Fidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary care
Abstract Background Assessing the fidelity of an implementation strategy is important to understand why and how the strategy influences the uptake of evidence-based interventions. The present study aims to assess the fidelity of the two procedures for engaging primary care (PC) professionals and for...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-02-01
|
| Series: | BMC Family Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-021-01378-z |
| _version_ | 1818120188063645696 |
|---|---|
| author | Alvaro Sánchez Heather L. Rogers Susana Pablo Esther García Inmaculada Rodríguez Mª. Antonia Flores Olga Galarza Ana B. Gaztañaga Pedro A. Martínez Eider Alberdi Elena Resines Ana I. Llarena Gonzalo Grandes on behalf of the PREDIAPS Group |
| author_facet | Alvaro Sánchez Heather L. Rogers Susana Pablo Esther García Inmaculada Rodríguez Mª. Antonia Flores Olga Galarza Ana B. Gaztañaga Pedro A. Martínez Eider Alberdi Elena Resines Ana I. Llarena Gonzalo Grandes on behalf of the PREDIAPS Group |
| author_sort | Alvaro Sánchez |
| collection | DOAJ |
| description | Abstract Background Assessing the fidelity of an implementation strategy is important to understand why and how the strategy influences the uptake of evidence-based interventions. The present study aims to assess the fidelity of the two procedures for engaging primary care (PC) professionals and for the deployment of an implementation strategy for optimizing type 2 diabetes prevention in routine PC within the PREDIAPS randomized cluster implementation trial. Method We conducted a mixed-method fidelity evaluation study of the PVS-PREDIAPS implementation strategy. Nine PC centers from the Basque Health Service (Osakidetza) were allocated to two different procedures to engage physicians and nurses and deploy a implementation strategy to model and adapt the clinical intervention and its implementation to their specific contexts: a Global procedure, promoting the cooperation of all healthcare professionals from the beginning; or a Sequential procedure, centered first on nurses who then pursued the pragmatic cooperation of physicians. Process indicators of the delivery and receipt of implementation strategy actions, documented modifications to the planned implementation strategy, and a structured group interview with centers’ leaders were all used to assess the following components of fidelity: adherence, dose, quality of delivery, professionals’ responsiveness and program differentiation. Results Generally, the procedures compared for professionals engagement and deployment of the implementation strategy were carried out with the planned differentiation. Nonetheless, some unexpected between-group differences were observed, the initial rate of collaboration of nurses being higher in the Sequential (93%) than in the Global (67%) groups. Exposure rate to the programed implementation actions (% of hours received out of those delivered) were similar in both groups by professional category, with nurses (86%) having a higher rate of exposure than physicians (75%). Professionals identified half of the planned discrete strategies and their rating of strategies’ perceived usefulness was overwhelmingly positive, with few differences between Sequential and Global centers. Conclusions The PVS-PREDIAPS implementation strategy has been implemented with high fidelity and minor unplanned reactive modifications. Professionals’ exposure to the implementation strategy was high in both groups. The centers’ organizational context (i.e., work overload) led to small mismatches between groups in participation and exposure of professionals to implementation actions. Trial registration Clinicaltrials.gov identifier: NCT03254979 . Registered 16 August 2017. |
| first_indexed | 2024-12-11T05:22:07Z |
| format | Article |
| id | doaj.art-170256d58fb74f4ea757a4207deb4d28 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-12-11T05:22:07Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-170256d58fb74f4ea757a4207deb4d282022-12-22T01:19:40ZengBMCBMC Family Practice1471-22962021-02-0122111610.1186/s12875-021-01378-zFidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary careAlvaro Sánchez0Heather L. Rogers1Susana Pablo2Esther García3Inmaculada Rodríguez4Mª. Antonia Flores5Olga Galarza6Ana B. Gaztañaga7Pedro A. Martínez8Eider Alberdi9Elena Resines10Ana I. Llarena11Gonzalo Grandes12on behalf of the PREDIAPS GroupPrimary Care Research Unit, Deputy Directorate of Healthcare Assistance, Biocruces Bizkaia Health Research Institute, Basque Healthcare Service – OsakidetzaBiocruces Bizkaia Health Research Institute and Ikerbasque Basque Foundation for SciencePrimary Care Research Unit, Deputy Directorate of Healthcare Assistance, Biocruces Bizkaia Health Research Institute, Basque Healthcare Service – OsakidetzaZalla Primary Care CenterSodupe Primary Care CenterErandio Primary Care CenterAlango Primary Care CenterEgia Primary Care CenterSan Vicente Primary Care CenterIztieta Primary Care CenterZuazo Primary Care CenterPortugalete Primary Care CenterPrimary Care Research