A systematic approach to context-mapping to prepare for health interventions: development and validation of the SETTING-tool in four countries

Effectiveness of health interventions can be substantially impaired by implementation failure. Context-driven implementation strategies are critical for successful implementation. However, there is no practical, evidence-based guidance on how to map the context in order to design context-driven stra...

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Main Authors: Sally Singh, Bruce Kirenga, Mattijs E Numans, Hilary Pinnock, Maarten J Postma, Niels H Chavannes, Susanne Reventlow, Andy Barton, Grace Ndeezi, Janwillem Kocks, Sian Williams, Winceslaus Katagira, Rebecca Nantanda, Ioanna Tsiligianni, Sophia Papadakis, Christos Lionis, Patrick Musinguzi, Rupert Jones, Evelyn A Brakema, Rianne MJJ van der Kleij, Charlotte C Poot, Simon Walusimbi, Pham Le An, Talant Sooronbaev, Matty R Crone, Ria R Reis, Marilena Anastasaki, Azamat Akylbekov, Antonios Bertsias, Pham Duong Uyen Binh, Job FM van Boven, Dennis Burges, Lucy Cartwright, Vasiliki E Chatzea, Liza Cragg, Tran Ngoc Dang, Ilyas Dautov, Berik Emilov, Irene Ferarrio, Frederik A van Gemert, Ben Hedrick, Le Huynh Thi Cam Hong, Nick Hopkinson, Elvira Isaeva, Corina de Jong, Sanne van Kampen, Jesper Kjærgaard, Le Thi Tuyet Lan, Tran Thanh Duv Linh, Kim Xuan Loan, Maamed Mademilov, Andy McEwen, Jillian Pooler, Anja Poulsen, Pippa Powell, Nguyen Nhat Quynh, Dimitra Sifaki-Pistolla, Jaime Correia de Sousa, James Stout, Marianne Stubbe Østergaard, Aizhamal Tabyshova, Tran Diep Tuan, Le Thanh Van, Nguyen Nhu Vinh, Louise Warren
Format: Article
Language:English
Published: BMJ Publishing Group 2021-01-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/6/1/e003221.full
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author Sally Singh
Bruce Kirenga
Mattijs E Numans
Hilary Pinnock
Maarten J Postma
Niels H Chavannes
Susanne Reventlow
Andy Barton
Grace Ndeezi
Janwillem Kocks
Sian Williams
Winceslaus Katagira
Rebecca Nantanda
Ioanna Tsiligianni
Sophia Papadakis
Christos Lionis
Patrick Musinguzi
Rupert Jones
Evelyn A Brakema
Rianne MJJ van der Kleij
Charlotte C Poot
Simon Walusimbi
Pham Le An
Talant Sooronbaev
Matty R Crone
Ria R Reis
Marilena Anastasaki
Azamat Akylbekov
Antonios Bertsias
Pham Duong Uyen Binh
Job FM van Boven
Dennis Burges
Lucy Cartwright
Vasiliki E Chatzea
Liza Cragg
Tran Ngoc Dang
Ilyas Dautov
Berik Emilov
Irene Ferarrio
Frederik A van Gemert
Ben Hedrick
Le Huynh Thi Cam Hong
Nick Hopkinson
Elvira Isaeva
Corina de Jong
Sanne van Kampen
Jesper Kjærgaard
Rianne MJJ van der Kleij
Le Thi Tuyet Lan
Tran Thanh Duv Linh
Kim Xuan Loan
Maamed Mademilov
Andy McEwen
Jillian Pooler
Anja Poulsen
Pippa Powell
Nguyen Nhat Quynh
Dimitra Sifaki-Pistolla
Jaime Correia de Sousa
James Stout
Marianne Stubbe Østergaard
Aizhamal Tabyshova
Tran Diep Tuan
Le Thanh Van
Nguyen Nhu Vinh
Louise Warren
author_facet Sally Singh
Bruce Kirenga
Mattijs E Numans
Hilary Pinnock
Maarten J Postma
