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dc.contributor.authorRycroft-Malone, Joen_US
dc.contributor.authorSeers, Kateen_US
dc.contributor.authorEldh, Ann Catrineen_US
dc.contributor.authorCox, Karenen_US
dc.contributor.authorCrichton, Nicolaen_US
dc.contributor.authorHarvey, Gillen_US
dc.contributor.authorHawkes, Claireen_US
dc.contributor.authorKitson, Alisonen_US
dc.contributor.authorMcCormack, Brendanen_US
dc.contributor.authorMcMullan, Christelen_US
dc.contributor.authorMockford, Caroleen_US
dc.contributor.authorNiessen, Theoen_US
dc.contributor.authorSlater, Paulen_US
dc.contributor.authorTitchen, Angieen_US
dc.contributor.authorvan der Zijpp, Teatskeen_US
dc.contributor.authorWallin, Larsen_US
dc.date.accessioned2018-10-19T11:57:22Z
dc.date.available2018-10-19T11:57:22Z
dc.date.issued2018-11-16
dc.identifier.citationRycroft-Malone, J., Seers, K., Eldh, A. C., Cox, K., Crichton, N., Harvey, G., Hawkes, C., Kitson, A., McCormack, B., McMullan, C., Mockford, C., Niessen, T., Slater, P., Titchen, A., van der Zijpp, T. & Wallin, L. (2018) A realist process evaluation within the Facilitating Implementation of Research Evidence (FIRE) cluster randomised controlled international trial: An exemplar. Implementation Science, 13 (138).en_US
dc.identifier.issn1748-5908en_US
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/8999
dc.identifier.urihttps://doi.org/10.1186/s13012-018-0811-0
dc.descriptionTrial Registration: Current Controlled Trials ISRCTN11598502en_US
dc.description.abstractBackground Facilitation is a promising implementation intervention, which requires theory informed evaluation. This paper presents an exemplar of a multi-country realist process evaluation that was embedded in the first international randomised controlled trial evaluating two types of facilitation for implementing urinary continence care recommendations. We aimed to uncover what worked (and did not work), for whom, how, why and in what circumstances during the process of implementing the facilitation interventions in practice. Methods This realist process evaluation included theory formulation, theory testing and refining. Data were collected in 24 care home sites across four European countries. Data were collected over four time-points using multiple qualitative methods: observation (372 hours), interviews with staff (n=357), residents (n=152), next of kin (n=109) other stakeholders (n=128), supplemented by facilitator activity logs. A combined inductive and deductive data analysis process focused on realist theory refinement and testing. Results The content and approach of the two facilitation programmes prompted variable opportunities to align and realign support with the needs and expectations of facilitators and homes. This influenced their level of confidence in fulfilling the facilitator role, and ability to deliver the intervention as planned. The success of intervention implementation was largely dependent on whether sites prioritised their involvement in both the study and the facilitation programme. In contexts where the study was prioritised (including release of resources) and where managers and staff support was sustained, this prompted collective engagement (as an attitude and action). Internal facilitators’ (IF) personal characteristics and abilities, including personal and formal authority, in combination with a supportive environment prompted by managers triggered the potential for learning over time. Learning over time resulted in a sense of confidence and personal growth, and enactment of the facilitation role, which resulted in practice changes. Conclusion The scale and multi-country nature of this study provided a novel context to conduct one of the few trial embedded realist informed process evaluations. In addition to providing an explanatory account of implementation processes, a conceptual platform for future facilitation research is presented. Finally a realist informed process evaluation framework is outlined, which could inform future research of this nature.en_US
dc.description.sponsorshipThe research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 223646. The funder had no role in designing, conducting, or interpreting study findings.en_US
dc.description.urihttps://implementationscience.biomedcentral.com/articlesen_US
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.relation.ispartofImplementation Scienceen_US
dc.rights© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.subjectFacilitationen_US
dc.subjectRealist Process Evaluationen_US
dc.subjectImplementationen_US
dc.subjectPARIHSen_US
dc.subjectUrinary Incontinenceen_US
dc.subjectContexten_US
dc.subjectOlder Peopleen_US
dc.titleA realist process evaluation within the Facilitating Implementation of Research Evidence (FIRE) cluster randomised controlled international trial: An exemplaren_US
dc.typeArticleen_US
dcterms.dateAccepted2018-08-27
dc.description.volume13
dc.description.ispublishedpub
rioxxterms.typeJournal Article/Reviewen_US
refterms.dateFCD2018-10-19
refterms.depositExceptionNAen_US
refterms.accessExceptionNAen_US
refterms.technicalExceptionNAen_US
refterms.panelUnspecifieden_US
qmu.authorMcCormack, Brendan
qmu.centreCentre for Person-centred Practise Researchen_US
dc.description.statuspub
dc.description.number138
refterms.versionAMen_US
refterms.dateDeposit2018-10-19


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