Facilitating Implementation of Research Evidence (FIRE): an international cluster randomised controlled trial to evaluate two models of facilitation informed by the Promoting Action in Research Implementation in Health Services (PARIHS) framework.

Journal article


Crichton, N, Seers, K, Rycroft-Malone, J, Edwards, RT, Eldh, AC, Estabrooks, C, Harvey, G, Hawkes, C, Jones, C, Kitson, A, McCormack, B, McCullan, C, Mockford, C, Niessen, T, Slater, P, Titchen, A, van der Zijpp, T and Wallin, L (2018). Facilitating Implementation of Research Evidence (FIRE): an international cluster randomised controlled trial to evaluate two models of facilitation informed by the Promoting Action in Research Implementation in Health Services (PARIHS) framework. Implementation Science. 13 (1). https://doi.org/10.1186/s13012-018-0831-9
AuthorsCrichton, N, Seers, K, Rycroft-Malone, J, Edwards, RT, Eldh, AC, Estabrooks, C, Harvey, G, Hawkes, C, Jones, C, Kitson, A, McCormack, B, McCullan, C, Mockford, C, Niessen, T, Slater, P, Titchen, A, van der Zijpp, T and Wallin, L
Abstract

Background Health care practice needs to be underpinned by high quality research evidence, so that the best possible care can be delivered. However, evidence from research is not always utilised in practice. This study used the Promoting Action of Research Implementation in Health Services (PARIHS) framework as its theoretical underpinning to test whether two different approaches to facilitating implementation could affect the use of research evidence in practice. Methods A pragmatic clustered randomised controlled trial with embedded process and economic evaluation was used. The study took place in four European countries across 24 long term nursing care sites, for people aged 60 years or more with documented urinary incontinence. In each country, sites were randomly allocated to standard dissemination, or one of two different types of facilitation. The primary outcome was the documented percentage compliance with the continence recommendations, assessed at baseline, then at 6, 12, 18 and 24 months after the intervention. Data were analysed using STATA15, multi-level mixed effects linear regression models were fitted to scores for compliance with continence recommendations, adjusting for clustering. Results Quantitative data were obtained from reviews of 2313 records. There were no significant differences in the primary outcome (documented compliance with continence recommendations) between study arms and all study arms improved over time. Conclusions This was the first cross European randomised controlled trial with embedded process evaluation that sought to test different methods of facilitation. There were no statistically significant differences in compliance with continence recommendations between the groups. It was not possible to identify whether different types and "doses" of facilitation were influential within very diverse contextual conditions. The process evaluation (linked paper) revealed the models of facilitation used were limited in their ability to overcome the influence of contextual factors.

Keywords11 Medical And Health Sciences; 08 Information And Computing Sciences; Health Policy & Services
Year2018
JournalImplementation Science
Journal citation13 (1)
PublisherBMC
ISSN1748-5908
Digital Object Identifier (DOI)https://doi.org/10.1186/s13012-018-0831-9
Web address (URL)https://implementationscience.biomedcentral.com/articles/10.1186/s13012-018-0831-9
Publication dates
Print16 Nov 2018
Publication process dates
Deposited05 Nov 2018
Accepted19 Oct 2018
Accepted author manuscript
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File Access Level
Open
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