How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol

Implementation Science

Anna-Karin Hurtig³  Guy Kegels²  Bruno Marchal²  Miguel San Sebastian³  Carmen Vives-Cases¹  Isabel Goicolea⁴ 

[1] CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain;Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umea University, SE-90187 Umea, Sweden;Public Health Research Group, Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Alicante University, Alicante, Spain

关键词: Spain;    Health systems;    Team learning;    Primary healthcare teams;    Intimate partner violence;    Realist evaluation;   

Others  :  813733
DOI  :  10.1186/1748-5908-8-36

 received in 2013-01-14, accepted in 2013-03-20,  发布年份 2013

【 摘 要 】

Background

Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues—such as IPV management—get integrated into health systems, and that focuses on healthcare teams’ learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services.

Methods

This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management.

Discussion

Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning and how team learning is connected with changes in organizational culture and values, and in service delivery. This realist evaluation protocol aims to contribute to this knowledge by conducting this project in a country, Spain, where great endeavours have been made towards the integration of IPV management within the health system.

【 授权许可】

   
2013 Goicolea et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]World Health Organization: Preventing intimate partner and sexual violence against women. Taking action and generating evidence. http://www.who.int/violence_injury_prevention webcite /publications/violence/9789241564007_eng.pdf
• [2]Ellsberg M, Jansen HA, Heise L, Watts CH, Garcia-Moreno C: Intimate partner violence and women’s physical and mental health in the WHO multi-country study on women’s health and domestic violence: an observational study. Lancet 2008, 371:1165-1172.
• [3]Krantz G, Garcia-Moreno C: Violence against women. J Epidemiol Community Health 2005, 59:818-821.
• [4]Colombini M, Mayhew S, Watts C: Health-sector responses to intimate partner violence in low- and middle-income settings: a review of current models, challenges and opportunities. Bull World Health Organ 2008, 86:635-642.
• [5]Gottlieb AS: Intimate partner violence: a clinical review of screening and intervention. Womens Health (Lond Engl) 2008, 4:529-539.
• [6]World Health Organization: Expert meeting on health-sector responses to violence against women. http://whqlibdoc.who.int/publications/2010/9789241500630_eng.pdf webcite
• [7]Tower M: Intimate partner violence and the health care response: a postmodern critique. Health Care Women Int 2007, 28:438-452.
• [8]Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004, 82:581-629.
• [9]Berta W, Teare GF, Gilbart E, Ginsburg LS, Lemieux-Charles L, Davis D, Rappolt S: The contingencies of organizational learning in long-term care: factors that affect innovation adoption. Health Care Manage Rev 2005, 30:282-292.
• [10]Edmondson AC, Dillon JR, Roloff KS: Three perspectives on team learning. The Academy of Management Annals 2007, 1:269-314.
• [11]Olson CA, Tooman TR, Alvarado CJ: Knowledge systems, health care teams, and clinical practice: a study of successful change. Adv Health Sci Educ Theory Pract 2010, 15:491-516.
• [12]Barnsley J, Lemieux-Charles L, McKinney MM: Integrating learning into integrated delivery systems. Health Care Manage Rev 1998, 23:18-28.
• [13]Ferlie E, Fitzgerald L, Wood M, Hawkins C: The non-spread of innovations: the mediating role of professionals. Acad Manage J 2005, 48:117-134.
• [14]Abelson J: Understanding the role of contextual influences on local health-care decision making: case study results from Ontario, Canada. Soc Sci Med 2001, 53:777-793.
• [15]Fitzgerald L, Ferlie E, Hawkins C: Innovation in healthcare: how does credible evidence influence professionals? Health Soc Care Community 2003, 11:219-228.
• [16]Berwick DM: Disseminating innovations in health care. JAMA 2003, 289:1969-1975.
