Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol

Introduction Integrated care interventions for type 2 diabetes (T2D) and hypertension (HT) are effective, yet challenges exist with regard to their implementation and scale-up. The ‘SCale-Up diaBetes and hYpertension care’ (SCUBY) Project aims to facilitate the scale-up of integrated care for T2D an...

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Main Authors: Josefien van Olmen, Kerstin Klipstein-Grobusch, Por Ir, Wim Van Damme, Roy Remmen, Edwin Wouters, Veerle Buffel, Srean Chhim, Grace Marie V Ku, Daniel Boateng, Monika Martens, Zalika Klemenc Ketiš, Savina Chham, Katrien Danhieux, Nataša Stojnić, Črt Zavrnik, Antonija Poplas Susič
Format: Article
Language:English
Published: BMJ Publishing Group 2022-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/12/e062151.full
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author Josefien van Olmen
Kerstin Klipstein-Grobusch
Por Ir
Wim Van Damme
Roy Remmen
Edwin Wouters
Veerle Buffel
Srean Chhim
Grace Marie V Ku
Daniel Boateng
Monika Martens
Zalika Klemenc Ketiš
Savina Chham
Katrien Danhieux
Nataša Stojnić
Črt Zavrnik
Antonija Poplas Susič
author_facet Josefien van Olmen
Kerstin Klipstein-Grobusch
Por Ir
Wim Van Damme
Roy Remmen
Edwin Wouters
Veerle Buffel
Srean Chhim
Grace Marie V Ku
Daniel Boateng
Monika Martens
Zalika Klemenc Ketiš
Savina Chham
Katrien Danhieux
Nataša Stojnić
Črt Zavrnik
Antonija Poplas Susič
author_sort Josefien van Olmen
collection DOAJ
description Introduction Integrated care interventions for type 2 diabetes (T2D) and hypertension (HT) are effective, yet challenges exist with regard to their implementation and scale-up. The ‘SCale-Up diaBetes and hYpertension care’ (SCUBY) Project aims to facilitate the scale-up of integrated care for T2D and HT through the co-creation and implementation of contextualised scale-up roadmaps in Belgium, Cambodia and Slovenia. We hereby describe the plan for the process and scale-up evaluation of the SCUBY Project. The specific goals of the process and scale-up evaluation are to (1) analyse how, and to what extent, the roadmap has been implemented, (2) assess how the differing contexts can influence the implementation process of the scale-up strategies and (3) assess the progress of the scale-up.Methods and analysis A comprehensive framework was developed to include process and scale-up evaluation embedded in implementation science theory. Key implementation outcomes include acceptability, feasibility, relevance, adaptation, adoption and cost of roadmap activities. A diverse range of predominantly qualitative tools—including a policy dialogue reporting form, a stakeholder follow-up interview and survey, project diaries and policy mapping—were developed to assess how stakeholders perceive the scale-up implementation process and adaptations to the roadmap. The role of context is considered relevant, and barriers and facilitators to scale-up will be continuously assessed.Ethics and dissemination Ethical approval has been obtained from the Institutional Review Board (ref. 1323/19) at the Institute of Tropical Medicine (Antwerp, Belgium). The SCUBY Project presents a comprehensive framework to guide the process and scale-up evaluation of complex interventions in different health systems. We describe how implementation outcomes, mechanisms of impact and scale-up outcomes can be a basis to monitor adaptations through a co-creation process and to guide other scale-up interventions making use of knowledge translation and co-creation activities.
