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The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma

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dc.contributor.author Daivadanam, Meena
dc.contributor.author Ingram, Maia
dc.contributor.author Sidney Annerstedt, Kristi
dc.contributor.author Parker, Gary
dc.contributor.author Bobrow, Kirsty
dc.contributor.author Dolovich, Lisa
dc.contributor.author Gould, Gillian
dc.contributor.author Riddell, Michaela
dc.contributor.author Vedanthan, Rajesh
dc.contributor.author Webster, Jacqui
dc.contributor.author Absetz, Pilvikki
dc.contributor.author Molsted Alvesson, Helle
dc.contributor.author Androutsos, Odysseas
dc.contributor.author Chavannes, Niels
dc.contributor.author Cortez, Briana
dc.contributor.author Devarasetty, Praveen
dc.contributor.author Fottrell, Edward
dc.contributor.author Gonzalez-Salazar, Francisco
dc.contributor.author Goudge, Jane
dc.contributor.author Herasme, Omarys
dc.contributor.author Jennings, Hannah
dc.contributor.author Kapoor, Deksha
dc.contributor.author Kamano, Jemima
dc.contributor.author Kasteleyn, Marise J.
dc.contributor.author Kyriakos, Christina
dc.contributor.author Manios, Yannis
dc.contributor.author Mogulluru, Kishor
dc.contributor.author Owolabi, Mayowa
dc.contributor.author Lazo Porras, María de los Ángeles
dc.contributor.author Silva, Wnurinham
dc.contributor.author Thrift, Amanda
dc.contributor.author Uvere, Ezinne
dc.contributor.author Webster, Ruth
dc.contributor.author van der Kleij, Rianne
dc.contributor.author van Olmen, Josefien
dc.contributor.author Vardavas, Constantine
dc.contributor.author Zhang, Puhong
dc.date.accessioned 2019-07-04T17:01:21Z
dc.date.available 2019-07-04T17:01:21Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6930
dc.description.abstract INTRODUCTION: Understanding context and how this can be systematically assessed and incorporated is crucial to successful implementation. We describe how context has been assessed (including exploration or evaluation) in Global Alliance for Chronic Diseases (GACD) implementation research projects focused on improving health in people with or at risk of chronic disease and how contextual lessons were incorporated into the intervention or the implementation process. METHODS: Using a web-based semi-structured questionnaire, we conducted a cross-sectional survey to collect quantitative and qualitative data across GACD projects (n = 20) focusing on hypertension, diabetes and lung diseases. The use of context-specific data from project planning to evaluation was analyzed using mixed methods and a multi-layered context framework across five levels; 1) individual and family, 2) community, 3) healthcare setting, 4) local or district level, and 5) state or national level. RESULTS: Project teams used both qualitative and mixed methods to assess multiple levels of context (avg. = 4). Methodological approaches to assess context were identified as formal and informal assessments, engagement of stakeholders, use of locally adapted resources and materials, and use of diverse data sources. Contextual lessons were incorporated directly into the intervention by informing or adapting the intervention, improving intervention participation or improving communication with participants/stakeholders. Provision of services, equipment or information, continuous engagement with stakeholders, feedback for personnel to address gaps, and promoting institutionalization were themes identified to describe how contextual lessons are incorporated into the implementation process. CONCLUSIONS: Context is regarded as critical and influenced the design and implementation of the GACD funded chronic disease interventions. There are different approaches to assess and incorporate context as demonstrated by this study and further research is required to systematically evaluate contextual approaches in terms of how they contribute to effectiveness or implementation outcomes. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Article en_US
dc.subject cross-sectional study en_US
dc.subject diabetes mellitus en_US
dc.subject health care planning en_US
dc.subject health service en_US
dc.subject health survey en_US
dc.subject hypertension en_US
dc.subject interpersonal communication en_US
dc.subject lung disease en_US
dc.subject medical research en_US
dc.subject methodology en_US
dc.subject non communicable disease en_US
dc.subject qualitative analysis en_US
dc.subject quantitative analysis en_US
dc.subject questionnaire en_US
dc.subject stakeholder engagement en_US
dc.title The role of context in implementation research for non-communicable diseases: Answering the 'how-to' dilemma en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0214454
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.02
dc.relation.issn 1932-6203

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