMed Central Full Text
- [14]Paul C, et al.: Diabetes in rural towns: effectiveness of continuing education and feedback for healthcare providers in altering diabetes outcomes at a population level: protocol for a cluster randomised controlled trial. Implementation Science 2013, 8(1):30. BioMed Central Full Text
- [15]Oliver ML: The transfer process: Implications for evaluation, in Knowledge utilization, diffusion, implementation, transfer, and translation: Implications for evaluation. In New Directions for Evaluation. Edited by Ottoson JM, Hawe P. San Francisco CA: Wiley Periodicals; 2009:61-73.
- [16]Ottoson J: Knowledge-for action theories in evaluation: Knowledge utilization, diffusion, implementation, transfer and translation. In Knowledge utilization, diffusion, implementation, transfer, and translation: implications for evaluation. New directions for Evaluation. Edited by Ottoson JM, Hawe P. San Francisco CA: Wiley Periodicals; 2009:396-422.
- [17]Greenhalgh T, et al.: Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Q 2004, 82(4):581-629.
- [18]McCashen: The strengths approach: a strengths based resource for sharing power and creating change. Bendigo, Victoria: St. Luke’s Innovative Resources; 2005.
- [19]Smith LT, Denzin N, Lincoln Y: On tricky ground. Researching the native in the age of uncertainty, in The SAGE handbook of qualitative research. Thousand Oaks: Sage Publications; 2005:85-107.
- [20]Bainbridge R, McCalman J, Whiteside M: Being, knowing and doing: a phronetic approach to constructing grounded theory with Indigenous partners. Qual Health Res 2013, 23(2):275-288.
- [21]Charmaz K: Constructing grounded theory : a practical guide through qualitative analysis. Volume xiii. London: SAGE; 2006::208.
- [22]Bainbridge R, McCalman J, Whiteside M: Being, knowing and doing: a phronetic approach to constructing grounded theory with Indigenous partners. Qual Health Res 2012, 23(2):275-288.
- [23]Aboriginal Employment Development Branch: Strategy for comprehensive Aboriginal development and wellbeing. Adelaide: South Australian Department of Education, Training and Employment; 1994:21.
- [24]Tsey K, et al.: Empowerment and indigenous australian health: a synthesis of findings from family wellbeing formative research. Health and Social Care in the Community 2009, 18:169-179.
- [25]Tsey K, Every A: Evaluating aboriginal empowerment programs - the case of family wellbeing. Aust N Z J Public Health 2000, 24:509-514.
- [26]McCalman J, et al.: Towards social sustainability: the case of the Family Wellbeing community empowerment education program. Journal of Social and Economic Policy 2011, 13:211-249.
- [27]Tsey K, et al.: The role of empowerment through life skills development in building comprehensive primary health care systems in indigenous Australia. Aust J Prim Health 2005, 11:16-25.
- [28]McEwan A, et al.: Empowerment and change management in Aboriginal organisations: a case study. Aust Health Rev 2010, 34:360-367.
- [29]Gelfand MJ, Erez M, Aycan Z: Cross cultural organisational behaviour. Ann Rev Pysch 2007, 58:479-514.
- [30]Wenger E: Communities of practice and social learning systems. Organization 2000, 7(2):225-246.28.
- [31]McCalman J: A grounded theory of program transfer: How an Aboriginal empowerment initiative became 'bigger than a program,’ in School of Education. Cairns: James Cook University; 2013:283.
- [32]Commonwealth of Australia: Prime minister's ministerial statement closing the gap. Edited by Australia PMO. Canberra: Coomonwealth Government; 2010.
- [33]Steering Committee for the Review of Government Service Provision SCRGSP: Overcoming Indigenous Disadvantage: Key Indicators. Canberra: Productivity Commission; 2011.
- [34]Clarke A: Situational analysis. Grounded theory after the postmodern turn. Thousand Oaks: Sage; 2005:364.
- [35]Glaser BG, Strauss AL: The discovery of grounded theory; strategies for qualitative research. Volume x. Chicago: Aldine Pub. Co; 1967::271.
- [36]Birks M, Mills J: Grounded theory: a practical guide. London: Sage Publications; 2011.
- [37]Contandriopoulos D, et al.: Knowledge exchange processes in organizations and policy arenas: a narrative systematic review of the literature. Milbank Q 2010, 88(4):444-483.