Unit, Deputy Directorate of Healthcare Assistance, Biocruces Bizkaia Health Research Institute, Basque Healthcare Service – OsakidetzaAbstract Background Assessing the fidelity of an implementation strategy is important to understand why and how the strategy influences the uptake of evidence-based interventions. The present study aims to assess the fidelity of the two procedures for engaging primary care (PC) professionals and for the deployment of an implementation strategy for optimizing type 2 diabetes prevention in routine PC within the PREDIAPS randomized cluster implementation trial. Method We conducted a mixed-method fidelity evaluation study of the PVS-PREDIAPS implementation strategy. Nine PC centers from the Basque Health Service (Osakidetza) were allocated to two different procedures to engage physicians and nurses and deploy a implementation strategy to model and adapt the clinical intervention and its implementation to their specific contexts: a Global procedure, promoting the cooperation of all healthcare professionals from the beginning; or a Sequential procedure, centered first on nurses who then pursued the pragmatic cooperation of physicians. Process indicators of the delivery and receipt of implementation strategy actions, documented modifications to the planned implementation strategy, and a structured group interview with centers’ leaders were all used to assess the following components of fidelity: adherence, dose, quality of delivery, professionals’ responsiveness and program differentiation. Results Generally, the procedures compared for professionals engagement and deployment of the implementation strategy were carried out with the planned differentiation. Nonetheless, some unexpected between-group differences were observed, the initial rate of collaboration of nurses being higher in the Sequential (93%) than in the Global (67%) groups. Exposure rate to the programed implementation actions (% of hours received out of those delivered) were similar in both groups by professional category, with nurses (86%) having a higher rate of exposure than physicians (75%). Professionals identified half of the planned discrete strategies and their rating of strategies’ perceived usefulness was overwhelmingly positive, with few differences between Sequential and Global centers. Conclusions The PVS-PREDIAPS implementation strategy has been implemented with high fidelity and minor unplanned reactive modifications. Professionals’ exposure to the implementation strategy was high in both groups. The centers’ organizational context (i.e., work overload) led to small mismatches between groups in participation and exposure of professionals to implementation actions. Trial registration Clinicaltrials.gov identifier: NCT03254979 . Registered 16 August 2017.https://doi.org/10.1186/s12875-021-01378-zFidelityImplementation strategyDiabetes preventionPrimary healthcare |
| spellingShingle | Alvaro Sánchez Heather L. Rogers Susana Pablo Esther García Inmaculada Rodríguez Mª. Antonia Flores Olga Galarza Ana B. Gaztañaga Pedro A. Martínez Eider Alberdi Elena Resines Ana I. Llarena Gonzalo Grandes on behalf of the PREDIAPS Group Fidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary care BMC Family Practice Fidelity Implementation strategy Diabetes prevention Primary healthcare |
| title | Fidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary care |
| title_full | Fidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary care |
| title_fullStr | Fidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary care |
| title_full_unstemmed | Fidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary care |
| title_short | Fidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary care |
| title_sort | fidelity evaluation of the compared procedures for conducting the pvs prediaps implementation strategy to optimize diabetes prevention in primary care |
| topic | Fidelity Implementation strategy Diabetes prevention Primary healthcare |
| url | https://doi.org/10.1186/s12875-021-01378-z |
| work_keys_str_mv | AT alvarosanchez fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT heatherlrogers fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT susanapablo fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT esthergarcia fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT inmaculadarodriguez fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT maantoniaflores fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT olgagalarza fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT anabgaztanaga fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT pedroamartinez fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT eideralberdi fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT elenaresines fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT anaillarena fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT gonzalograndes fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare AT onbehalfoftheprediapsgroup fidelityevaluationofthecomparedproceduresforconductingthepvsprediapsimplementationstrategytooptimizediabetespreventioninprimarycare |