• [17]Walker L, Gilson L: ‘We are bitter but we are satisfied’: nurses as street-level bureaucrats in South Africa. Soc Sci Med 2004, 59:1251-1261.
• [18]Thurston WE, Eisener AC: Successful integration and maintenance of screening for domestic violence in the health sector: moving beyond individual responsibility. Trauma Violence Abuse 2006, 7:83-92.
• [19]Connell RW: Gender. Cambridge: Polity Press; 2002.
• [20]Connell RW: Gender and Power. Standford: Standford University Press; 1987.
• [21]Government of Spain: Ley Orgánica 1/2004, de 28 de diciembre, de Medidas de Protección Integral contra la Violencia de Género [Organic Law 1/2004, of Protective Measures against gender based violence]. 2004. http://www.boe.es/boe/dias/2004/12/29/pdfs/A42166-42197.pdf webcite
• [22]Vives-Cases C: Intimate partner violence against women in Spain. J Epidemiol Community Health 2006, 60:652-653.
• [23]Ruiz-Perez I, Plazaola-Castano J, Vives-Cases C, Montero-Pinar MI, Escriba-Aguir V, Jimenez-Gutierrez E, Martin-Baena D: [Geographical variability in violence against women in Spain]. Gac Sanit 2010, 24:128-135.
• [24]Ruiz-Perez I, Blanco-Prieto P, Vives-Cases C: [Intimate partner violence: social and health determinants and responses]. Gac Sanit 2004, 18(Suppl 2):4-12.
• [25]Ruiz-Perez I, Plazaola-Castano J, Del Rio-Lozano M: Physical health consequences of intimate partner violence in Spanish women. Eur J Public Health 2007, 17:437-443.
• [26]Gervas J, Perez Fernandez M, Sanchez Sanchez RJ: [Longitudinality, prestige, good reputation (social and professional) and general/family medicine. Clinical and public health aspects. SESPAS Report 2012]. Gac Sanit 2012, 26(Suppl 1):52-56.
• [27]Simo J, Gervas J: [Health expenditure on primary care in Spain: not enough to provide attractive services to patients and health professionals. SESPAS Report 2012]. Gac Sanit 2012, 26(Suppl 1):36-40.
• [28]Manuel Martin G: La atencion primaria, antes y despues de la Ley general de Sanidad [Primary health care before and after the Health Law]. In Treinta años del Sistema Sanitario español (1981–2011) Treinta años de la federación de asociaciones para la defensa de la sanidad publica [Thirty years of the Spanish Health System (1981–2011) Thirty years of the federation of associations for the defense of public health care]. Edited by Palomo L. Madrid: FADSP; 2011.
• [29]Government of Spain: Ley Organica 3/2007 del 22 de Marzo para la igualdad efectiva de mujeres y hombres [Law for the effective equality of women and men]. 2007. http://www.boe.es/boe/dias/2007/03/23/pdfs/A12611-12645.pdf webcite
• [30]Ministry of Health and Social Policy of Spain: Informe de Violencia de Género 2005 [Gender Based Violence Report 2005]. Madrid (Spain): Ministry of Health and Social Policy of Spain; 2005.
• [31]Ministry of Health and Social Policy of Spain: Informe de Violencia de Género 2006 [Gender Based Violence Report 2006]. Madrid (Spain): Ministry of Health and Social Policy of Spain; 2006.
• [32]Ministry of Health and Social Policy of Spain: Informe de violencia de género 2007 [Gender Based Violence Report 2007]. Madrid (Spain): Ministry of Health and Social Policy of Spain; 2007.
• [33]Ministry of Health and Social Policy of Spain: Informe de violencia de género 2008 [Gender Based Violence Report 2008]. Madrid (Spain): Ministry of Health and Social Policy of Spain; 2008.
• [34]Ministry of Health and Social Policy of Spain: Informe de violencai de género 2009 [Gender Based Violence Report 2009]. Madrid (Spain): Ministry of Health and Social Policy of Spain; 2009.
• [35]Ministry of Health and Social Policy of Spain: Common protocol for a healthcare response to gender violence. Madrid (Spain): Ministry of Health and Social Policy of Spain; 2007.
• [36]Sistema Nacional de Salud [National Health System]: Contenidos educativos básicos y materiales comunes. Formación de profesionales en materia de violencia de género [Basic educational contents. Training of health proffesionals on gender based violence]. Madrid: Ministry of Health and Social Policy of Spain; 2010.
• [37]Pawson R, Tilley N: Realistic evaluation. London: SAGE Publications; 1997.
