Tool for evaluating research implementation challenges: A sense-making protocol for addressing implementation challenges in complex research settings

Implementation Science

Ruth A Anderson²  Alyson Stalzer²  Kathryn A Daily²  Cathleen Colón-Emeric²  Eleanor S McConnell²  Kristie Porter²  Kelly M Simpson¹ 

[1] KayeM, Inc, 24 Tinsbury Place, Durham, NC, 27713, USA;Duke University, School of Nursing, 307 Trent Dr., Durham, NC, 27710, USA

关键词: Research fidelity;    Sense-making;    Staff intervention;    Research design;    Intervention research;    Implementation research;    Nursing homes;    Complexity science;    Long-term care;   

Others  :  813839
DOI  :  10.1186/1748-5908-8-2

 received in 2012-05-21, accepted in 2012-12-10,  发布年份 2013

【 摘 要 】

Background

Many challenges arise in complex organizational interventions that threaten research integrity. This article describes a

T

ool for

E

valuating Research Implementation

Ch

allenges (TECH), developed using a complexity science framework to assist research teams in assessing and managing these challenges.

Methods

During the implementation of a multi-site, randomized controlled trial (RCT) of organizational interventions to reduce resident falls in eight nursing homes, we inductively developed, and later codified the TECH. The TECH was developed through processes that emerged from interactions among research team members and nursing home staff participants, including a purposive use of complexity science principles.

Results

The TECH provided a structure to assess challenges systematically, consider their potential impact on intervention feasibility and fidelity, and determine actions to take. We codified the process into an algorithm that can be adopted or adapted for other research projects. We present selected examples of the use of the TECH that are relevant to many complex interventions.

Conclusions

Complexity theory provides a useful lens through which research procedures can be developed to address implementation challenges that emerge from complex organizations and research designs. Sense-making is a group process in which diverse members interpret challenges when available information is ambiguous; the groups’ interpretations provide cues for taking action. Sense-making facilitates the creation of safe environments for generating innovative solutions that balance research integrity and practical issues. The challenges encountered during implementation of complex interventions are often unpredictable; however, adoption of a systematic process will allow investigators to address them in a consistent yet flexible manner, protecting fidelity. Research integrity is also protected by allowing for appropriate adaptations to intervention protocols that preserve the feasibility of ‘real world’ interventions.

【 授权许可】

   
2013 Simpson et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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