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spelling doaj-art-2ff7d2cf512f4efd925ede81a1e5f6eb2025-08-20T02:27:22ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2022-062151Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocolJosefien van Olmen0Kerstin Klipstein-Grobusch1Por Ir2Wim Van Damme3Roy Remmen4Edwin Wouters5Veerle Buffel6Srean Chhim7Grace Marie V Ku8Daniel Boateng9Monika Martens10Zalika Klemenc Ketiš11Savina Chham12Katrien Danhieux13Nataša Stojnić14Črt Zavrnik15Antonija Poplas Susič163 Department of Family Health and Population Medicine, University of Antwerp, Antwerpen, Belgium9 Faculty of Health Sciences University of the Witwatersrand, Johannesburg, South AfricaNational Institute of Public Health, Phnom Penh, Cambodia2 Department of Public Health, Institute of Tropical Medicine, Antwerp, BelgiumDepartment of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium4 Department of Sociology, Centre for Population, Family & Health, University of Antwerp, Antwerpen, BelgiumCentre for Population, Family & Health, Department of Social Sciences, University of Antwerp, Antwerp, BelgiumNational Institute of Public Health, Phnom Penh, CambodiaDepartment of Public Health, Institute of Tropical Medicine, Antwerp, Belgium2Kwame Nkrumah University of Science and Technology, Kumasi, GhanaDepartment of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BelgiumCommunity Health Center Ljubljana, Ljubljana, SloveniaCentre for Population, Family & Health, Department of Social Sciences, University of Antwerp, Antwerp, BelgiumDepartment of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BelgiumCommunity Health Center Ljubljana, Ljubljana, SloveniaCommunity Health Center Ljubljana, Ljubljana, SloveniaCommunity Health Center Ljubljana, Ljubljana, SloveniaIntroduction Integrated care interventions for type 2 diabetes (T2D) and hypertension (HT) are effective, yet challenges exist with regard to their implementation and scale-up. The ‘SCale-Up diaBetes and hYpertension care’ (SCUBY) Project aims to facilitate the scale-up of integrated care for T2D and HT through the co-creation and implementation of contextualised scale-up roadmaps in Belgium, Cambodia and Slovenia. We hereby describe the plan for the process and scale-up evaluation of the SCUBY Project. The specific goals of the process and scale-up evaluation are to (1) analyse how, and to what extent, the roadmap has been implemented, (2) assess how the differing contexts can influence the implementation process of the scale-up strategies and (3) assess the progress of the scale-up.Methods and analysis A comprehensive framework was developed to include process and scale-up evaluation embedded in implementation science theory. Key implementation outcomes include acceptability, feasibility, relevance, adaptation, adoption and cost of roadmap activities. A diverse range of predominantly qualitative tools—including a policy dialogue reporting form, a stakeholder follow-up interview and survey, project diaries and policy mapping—were developed to assess how stakeholders perceive the scale-up implementation process and adaptations to the roadmap. The role of context is considered relevant, and barriers and facilitators to scale-up will be continuously assessed.Ethics and dissemination Ethical approval has been obtained from the Institutional Review Board (ref. 1323/19) at the Institute of Tropical Medicine (Antwerp, Belgium). The SCUBY Project presents a comprehensive framework to guide the process and scale-up evaluation of complex interventions in different health systems. We describe how implementation outcomes, mechanisms of impact and scale-up outcomes can be a basis to monitor adaptations through a co-creation process and to guide other scale-up interventions making use of knowledge translation and co-creation activities.https://bmjopen.bmj.com/content/12/12/e062151.full
spellingShingle Josefien van Olmen
Kerstin Klipstein-Grobusch
Por Ir
Wim Van Damme
Roy Remmen
Edwin Wouters
Veerle Buffel
Srean Chhim
Grace Marie V Ku
Daniel Boateng
Monika Martens
Zalika Klemenc Ketiš
Savina Chham
Katrien Danhieux
Nataša Stojnić
Črt Zavrnik
Antonija Poplas Susič
Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol
BMJ Open
title Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol
title_full Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol
title_fullStr Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol
title_full_unstemmed Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol
title_short Process evaluation of the scale-up of integrated diabetes and hypertension care in Belgium, Cambodia and Slovenia (the SCUBY Project): a study protocol
title_sort process evaluation of the scale up of integrated diabetes and hypertension care in belgium cambodia and slovenia the scuby project a study protocol
url https://bmjopen.bmj.com/content/12/12/e062151.full
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