Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries
Abstract Background Process evaluation is increasingly recognized as an important component of effective implementation research and yet, there has been surprisingly little work to understand what constitutes best practice. Researchers use different methodologies describing causal pathways and under...
Main Authors: | , , , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2019-07-01
|
Series: | BMC Public Health |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12889-019-7261-8 |
id |
doaj-650a56ea76a94df39e50fb230d7973a6 |
---|---|
record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Felix Limbani Jane Goudge Rohina Joshi Marion A. Maar J. Jaime Miranda Brian Oldenburg Gary Parker Maria Amalia Pesantes Michaela A. Riddell Abdul Salam Kathy Trieu Amanda G. Thrift Josefien Van Olmen Rajesh Vedanthan Ruth Webster Karen Yeates Jacqui Webster The Global Alliance for Chronic Diseases, Process Evaluation Working Group |
spellingShingle |
Felix Limbani Jane Goudge Rohina Joshi Marion A. Maar J. Jaime Miranda Brian Oldenburg Gary Parker Maria Amalia Pesantes Michaela A. Riddell Abdul Salam Kathy Trieu Amanda G. Thrift Josefien Van Olmen Rajesh Vedanthan Ruth Webster Karen Yeates Jacqui Webster The Global Alliance for Chronic Diseases, Process Evaluation Working Group Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries BMC Public Health Process evaluation Implementation science Complex interventions Mixed-methods Low and middle-income countries Hypertension |
author_facet |
Felix Limbani Jane Goudge Rohina Joshi Marion A. Maar J. Jaime Miranda Brian Oldenburg Gary Parker Maria Amalia Pesantes Michaela A. Riddell Abdul Salam Kathy Trieu Amanda G. Thrift Josefien Van Olmen Rajesh Vedanthan Ruth Webster Karen Yeates Jacqui Webster The Global Alliance for Chronic Diseases, Process Evaluation Working Group |
author_sort |
Felix Limbani |
title |
Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries |
title_short |
Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries |
title_full |
Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries |
title_fullStr |
Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries |
title_full_unstemmed |
Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries |
title_sort |
process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2019-07-01 |
description |
Abstract Background Process evaluation is increasingly recognized as an important component of effective implementation research and yet, there has been surprisingly little work to understand what constitutes best practice. Researchers use different methodologies describing causal pathways and understanding barriers and facilitators to implementation of interventions in diverse contexts and settings. We report on challenges and lessons learned from undertaking process evaluation of seven hypertension intervention trials funded through the Global Alliance of Chronic Diseases (GACD). Methods Preliminary data collected from the GACD hypertension teams in 2015 were used to inform a template for data collection. Case study themes included: (1) description of the intervention, (2) objectives of the process evaluation, (3) methods including theoretical basis, (4) main findings of the study and the process evaluation, (5) implications for the project, policy and research practice and (6) lessons for future process evaluations. The information was summarized and reported descriptively and narratively and key lessons were identified. Results The case studies were from low- and middle-income countries and Indigenous communities in Canada. They were implementation research projects with intervention arm. Six theoretical approaches were used but most comprised of mixed-methods approaches. Each of the process evaluations generated findings on whether interventions were implemented with fidelity, the extent of capacity building, contextual factors and the extent to which relationships between researchers and community impacted on intervention implementation. The most important learning was that although process evaluation is time consuming, it enhances understanding of factors affecting implementation of complex interventions. The research highlighted the need to initiate process evaluations early on in the project, to help guide design of the intervention; and the importance of effective communication between researchers responsible for trial implementation, process evaluation and outcome evaluation. Conclusion This research demonstrates the important role of process evaluation in understanding implementation process of complex interventions. This can help to highlight a broad range of system requirements such as new policies and capacity building to support implementation. Process evaluation is crucial in understanding contextual factors that may impact intervention implementation which is important in considering whether or not the intervention can be translated to other contexts. |
topic |
Process evaluation Implementation science Complex interventions Mixed-methods Low and middle-income countries Hypertension |
url |
http://link.springer.com/article/10.1186/s12889-019-7261-8 |
work_keys_str_mv |