Niels H Chavannes
Susanne Reventlow
Andy Barton
Grace Ndeezi
Janwillem Kocks
Sian Williams
Winceslaus Katagira
Rebecca Nantanda
Ioanna Tsiligianni
Sophia Papadakis
Christos Lionis
Patrick Musinguzi
Rupert Jones
Evelyn A Brakema
Rianne MJJ van der Kleij
Charlotte C Poot
Simon Walusimbi
Pham Le An
Talant Sooronbaev
Matty R Crone
Ria R Reis
Marilena Anastasaki
Azamat Akylbekov
Antonios Bertsias
Pham Duong Uyen Binh
Job FM van Boven
Dennis Burges
Lucy Cartwright
Vasiliki E Chatzea
Liza Cragg
Tran Ngoc Dang
Ilyas Dautov
Berik Emilov
Irene Ferarrio
Frederik A van Gemert
Ben Hedrick
Le Huynh Thi Cam Hong
Nick Hopkinson
Elvira Isaeva
Corina de Jong
Sanne van Kampen
Jesper Kjærgaard
Rianne MJJ van der Kleij
Le Thi Tuyet Lan
Tran Thanh Duv Linh
Kim Xuan Loan
Maamed Mademilov
Andy McEwen
Jillian Pooler
Anja Poulsen
Pippa Powell
Nguyen Nhat Quynh
Dimitra Sifaki-Pistolla
Jaime Correia de Sousa
James Stout
Marianne Stubbe Østergaard
Aizhamal Tabyshova
Tran Diep Tuan
Le Thanh Van
Nguyen Nhu Vinh
Louise Warren
author_sort Sally Singh
collection DOAJ
description Effectiveness of health interventions can be substantially impaired by implementation failure. Context-driven implementation strategies are critical for successful implementation. However, there is no practical, evidence-based guidance on how to map the context in order to design context-driven strategies. Therefore, this practice paper describes the development and validation of a systematic context-mapping tool. The tool was cocreated with local end-users through a multistage approach. As proof of concept, the tool was used to map beliefs and behaviour related to chronic respiratory disease within the FRESH AIR project in Uganda, Kyrgyzstan, Vietnam and Greece. Feasibility and acceptability were evaluated using the modified Conceptual Framework for Implementation Fidelity. Effectiveness was assessed by the degree to which context-driven adjustments were made to implementation strategies of FRESH AIR health interventions. The resulting Setting-Exploration-Treasure-Trail-to-Inform-implementatioN-strateGies (SETTING-tool) consisted of six steps: (1) Coset study priorities with local stakeholders, (2) Combine a qualitative rapid assessment with a quantitative survey (a mixed-method design), (3) Use context-sensitive materials, (4) Collect data involving community researchers, (5) Analyse pragmatically and/or in-depth to ensure timely communication of findings and (6) Continuously disseminate findings to relevant stakeholders. Use of the tool proved highly feasible, acceptable and effective in each setting. To conclude, the SETTING-tool is validated to systematically map local contexts for (lung) health interventions in diverse low-resource settings. It can support policy-makers, non-governmental organisations and health workers in the design of context-driven implementation strategies. This can reduce the risk of implementation failure and the waste of resource potential. Ultimately, this could improve health outcomes.
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spelling doaj-art-20f01e21aa064f03853df07c78d784d42025-08-20T02:09:45ZengBMJ Publishing GroupBMJ Global Health2059-79082021-01-016110.1136/bmjgh-2020-003221A systematic approach to context-mapping to prepare for health interventions: development and validation of the SETTING-tool in four countriesSally Singh0Bruce Kirenga1Mattijs E Numans2Hilary Pinnock3Maarten J Postma4Niels H Chavannes5Susanne Reventlow6Andy Barton7Grace Ndeezi8Janwillem KocksSian Williams9Winceslaus Katagira10Rebecca Nantanda11Ioanna Tsiligianni12Sophia Papadakis13Christos Lionis14Patrick Musinguzi15Rupert Jones16Evelyn A Brakema17Rianne MJJ van der Kleij18Charlotte C Poot19Simon Walusimbi20Pham Le An21Talant Sooronbaev22Matty R Crone23Ria R Reis24Marilena Anastasaki25Azamat Akylbekov26Antonios Bertsias27Pham Duong Uyen BinhJob FM van BovenDennis BurgesLucy CartwrightVasiliki E ChatzeaLiza CraggTran Ngoc Dang28Ilyas DautovBerik EmilovIrene FerarrioFrederik A van GemertBen HedrickLe Huynh Thi Cam HongNick Hopkinson29Elvira IsaevaCorina de JongSanne van KampenJesper Kjærgaard30Rianne MJJ van der KleijLe Thi Tuyet LanTran Thanh Duv LinhKim Xuan LoanMaamed Mademilov31Andy McEwenJillian PoolerAnja Poulsen32Pippa PowellNguyen Nhat QuynhDimitra Sifaki-PistollaJaime Correia de SousaJames StoutMarianne Stubbe ØstergaardAizhamal TabyshovaTran Diep Tuan33Le Thanh VanNguyen Nhu VinhLouise Warren2University of LeicesterLung Institute, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The NetherlandsThe University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, Edinburgh, UKHealth-Ecore, Zeist, The NetherlandsDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The NetherlandsResearch Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, DenmarkconsultantDepartment of Paediatrics and Child Health, Makerere University, Kampala, UgandaSchool of Allied Health, Curtin University, Perth, Western Australia, AustraliaLung Institute, Makerere University College of Health Sciences, Kampala, UgandaMakerere University College of Health Sciences, Kampala, UgandaDepartment of Social Medicine, Faculty of Medicine, University of Crete, Rethimno, Greece3 Clinic of Social and Family Medicine, University of Crete School of Medicine, Heraklion, Crete, GreeceClinic of Social and Family Medicine, University of Crete School of Medicine, Heraklion, Greece6 Makerere University College of Health Sciences, Kampala, UgandaPlymouth Marjon University, Plymouth, UKDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The NetherlandsDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Medicine and Makerere Lung Institute, Makerere University Faculty of Medicine, Kampala, UgandaCenter of Training Family Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Viet NamRespiratory medicine, National Center for Cardiology and Therapy named after academician Mirsaid Mirrakhimov under the Ministry of Health of the Kyrgyz Republic, Bishkek, KyrgyzstanPublic Health and Primary Care, Leiden University Medical Center, Leiden, the NetherlandsPublic Health and Primary Care, Leiden University Medical Center, Leiden, the NetherlandsClinic of Social and Family Medicine, University of Crete, Heraklion, GreeceRespiratory medicine, National Center for Cardiology and Therapy named after academician Mirsaid Mirrakhimov under the Ministry of Health of the Kyrgyz Republic, Bishkek, KyrgyzstanRheumatology, Clinical Immunology and Allergy Department, School of Medicine, University of Crete, Heraklion, Crete, Greecelecturerchair and professorDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkRespiratory medicine, National Center for Cardiology and Therapy named after academician Mirsaid Mirrakhimov under the Ministry of Health of the Kyrgyz Republic, Bishkek, KyrgyzstanDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, DenmarkUniversity of Medicine and Pharmacy, Ho Chi Minh City, Viet NamEffectiveness of health interventions can be substantially impaired by implementation failure. Context-driven implementation strategies are critical for successful implementation. However, there is no practical, evidence-based guidance on how to map the context in order to design context-driven strategies. Therefore, this practice paper describes the development and validation of a systematic context-mapping tool. The tool was cocreated with local end-users through a multistage approach. As proof of concept, the tool was used to map beliefs and behaviour related to chronic respiratory disease within the FRESH AIR project in Uganda, Kyrgyzstan, Vietnam and Greece. Feasibility and acceptability were evaluated using the modified Conceptual Framework for Implementation Fidelity. Effectiveness was assessed by the degree to which context-driven adjustments were made to implementation strategies of FRESH AIR health