• [38]Pawson R: Evidence based policy. A realist perspective. London: Sage publications; 2006.
• [39]Pawson R, Manzano Santaella A: A realist disgnostic workshop. Evaluation 2012, 18:176-191.
• [40]Marchal B: Why do some hospitals perform better than others? A realist evaluation of the role of health workforce management in well-performing health care organisations. A study of 4 hospitals in Ghana. PhD thesis. Vrije (Brussel): Vrije Universiteit Brussel, Faculty of Medicine and Pharmacy; 2011.
• [41]Chen H: Theory-driven evaluations. Newbury Park, California: Sage publications; 1990.
• [42]Chen H: Practical programme evaluation. Thousand Oaks: Sage Publications; 2005.
• [43]Pommier J, Guevel MR, Jourdan D: Evaluation of health promotion in schools: a realistic evaluation approach using mixed methods. BMC Publ Health 2010, 10:43. BioMed Central Full Text
• [44]Anderson PJJ, Blatt R, Christianson MK, Grant AM, Marquis C, Neuman EJ, Sonenshein S, Sutcliffe KM: Understanding mechanisms in organizational research. J Manag Inq 2006, 15:102-113.
• [45]Goicolea I, Coe AB, Hurtig AK, San Sebastian M: Mechanisms for achieving adolescent-friendly services in ecuador: a realist evaluation approach. Global Health Action 2012., 5
• [46]Marchal B, Hoerée T, da Silveira Valéria Campos V, Kegels G: The multipolar performance framework for assessing the dynamics of performance of health care organisations- Working paper. Antwerp (Belgium): Institute of Tropical Medicine; 2012.
• [47]Ranmuthugala G, Cunningham FC, Plumb JJ, Long J, Georgiou A, Westbrook JI, Braithwaite J: A realist evaluation of the role of communities of practice in changing healthcare practice. Implement Sci 2011, 6:49. BioMed Central Full Text
• [48]Rycroft-Malone J, Wilkinson JE, Burton CR, Andrews G, Ariss S, Baker R, Dopson S, Graham I, Harvey G, Martin G: Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC). Implement Sci 2011, 6:74. BioMed Central Full Text
• [49]Prashanth NS, Marchal B, Hoeree T, Devadasan N, Macq J, Kegels G, Criel B: How does capacity building of health managers work? A realist evaluation study protocol. BMJ Open 2012, 2:e000882.
• [50]Marchal B, Van Belle SB, Van Olmen J, Hoeree T, Kegels G: Is realist evaluation keeping its promise_ A review of published empirical studies in the field of health systems research. Evaluation 2012, 18:192-212.
• [51]Yin RK: Case study research. Thousand Oaks, California: SAGE; 2009.
• [52]Open Code 3.4: UMDAC and Division of Epidemiology and Public Health Sciences, Umea University. Umea (Sweden): Umea University; 2007.
• [53]Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol 2006, 3:77-101.
• [54]Blaise P, Kegels G: A realistic approach to the evaluation of the quality management movement in health care systems: a comparison between European and African contexts based on Mintzberg’s organizational models. Int J Health Plann Manage 2004, 19:337-364.
• [55]Byng R, Norman I, Redfern S: Using realistic evaluation to evaluate a practice/level intervention to improve primary healthcare for patients with long/term mental illness. Evaluation 2005, 11:69-93.
• [56]Maluka S, Kamuzora P, Sansebastian M, Byskov J, Ndawi B, Olsen OE, Hurtig AK: Implementing accountability for reasonableness framework at district level in Tanzania: a realist evaluation. Implement Sci 2011, 6:11. BioMed Central Full Text
• [57]Manzano Santaella A: A realistic evaluation of fines for hospital discharges. Incorporating the istory of programme evaluations in the analysis. Evaluation 2011, 17:21-36.
• [58]Marchal B, Dedzo M, Kegels G: A realist evaluation of the management of a well-performing regional hospital in Ghana. BMC Health Serv Res 2010, 10:24. BioMed Central Full Text
• [59]Van Belle SB, Marchal B, Dubourg D, Kegels G: How to develop a theory-driven evaluation design? Lessons learned from an adolescent sexual and reproductive health programme in West Africa. BMC Publ Health 2010, 10:741. BioMed Central Full Text
• [60]Gené-Badia J, Gallo P, Hernández-Quevedo C, García-Armesto S: Spanish health care cuts: penny wise and pound foolish? Health Policy 2012, 106:23-28.