TY - JOUR

T1 - REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings (RESTORE): study protocol

AU - MacFarlane, Anne

AU - O'Donnell, Catherine A.

AU - Mair, Frances

AU - O'Reilly-de Brún, Mary

AU - de Brún, Tomas

AU - Spiegel, Wolfgang

AU - van den Muijsenbergh, Maria

AU - van Baumgarten, Evelyn

AU - Lionis, Christos

AU - Burns, Nicola

AU - Gravenhorst, Katja

AU - Princz, Christine

AU - Teunissen, Erik

AU - van den Driessen Mareeuw, Francine

AU - Saridaki, Aristoula

AU - Papadakaki, Maria

AU - Vlahadi, Maria

AU - Dowrick, Christopher

PY - 2012/11/20

Y1 - 2012/11/20

N2 - Background The implementation of guidelines and training initiatives to support communication in crosscultural primary care consultations is ad hoc across a range of international settings with a range of negative consequences particularly for migrants. This situation reflects a welldocumented translational gap between evidence and practice and is part of the wider problem of implementing guidelines and the broader range of professional educational and quality interventions in routine practice. In this paper, we describe our use of a contemporary social theory, Normalization Process Theory and participatory research methodology--Participatory Learning and Action--to investigate and support implementation of such guidelines and training initiatives in routine practice. Methods This is a qualitative case study, using multiple primary care sites across Europe. Purposive and maximum variation sampling approaches will be used to identify and recruit stakeholders--migrant service users, general practitioners, primary care nurses, practice managers and administrative staff, interpreters, cultural mediators, service planners, and policy makers. We are conducting a mapping exercise to identify relevant guidelines and training initiatives. We will then initiate a PLA-brokered dialogue with stakeholders around Normalization Process Theory's four constructs--coherence, cognitive participation, collective action, and reflexive monitoring. Through this, we will enable stakeholders in each setting to select a single guideline or training initiative for implementation in their local setting. We will prospectively investigate and support the implementation journeys for the five selected interventions. Data will be generated using a Participatory Learning and Action approach to interviews and focus groups. Data analysis will follow the principles of thematic analysis, will occur in iterative cycles throughout the project and will involve participatory co-analysis with key stakeholders to enhance the authenticity and veracity of findings. Discussion This research employs a unique combination of Normalization Process Theory and Participatory Learning and Action, which will provide a novel approach to the analysis of implementation journeys. The findings will advance knowledge in the field of implementation science because we are using and testing theoretical and methodological approaches so that we can critically appraise their scope to mediate barriers and improve the implementation processes.

AB - Background The implementation of guidelines and training initiatives to support communication in crosscultural primary care consultations is ad hoc across a range of international settings with a range of negative consequences particularly for migrants. This situation reflects a welldocumented translational gap between evidence and practice and is part of the wider problem of implementing guidelines and the broader range of professional educational and quality interventions in routine practice. In this paper, we describe our use of a contemporary social theory, Normalization Process Theory and participatory research methodology--Participatory Learning and Action--to investigate and support implementation of such guidelines and training initiatives in routine practice. Methods This is a qualitative case study, using multiple primary care sites across Europe. Purposive and maximum variation sampling approaches will be used to identify and recruit stakeholders--migrant service users, general practitioners, primary care nurses, practice managers and administrative staff, interpreters, cultural mediators, service planners, and policy makers. We are conducting a mapping exercise to identify relevant guidelines and training initiatives. We will then initiate a PLA-brokered dialogue with stakeholders around Normalization Process Theory's four constructs--coherence, cognitive participation, collective action, and reflexive monitoring. Through this, we will enable stakeholders in each setting to select a single guideline or training initiative for implementation in their local setting. We will prospectively investigate and support the implementation journeys for the five selected interventions. Data will be generated using a Participatory Learning and Action approach to interviews and focus groups. Data analysis will follow the principles of thematic analysis, will occur in iterative cycles throughout the project and will involve participatory co-analysis with key stakeholders to enhance the authenticity and veracity of findings. Discussion This research employs a unique combination of Normalization Process Theory and Participatory Learning and Action, which will provide a novel approach to the analysis of implementation journeys. The findings will advance knowledge in the field of implementation science because we are using and testing theoretical and methodological approaches so that we can critically appraise their scope to mediate barriers and improve the implementation processes.

U2 - 10.1186/1748-5908-7-111

DO - 10.1186/1748-5908-7-111

M3 - Journal article

VL - 7

JO - Implementation Science

JF - Implementation Science

SN - 1748-5908

M1 - 111

ER -