interventions. The resulting Setting-Exploration-Treasure-Trail-to-Inform-implementatioN-strateGies (SETTING-tool) consisted of six steps: (1) Coset study priorities with local stakeholders, (2) Combine a qualitative rapid assessment with a quantitative survey (a mixed-method design), (3) Use context-sensitive materials, (4) Collect data involving community researchers, (5) Analyse pragmatically and/or in-depth to ensure timely communication of findings and (6) Continuously disseminate findings to relevant stakeholders. Use of the tool proved highly feasible, acceptable and effective in each setting. To conclude, the SETTING-tool is validated to systematically map local contexts for (lung) health interventions in diverse low-resource settings. It can support policy-makers, non-governmental organisations and health workers in the design of context-driven implementation strategies. This can reduce the risk of implementation failure and the waste of resource potential. Ultimately, this could improve health outcomes.https://gh.bmj.com/content/6/1/e003221.full
spellingShingle Sally Singh
Bruce Kirenga
Mattijs E Numans
Hilary Pinnock
Maarten J Postma
Niels H Chavannes
Susanne Reventlow
Andy Barton
Grace Ndeezi
Janwillem Kocks
Sian Williams
Winceslaus Katagira
Rebecca Nantanda
Ioanna Tsiligianni
Sophia Papadakis
Christos Lionis
Patrick Musinguzi
Rupert Jones
Evelyn A Brakema
Rianne MJJ van der Kleij
Charlotte C Poot
Simon Walusimbi
Pham Le An
Talant Sooronbaev
Matty R Crone
Ria R Reis
Marilena Anastasaki
Azamat Akylbekov
Antonios Bertsias
Pham Duong Uyen Binh
Job FM van Boven
Dennis Burges
Lucy Cartwright
Vasiliki E Chatzea
Liza Cragg
Tran Ngoc Dang
Ilyas Dautov
Berik Emilov
Irene Ferarrio
Frederik A van Gemert
Ben Hedrick
Le Huynh Thi Cam Hong
Nick Hopkinson
Elvira Isaeva
Corina de Jong
Sanne van Kampen
Jesper Kjærgaard
Rianne MJJ van der Kleij
Le Thi Tuyet Lan
Tran Thanh Duv Linh
Kim Xuan Loan
Maamed Mademilov
Andy McEwen
Jillian Pooler
Anja Poulsen
Pippa Powell
Nguyen Nhat Quynh
Dimitra Sifaki-Pistolla
Jaime Correia de Sousa
James Stout
Marianne Stubbe Østergaard
Aizhamal Tabyshova
Tran Diep Tuan
Le Thanh Van
Nguyen Nhu Vinh
Louise Warren
A systematic approach to context-mapping to prepare for health interventions: development and validation of the SETTING-tool in four countries
BMJ Global Health
title A systematic approach to context-mapping to prepare for health interventions: development and validation of the SETTING-tool in four countries
title_full A systematic approach to context-mapping to prepare for health interventions: development and validation of the SETTING-tool in four countries
title_fullStr A systematic approach to context-mapping to prepare for health interventions: development and validation of the SETTING-tool in four countries
title_full_unstemmed A systematic approach to context-mapping to prepare for health interventions: development and validation of the SETTING-tool in four countries
title_short A systematic approach to context-mapping to prepare for health interventions: development and validation of the SETTING-tool in four countries
title_sort systematic approach to context mapping to prepare for health interventions development and validation of the setting tool in four countries
url https://gh.bmj.com/content/6/1/e003221.full
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AT riannemjjvanderkleij systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT lethituyetlan systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT tranthanhduvlinh systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT kimxuanloan systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT maamedmademilov systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT andymcewen systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT jillianpooler systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT anjapoulsen systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT pippapowell systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT nguyennhatquynh systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT dimitrasifakipistolla systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT jaimecorreiadesousa systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT jamesstout systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT mariannestubbeøstergaard systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT aizhamaltabyshova systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT trandieptuan systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT lethanhvan systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT nguyennhuvinh systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries
AT louisewarren systematicapproachtocontextmappingtoprepareforhealthinterventionsdevelopmentandvalidationofthesettingtoolinfourcountries