Process evaluation in the field: global learnings from seven implementation research hypertension projects in low-and middle-income countries

• Autores: Limbani, Felix; Goudge, Jane; Joshi, Rohina; Maar, Marion A.; Miranda, J. Jaime; Oldenburg, Brian; Parker, Gary; Pesantes, Maria Amalia; Riddell, Michaela A.; Salam, Abdul; Trieu, Kathy; Thrift, Amanda G.; Van Olmen, Josefien; Vedanthan, Rajesh; Webster, Ruth; Yeates, Karen; Webster, Jacqui; Irazola, Vilma
• Año de publicación: 2019
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: COMPLEX INTERVENTIONS; HYPERTENSION; IMPLEMENTATION SCIENCE; LOW AND MIDDLE-INCOME COUNTRIES; MIXED-METHODS; PROCESS EVALUATION
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

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.
Fil: Limbani, Felix. University of the Witwatersrand; Sudáfrica
Fil: Goudge, Jane. University of the Witwatersrand; Sudáfrica
Fil: Joshi, Rohina. University Of Technology Sydney.; Australia
Fil: Maar, Marion A.. University of New South Wales; Australia
Fil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; Perú
Fil: Oldenburg, Brian. University of Melbourne; Australia
Fil: Parker, Gary. University College London; Estados Unidos
Fil: Pesantes, Maria Amalia. Universidad Peruana Cayetano Heredia; Perú
Fil: Riddell, Michaela A.. School Of Clinical Sciences At Monash Health; Australia
Fil: Salam, Abdul. University of New South Wales; Australia
Fil: Trieu, Kathy. University Of Technology Sydney.; Australia
Fil: Thrift, Amanda G.. School Of Clinical Sciences At Monash Health; Australia
Fil: Van Olmen, Josefien. Bernhard Nocht Institute For Tropical Medicine.; Alemania
Fil: Vedanthan, Rajesh. University of New York; Estados Unidos
Fil: Webster, Ruth. The George Institute For Global Health; Australia
Fil: Yeates, Karen. Queens University; Canadá
Fil: Webster, Jacqui. University Of Technology Sydney.; Australia
Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina