Show simple item record

dc.contributor.authorHarvey, Gillen_US
dc.contributor.authorMcCormack, Brendanen_US
dc.contributor.authorKitson, Alisonen_US
dc.contributor.authorLynch, Elizabethen_US
dc.contributor.authorTitchen, Angieen_US
dc.date.accessioned2018-10-22T13:38:07Z
dc.date.available2018-10-22T13:38:07Z
dc.date.issued2018-11-16
dc.identifier.citationHarvey, G., McCormack, B., Kitson, A., Lynch, E. and Titchen, A. (2018) Designing and implementing two facilitation interventions within the 'Facilitating Implementation of Research Evidence (FIRE)' study: A qualitative analysis from an external facilitators' perspective. Implementation Science, 13, (1), 141.en_US
dc.identifier.issn1748-5908en_US
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/9005
dc.identifier.urihttps://doi.org/10.1186/s13012-018-0812-z
dc.descriptionAcknowledgement: We extend our sincere thanks to FIRE project team colleagues, in particular lead investigators and research fellows involved in data collection and analysis that contributed to the current paper. We also acknowledge the facilitators and their buddy colleagues that we were worked with during the course of the study.en_US
dc.description.abstractBackground The 'Facilitating Implementation of Research Evidence' study found no significant differences between sites that received two types of facilitation support and those that did not on the primary outcome of documented compliance with guideline recommendations. Process evaluation highlighted factors that influenced local, internal facilitators' ability to enact the roles as envisaged. In this paper, the external facilitators responsible for designing and delivering the two types of facilitation intervention analyse why the interventions proved difficult to implement as expected, including the challenge of balancing fidelity and adaptation. Methods Qualitative data sources included notes from monthly internal-external facilitator teleconference meetings, from closing events for the two facilitation interventions and summary data analyses from repeated interviews with 16 internal facilitators. Deductive and inductive data analysis was led by an independent researcher to evaluate how facilitation in practice compared to the logic pathways designed to guide fidelity in the delivery of the interventions. Results The planned facilitation interventions did not work as predicted. Difficulties were encountered in each of the five elements of the logic pathway: recruitment and selection of appropriate internal facilitators; preparation for the role; ability to apply facilitation knowledge and skills at a local level; support and mentorship from external facilitators via monthly teleconferences; working collaboratively and enabling colleagues to implement guideline recommendations. Moreover, problems were cumulative and created tensions for the external facilitators in terms of balancing the logic pathway with a more real-world, flexible and iterative approach to facilitation. Conclusion Evaluating an intervention that is fluid and dynamic within the methodology of a randomised controlled trial is complex and challenging. At a practical level, relational aspects of facilitation are critically important. It is essential to recruit and retain individuals with the appropriate set of skills and characteristics, explicit support from managerial leaders and accessible mentorship from more experienced facilitators. At a methodological level, there is a need for attention to the balance between fidelity and adaptation of interventions. For future studies, we suggest a theoretical approach to fidelity, with a focus on mechanisms, informed by prospective use of process evaluation data and more detailed investigation of the context-facilitation dynamic.en_US
dc.description.sponsorshipFunding: The 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.sponsorshipFunder: FP7 Health, Grants: 223646
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.subjectInternal-external Facilitatorsen_US
dc.subjectPARIHSen_US
dc.subjectFidelityen_US
dc.subjectAdaptationen_US
dc.titleDesigning and implementing two facilitation interventions within the 'Facilitating Implementation of Research Evidence (FIRE)' study: A qualitative analysis from an external facilitators' perspectiveen_US
dc.typeArticleen_US
dcterms.dateAccepted2018-09-03
dc.date.updated2019-01-14
dc.description.volume13
dc.description.ispublishedpub
rioxxterms.typeJournal Article/Reviewen_US
refterms.dateFCD2018-10-22
refterms.depositExceptionpublishedGoldOAen_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.number1
refterms.versionAMen_US
refterms.dateDeposit2018-10-22


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record