Application of the i-PARIHS framework for enhancing understanding of interactive dissemination to achieve wide-scale improvement in Indigenous primary healthcare

Health Research Policy and Systems

Kerry Copley¹  Louise Patel¹  Gillian Harvey²  Frances Cunningham³  Alison Laycock³  Nikki Percival⁴  Veronica Matthews⁵  Jodie Bailie⁵  Ross Bailie⁵ 

[1] Aboriginal Medical Services Alliance Northern Territory;Adelaide Nursing School, The University of Adelaide;Menzies School of Health Research, Charles Darwin University;The Australian Centre for Public and Population Health Research, University of Technology Sydney;The University of Sydney, University Centre for Rural Health;

关键词: Dissemination;    interactive;    i-PARIHS;    integrated knowledge translation;    continuous quality improvement;    Indigenous health;   

DOI  :  10.1186/s12961-018-0392-z

来源: DOAJ

【 摘 要 】

Abstract Background Participatory research approaches improve the use of evidence in policy, programmes and practice. Few studies have addressed ways to scale up participatory research for wider system improvement or the intensity of effort required. We used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to analyse implementation of an interactive dissemination process engaging stakeholders with continuous quality improvement (CQI) data from Australian Indigenous primary healthcare centres. This paper reports lessons learnt about scaling knowledge translation research, facilitating engagement at a system level and applying the i-PARIHS framework to a system-level intervention. Methods Drawing on a developmental evaluation of our dissemination process, we conducted a post-hoc analysis of data from project records and interviews with 30 stakeholders working in Indigenous health in different roles, organisation types and settings in one Australian jurisdiction and with national participants. Content-analysed data were mapped onto the i-PARIHS framework constructs to examine factors contributing to the success (or otherwise) of the process. Results The dissemination process achieved wide reach, with stakeholders using aggregated CQI data to identify system-wide priority evidence–practice gaps, barriers and strategies for improvement across the scope of care. Innovation characteristics influencing success were credible data, online dissemination and recruitment through established networks, research goals aligned with stakeholders’ interest in knowledge-sharing and motivation to improve care, and iterative phases of reporting and feedback. The policy environment and infrastructure for CQI, as well as manager support, influenced participation. Stakeholders who actively facilitated organisational- and local-level engagement were important for connecting others with the data and with the externally located research team. Developmental evaluation was facilitative in that it supported real-time adaptation and tailoring to stakeholders and context. Conclusions A participatory research process was successfully implemented at scale without intense facilitation efforts. These findings broaden the notion of facilitation and support the utility of the i-PARIHS framework for planning participatory knowledge translation research at a system level. Researchers planning similar interventions should work through established networks and identify organisational- or local-level facilitators within the research design. Further research exploring facilitation in system-level interventions and the use of interactive dissemination processes in other settings is needed.

【 授权许可】

Unknown