Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes
Abstract Background The transition from pediatric to adult care is a vulnerable time for young people living with type 1 diabetes (T1D). Bridging the Gap (BTG) is an audit-and-feedback (AF) intervention aimed at improving both transitions-in-care processes and diabetes management in the year followi...
| প্রধান লেখক: | , , , , , , , , |
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| বিন্যাস: | প্রবন্ধ |
| ভাষা: | English |
| প্রকাশিত: |
BMC
2024-10-01
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| মালা: | BMC Health Services Research |
| বিষয়গুলি: | |
| অনলাইন ব্যবহার করুন: | https://doi.org/10.1186/s12913-024-11734-1 |
| _version_ | 1827045571146285056 |
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| author | Janet A. Parsons Jannah Wigle Ian Zenlea Noah Ivers Geetha Mukerji Alanna Landry Zubin Punthakee Cheril L. Clarson Rayzel Shulman |
| author_facet | Janet A. Parsons Jannah Wigle Ian Zenlea Noah Ivers Geetha Mukerji Alanna Landry Zubin Punthakee Cheril L. Clarson Rayzel Shulman |
| author_sort | Janet A. Parsons |
| collection | DOAJ |
| description | Abstract Background The transition from pediatric to adult care is a vulnerable time for young people living with type 1 diabetes (T1D). Bridging the Gap (BTG) is an audit-and-feedback (AF) intervention aimed at improving both transitions-in-care processes and diabetes management in the year following transition. As part of BTG, we conducted a qualitative process evaluation to understand: (a) what was implemented and how; and (b) the contextual factors (micro-, meso- and macro-) that affected implementation, outcomes and study processes. Methods Using qualitative descriptive methodology, interviews were conducted with 13 healthcare professionals (HCPs) delivering diabetes care to transitioning youth. Participants were asked about their experiences of BTG study processes and feedback tools, the quality improvement (QI) initiatives implemented at their site, and potential spread and scale. Interviews also explored the impacts of COVID-19 on transition care and study processes and results. Results Five key themes were identified. Participants’ reflections on the BTG study design indicated they appreciated its flexible, site-specific approach to QI, which they saw as crucial to the success of their initiatives. Engagement with feedback reports and other study resources provided comparative, site-specific data. Participants described the challenges posed by the COVID-19 pandemic and its impacts on patients, care provision and study implementation. Their site-specific QI initiatives resulted in changes to their transition practices. Finally, participants commented on how BTG and its processes fostered a community of practice (CoP) between sites, resulting in new opportunities to collaborate and share experiences. Conclusions BTG resulted in a CoP among practitioners delivering transition care to youth with T1D, which could be scaled up to promote a learning health system in pediatric diabetes care. Qualitative process evaluation is a useful tool for understanding how contextual factors affect the implementation and outcomes of complex QI interventions. |
| first_indexed | 2025-02-18T14:25:49Z |
| format | Article |
| id | doaj.art-21bdf417a4b54d47b4a99b51d0cdaefb |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2025-02-18T14:25:49Z |
| publishDate | 2024-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-21bdf417a4b54d47b4a99b51d0cdaefb2024-10-28T08:25:36ZengBMCBMC Health Services Research1472-69632024-10-0124111010.1186/s12913-024-11734-1Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetesJanet A. Parsons0Jannah Wigle1Ian Zenlea2Noah Ivers3Geetha Mukerji4Alanna Landry5Zubin Punthakee6Cheril L. Clarson7Rayzel Shulman8Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of TorontoApplied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health TorontoInstitute for Better Health, Trillium Health PartnersInstitute of Health Policy Management & Evaluation, Dalla Lana School of Public Health, University of TorontoWomen’s College Hospital Institute for Health Systems Solutions and Virtual Care, Women’s College HospitalDepartment of Pediatrics, Oak Valley HealthDepartment of Medicine, McMaster UniversityDepartment of Paediatrics, University of Western OntarioInstitute of Health Policy, Management and Evaluation, University of TorontoAbstract Background The transition from pediatric to adult care is a vulnerable time for young people living with type 1 diabetes (T1D). Bridging the Gap (BTG) is an audit-and-feedback (AF) intervention aimed at improving both transitions-in-care processes and diabetes management in the year following transition. As part of BTG, we conducted a qualitative process evaluation to understand: (a) what was implemented and how; and (b) the contextual factors (micro-, meso- and macro-) that affected implementation, outcomes and study processes. Methods Using qualitative descriptive methodology, interviews were conducted with 13 healthcare professionals (HCPs) delivering diabetes care to transitioning youth. Participants were asked about their experiences of BTG study processes and feedback tools, the quality improvement (QI) initiatives implemented at their site, and potential spread and scale. Interviews also explored the impacts of COVID-19 on transition care and study processes and results. Results Five key themes were identified. Participants’ reflections on the BTG study design indicated they appreciated its flexible, site-specific approach to QI, which they saw as crucial to the success of their initiatives. Engagement with feedback reports and other study resources provided comparative, site-specific data. Participants described the challenges posed by the COVID-19 pandemic and its impacts on patients, care provision and study implementation. Their site-specific QI initiatives resulted in changes to their transition practices. Finally, participants commented on how BTG and its processes fostered a community of practice (CoP) between sites, resulting in new opportunities to collaborate and share experiences. Conclusions BTG resulted in a CoP among practitioners delivering transition care to youth with T1D, which could be scaled up to promote a learning health system in pediatric diabetes care. Qualitative process evaluation is a useful tool for understanding how contextual factors affect the implementation and outcomes of complex QI interventions.https://doi.org/10.1186/s12913-024-11734-1Type 1 diabetes mellitusAdolescenceTransitions in careQualitative methodsProcess evaluationQuality improvement |
| spellingShingle | Janet A. Parsons Jannah Wigle Ian Zenlea Noah Ivers Geetha Mukerji Alanna Landry Zubin Punthakee Cheril L. Clarson Rayzel Shulman Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes BMC Health Services Research Type 1 diabetes mellitus Adolescence Transitions in care Qualitative methods Process evaluation Quality improvement |
| title | Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes |
| title_full | Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes |
| title_fullStr | Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes |
| title_full_unstemmed | Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes |
| title_short | Bridging the gap: a qualitative process evaluation from the perspectives of healthcare professionals of an audit-and-feedback-based intervention to improve transition to adult care for young people living with type 1 diabetes |
| title_sort | bridging the gap a qualitative process evaluation from the perspectives of healthcare professionals of an audit and feedback based intervention to improve transition to adult care for young people living with type 1 diabetes |
| topic | Type 1 diabetes mellitus Adolescence Transitions in care Qualitative methods Process evaluation Quality improvement |
| url | https://doi.org/10.1186/s12913-024-11734-1 |
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