AT felixlimbani processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT janegoudge processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT rohinajoshi processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT marionamaar processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT jjaimemiranda processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT brianoldenburg processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT garyparker processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT mariaamaliapesantes processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT michaelaariddell processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT abdulsalam processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT kathytrieu processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT amandagthrift processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT josefienvanolmen processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT rajeshvedanthan processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT ruthwebster processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT karenyeates processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT jacquiwebster processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries AT theglobalallianceforchronicdiseasesprocessevaluationworkinggroup processevaluationinthefieldgloballearningsfromsevenimplementationresearchhypertensionprojectsinlowandmiddleincomecountries |
_version_ |
1724616081749835776 |
spelling |
doaj-650a56ea76a94df39e50fb230d7973a62020-11-25T03:20:52ZengBMCBMC Public Health1471-24582019-07-0119111110.1186/s12889-019-7261-8Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countriesFelix Limbani0Jane Goudge1Rohina Joshi2Marion A. Maar3J. Jaime Miranda4Brian Oldenburg5Gary Parker6Maria Amalia Pesantes7Michaela A. Riddell8Abdul Salam9Kathy Trieu10Amanda G. Thrift11Josefien Van Olmen12Rajesh Vedanthan13Ruth Webster14Karen Yeates15Jacqui Webster16The Global Alliance for Chronic Diseases, Process Evaluation Working GroupCentre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the WitwatersrandCentre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the WitwatersrandThe George Institute for Global HealthFaculty of Medicine, Northern Ontario School of Medicine, Laurentian UniversityCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano HerediaMelbourne School of Population and Global Health, University of MelbourneInstitute for Global Health, University College LondonCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano HerediaDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash UniversityThe George Institute for Global Health, University of New South WalesThe George Institute for Global Health, UNSWDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash UniversityDepartment of Public Health, Institute of Tropical MedicineNew York University School of MedicineThe George Institute for Global Health, UNSWFaculty of Health Sciences, Queens UniversityThe George Institute for Global Health, UNSWAbstract Background Process evaluation is increasingly recognized as an important component of effective implementation research and yet, there has been surprisingly little work to understand what constitutes best practice. Researchers use different methodologies describing causal pathways and understanding barriers and facilitators to implementation of interventions in diverse contexts and settings. We report on challenges and lessons learned from undertaking process evaluation of seven hypertension intervention trials funded through the Global Alliance of Chronic Diseases (GACD). Methods Preliminary data collected from the GACD hypertension teams in 2015 were used to inform a template for data collection. Case study themes included: (1) description of the intervention, (2) objectives of the process evaluation, (3) methods including theoretical basis, (4) main findings of the study and the process evaluation, (5) implications for the project, policy and research practice and (6) lessons for future process evaluations. The information was summarized and reported descriptively and narratively and key lessons were identified. Results The case studies were from low- and middle-income countries and Indigenous communities in Canada. They were implementation research projects with intervention arm. Six theoretical approaches were used but most comprised of mixed-methods approaches. Each of the process evaluations generated findings on whether interventions were implemented with fidelity, the extent of capacity building, contextual factors and the extent to which relationships between researchers and community impacted on intervention implementation. The most important learning was that although process evaluation is time consuming, it enhances understanding of factors affecting implementation of complex interventions. The research highlighted the need to initiate process evaluations early on in the project, to help guide design of the intervention; and the importance of effective communication between researchers responsible for trial implementation, process evaluation and outcome evaluation. Conclusion This research demonstrates the important role of process evaluation in understanding implementation process of complex interventions. This can help to highlight a broad range of system requirements such as new policies and capacity building to support implementation. Process evaluation is crucial in understanding contextual factors that may impact intervention implementation which is important in considering whether or not the intervention can be translated to other contexts.http://link.springer.com/article/10.1186/s12889-019-7261-8Process evaluationImplementation scienceComplex interventionsMixed-methodsLow and middle-income countriesHypertension |